6 Things to Know When Comparing Medicare Plans
There are many things to consider when it’s time to choose a Medicare Plan.
- How much are your premiums, deductibles, and other out-of-pocket costs?
- How much do you pay for services like hospital stays or doctor visits?
- Is there a yearly limit on what you could pay out-of-pocket for medical services?
- Which doctors and hospitals do you need access to?
- What prescriptions must be covered?
- Can you qualify for extra help?
By working with a local Medicare Advisor you get unbiased access to all your available options. We also make sure you understand each of the options, and keep you informed of new plans or changes to existing plans occurring each year.
Here the important points we will review with you in order to help you find the Medicare plan best suited for you.
Medicare Costs 💸
With Original Medicare there’s no limit on out-of-pocket cost per year, unless you have supplemental coverage or a Medicare Advantage Plan (Part C).
When comparing out-of-pocket costs, remember to also include what you pay each month for your plan’s premium.
This is often overlooked and can cost you thousands more if you’re not careful. Your agent can easily help you compare costs of each option, so you can feel confident the plan you choose fits your budget and risk tolerance.
Since so many details surrounding your costs & benefits are not covered beyond the benefit summary we help you with a deeper look at the plan in order to gain a complete understanding of the costs associated with each benefit and to make sure you understand all your benefits and how to access them.
Medical Coverage ⚕️
Medicare Supplements and Medicare Advantage Plans all offer coverage beyond that of Original Medicare.
Medicare Supplements work in combination with Original Medicare (Parts A & B) by filling in the gaps of Original Medicare.
These plans do not have networks and offer flexibility to see any doctor or use any hospital in the country as long as the provider accepts Medicare payments. But these plans do not offer additional benefits, such as dental, vision or hearing aids.
Medicare Advantage Plans offer the actuarial equivalent of all the services Original Medicare covers. Most do far better than this minimum requirement.
Some plans offer extra benefits that Original Medicare doesn’t cover – like vision, hearing, or dental.
By helping you understand the pros and cons of each option, you’ll be confident in the selection you make each year.
Prescription Drugs 💊
Prescription drug coverage is a vital component to your plan choice, not only for the coverage it provides, but in order to avoid penalties and fees according to the Medicare regulations.
Whether you take prescription medicines or not, Medicare requires you to have minimum drug coverage. This can be obtained by enrolling in a Part D stand alone plan, Medicare Advantage Plan that includes drug coverage, or what Medicare deems “creditable coverage” like larger employer group plans, retiree plans, or veteran coverage.
When you meet with your Plan Advisor, we will run a calculation with the Medicare.gov Rx Tool, taking your specific medications into account, ensuring they are covered under the desired plan and with an affordable copay
We will also help you apply for extra help or other available subsidies to cover the costs of medicines, as there are several resources and programs we can apply for.
For prescriptions alone, it pays to schedule a consultation.
Doctor and Hospital Choice 😷
We will always start with helping you find a plan that your desired Doctors and Hospitals accept and we will confirm that your primary care physician is able to refer to the specialists when necessary.
Many plans offer some out-of-network coverage. For out-of-network physicians we will help confirm that those doctors will accept your chosen plan as an out of network benefit. This is yet another important feature that our local agent will provide for you.
Quality of Care ✅
The quality of care and services offered by plans and other health care providers can vary.
Medicare Advantage plans are now graded on certain quality scores by Medicare, known as Star Ratings. A Star Rating is like the reviews you may read about with a local business or vendor.
It is important for you to know the star ratings as they also impact the funding of your selected plan, which may impact plan stability and costs.
Customer service is an important part of using your insurance. This is why having an agent is so important. If you cannot get the answers you need from your insurance company you can always rely on your agent to help.
With over 10 years of experience helping people with these Medicare plans in Maine I have gained a vast knowledge of how these plans work and help my clients resolve issues quickly and easily when the customer service rep on the phone cannot.
Travel Coverage ✈️
Original Medicare does not cover care outside the US so if coverage during travel is important to you, be sure to share this with your agent during our meeting.
Certain Medicare supplements do have travel features. Most Medicare Advantage plans cover emergencies or urgently needed care services outside the US as well.
Whatever your needs, we will review the plans and find one that travels with you.
Would you like my help? (it’s free!)
If you would like help understanding your costs or need help finding a plan or if just want to ask a few questions, you can 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.
The best part about working with me is that it will not cost you anything to talk with me to discuss your options and review the plans that are available. I am an independent insurance agent and I am paid by the insurance companies (not you) in the form of a commission when you enroll in a plan.
You will not pay anything to meet with me and you will pay the same price for your insurance that everyone pays whether they had my help or not.