There are a lot of things to take into consideration when you are choosing your Medicare plans for the first time. It is always advisable to contact a knowledgeable agent before making any Medicare decisions to avoid any costly Medicare mistakes. Picking a plan wisely can be beneficial to balancing your budget in retirement.

Your choice of Medicare plans is not a one-size-fits-all situation. It depends on a number of variables, such as your overall health, if you have dependents who require coverage under your employer's group plan, your financial situation, and your way of life.

With that said, here are 7 things you should consider when choosing your Medicare plan:

1. Costs

When deciding what Medicare plan makes sense for your individual needs you should take into account the premiums, deductibles, and out-of-pocket costs.

Many people do not realize that there are costs associated with Original Medicare. Part A of Medicare is generally zero premium if you have worked 40 quarters or are married to a spouse who meets that criteria. For those who do not meet those criteria, you can purchase Part A for a premium. Medicare Part B has a monthly premium associated with it. This premium changes yearly. Original Medicare also has no maximum out-of-pocket costs. This means that you could keep incurring costs.

When deciding between a Medicare Supplement (aka Medigap) and a Medicare Advantage plan you need to consider your financial ability to pay the premiums associated with a Supplement or your financial ability to pay co-pays with a Medicare Advantage plan.

▶️▶️Learn more about the difference between Medicare Supplement vs Medigap from our eBook "Medicare Supplement vs Medicare Advantage: Which is Right for You?"

2. Coverage

Does the plan cover the services that you need? If the plan is not going to offer you the medical services that you need then it may not be a good fit for you. Medicare Parts A and B alone are generally not enough coverage so weigh out your options and make the best decision for you.

3. Your other coverage

Make sure you are aware of how any additional health or prescription medication coverage interacts with Medicare if you have any. Before making any changes, speak with your benefits administrator or insurer if you have employment-related coverage or receive your healthcare through an Indian Health or Tribal Health Program. If you are on a state Medicaid plan you may be eligible for additional benefits at no cost to you.

4. Prescription Drug Coverage

Is it necessary for you to enroll in a Medicare Prescription Drug Plan? Do you currently have a creditable prescription insurance plan? If you later enroll in a drug program, would you be penalized? What is the overall star rating of the plan? What are the costs of your prescription medications under each plan? Are your medications included in the formulary for the plan? Do your medicines fall under any coverage restrictions? 

You need to know the answers to each of these questions before making a decision to enroll in a Medicare Drug plan.

▶️▶️Learn more about Medicare Part D from our eBook "Medicare Prescriptions: Your Guidebook to Managing Your Costs".

5. Doctors and Hospitals

Is the insurance plan accepted by your doctors? Do the medical professionals you want to see accept new patients? Do you have to select a network of hospitals and healthcare providers? Do you have to get referrals to see specialists? Do you want to be limited to which doctors you can see, or free to see whoever you want?

Each of these answers is dependent upon which type of insurance you choose. Supplements give you less restriction whereas Medicare Advantage plans have a network of providers.

6. Quality Care

Quality of care is highly important, especially as one begins to age and needs more medical care. You want to choose a plan that will satisfy the level of care you feel you need to receive.

7. Travel

Do you plan to travel outside of the United States? Medicare is designed to work in the United States and offers none to VERY LITTLE coverage outside for certain circumstances. If you are needing to travel you may be able to buy supplemental insurance that offers emergency care when you travel outside of the U.S. but do not expect Medicare to cover you for this.

Bonus Things to Consider -

Enrollment Windows

When you are on Medicare you do not just get to enroll whenever you feel like it. There are certain enrollment windows that you are allowed to enroll into a plan and change your plan for the following year.

AEP - Annual Enrollment Period

AEP is from October 15 to December 7th each year. It is the time that the Medicare commercials are at their highest, your phone is ringing non-stop, even getting bombarded through the mail. Everywhere you turn it is about Medicare. That is because during that time of year you are able to enroll or change your Medicare plans for the upcoming year.

It is highly important that you review your plans in this time frame because there can be changes from year to year.

▶️▶️Learn more about Enrollment Periods from our eBook "Medicare Enrollment Periods".

What isn't covered

Medicare does not cover everything. Medicare doesn't cover routine dental, vision, or hearing services. Medicare does not cover custodial care, such as long-term care. Medicare does not cover elective procedures. Medicare does not cover experimental treatments, such as for cancer. Medicare does not cover podiatry or prescriptions either. Some of the things listed above can be covered when you purchase an additional Medicare plan, such as Supplement or Advantage plans, and you can purchase additional policies that will cover some of the other risks, such as cancer, dental or vision insurance.

Take time now to research your options. There are many new Medicare Advantage and Medicare Supplement offerings this year, so it is worth taking the time to evaluate your options to find the best plan for your healthcare needs — and your wallet. The best advice you can receive as a Medicare beneficiary is to speak to a licensed insurance agent who is knowledgeable and transparent to help guide you in these important decisions.

Don't have an agent to work with? Call us at 270-904-6070 and we will help you, or schedule an appointment.