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Helpful Tips for Medicare Planning

When it comes to Medicare planning, your lifestyle, budget, and health are key considerations. You’ve worked hard to get to Medicare and now you deserve the freedom to pursue your interests without stressing about health insurance.  

Before you enroll in a plan, ask how much it will pay for each of the following:

  • Inpatient hospital care
  • Doctor and specialist office visits
  • Outpatient services and surgeries
  • Durable medical equipment
  • Medications
  • Medical coverage while away from home 

Set Your Meeting

I understand and agree that, by submitting my information, a licensed insurance broker will contact me to provide additional information about the health insurance plans available in my local area.

How to Choose a Medicare Plan Type

Determining which type of Medicare insurance plan offers you the best value will depend on what’s most important to you. For example, how important is peace of mind to you? Do you travel a great deal or own homes in more than one location? 

If you’re the kind of person who worries often, you may feel more comfortable with a Medicare Supplement plan. Most of these policies leave you with very little to pay out of pocket. Enrolling in a good plan like F, G, or N means that if you have a severe illness or lengthy hospital stay, you’ll still pay almost $0 for Medicare-covered services. 

Medicare Supplements provide notable peace of mind for millions of seniors nationwide.

Choosing a Medicare Supplement Plan

When you shop for Medicare Supplements (Medigap policies), consider the following:

Costs

What monthly premium can you afford? The monthly premiums and annual deductibles vary by plan, but typically, Medigap plans will cost upwards of $100 per month. And inflation can cause the premiums to increase. It is also important to keep in mind that most plans have an annual rate increase.

Some plans have annual limits on how much you will pay out-of-pocket. When comparing plans, consider the deductibles, copays, hospital stays, and other medical expenses. 

Coverage

It’s also important to consider the Medigap plan’s coverage. Does a particular plan cover all the medical services you need, such as cancer screenings, surgeries, transportation, lab work, medical equipment, and home health care? All Medigap plans offer standardized coverage, aka the same “basic” benefits. 

Travel Plans 

Medigap plans allow you to go to any doctor in America that accepts Medicare. If you know you’ll be traveling often and need to have access to doctors in different locations around the U.S., then Medigap is a great fit.

Many retirees also like to travel abroad. Some Medigap plans offer coverage for foreign travel emergency care (up to plan limits).

Prescription Drugs

While some Medigap policies covered prescription drugs in the past, they don’t anymore—so if you’re enrolled in Original Medicare, you’ll need to enroll in a separate Medicare Part D plan.

Choosing a Medicare Advantage Plan

Medicare Advantage (Medicare Part C) plans have lower premiums but higher out-of-pocket costs. You may find that the lowest premium plan may not be the cheapest option for you. 

Costs

Medicare Advantage plans can have premiums as low as $0. If you’re living on a fixed income and think that spending $100+ per month on coverage would be difficult, then Medicare Advantage offers a way to spend less on premiums—which leaves more in your monthly budget. 

Remember, you’ll still pay for Medicare Part B while enrolled in Medicare Advantage. And you’ll have expenses like copays as you go along. 

Which Plans Does Your Doctor Accept?

Medicare Advantage plans have smaller local networks. If you have a doctor that you must be able to continue seeing, make sure that doctor participates in any Medicare Advantage plan before you join. Every plan has an online directory where you can look up participating providers. 

If you don’t travel that much and only need to see doctors in your local area, a Medicare Advantage plan’s local network may be just right for you. The question is, should you go with an HMO, PPO, or PFFS plan? 

A PPO plan may be right for you if you want the freedom to select doctors or facilities out of the network and you would rather see a specialist on your own.

On the other hand, an HMO plan may be right for you if you don’t mind picking from a list of doctors and facilities for your care and you like working with the main doctor who manages your care.  

Your Medical Usage

Medicare Advantage plans often require copays when you seek medical care. Let’s say you visit your specialist twice a month and your plan has a $50 copay for each visit. In that case, you know you’ll spend $100 out of pocket with that plan. 

Compare your potential out-of-pocket monthly expenses with each type of plan to help you see if the Advantage plan will help you save money. The frequent copays could lead to more spending for you.

Rainy Day Savings Fund

Under Medicare Advantage plans, there are some medical services where you will be responsible for 20% of the cost of treatment. This is known as coinsurance, and you may see it apply to things such as dialysis, durable medical equipment, and chemotherapy and radiation.

If you have reserved money for a future need, this may be no issue for you—should you have a year with some higher health care spending down the road.

Contact the Medicare Experts

Enrolling in the right Medicare plan is an important decision for you to make. If you’d like help understanding your Medicare options, get in touch with the experts at North American Health Plans.