How to Choose the Best Medicare Plan When Turning 65

Turning 65 is an exciting milestone. It's time to start thinking about retirement and take advantage of Medicare coverage. With Medicare, you get access to affordable health insurance, but you have decisions to make. Choosing the right Medicare Plan for your needs is key to getting the most out of your Medicare benefits. This blog post will walk you through the basics of Medicare and provide tips on how to choose a Medicare Plan in 2023 when you become eligible at 65.

Understanding the Different Parts of Medicare

The first thing to know is that there are several types of Medicare that work together to provide coverage.

·        Medicare Part A health plan covers hospital stays, skilled nursing care, hospice care, and some home health services. Most people get Part A automatically when they turn 65.

·        Medicare Part B covers preventive services, doctor visits, durable medical equipment, and more. Unlike Part A, you have to enroll and pay a monthly premium for Part B.

·        Medicare Part D offers prescription drug coverage through private plans you purchase separately. Like Part B, you have to enroll and pay extra for Part D.

The parts of Original Medicare (Part A and Part B) cover many health services but not everything. For example, Original Medicare doesn't cover vision, dental, hearing aids, and prescription drugs. To get complete coverage, you need to add a Supplement Plan.

You have two main options:

·        Medicare Supplement Plan (Medigap). This is additional coverage you can purchase from a private insurer to help pay Original Medicare out-of-pocket costs like copays and deductibles.

·        Medicare Part C. Best Medicare Advantage Plans are offered by private insurers as an alternative to Original Medicare. Many Medicare Advantage Plans include prescription drug coverage and extra benefits Original Medicare doesn't cover.

Now let's go over some key factors to weigh when deciding between Original Medicare plus a Medigap policy versus Medicare Advantage.

Choosing Between Original Medicare and Medicare Advantage

When first enrolling in Medicare, you'll need to decide whether Original Medicare or Medicare Advantage better suits your needs and budget. Here are some things to consider:

·        Cost: With Original Medicare, you pay a monthly premium for Part B. You'll likely need to purchase a Medigap Plan too, which has its own premium. Medicare Advantage Plans also have monthly premiums but total costs may be lower since many cover extra benefits.

·        Coverage: Both options cover all Part A and Part B services. But with Original Medicare, you may need a separate Part D prescription drug plan and Medigap policy. Most Medicare Advantage Plans include prescription drug coverage.

·        Providers: Original Medicare lets you see any doctor that accepts Medicare nationwide. Medicare Advantage Plans have provider networks, so your choice of doctors may be limited to those in-network.

·        Extra benefits: Most Medicare Advantage Plans offer dental, vision, hearing and other benefits not covered by Original Medicare.

·        Travel: Original Medicare gives you coverage for health emergencies across the U.S. Medicare Advantage Plans generally only cover you in your service area.

Doing a side-by-side comparison and crunching the numbers for costs can help determine if Original Medicare or Medicare Advantage makes more financial sense for you. Also consider your health, lifestyle and how you use healthcare when deciding.

Enrolling in Medicare Plan Parts A & B

You have a 7-month Initial Enrollment Period to sign up for Medicare that starts 3 months before your 65th birthday month and ends 3 months after. It's important to enroll in Medicare Parts A and B during this time to avoid lifelong late enrollment penalties.

Here are some tips for smoothly enrolling when you turn 65:

·        Mark your calendar with Medicare enrollment deadlines so you don't miss them.

·        If you're collecting Social Security, you'll be automatically enrolled in Parts A and B so watch for your Medicare card in the mail.

·        You can sign up online through Social Security or Medicare.gov. Make sure to have your Social Security number handy.

·        If you're still working and have health insurance through your job, talk to your benefits administrator before signing up. You may be able to delay Part B enrollment.

·        Compare Medigap and Medicare Advantage Plans in your area as you get closer to your enrollment period.

·        The Centers for Medicare and Medicaid Services website has checklists and timelines to guide you through enrolling.

Signing up on time prevents lifelong surcharges added to your Part B and Part D premiums down the road. Avoid Medicare enrollment mistakes by planning ahead and understanding your options.

Choosing Best Medicare Supplement Insurance (Medigap)

After enrolling in Original Medicare, you may want to buy a Medicare Supplement Insurance policy to limit out-of-pocket costs. These plans are also called Medigap policies. Here are some tips on choosing Medigap coverage:

·        Shop for plans during your 6-month Medigap Open Enrollment Period that starts when you're 65 and enrolled in Part B. Insurers must cover you regardless of health during this time.

·        Compare plans. There are 10 standardized plans labeled Plan A through Plan N. Each offers a different combination of basic and extra benefits.

·        Know that premiums vary by insurer so check multiple companies. But coverage is identical for a given plan across insurance providers.

·        Medicare Plan F is the most comprehensive but has high premiums. Consider other options like Plans G or N for better value.

·        Ask about discounts for paying annually or enrolling in automatic payments. Some insurers offer discounts for married couples too.

·        Make sure the company is reputable and knowledgeable about Medicare. Look at financial ratings when comparing carriers.

Purchasing Medigap in your Initial Enrollment Period saves money. Take time to find the right plan to pair with Original Medicare before that window closes.

Choosing Medicare Part D Prescription Drug Coverage

Original Medicare does not cover prescriptions so you'll need to enroll in a Part D prescription drug plan. Here are some tips for picking separate Part D Plan coverage:

·        Compare plans annually during Open Enrollment (October 15 to December 7) when you can change plans. Your medications and costs may have changed.

·        Use the Medicare Plan Finder to find plans that cover your drugs. Make sure your prescriptions are on the plan’s formulary list.

·        Check that your preferred pharmacies are in-network for the plan. This helps avoid higher costs.

·        Look at the plan’s pricing tiers and what you’ll pay for each drug. For example, generics on Tier 1 may have low copays.

·        See if the plan offers extra benefits like dental or vision that could provide more value.

·        Understand the costs you’ll pay out-of-pocket monthly and yearly. A plan with a higher premium may end up costing you less overall.

Doing your homework pays off when picking Part D prescription coverage. An economical plan makes medications more affordable.

Selecting a Medicare Advantage Plan

Medicare Advantage Plans are another route to consider when you want all-in-one convenience. Here are helpful tips on choosing a plan:

·        Compare costs like premiums, deductibles, copays when using services, and maximum out-of-pocket limits.

·        Look at the plan’s provider network to see if your doctors are included and if referrals are required for specialists.

·        Check that your medications are covered and understand the pharmacy network and costs.

·        See what extra benefits like vision, hearing, dental and gym memberships are offered.

·        Make sure the plan covers health services you need like hospital stays, urgent care, and preventive screenings.

·        Look at quality ratings and customer satisfaction scores when evaluating plans.

Shop around annually during Medicare Open Enrollment because plan costs and benefits can change each year. Switching to a Medicare Advantage Plan that better meets your needs may save you money.

Using Medicare.gov Plan Finder Tool

You have a powerful tool at your fingertips to help choose Medicare coverage. The Medicare Plan Finder allows you to:

·        Find and compare plans in your area including Medicare Advantage, Part D prescription plans, and Medigap options.

·        View estimated annual costs adjusted to your personal medications and healthcare needs.

·        See coverage and quality ratings to help narrow your choices.

·        Find healthcare providers that participate in each plan.

·        Enroll online in Medicare Advantage and Part D Plans.

The Medicare Plan Finder does the legwork of searching for plans and calculating total estimated costs. It provides unbiased information to help you make an informed decision. Use this free online tool to find your best Medicare options.

Getting Medicare Help from a Specialist

Even with helpful online tools, Medicare can still be confusing with all the choices available. Getting unbiased guidance from a Licensed Insurance Agent that specializes in Medicare can simplify the process.

A Licensed Insurance Agent that specializes in Medicare can help you:

·        Answer questions and understand how Medicare works.

·        Avoid common mistakes like missing enrollment deadlines.

·        Compare Medicare Plans objectively based on your individual situation.

·        Determine if Medicare Advantage or Medigap is a better fit.

·        Estimate costs more accurately under different plans.