According to the United States Census Bureau, about 10,000 baby boomers turn 65 each day — all of whom are now eligible to join the 56.5 million Americans enrolled in the national health insurance program. However, making the switch from private, employer-provided health insurance to Medicare often confuses people. For one, the average person will have to do their research to decode basic Medicare terms such as Part B, Medicare Advantage, and Medigap. In addition, most people also worry about choosing the right Medicare plan, as what they pick can significantly affect their out-of-pocket costs and healthcare quality.
If you’re not sure what Medicare plan to choose — don’t fret! This blog will discuss how you can find a Medicare plan that best fits your needs.
1.Check your options
There are two types of Medicare plans: Original Medicare and Medicare Advantage. Put simply, Original Medicare is a fee-for-service government-provided plan that is made up of two parts: Part A, which is hospital insurance, and Part B, which is medical insurance. If you need prescription drugs, you’ll have to go out of your way and join a Part D drug plan in your area. In Original Medicare, the government will pay for any healthcare services you may need.
On the other hand, Medicare Advantage are plans offered by private insurance companies that are combined with Medicare. KelseyCare Advantage highlights how Medicare Advantage plans often include Part A and Part B coverage, as well as Part D and other benefits that you may not find in Original Medicare. In addition, Medicare Advantage can also be set up as an HMO, PPO, or fee-for-service plan. Be sure to choose wisely between these two, as your decision can affect how much you’ll pay for healthcare services for the rest of your life.
2. Consider the cost
It doesn’t matter if you choose Original Medicare or a Medicare Advantage plan — you’ll still have premiums, copays, and deductibles to pay. For this reason, it’s important to find a Medicare plan that you can pay comfortably, but still covers your healthcare needs. When estimating your yearly costs, be sure to consider the deductible, premium, and out-of-pocket max. In addition, you should also include how often you’ll need to refill prescription drugs or make visits to the doctor. Specialist and out-of-network visits should also be noted in your estimate as well. By making a precise estimate of your yearly healthcare needs. You’ll have an easier time shopping for a Medicare plan that works best for you.
3. Look at the ratings
If you’re not sure about a particular Medicare Advantage plan, try to check the Star Ratings attached to it. Given by the Centers for Medicare & Medicaid Services, Star Ratings can help you better understand the quality and performance of a plan. These consider factors such as customer service, member complaints, drug safety and accuracy of drug pricing, and availability of screening tests, vaccines, and other preventive care services.
4. Factor in your future travel plans
If you often travel or have plans of moving around in the future, it’s best to check if a particular Medicare plan will still cover you once you relocate. Healthline points out that while you can use Original Medicare in another state, the coverage may vary depending on the plan you choose. What’s more confusing is that different rules apply to Medicare Advantage, Medicare Part D, or even Medigap. Medicare Advantage plans are particularly troublesome, as they require you to stay in-network to save money. Thankfully, life-threatening injuries will be covered by Medicare Advantage, even if you use out-of-network providers.
The information we’ve discussed above can be a lot to take in. But if you want to choose a Medicare plan that best suits your medical and personal needs, be sure to take what we’ve written into account. For more healthcare posts and insights, do visit our blog here on myOnsite Healthcare.
Exclusively written for myOnsite HealthCare by: Rhiya Jasleen