Questions to ask when choosing a Medicare plan...

COSTS 

How much are the plan's 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? What is the plan's minimum out-of-pocket?  

BASIC COVERAGE 

Will the plan cover the services you think you might need? Original Medicare (parts A & B) covers about 80% of your medical services in hospitals, doctor offices, and some other healthcare facilities. Medicare Supplements help cover the "gaps" that Original Medicare doesn't cover, like some co-pays, coinsurance, and deductibles. Most Medicare Advantage plans offer additional benefits like some dental, vision, and hearing. Check the plan's EOC (Evidence of Coverage) for details.  

OTHER COVERAGE 

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

PRESCRIPTION DRUGS 

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

NETWORKS 

Medicare Advantage plans are network plans (like HMOs and PPOs) so you need to be aware of your plan's network. Medicare Supplements are not network plans so you can go to any doctor who accepts Medicare. Some doctors "opt out" of Medicare and may charge up to 15% more for services.  

ADDITIONAL BENEFITS  

Many Medicare plans include "extras" such as fitness center memberships, home meal delivery after hospital stays, 24/7 nurse lines, some dental, vision, & hearing benefits, and Over-The-Counter allowances so you can order non-prescription pharmacy items online to be delivered to your home. 

QUALITY OF CARE 

Medicare gives every Medicare Advantage plan (part C) a "Star Rating" from 1 to 5 stars every year as a measure of the quality of services provided by the plan. These annual ratings are based on over 50 healthcare categories like ease of scheduling, wait times, coding accuracy, effectiveness of care, timeliness of care, etc. Medicare Supplement plans are not given star ratings by Medicare since they are not a part of Medicare. 

FOREIGN TRAVEL 

Most Medicare Supplements and Medicare Advantage plans provide coverage only for emergencies during foreign travel. Some supplement plans cover 80% of your cost after a $250 deductible up to a lifetime maximum of $50,000. 

USA TRAVEL 

Coverage while traveling within the United States is provided by most Medicare Supplement plans and is provided by most Medicare Advantage plans as out-of-network coverage. 

MedicareCENTER 

Visit our MedicareCENTER where you can find much more information and where you can even enroll yourself in a plan when you're ready! 

HOW WE ARE COMPENSATED 

Our compensation comes from the companies that our clients enroll in (like Wellmark, Aetna, UnitedHealthcare, etc.) and compensation amounts are standardized by Medicare so there is no incentive for us to push certain companies over others.  We explain the options and you choose the plan you want.  

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SOME CAUTIONS... 

BEWARE OF SCAM CALLS!  Medicare will never call you - unless they are calling you back. 

Medicare will not call to enroll you in a plan and will never ask for your Medicare number. 

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

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