Your health care needs are personal, and your Medicare choices should be too. Of course, you want a plan with the coverage you need. You also want one that’s kind to your pocketbook.
Use these tips to help sort through your choices and nail down what’s right for you.
Tip 1: It’s not just about the plan premium
Plan costs may include premiums, deductibles, copays and coinsurance. Premiums are often what people mistakenly focus only on – usually because this amount is paid monthly and can seem larger than your other costs. But you want to compare all the costs of plans, not just premiums. Why? Because while your monthly premiums are consistent, your other costs can vary and add up quickly! You pay towards your deductibles and for copays and coinsurance when you receive covered services, so the more services you use, the higher the other costs may be.
In general, low premiums often come with high deductibles, copays and coinsurance. This may suit you if you are generally healthy and use few health care services. The opposite is also true; you may choose to pay relatively high premiums and few or no other costs if you have a lot of medical needs.
The main point is to look at all your costs – not just premiums – when comparing and choosing plans. Also check the limits on annual out-of-pocket costs offered with Medicare Advantage plans (Part C).
Tip 2: Drug formularies are your friends
Medicare plans have a list of covered drugs called a formulary. Each plan creates its own formulary and can change it from year to year. Check each formulary when shopping and reject any plan that doesn’t list the prescription drugs you take.
Once you find a few plans that offer the medications you need, then compare costs and other factors (such as other offered benefits like vision coverage) for the remaining plans you’re interested in. Most plans have pharmacy networks that offer plan pricing to members, so you’ll want to find one that includes the pharmacy you like to use as well.
You can get prescription drug coverage through a standalone Medicare Part D plan or as part of a Medicare Advantage plan.
Tip 3: Consider whether you want specific benefits
Original Medicare (Parts A & B) only covers hospital and medical services and items, respectively. And often some services or health care items you need come with a lot of conditions for them to even be covered. Moreover, Original Medicare doesn’t cover prescription drugs (you need either a Part D or Medicare Advantage plan), and it doesn’t offer coverage for some important things you may be used to getting such as dental and vision.
If you want specific health items like dental, vision or hearing coverage, you should make a list of what you want. Then after you have that list, start exploring plans that may offer these benefits in your area.
Tip 4: Take time to understand available Medicare plans
There are a lot of options when it comes to choosing Medicare coverage. You actually have seven different ways you can combine the parts of Medicare to find the right fit for you.
The right plan fits your personal health needs
You may get a lot of advice about what Medicare plan you should get. But the final decision for you needs to be made by you, and for unique health care and lifestyle needs.
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