A general question everyone asks is, “What is the best medicare insurance plan?” The truth is that there is not a one-size-fits-all solution when it comes to choosing Medicare Insurance. The most effective Medicare insurance plan depends on your budget and needs.
Your health care needs are personal, and so your Medicare options should be. Of course, you need a plan with coverage that suits your needs.
Here are ten steps to help you find the best Medicare insurance plan for your requirements.
- Plan Yearly Expenses
Medicare costs can vary widely for individuals depending on their requirements and the type of coverage they need. Original Medicare typically covers 80% of a person’s Part A and Part B expenses, including hospital stays, doctor visits, and lab tests. The individual is liable for the other 20%, with no annual limit on out-of-pocket costs.
Medicare Advantage plans offer estimated copays and limit your annual out-of-pocket expenses. Whenever you enter the out-of-pocket limit set by your plan, all additional costs for Medicare-covered services get covered at 100% for the rest of the year. It adds peace of mind if you have an unexpected illness or plan to undergo a major medical procedure.
- It’s Not Just about Premium
The cost of the plan may include premiums, deductibles, copays, and co-insurance. Premiums are often ones that people primarily focus on — usually because this amount is paid monthly and may seem more significant than other costs. But you should compare all the costs of the plan, not just the premium.
Why? Because when your monthly premiums are the same, your other costs may vary and increase exponentially! When you receive covered services, you pay for your deductibles and copays, and coins. So the more services you take, the higher the other costs could be.
When comparing and selecting plans, the goal is to look at all your costs — not just premiums. See also the range of annual out-of-pocket costs offered with the Medicare Advantage Plan (Part C).
- Evaluate Your Current Plan’s Annual Notice of Change
You will receive this form around the end of September. This will indicate any changes in the cost and coverage of your current plan for next year. Pay special attention to changes in drug formulary, drug tier, and co-payment that affect the drugs you take.
- Fire Up Medicare’s Plan Finder
Even if your current coverage is not changing, it is a good idea to compare all your options during open enrollment. And using Plan Finder on Medicare.gov is an excellent way to do this, which has all details about all the plans. The tool makes it easy to compare premiums and copays for all plans available in your area. It also estimates your total cost for your medications and supplements (and your general health status, if you have a Medicare Advantage Plan). Indeed, it is the best place to start.
- Fill the Gaps
In 2003, Congress addressed a significant gap in Medicare coverage: prescription drug costs. It approved the creation of Medicare Part D, which provides low-cost plans that cover prescription drugs.
Note: Part D’s plans vary widely. For example, two plans for the same drug may have very different copies. It is financially intelligent to rethink your coverage every year, significantly if your drug needs have changed.
CMS estimates that Part D premiums will average $33.50 per month in 2018, the first average decline since 2012.
There are many other costs that you need to cover under Medicare. For example, Medicare Part A covers 100 percent of the first 60 days of hospital stay. But for the original Medicare nominees, you must cover the deductible amount for each hospital stay. That deductible in 2017 was $1,316. Another major expense for Part B under basic Medicare: 20 percent payment for doctor visits and other related medical expenses.
Some people have insurance from the military or current or previous employers to help pay for these costs. And there are government aid programs such as Medicaid and Medicare Saving Programs, making Americans capable of paying these costs.
If you do not fall under such plans and have enrolled in original Medicare, you can consider purchasing supplemental insurance or Medigap.
- Primary Care Providers
If staying with your current healthcare provider is essential to you, you need to determine whether they participate in the plan you are considering.
If you choose traditional Medicare, you are more likely to have the option of staying with your current provider. If you are looking at an HMO Advantage plan, you must select a primary care physician from their list of approved doctors.
The PPO Advantage Plan gives you a bit more freedom and does not require that you use the approved in-network practitioners of the plan. However, if that’s the case, you will pay a higher out-of-pocket fee.
- Identify whether Insurance Companies Offer Discounts
All we can say is many things can affect the cost of Medicare Insurance. One more way to get the best pricing for a Medicare insurance plan is to ask whether the insurance company offers a discount.
Hopefully, you’ll now have a clear idea of what you should consider while choosing the best Medicare Insurance Plan for your budget, needs, and priorities.
Not all plans are available in all areas and are subject to the limitations of the scheme and applicable laws, rules, and regulations. The general information in this article is not intended to elucidate any specific plan fully. Please refer to the official plan documents for complete information about a specific plan.
You can also book a consultation call with us, and our licensed Medicare Insurance agents will help you choose the right plan.