The Five Decisions to Make When Choosing a Medicare Advantage Plan

The Five Decisions to Make When Choosing a Medicare Advantage Plan

When the fall arrives, it signals the start of the season when it’s time to think about health care options.  And for Medicare beneficiaries, there’s a lot to consider. Medicare can be confusing, which is why it’s important to consider the 5 decisions you’ll have to make to ensure there are no gaps in your health care coverage. With the Medicare annual enrollment period here (Oct. 15 – Dec. 7), there are a variety of plan types available for you to make the most of your Medicare benefits.

You enroll in Medicare when you are first eligible at 65, to avoid penalties and coverage gaps.  Original Medicare includes Part A and Part B. Part A helps pay for inpatient care in hospitals, hospice care, home health care and care provided in a nursing facility. Part B covers doctor visits, procedures that don’t require a hospital stay, and many preventive care services.

But Original Medicare doesn’t cover everything when it comes to your medical expenses. Medicare Advantage plans (also referred to as “Medicare Part C”) often include Part D prescription drug coverage and also extra benefits beyond Original Medicare, including an annual cap on out-of-pocket expenses.

To choose a plan that best fits your health care needs, there are five decisions you need to make.

  1. Determine what type of medical care you need based on your health, lifestyle and budget. If Original Medicare does not cover all of the services you need, you might want to look into a Medicare Advantage plan.
  1. If Original Medicare is your choice, it doesn’t include prescription drug coverage so you may want to consider a standalone Part D drug plan. These plans can be added to Original Medicare, or you can choose a Medicare Advantage plan that includes prescription drug coverage.
  1. Do you have any special needs that require focused medical attention? Decide whether it would be beneficial to have additional health coverage that supports your condition.
  1. Do you travel outside of the country? Original Medicare does not cover you when you are out of the country, except in rare cases.
  1. If you choose a Medicare Advantage plan, understand the different ways in which care is provided and determine what type is best for you. There are three different types of plans, each with unique product options, features and benefits. You can choose coverage from a Health Maintenance Organization (HMO), a Point of Service plan (POS), or a Preferred Provider Organization (PPO).

As you become eligible for Medicare it’s important to choose a plan that’s a good fit for you, your health needs and your budget. For more information and help to assess your health care coverage needs, check out Blue Cross’ Medicare Advantage website.

Interested in learning more about Medicare? Check out these informative posts:

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