Your Plan Options
There are 5 different types of Medicare to choose from:
- Part A
- Part B (Parts A and B together are called Original Medicare)
- Part C (Medicare Advantage)
- Part D
- Medicare Supplements (Medigap)
Medicare Part A covers short-term hospital inpatient and emergency care. Part B covers general medical costs, almost anything that is considered “medically necessary” by a doctor.
Medicare Advantage (Part C) can replace Original Medicare (Parts A and B) by combining all of their benefits and providing healthcare coordination. This means that your out-of-pocket costs for regular care will be reduced when you see in-network doctors. It also provides some additional benefits. There are 4 different plan structures with their own costs and networks for you to choose from.
Part D provides prescription drug coverage—it can be added to Original Medicare, or Medicare Advantage if it is not already included. The cost of plans varies based on the prescriptions it offers, and you will pay an established coinsurance or copayment for each drug you receive.
Medicare supplements are added to (not a replacement for) Original Medicare. There are 10 different plans, each with its own benefits, for you to choose from. The more coverage you buy, the more it will cost. They cover costs such as your Part A and Part B deductible, nursing facility care, outpatient services, and more (depending on the plan).
Your Eligibility
When choosing a Medicare plan, you first have to know what you’re eligible for. You must at the very least be eligible for Original Medicare (Parts A and B). If you are not, you cannot choose a plan in the first place.
Your Personal Coverage Needs
Medicare’s website lists these 7 factors to consider when choosing a Medicare plan:
- Costs: The more you’re able/willing to pay, the more coverage you can purchase. Higher-cost, higher-coverage plans include PPO Advantage plans, or supplement plans C, F, and G. For lower-cost coverage, you may want to choose either Original Medicare alone, an Advantage HMO plan, or supplements A, B, K, or L.
- Coverage: See the previous point. If you have special coverage needs, you may be eligible for C-SNP or D-SNP coverage.
- Your other coverage: You cannot have a supplement plan and Part D coverage, or Medicare Advantage. So, if you want either of those plans, you should not choose a supplement, and vice versa.
- Prescription drugs: Once again, you cannot have Part D and a supplement plan. So, if you need prescription drugs, you may choose an Advantage or Part D plan instead.
- Doctor and hospital choice: Not all plans cover your preferred healthcare providers. Make sure that the plan you choose includes providers you like and need.
- Quality of care: This not only applies to the healthcare providers but the insurance company themselves. When choosing a plan, make sure there is a company in your area that offers it.
- Travel: If you travel frequently and want care while doing it, you will likely want to choose a supplement that covers 80% of foreign travel emergency care.