Turning 65? We Can Help You Choose the Right Medicare Route

Here’s what you need to know about Medicare plans

Choosing the right Medicare plan is a big decision, particularly if you won’t have retiree coverage under an employer-sponsored plan. Medicare is complex and can be quite confusing. So making the right choice for your budget and health needs is as important as your decision when to retire. This article will help make it easier to arrive at a decision.

First, there are two main roads to consider in choosing Medicare coverage, so it’s important to determine your needs before making a decision. It’s equally important to compare the various plans available in your region to ensure they fit your budget as well as meet your medical and prescription drug needs.

You can choose to take either Original Medicare or a Medicare Advantage Plan (Part C). Both routes include Part A (inpatient hospital care) and Part B (medical insurance) coverage. Either way, you will need to make sure you are eligible and/or sign up for Parts A and B. The best way to do this is to call Social Security directly. At the same time, you will need to decide if you want Medicare Part D coverage, either as a stand-alone Part D plan or as part of a Medicare Advantage Plan.

Let’s take a closer look at both choices in this chart.

Now that you’ve reviewed this information, you might have a better idea of which option is right for you. The information below should help you make a more educated decision.

Consider Original Medicare and a Stand-Alone Part D Plan If You:

  • Wish to have more choice and access to a larger network of health providers and facilities
  • Have supplemental coverage from an employer to cover some costs and services Medicare does not cover
  • Do not mind coordinating coverage from multiple providers
  • Can buy a Medigap policy from a private company to help pay some of the costs that Original Medicare doesn’t cover, like copayments, coinsurance and deductibles. Depending on the type of Medigap plan you buy, additional benefits may include:
  • 100% of your Part A coinsurance and hospital costs after your Medicare benefits are used
  • 50% – 100% of your Part B coinsurance or copayment
  • 50% – 100% of your Part A hospice care coinsurance or copayment
  • 50% – 100% of the coinsurance for skilled nursing care
  • 80% of your costs for a travel emergency outside the U.S.

Consider a Medicare Advantage Plan If You:

  • Like the convenience of having just one provider instead of coordinating coverage from multiple providers
  • Prefer a plan that is similar to what you may receive from an employer
  • Want to purchase a plan that covers services not available through Medicare
    • This option can include vision, dental, and hearing plans
  • Are willing to use in-network doctors and medical facilities like in an HMO
    or PPO
  • Are not concerned about having coverage outside the United States

Medicare offers a lot of choices. Finding the best route takes a bit of research to make sure you’re on track for making the right decision for you.

If a Medicare Part D plan is the right route for you, we have four simple rules to help you have a smoother ride! Watch this video to learn more.

Posted on: August 25, 2016
by
Express Scripts Medicare Advisor
Ms. Kyong specializes in personal finance issues for Medicare recipients. Topics include managing healthcare costs in retirement.

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