Medicare is available to all U.S. citizens aged 65 or older, as well as those who have been legal permanent residents for at least five years. Many people acquire Medicare coverage through their employer or union (or their spouse’s employer). It can often be difficult to compare different types of Medicare plans. Each “Part” of Medicare is designed to cover a specific set of needs. Here is a guide to each type of plan, including four things to consider when comparing plans.
Factors To Consider When Comparing Medicare Plans
Total Cost of Care
As with any other type of product or service, it’s imperative to consider the total cost of a health insurance plan. This includes your out-of-pocket expenses, as well as coinsurance, copayments, deductibles, maximums, and the cost of prescription drugs. There are plenty of tools online that can help you compare all of these costs. According to the Kaiser Family Foundation, (KFF) the average out-of-pocket maximum for those enrolled in Medicare Advantage plans is $4,925 for in-network services.
For Preferred Provider Organization (PPO) plans, which also include out-of-network services, this figure is $8,828. Premiums for Medicare Advantage plans have also gradually decreased over the last six years, per KFF, so you may not have to ultimately pay much each month.
Provider Choice
Certain types of Medicare plans offer a series of providers you must use if you wish to spend a lower amount. If there is a specific pharmacy or physician that you prefer to visit, (e.g. because they are geographically close) be sure to check whether that plan offers those options in-network.
Benefits
Several Medicare Advantage (also called Medicare Part C) plans include various types of health coverage, including dental services, hearing aids, vision care, and prescription drugs. If you frequently travel or spend a few months each year in another state, be sure to verify whether your plan can cover you while you’re traveling.
Overall Star Rating
The “Overall Star Rating” provides you with a general assessment of a plan’s performance and quality given the kinds of benefits it offers. This rating system runs from 1 to 5 stars, with the latter being the best rating. If a 5-star Medicare plan is available to you, then you may use the corresponding Special Enrollment Period once annually in order to change to a plan with this high rating. Per KFF, 78% of individuals enrolled in Medicare Advantage have plans that have high ratings (4 or 5), as well as associated bonus payments. This proportion has increased gradually in recent years (it was 62% in 2015).
If you carefully review each of these characteristics, you can make a significantly more informed decision when choosing a Medicare plan.
Compare With Insured American
There are many different factors to consider when selecting a medicare plan, and it can be very daunting. Don’t let this decision be on you alone. Get in touch with Insured American today, and we will provide you with help to decide what medicare plan is right for you.