Five tips for choosing your Medicare coverage

September 9, 2021

Whether you have turned 65, or are about to in the next few months, it’s important that you understand all your Medicare coverage options. Many aspects of Medicare coverage — prescription prices, premiums, and other mandates — change from year to year, so you should do your research early. Remember that Medicare’s Annual Election Period (AEP) begins on October 15 and ends December 7. During this time, you can change your Medicare coverage by:

  • Switching from Original Medicare to a Medicare Advantage (MA) plan
  • Changing from one MA plan to another
  • Changing from one Medicare Part D (prescription drug) plan to another

Of course, if you’re happy with your current coverage, you can also stay put. Keeping this in mind, the Aspire Health Plan team put together five tips for choosing your Medicare coverage.

1. Compare plans

Not all Medicare options are equal. Think about elements that are important to you:

  • Are you looking for extra benefits beyond traditional Medicare, such as a dental, vision, and hearing, transportation or a fitness benefit?
  • Do you want to speak face-to-face with a customer service representative if you are having issues?
  • Do you want a Medicare option that knows the local providers?
  • What monthly premiums are you willing to pay?
  • Do you want health coaches or care managers to help manage your chronic condition?

These are all important questions to ask the person helping you enroll in a Medicare plan.

2. Reputation matters

Go online and see what others are saying about the plans you are considering. Hearing from people just like you will help you make a good decision.

3. Pay close attention to your medications

The prescriptions and pharmacy of choice are two very important elements when choosing a plan. You want to know the costs of the prescriptions you need, if they are covered on the plan’s drug list (formulary), what pharmacy will carry them, and how much you are expected to pay. Also, keep in mind that Original Medicare does not include prescription drug coverage, so you will need to enroll in separate a Part D plan or choose an MA plan with Part D coverage (MAPD).

4. Call your doctor

primary care physician, PCP for short, is the doctor you see first for most health problems. He or she makes sure you get the care you need to keep you healthy. Odds are, you trust and like your doctor and want to keep him/her. Give their office a call and ask if they are available with your Medicare plan. If you have a favorite doctor or office, this will help you narrow the options.

5. In case of an emergency

Going to the emergency room or needing a hospital stay could mean a big hit to your wallet. Check the costs for these items in the Medicare plans you are considering ahead of time, so you are well-prepared if an emergency were to occur. And should you become very ill and face numerous healthcare bills, find out the maximum amount you would pay out of your own pocket. You want to know you have protections. Remember that there is no limit on out-of-pocket costs in Original Medicare (Part A and Part B) meaning that the more medical services you need, the more you’ll pay in Medicare costs.

Your health is the most valuable asset you have. As you plan to enroll in Medicare or review your annual options, it’s essential to do all your research early and make an informed decision. If you have any questions, the Aspire Health Plan team can be reached easily. Join us at one of our free Medicare seminars where you can learn the basics of Medicare with no obligation to enroll. We are located at 10 Ragsdale Drive, Suite 101 in Monterey, and we have walk-in office hours 8 a.m. – 5 p.m. PT, Monday through Friday. We can also be reached over the phone. Call (855) 570-1600 for Member Services or call (866) 798-1530 for Sales. TTY users can call 711.

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