Most people qualify for Medicare around the age of 65. This period is known as the Initial Enrollment Period, and it allows you to enroll in Medicare for the first time. Most will typically enroll in Original Medicare, i.e., Medicare Part A and Part B, but after enrolling in these two parts, you will have the option of also enrolling in Medicare Advantage, Part D, or Medicare Supplements.
It is important to carefully consider your options before enrolling in a Medicare plan. There are different factors to consider when making a choice, such as your healthcare needs, coverage options, and cost. In this guide, we’ll explain how to choose the right Medicare plan.
Coverage Options
To choose the right Medicare plan, you need to consider different Medicare plans and the coverage options of each plan. This will help you get a plan that adequately covers your healthcare needs. Enrolling in just any plan without comparing the coverage options with other plans can result in you getting coverage that doesn’t meet your needs.
Medicare Part A and Part B, also known as Original Medicare, cover inpatient and outpatient services such as hospice care, skilled nursing facility care, durable medical equipment, preventive screenings, and other services. If you have healthcare needs that are restricted to these, then Medicare Part A and Part B alone may be adequate.
Suppose you take prescription drugs frequently. In that case, you may need to enroll in a Part D plan or a Part C (Medicare Advantage) plan that includes prescription drug coverage. There are many types of Medicare Advantage plans with different coverage features and costs, such as HMO, PPO, MSA, PFFS, and SNP. If your out-of-pocket costs from Original Medicare are high, then you can enroll in a Medicare Supplement plan.
If you have Part D, you can get help with your Part D costs through the Part D extra help program if you qualify. Also, you can enroll in both Medicare and a group health plan or VA benefits if you are eligible.
Costs
Medicare does not cover all your healthcare expenses. While Medicare covers a large part of the costs (about 80%), enrollees will cover the rest of the costs in the form of deductibles, copayments, and coinsurance. You’ll also need to pay monthly premiums to stay enrolled.
To choose the right plan, you need to ensure that you can afford the costs associated with the plan, apart from ensuring the plan meets your healthcare needs. There are cost-saving plans such as Medicare Supplement plans and the Part D Extra Help program to help you pay for costs that you would not otherwise be able to pay for out-of-pocket.
Lastly, ensure you are comfortable with a plan’s coverage policy before enrolling. Some plans restrict coverage to in-network providers, while some are tailored for people with certain health conditions.
To learn more about Medicare coverage and which plan would work best for your needs, contact Senior Health Solutions today.
