Original Medicare and Medicare Advantage insurance isn’t a one-size-fits-all. Whether it’s the cost of premiums, the carrier, prescription drug coverage or extra benefits, there’s a lot to consider when shopping for coverage. Here are the top seven questions to ask as you explore your Medicare Advantage insurance options.
1. Does Original Medicare insurance cover my needs or will I need additional coverage?
Unfortunately, Medicare Part A and Medicare Part B don’t cover everything. In fact, Original Medicare only pays about 80% of your medical expenses. Additional options such as Medicare Advantage plans and Medicare Supplement Insurance plans could potentially help you fill that 20% gap.
2. What is the difference between Medicare Advantage and Medicare Supplement plans?
Medicare Advantage plans—also referred to as Medicare Part C—provide an alternative to Original Medicare. These plans are approved by CMS (Centers for Medicare & Medicaid Services) and are offered by private health insurance companies. Medicare Advantage plans offer the same benefits as Original Medicare but can also include additional routine coverage.
Medicare Supplement plans—also known as Medigap Insurance—help cover gaps in coverage from Medicare Part A and Part B. If you have fairly frequent doctor or hospital visits, you’ll likely end up with out-of-pocket costs. Medigap can help fill the gaps in basic benefits, such as deductibles, coinsurance and copayments.
This worksheet can help you determine what type of plan could fit your needs.
3. Can I still go to my preferred doctor, specialist and hospital?
Under Original Medicare, you can go to any doctor or hospital that takes Medicare, and in most cases, you don’t need a referral to see a specialist. If you have a Medicare Advantage plan, you’ll likely need to use doctors who are in the plan’s network. You can ask your doctor if they participate in any Medicare Advantage plans.
4. Are my prescription drugs covered?
Original Medicare (Part A and Part B) doesn’t typically cover all prescription drug costs. However, you can consider a Medicare Prescription Drug plan. Also known as Medicare Part D, these plans provide Original Medicare beneficiaries and Medicare Advantage enrollees access to retail prescription drugs with affordable copays.
5. Are there Medicare Advantage plans that cover additional routine benefits?
Medicare Advantage plans offer the same coverage as Medicare Parts A and B, but may also include additional routine benefits. If you are looking for a specific type of coverage not included in Original Medicare, consider exploring Medicare Advantage plans.
6. How do I use my Original Medicare or Medicare Advantage insurance coverage?
After enrolling in Original Medicare, you receive a red, white and blue Original Medicare card by mail. Your Original Medicare card is unique to you (much like your Social Security card) and shows which plan you have. You’ll also receive an additional card if you choose to have a Medicare Advantage Plan. You’ll want to carry your Medicare cards with you and let your doctor, hospital or other health care provider see your cards if you need medical care.
7. Am I covered if I travel?
If you have Original Medicare, you should have coverage anywhere in the U.S. and its territories. If you have a Medicare Advantage plan, your plan may or may not cover care outside of its service area.
Some Medigap plans provide for foreign travel emergency care while some plans do not. If you often travel outside the United States, that will be important to keep in mind while enrolling, to ensure you’re getting a plan with the type of coverage you need.
Let SelectQuote Help You Understand Your Medicare Advantage Insurance Options
Figuring out which Medicare Advantage plan is right for you isn’t something you have to do on your own. Once you better understand the basics, save yourself the time and the hassle of navigating your coverage and let us do it for you. In just minutes, we can compare Medicare Advantage plans from some of the most recognized carriers to find the right coverage for you. The service is free and there’s no obligation to enroll.
