You want the best Medicare possible—but it's hard to point to one arrangement of choices and say, "This one is the best." However, the government has divided the criteria into several areas. If you go over them carefully, you can find the best one for you.
Consider costs
How much are your premiums, deductibles and other costs for each of your choices? How much do you pay for services like hospital stays or doctor visits? Are you bound by a yearly limit on what you could pay out-of-pocket for medical services? Read the details to make sure you know what you'll pay. Understand that in "Original Medicare" there’s no limit on how much you pay out-of-pocket per year unless you have supplemental coverage. However, "Medicare Advantage"
plans have a yearly limit on your out-of-pocket costs. If you join a Medicare Advantage Plan, once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year. This option may be more cost effective for you.
Look at the extent of coverage
Original Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care facilities. Services are either covered under Part A or Part B. Medicare Advantage
Plans must cover all of the services that Original Medicare covers. Some plans offer benefits that Original Medicare doesn’t cover like vision, hearing, or dental. Many Medicare Advantage plans offer vision, hearing, and dental—read the fine print.
You may decide you only need a Medigap plan, which helps fill "gaps" in Original Medicare and is sold by private companies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like copayments, coinsurance and deductibles. Do not confuse this with Medicare Advantage Plans, however. Indeed, you cannot have both.
If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you're still with employment-related coverage, talk to your benefits administrator or insurer before making any changes.
Keep your choices in mind
How important is it to you if you want to use specific doctors and hospitals? There may be limitations. Do the doctors you want accept the coverage you have? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?
Read the details of the plans available and consider what's important to you. This is the best way to ensure you'll have what is truly the "best plan."
For more information on Medicare products, contact Pam Morton at Benefits by Design Insurance Services at PamM@benefitsbydesignca.com or 760-696-3573.
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