Medicare benefits many people by helping them meet their healthcare expenses. But providers offer multiple plans with unique features, making choosing difficult. A good way to select a Medicare plan is to research the options well and become familiar with their coverage limits, add-ons, terms and conditions, and other aspects. One must take time and never decide in a hurry. An individual will find that making a choice is much easier after adequate research.

Costs
When choosing a Medicare plan, one should understand its associated costs, such as premiums, deductibles, and, most importantly, out-of-pocket expenses. Most plans cover a portion of the expenses for doctor visits or hospital stays and require the policyholder to pay the rest. So, one should consider whether there are any yearly limits on out-of-pocket expenses for healthcare services. Usually, there is no yearly limit on paying out of pocket unless an individual has supplemental coverage, such as Medicare Supplement Insurance (Medigap). Medicare Advantage typically has a yearly limit on what one pays out of pocket for services covered by Medicare Part A and Part B. Once the plan’s limit is reached, one will not need to pay anything for Part A and Part B services for the rest of the year.

Overall coverage
Before signing up for a Medicare plan, one should check which services it covers. Original Medicare covers medically necessary services and supplies in hospitals, doctors’ offices, and other health establishments but not routine exams, eye exams, and dental care. A Medicare Advantage plan will cover all medically necessary services, similar to Original Medicare, plus additional benefits. For instance, it may also cover hearing, dental, and vision services. Before signing up, one should ask the provider whether the plan covers the healthcare services one usually avails of. Doing so will help avoid confusion later and streamline the claim process.

Supplemental coverage
Those who have purchased supplemental coverage for certain treatments or healthcare services should understand how it works with Medicare. Suppose someone already has employment-related coverage or receives coverage from an Indian Health or Tribal Health Program. In that case, they should talk to the benefits administrator or insurer before changing their plan. Those without supplemental insurance can use a policy from a current or former employer, union, or Medicaid. One could also buy Medigap to pay outstanding out-of-pocket costs (such as 20% of the coinsurance). But individuals should note that they cannot buy Medigap if they are on a Medicare Advantage plan. A Medicare Advantage plan is suitable as it may offer additional benefits that Original Medicare does not cover, such as hearing, dental, or vision services.

Doctor and hospital choice
One should choose a hospital or doctor carefully if they have a Medicare plan. People enrolled in Original Medicare can use any doctor or hospital in the country that accepts Medicare. Those with this plan might also not require a referral to a specialist. As for Medicare Advantage, one can use only doctors and other providers in the plan’s network and service area (for non-emergency care). Other plans might offer non-emergency assistance out of the network, but typically at a higher cost. One might also need a referral to see a specialist with such plans.

Quality of care
An individual considering Medicare coverage of any type should assess the quality of care promised. Each plan might offer different levels of care and services. One should read reviews to understand what current and past customers think about a potential healthcare coverage provider’s quality of care and services. Doing so could help one make a more informed decision when picking a Medicare plan.

Travel coverage
Those who travel to other states or countries might need to assess their Medicare options more carefully. Original Medicare and Medicare Advantage usually do not cover healthcare outside the country. That’s why one might have to consider a Medigap policy or another policy with international coverage as an add-on. Plans that provide this feature may charge a higher premium, so one should think before signing up.

Prescription coverage
Another important thing to consider when joining Medicare is whether the plan covers the cost of prescriptions. If it does, one should determine which prescriptions it covers and if there are any terms and conditions. Medicare plans that offer prescriptions also offer an MTM program that teaches eligible policyholders how to use the treatments well. While those enrolled in Original Medicare may have to join Medicare Part D for appropriate coverage, individuals on select Medicare Advantage plans are automatically covered. Eligible individuals can join a separate Part D plan if their Medicare Advantage plan does not cover prescriptions. If one already has creditable prescription coverage, they should ask the provider if there is a penalty for joining the plan later, once the current contract expires.

Extra perks
Original Medicare does not cover certain healthcare services, so many opt for Medicare Advantage and Cost plans. These plans offer various perks, including virtual care options, travel coverage, fitness programs, transportation coverage, and gym memberships. But that does not mean everyone should go for Medicare Advantage and Cost plans. Individuals should only choose a policy that has the features they need.