The 5 Most Important Things When Shopping For Medicare Insurance

Every year, between October 15th and December 7th, you will get bombarded with TV commercials about Medicare and all the different plans. So this leads seniors to believe that it’s the only time of year they could shop for insurance plans. That’s not entirely true and it pays to understand how insurance works. Many seniors depend on a fixed income and need every penny of it. They usually don’t know what’s available and end up paying more than they should. Other times they completely go without care, because they can’t afford it.

The “Medicare And You” book is available for free and is sent to seniors every year. That only helps so much because Medicare is such a complicated topic. Many seniors don’t fully understand it and end up settling with the very first plan offered. In this article we will help you understand the five most important things when it comes to shopping for Medicare health plans.

Cost

It usually comes down to the dollars and cents. Medicare is heavily regulated, but it doesn’t mean that the third party insurance companies can’t control their plan premiums or co-pays. Companies change premiums, co-pays, benefits, deductibles, annually and hope you stick around to pay. When looking for either a Medicare advantage, supplement, prescription, vision, or dental plan, make sure to have all the options available to you so you can make the right decision for your situation.

If you don’t know what the different plans charge or cover, you might end up holding off on a decision that could have potentially saved you a lot of money. Take the time to speak with an independent insurance agent to learn about the different options.

Benefits

Health insurance is one of the most important pieces to your health and financial being. When dependent on a fixed income, having medical bills covered can be the difference between losing everything or being ok. The insurance company might have covered a certain prescription this year, but next year you might have to pay the full price or meet a higher deductible. Depending on your health and age, you need to look into coverage that will meet your personal needs.

Will one plan cover more hospital visits, or will it cover a treatment that another insurance company wouldn’t? If your health is getting worse and you have minimal coverage, it might be a good time to look for a plan that will help you keep more money in your pocket in the long run while providing the benefits you need.

Eligibility

Depending on income and which state you live in, you might be eligible for additional benefits at no extra cost. If you are lower income, you might not have to pay your Medicare Part B(insurance that covers out patient services) monthly premium and could possibly receive help with prescription co-pays. Maybe you plan to move and your current insurance isn’t accepted there? You would now have a special enrollment option to shop different plans in that county. Or maybe you’re nearing the age of 65 and you don’t have a prescription plan, but would like to avoid a Medicare Part D(Prescription insurance) penalty down the road?

Being aware or your eligibility can help you make decisions and gives you a peace of mind.

Providers

When shopping for a Medicare insurance plan, make sure you can see the doctors you want to see and get the services you need. Depending on the type of medicare insurance plan you have, you might be limited to a network of providers and services. For example, in an HMO plan, not every doctor is considered as an “In network” provider and they have a right to deny services, or they may provide the services, but you will end up paying more than if you were to see and in network provider.

So when looking at the different plans, make sure your doctors take the specific plan. If you really like the plan and your current primary care physician doesn’t take the insurance plan, be ready to change to a new primary care physician and a new network of specialists. Or maybe, depending on your situation, it would be more cost effective and convenient to get a plan that is honored by any medical provider that accepts Medicare, also known as Medicare Supplement Plans.

Enrolling

Knowing when and how you can enroll is very important to know. If you are just turning 65, you have three months before and after to enroll into Original Medicare. This period is also called the Initial Enrollment Period. During this period you can enroll into Part A(Inpatient Care Coverage), Part B(Out patient services) or both. In addition to that, you can choose other plans to help cover the portion of medical services that Original Medicare wouldn’t.

You have the option to enroll into Part B or refuse it, but note that if you decide to enroll into Part B later down the road, you might be charged a Part D premium penalty. If you were automatically enrolled into Original Medicare, and received your red, white, and blue card, you still might have to take additional action to enroll yourself and get the coverage you want.

There are other enrollment periods to keep in mind as well. The Annual Election Period (AEP) is between October 15th and December 7th, and the Special Enrollment Period (SEP) applies to folks that are either on a low income, moved to a new service area, or lost insurance coverage. This is the period where you have the option to choose a Medicare Advantage Plan and Prescription plan.

Taking the next step

Now that we have discussed the five major keys when shopping for Medicare insurance, we would like to hear from you. What are you looking for in a plan? What doctors do you need to see? What prescriptions do you need help paying for?  Share this post with your friends that might find it helpful and answer some of the questions they may have. Click HERE to speak with a licensed agent about your needs today!

Back to top button