Tips for choosing a Medicare plan
- There are two main ways to get Medicare coverage. You can choose Original Medicare (Part A and B), which is provided by the federal government. Original Medicare includes Part A for hospital stays and Part B for doctor visits. OR You can choose a Medicare Advantage (Part C) plan from a private insurance company. Medicare Advantage plans combine Part A and Part B coverage, and many also include prescription drug coverage as well as additional benefits, such as routine hearing and vision care.
- You will pay a share of your costs. Original Medicare doesn’t pay for everything, and there is no limit on your out-of-pocket costs. No matter what type of Medicare plan you choose, you will pay a share of your costs through monthly premiums, deductibles, co-pays and co-insurance.
- Medicare supplement insurance plans help pay some of your out-of-pocket costs. Medicare supplement insurance plans, which are sold by private insurance companies, help pay for some of the expenses not covered by Original Medicare, like deductibles and co-pays.
- There are two ways you can get coverage for prescription drugs. You can enroll in a stand-alone Part D prescription drug plan to go with your Original Medicare coverage. Part D plans are sold by private companies. OR You can enroll in a Medicare Advantage (Part C) plan that includes prescription drug coverage. Part C plans are also sold by private companies.
- Know the choices in your state. Original Medicare (Part A and B) is the same across the U.S. Medicare Advantage (Part C) plans and prescription drug (Part D) plans may be available in only certain counties, states or regions. Medicare supplement insurance plans help pay some of your out-of-pocket costs. They travel with you nationwide. Not all plans are available in all states.
- Enroll at the right time. Your Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. Your IEP is seven months long and includes the three months before the month you turn 65, your birthday month and the three months after your birthday month. If you enroll before the month you turn 65, your coverage starts the first day of your birthday month. If you enroll during your birthday month or later, your coverage start date could be delayed. If you’re under 65 and have a qualifying disability, you are automatically enrolled in Part A and Part B after you get Social Security or Railroad Retirement benefits for 24 months. If you’re under 65 and have ALS, you are automatically enrolled in Part A and Part B the first month you get disability benefits from Social Security or the Railroad Retirement Board.
- You can review your choices once a year. After you choose your Medicare coverage, you can make changes each year during Medicare Open Enrollment, which is from October 15 to December 7.
- You may be eligible for a Special Enrollment Period. You may be able to switch your Medicare coverage during a Special Enrollment Period (SEP) if you have certain life changes, such as: You retire and leave a health care plan offered by your employer or union. You move out of your current plan’s service area.
When it comes to Medicare, you have choices.