• Harry N. Stout

266- What Should You Consider When Comparing Medicare Plans?


Today’s post is from the contributing organization Medicare Advantage Plans and their team of writers.


There are many important elements to consider when comparing Medicare plans, from cost and benefits to a company’s reputability.


Consider the following when comparing Medicare plans:

  • Total anticipated out-of-pocket costs, including premiums, deductibles, copayments, coinsurance, drug costs and the out-of-pocket maximums.

  • Provider choice.

  • Benefits, such as inpatient, outpatient, labs, prescription drugs, vision, dental and hearing coverage.

  • The insurance company’s rating.

The monthly cost, or premiums, and what is covered by the plan are what matter when choosing an insurance policy. You should ultimately consider your total out-of-pocket costs, which includes premiums, deductibles, copayments, coinsurance, drug costs and the out-of-pocket maximum.


Cost is about more than just total out-of-pocket expenses, however. You should also understand how you’ll pay. For instance, with a Medigap plan you pay a higher premium up front and less on the backend, while with Medicare Advantage, you pay less on the front end and then more on the backend. You may pay the same overall, but the plan you choose in essence determines if you pay now or pay later.


Sometimes people are eligible for different state and federal programs that can help with copays or the cost of prescription drugs. These programs – of which there are many – are often income-based.


Similarly, there are Medicare plans designed specifically for people who get benefits from the Veterans’ Administration or Tricare.


The benefits you want to consider will depend on your healthcare needs. For instance, if you may need hearing or vision coverage or want to go to a chiropractor. Some Medicare plans provide better travel coverage. You should look at what benefits are included in the plan based on your usage. You can find out more about a plan’s benefits offering in the Summary of Benefits section.


Some Medicare plans use a provider network similar to how employer-sponsored health plans work. If you already have a certain doctor, health care facility or pharmacy you prefer to use, you may want to check if that person or facility is in the plan’s network. At the very least, verify that the plan you’re considering has providers that are convenient to you.


You also want to ensure you’re dealing with a reputable insurance company. Even though all of the insurance companies offering Medicare coverage must be approved by the Centers for Medicare and Medicaid Services (CMS) to offer the plans, companies with poor financial ratings could lead to problems down the road. To view an insurance company’s financial rating, go to AMBest.com or S&P Global Ratings.


Medicare.gov’s Medicare Plan Finder uses a star rating system to designate a plan’s quality and performance. Each plan can rate between one (lowest) and five (highest) stars based on the plan, member satisfaction surveys and health care providers. There is even a special 5-Star Special Enrollment Period which allows you to switch from your current Medicare plan to a new 5-star plan once between December 8 and November 30.

 

To learn more about Medicare and find in-depth guides and resources to help you make educated health care decisions, visit Medicare Advantage Plans.

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