5 Things to Consider When Choosing Medicare Coverage

Updated on May 20, 2020

President Lyndon Johnson established Medicare in 1966. It’s a national health insurance program created for people who are 65 or older. Currently, there are almost 60 million people enrolled in this program. Although it’s arguably the most known health insurance option, people are still often confused when it comes to the enrollment process. If you have any doubts or questions, read this article. It will help you when you’re about to choose your Medicare coverage.

Know the plans

There are multiple coverage options, but the majority of people don’t know much about it. Below you can find a clear description of each coverage. Part A and B are offered by the US government and are known as “Original Medicare”.

Medicare Part A – it’s hospital insurance. Part A covers inpatient care, so you won’t have to worry about room costs or expenses such as hospital meals and supplies. No premium is required if you are qualified and have paid Social Security taxes for at least ten years. Deductible lasts for a year, and 60 days of your hospitalization will be fully covered. Unfortunately, after this period you’ll have to pay a previously determined amount of money. 

Medicare Part B – it’s medical insurance which covers home health care, hospital outpatient care as well as doctor services. Part B premium is individually determined because it depends on your yearly income. The deductible is yearly, and once you meet it, Medicare will cover 80% of services costs. Keep in mind that Medicare also fully covers the most preventive services.

On top of those two plans, you can also enroll for a Part C (Medicare Advantage Plan) and Part D (Prescription Drug Plan) programs. Here is their description.

Medicare Part C – it’s alternative to original Medicare. It covers all the services that Part A and B offers, but it’s provided by private insurance companies. Plan price is dependent on the insurance company, that provides the plan.

Medicare Part D – this Medicare plan will pay part of prescription drugs cost; that’s why it’s often referred to as prescription drug coverage. Unfortunately, it’s impossible to predict how high costs of your plan will be because it all depends on the prescription drug that you need and if you qualify for Extra Help.

There’s also one more plan, known as Medigap insurance. It helps to cover all the costs that aren’t included in Original Medicare, for example, excess hospitalization. Private insurers sell this kind of insurance, that’s why prices can vary.

Compare the prices

Be sure to analyze each and every plan price diligently. Make sure that premium and other costs will be affordable for you. Calculate how much you pay for doctor visits and hospital stays. Also, ask yourself a question about how much could you pay out-of-pocket for medical services. Then choose the plan that will benefit you the most.

Quality of care

It’s a factor that you can’t neglect under no circumstances. Quality of services offered by plans is not always the best. Look for the opinions of others who have already enrolled in a particular program. Compare reviews of different insurance companies. Talk to them, and ask about their opinion. How do they rate the plan that you’re interested in? Their advice will undoubtedly help you make the right decision.

Plan change 

There are annual enrollment periods when you can pick the plan that you need. However, if you’re not satisfied with it, it’s possible to change it if you chose the Medicare Advantage plan. If you’d like to be easily able to switch the program, then you should go with that option. 

Doctor and hospital choice

Before you enroll, there’s one more thing to consider. Make sure that your doctors accept the coverage. Original Medicare is a nation-wide health program, and over 90% of doctors participate. Besides, check out if you’ll need any referrals, and make sure that doctors that you want to see are accepting new patients.

There is still plenty of time to choose the right plan; the enrollment period ends on 31st March. However, you shouldn’t leave it until the last minute. Start comparing the available programs right now, and choose the one that will be best for you, basing on the criteria that we listed in the article.

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