It all comes down to a personal decision on what you feel fits your needs the best. There isn’t one magical plan that fits everybody’s needs the best!
Some important questions and items you should ask or review with an *independent" agent before switching plans are listed below.
*I added the word “independent” since independent agents can offer multiple insurance companies giving you more flexibility and choices than just a captive agent that only works for one insurance company.
- Star Ratings for Medicare Advantage Plans and Prescription Drug Plans.
(Provided each year by Medicare. Keep in mind that they can change from year to year. The star ratings can be found at Medicare.gov. If you cannot go online, each Medicare insurance plan enrollment guide booklet should also include the updated upcoming year’s Medicare star ratings for that specific plan.) - Carefully review the "Benefits at a Glance” and/or the more comprehensive “Summary Of Benefits.”
In my opinion, some of the important (but not limited to) items to focus on and that should be considered before making a decision on which plan you choose are:- What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
- Annual Out-Of-Pocket Maximum (That is the most you will pay in a year for Medical care provided by the plan. Note: This Annual Out-Of-Pocket Maximum amount does NOT include a maximum amount for prescription drugs, even if prescription drugs happen to be included in your plan.)
- Copays for primary care physicians and also copay amounts for specialists.
- Inpatient hospital care per day cost and how many days you have to pay.
- Outpatient surgery cost (Find out if that outpatient surgery amount you are responsible for is just a plan flat copay amount or a percentage of the total amount?)
- Emergency Care costs
- Diagnostic radiology services and diagnostic tests/procedures costs
- Ambulance
- Prescription Drugs - Find out if your specific drugs are included in the formulary (complete drug list) of the plan you choose. (Note: Each specific plan can have a different formulary, even if they are with the same insurance carrier.) Then find out the Tier level and/or cost of each of your drugs, plus what the annual drug deductible will be (if any). Also find out which Pharmacies are in the network and also which are considered preferred Pharmacies for that plan - allowing you to get the least expensive prices.
- If the Medicare insurance plan you choose has a network. Find out in advance if each of your specific doctors, hospitals, and other providers are in network for that specific Medicare insurance plan.
- If a fitness program is important to you, find out if a basic gym membership is included in your Medicare insurance plan at no additional cost.
- Find out what additional benefits, such as dental, vision, hearing, or even if there may be an allowance for "Over The Counter Drugs” is included with the plan you are considering.
- Find out in advance if you can travel and still be covered for non-emergency visits to the doctor, etc. with that specific plan. (Note: Almost all the Medicare insurance plans do cover you if it is a true emergency!)
- Plus there are many other items to compare, so determine what is important to your specific needs before making a decision!
- What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
Click on web link below for related blog post:
Medicare Insurance Plan Choices for this Upcoming Annual Enrollment Period
Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.
By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.
By calling this number, I understand I will be directed to a licensed insurance sales agent.