Consider these 5 things when choosing coverage

3 min


Medicare is the federal health insurance program designed for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease. From October 15 to December 7, you can pick a Medicare Part D prescription-drug plan or a Medicare Advantage plan for the next year. At the same time, you can switch from one Plan to another.

When you enroll in Medicare you can choose how to get the Medicare coverage. There are two ways for that, Original Medicare, which is Part A and B, or Medicare Advantage Plan, Part C. Some people also get Medicare drug coverage or Medicare Supplement Insurance.

The plan that works for you one year, may not be the best one for the next year. For example, you might change the drugs you take. Or the coverage changed. Or there might be new plans in your area that works better for you.

No matter the case, when you look at MedisuppsSupplement Plans reviews, it is important that you consider a couple of factors. These factors will help you determine which coverage works best for you. Let’s take a look.

Cost

For many people, the price/cost is the main factor. But the cost is deeper than just the pure amount of money you pay. How much are your premiums? How much are your deductibles? What about any other costs? How much do you pay for hospital stays and doctor visits?

There are two plans you can choose here. Original Medicare doesn’t set a limit on how much you pay out-of-pocket per year. That is unless you have supplemental coverage.

With Medicare Advantage, plans have a yearly limit. And once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year. This option is much more cost-effective for most users.

Coverage

Let’s talk about another factor. And that is how much does the plan cover the services you need? Think about all of the services you need and you want your coverage to cover.

The Original Medicare covers supplies in hospitals, doctors’ offices, and many more health care services. You can get them either under Part A or Part B.

Medicare Advantage, on the other hand, covers all of the services in Original Medicare, and something extra. For example, you can get a plan with bonus benefits like vision, hearing, and dental services.

Other coverage

Some people get an extra coverage in addition to Original Medicare and Medicare Advantage. If you have other types of health coverage, you have to understand how it works in cooperation with Medicare. Some other types of coverage include employment-related coverage.

But in most cases, people opt for Supplemental coverage. The popular term for this type of coverage is Medigap. It helps pay your out-of-pocket costs in Original Medicare.

And if you combine Supplemental Coverage with Medicare Advantage, you have to consider this. Your cost sharing is lower. Many Medicare Advantage plans offer vision, hearing, and dental benefits. Basically, you pay for the same services two times.

Prescription drugs

For seniors, prescription drugs play a huge role in deciding which coverage to get. Let’s talk honestly, seniors usually take a bundle of prescription drugs.

So, do you need a Medicare Prescription Drug Plan? Or do you have another prescription drug coverage? Will you pay a penalty for joining the drug plan later? What is the rating of that plan?

In the Original Medicare, you need to join a Medicare drug plan to get drug coverage. On the other hand, most Medicare Advantage plans offer and include drug coverage. And if they do not, you can always join a separate Part D plan.

Doctor and Hospital Choice

This is another important factor. Do you have doctors nearby that accept your coverage? And do they accept new patients? Or do you have to choose the hospital and health care providers depending on your coverage? If your coverage limits your options, you have a problem. And most importantly, do you need to get referrals?

With the Original Medicare, you can go to any doctor that accepts Medicare. And with Medicare Advantage, you have to use doctors and health care providers that participate in the plan’s Network. In a way, Medicare Advantage limits your options. You have to find out how close the network’s doctor is to your home.

Travel

Last, but not least, let’s talk about travel. You will leave the US at one point. You want to know how much does your coverage cover. Original Medicare doesn’t cover care outside the US. For that purpose, you need to get supplemental insurance that offers travel coverage. Medicare Advantage doesn’t cover care outside of the US as well.

What to Choose?

The three main choices you can choose from are Original Medicare, add a Medigap, and Medicare Advantage. Here is a good idea when to choose what. Go with Original Medicare if:

  • You don’t visit the doctor’s office often
  • You have other coverage through an employer
  • You can pay 20% of your hospital and medical costs
  • You do not need prescription drug coverage

You should add a Medicare Supplement plan if:

  • You need a plan that covers costs that the Original Medicare doesn’t
  • You want to buy prescription drug coverage separately
  • You want more freedom for visiting any doctor that accepts Medicare
  • You want to pay less when the medical care outweighs having higher monthly premiums

And last, but not least, choose Medicare Advantage with a prescription drug plan if:

  • You want to pay lower monthly premiums than Medigap
  • You prefer predictable copayments over deductible or 20% of costs
  • You prefer doctors in the plan’s network
  • You want to use extras like dental and free gym membership
  • The plan pays you 100% of your costs once you pay the out-of-pocket limit

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