Questions to ask when choosing a Medicare plan...

COSTS 

How much are the premiums, co-pays, coinsurance, and deductibles? How much will you pay for doctor visits and hospital stays? What is the plan's maximum out-of-pocket cost? What is the plan's minimum out-of-pocket cost?  

COVERAGE 

Will the plan cover the services you need? Original Medicare (parts A & B) helps cover medical services in hospitals, in doctor offices, and in some other healthcare facilities. Medicare Supplements help cover the gaps that Original Medicare doesn't cover, like co-pays, coinsurance, and deductibles. Most Medicare Advantage plans offer additional benefits like dental, vision, and hearing. Check the plan's EOC (Evidence of Coverage) for details.  

OTHER COVERAGES 

Will you have other medical or prescription drug coverage (e.g. as a Federal employee)? Do you understand how that coverage will work with Original Medicare (A&B)? Understand your options for enrolling in a Medicare Supplement or Medicare Advantage plan. Remember you can't have both a Medicare Supplement plan and a Medicare Advantage plan. 

PRESCRIPTION DRUGS 

Will you need prescription drug coverage? Do you have "creditable" coverage at work and do you plan to retire or continue working? When will you need to enroll in a part D plan to avoid a penalty? Are all your prescriptions covered by the plan's formulary? What are the premiums, deductibles, and coinsurance? Medicare Advantage plans include part D at no additional cost. Medicare Supplement plans do not include part D. 

DOCTOR NETWORKS 

Do you want a network plan that includes your hospital and your doctors? Or do you want a no-network plan? Medicare Advantage plans are network plans (like HMOs and PPOs) and starting in 2022 some have made their out-of-network cost and coverage the same as their in-network cost and coverage. Medicare Supplement plans are not network plans - you can go to any doctor who accepts Medicare.  

ADDITIONAL BENEFITS  

Many Medicare Advantage plans include "extras" such as gym memberships like SilverSneakers, home meal delivery after hospital stays, 24/7 teledoc or nurse lines, and Over-the-Counter allowances that let you order non-prescription pharmacy items. 

QUALITY OF CARE 

Will the plan provide the medical care and prescription drug coverage you need? Does the plan have a high Star Rating from Medicare? Are other plans in your area rated higher? All Medicare Advantage plans and all part D plans are given a Star Rating (from 1 to 5 stars) every year from Medicare. Medicare Supplement plans are not given star ratings by Medicare. 

TRAVEL 

Original Medicare generally does not provide coverage outside the United States. Some Medicare Supplements and Medicare Advantage plans provide some foreign travel coverage. One Medicare Advantage plan includes "Assist America" for foreign travelers. Coverage while traveling within the U.S. is generally provided by Medicare Supplements and by Medicare Advantage plans. 

**********************************************************************************************************************

SOME CAUTIONS... 

Medicare will never call you to sell you anything. 

Medicare will only call you if they are calling you back. 

If someone calls promising you some benefit if you give them your Medicare number, don't do it. 

Medicare doesn't enroll you in supplements, advantage plans, or drug plans. 

Medicare will never visit you at your home. 

Don't let anyone rush you into making a decision - take your time and consider all your options. 

Consult with a knowledgeable and trusted source. 

If you suspect fraud or abuse of any kind, report it to Medicare at 1-800-MEDICARE (1-800-633-4227).