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3 things to know before choosing a Medicare Plan

3 things to know before choosing a Medicare Plan
10/14/2022
  • Medicare with Melissa

Whether you’re turning 65 and new to Medicare or changing your plan during the Annual Enrollment Period, here are 3 things to know before choosing a Medicare plan.

Before you jump to our big reveal, it’s important to understand that there are two types of Medicare Plans to choose from. Let’s take a closer look at your Medicare Plan Options.

Medicare Supplement vs. Medicare Advantage

There are several types of Medicare plans to choose from. Lets start with the basics. First, you need to decide if you want a Medicare Supplement Plan or Medicare Advantage Plan.

  1. Medicare Supplement Plans (Medigap Insurance Plans)
    • Work with Original Medicare and act as secondary insurance.
    • Most popular Medigap Plans are: Medigap Plan F, Medigap Plan G and Medigap Plan N.
    • Medicare Supplemental Insurance Plans have no network and do not require referrals. You can see any facility or provider in the country as long as they accept Medicare.
    • Supplemental Insurance Plans do not include coverage for drugs, dental, vision and hearing. You can purchase those plans in addition to your Medigap Plan.
  2. Medicare Advantage Plans (Medicare Part C)
    • Are considered “Medicare Replacement” Plans, as these plans act as your Primary payor.
    • The most popular plans: HMO, PPO, and Dual-Eligible for Medicaid.
    • Attractive because of the low to $0 premiums.
    • All plans have a network, and some require referrals.
    • Most include coverage for drugs and sometimes include dental, vision, hearing and more.

To learn more about the difference between Medicare Supplement and Medicare Advantage plans, watch our short video here https://youtu.be/Lk5riDwO51o .

Ok, now that you have a better understanding on the types of Medicare plans available to you, lets dig in a bit more.

3 things to know before choosing a Medicare Plan

Cost

  • Budget. Now that you are retired, budgeting should play a key role in your decision-making process.
  • Premiums. Think about what you can afford. Sometimes you get what you pay for with insurance.
  • Deductibles, Co-pays, Co-insurance, Max-Out-Of-Pocket. Regardless of the plan you choose, you will have expenses throughout the year (unless you have a Medigap Plan F). Be sure to ask your agent about these costs and how it may impact you based on your previous and current overall health.

Lifestyle

  • Travel. Some Medicare plans will not cover you when traveling our of the service area (unless in emergency). Take this into consideration when choosing a plan. Medigap plans have no network and traditionally provide the most flexibility when traveling.
  • Health. Consider your past and current health. We don’t have a crystal ball- but you know yourself. Medicare Advantage plans can be a great fit for healthy individuals.

Convenience

  • Network. Medicare Advantage plans have a network. Be sure your doctor(s) accept the plan(s) you are considering.
  • Referrals. Traditionally, HMO plans require referrals. However, we have seen recently that not all HMO’s require referrals for a specialist. Keep this in mind when choosing a plan.
  • All-In-One Plans. Medicare Advantage plans are convenient because they generally include your health, drugs and additional benefits in one plan. On the other hand, if you choose traditional Medicare and a Medicare Supplemental Plan, you need to purchase additional coverage to obtain those additional benefits.

Medicare Enrollment Periods

😤Choosing the right Medicare plan can be confusing and stressful.

🤗The good news is that if you make a mistake or are not happy with your plan, you may be able to change. There are several Medicare Enrollment Periods throughout the year that you may be eligible for. Below are some examples of different Medicare Enrollment Periods.

  • Initial Enrollment Period (New to Medicare or Turning 65)
  • Medicare Advantage Open Enrollment Period (Allows Medicare beneficiaries with a Medicare Advantage Plan to make changes)
  • Medicare Annual Enrollment Period (Allows all Medicare beneficiaries to make plan changes)
  • Special Enrollment Period (Allows specific, eligible beneficiaries to change plans based on qualifying scenarios).

Need help choosing a Medicare Plan?

Speaking a licensed agent can help save time, headache and most importantly, provide peace of mind knowing you’ve chosen a plan that’s best for you.

Our team at Senior HealthCare Solutions has assisted thousands of beneficiaries and are equipped to compare over 25+ top-rated insurance companies and secure your coverage for all of your Medicare health needs.

Call us today at 866-MEDIGAP (866-633-4427). You can also click here to schedule your appointment today.

Frequently Asked Medicare Questions

What is the best Medicare Plan?

The best Medicare Plan is different for everyone. There is no one-size fits all when it comes to choosing the right insurance plan for you. We have clients on Medicare Supplement and Medicare Advantage Plans. Some clients prefer a PPO over a Plan G.

If I don’t like my Medicare plan, can I change?

Yes. You can change your Medicare plan if you don’t like it. You may qualify for a special enrollment period that allows you to change in the middle of the year. Call us today to see if you’re eligible. 866-633-4427.

What is the difference between a Medicare Supplement and Medicare Advantage Plan?

There are 3 key differences between a Medicare Supplement and Medicare Advantage Plan.

  1. Cost
  2. Network
  3. Additional Benefits
If Medigap Plan G better than Medigap Plan N?

Medigap Plan G is better than Medigap Plan N, because it provides more coverage. However, the plan N provides great value for the price and should not be overlooked when comparing plans. Watch this video, “Plan G vs Plan N, which is better?

What is the difference between a HMO and PPO?

HMO’s plans traditionally require referrals to see a specialist. Although, that is not true for all HMO plans. PPO plans provide more coverage if you have to go outside if the plan network for medical services. Watch this video, “HMO vs PPO, which is better?

How much do Medigap Insurance Plans cost?

Medigap Insurance Plans cost will vary depending on several factors, such as:

  1. Age
  2. Gender
  3. Location
  4. Tobacco Use
  5. Household discounts, if applicable
How much do Medicare Advantage Plans cost?

Many Medicare Advantage plans are little to $0 premium per month. Of course, nothing in life is free. So, you should expect copays and other out of pocket costs with these plans.

Free Medicare Resources

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Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.

-Melissa

Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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