| Tue, Oct 30, 2018 @ 08:00 AM

3 Surefire Tips for Picking a Medicare Plan that Fits Your Health Needs and Budget

Posted by Medicare Made Clear

Your health care needs are personal, and your Medicare choices should be too. Of course you want a plan with the coverage you need. You also want one that’s kind to your pocketbook.

Use these tips to help sort through your choices and nail down what’s right for you.


Tip 1: It’s Not Just about the Premium

 Plan costs may include premiums, deductibles, copays and coinsurance. Premiums are set monthly payments, but other costs are paid only when you receive covered services. So the more services you use, the higher the other costs may be.

In general, low premiums come with high deductibles, copays and coinsurance. This may suit you if you are generally healthy and use few health care services. The opposite is also true; you may choose to pay relatively high premiums and few or no other costs if you have a lot of medical needs.

The main point is to look at all your costs – not just premiums – when comparing and choosing plans. Also check the limits on annual out-of-pocket costs offered with Medicare Advantage plans (Part C).

Tip 2: Drug Formularies are Your Friends

Medicare plans have a list of covered drugs called a formulary. Each plan creates its own formulary and can change it from year to year. Generally you pay less out of pocket for drugs on your plan’s formulary than for those that are not.

Check each formulary when shopping and reject any plan that doesn’t list the prescription drugs you take. Then compare costs and other factors for the remaining plans you’re interested in. Most plans have pharmacy networks that offer plan pricing to members, so you’ll want to find one that includes the pharmacy you like to use as well.

You can get prescription drug coverage through a standalone Medicare Part D plan or as part of a Medicare Advantage plan.

Tip 3: Provider Networks Net Savings

Many Medicare Advantage plans require you to use network providers. You’ll need to check each plan’s network to see if your doctor is listed. If not, and you could get better coverage or save money by switching to a different doctor, would you do it? That’s a question you may have to answer if you find a plan that you like otherwise.



The Bottom Line

You may get a lot of advice about what Medicare plan you should get. But the final decision for you needs to be made by you based on your personal needs.

You get to choose Medicare coverage every year during the Medicare Annual Enrollment Period, Oct. 15 – Dec. 7. That may mean keeping the plan you already have, or it could mean switching to something different. Not sure if you should switch? Get help here.

For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.