Six Important Factors To Consider When Choosing Medicare Coverage

When you turn 65, you’re eligible to enroll for Medicare coverage. Medicare is health insurance for older adults on behalf of the federal government. It’s critical to do your research about Medicare before open enrollment every year.

The internet has a plethora of resources about Medicare and all of its options. While researching, you should make a list of what your specific needs are. That will help you ensure that your Medicare plan covers what you need. Read on to learn about six vital factors you should consider when choosing Medicare coverage.

Determine the Type of Coverage You Need


Your Medicare coverage decides essential factors that impact your healthcare. The options you select will determine everything from which doctors are covered under your plan to your out-of-pocket costs. That’s why it’s vital to enroll in coverage that includes the services you need most. Medicare has two types of coverage. The first is Original Medicare or Medicare Parts A and B. The second type is Medicare Advantage, or Part C. Medicare Advantage offers all of the services in Original Medicare with some additional coverage. Research what each of these plans covers.

Do You Plan to Travel?


Individuals over 65 years old who plan to travel outside of the United States may want to review their options and coverage under Medicare. Both Original Medicare and Medicare Advantage plans typically do not cover any medical care received outside of the United States. If this is your scenario, you may be able to purchase additional coverage or a different plan that does cover international healthcare costs. Yet be sure to read the fine print to be aware of precisely what’s covered.

Review Who Accepts Medicare In Your Area


Never assume a doctor accepts Medicare. Every doctor varies on the types of health insurance and policies or plans they receive. While some welcome Medicare, others do not. Before choosing your coverage and enrolling, check with your doctors to see if they will take Medicare. Original Medicare allows people to see any doctor who accepts Medicare, whereas Medicare Advantage may require you to see doctors or go to hospitals that participate in the plan’s network. Get the details from your doctor before making any changes to ensure you can continue seeing your current doctor. 

Adding Supplemental Coverage


You also have the option to increase your Medicare coverage by adding supplemental insurance. You can purchase supplemental insurance, or Medigap, from a private insurance company. Some of these gaps can include extra costs to you, such as copayments, coinsurance, and deductibles. The purpose of the Medigap plan is to help eliminate some of these additional costs or a portion of them. Keep in mind that you can only get a Medigap plan if you are enrolled in Original Medicare. It’s also important to note that a supplemental plan requires a monthly premium, and you may still have additional healthcare costs that you’ll be required to pay out of pocket. 

Do You Need Prescription Drug Coverage? 


When determining your coverage needs, it’s important to assess prescription needs. Medicare plans don’t usually cover all prescription costs. If you have many prescriptions, you should be aware that Medicare limitations may leave you with high out-of-pocket costs. If this is your scenario, you can join a Medicare Prescription Drug Plan or Part D. This additional plan will cover many medications and lower out-of-pocket costs. Be sure to review all of the details of your prescription drug coverage before making any changes. There are sometimes limitations or exclusions that people are unaware of. Review your regular prescriptions to ensure you are covered under your current plan, Part D, or Medicare Advantage plan. 

Figure Out-of-Pocket Costs


Finally, research and determine how much your Medicare choices will cost you. Many individuals over 65 years old live on a fixed income. Although it is crucial to ensure that all of your health needs are covered, it’s vital to know the amount you will pay out-of-pocket. Medicare is more complicated than just the premium costs. Although some premium rates are $0, there may be other costs you are responsible for. When researching potential costs, consider the monthly premium, copayments, annual deductible, prescription drug copayments, and yearly limits on out-of-pocket costs. Make sure to check your plan closely as each is different.