Medicare Blog

where to find help with choosing a medicare plan

by Susana Vandervort Published 2 years ago Updated 1 year ago
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To compare Medicare plans, use the Medicare Plan Finder at www.medicare.gov/find-a-plan, on the official U.S. government site for people with Medicare, which allows you to compare plans by cost, by quality and by other features that may be of importance to you.

Who can help me choose the right Medicare plan?

Get personalized help with choosing a Part D or Medicare Advantage plan from your local State Health Insurance Assistance Program (SHIP). Go to shiptacenter.org or call 800-633-4227 for local contacts.

What is the best way to find out about Medicare?

Visit Medicare.gov/about-us/nondiscrimination/accessibility-nondiscrimination.html, or call 1-800-MEDICARE (1-800-633-4227) for more information. TTY users can call 1-877-486-2048. Paid for by the Department of Health & Human Services.

Where can I get unbiased information about Medicare?

Call 1-800-MEDICARE For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Who has the best Medicare package?

Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states. Overall, Aetna Medicare ranks the best in the most (23) states. That said, there is no single “best plan.” Your needs and preferences will determine the best choice for you.

What are the negatives of a Medicare Advantage plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

When should you start looking at Medicare?

Generally, you're first eligible starting 3 months before you turn 65 and ending 3 months after the month you turn 65. If you don't sign up for Part B when you're first eligible, you might have to wait to sign up and go months without coverage.

What is the best Medicare helpline?

1-800-MEDICARE (1-800-633-4227) can help. TTY users should call 1-877-486-2048.

What are the 4 types of Medicare?

There are four parts of Medicare: Part A, Part B, Part C, and Part D.Part A provides inpatient/hospital coverage.Part B provides outpatient/medical coverage.Part C offers an alternate way to receive your Medicare benefits (see below for more information).Part D provides prescription drug coverage.

What is Medicare Plan G?

Plan G is a supplemental Medigap health insurance plan that is available to individuals who are disabled or over the age of 65 and currently enrolled in both Part A and Part B of Medicare. Plan G is one of the most comprehensive Medicare supplement plans that are available to purchase.

What is taken out of Social Security for Medicare?

Medicare Part B (medical insurance) premiums are normally deducted from any Social Security or RRB benefits you receive. Your Part B premiums will be automatically deducted from your total benefit check in this case. You'll typically pay the standard Part B premium, which is $170.10 in 2022.

Which is better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Why do I need Medicare Part C?

Medicare Part C provides more coverage for everyday healthcare including prescription drug coverage with some plans when combined with Part D. A Medicare Advantage prescription drug (MAPD) plan is when a Part C and Part D plan are combined. Medicare Part D only covers prescription drugs.

When Can I Enroll In Medicare?

Remember, you are automatically eligible to receive Medicare the day you turn 65. If you are already receiving Social Security benefits and enrolled in Medicare before you hit 65, you will automatically be enrolled in Part A of Medicare.

Can I Add, Drop, And Change Coverage?

You can’t add, drop, and change coverage as you please. There are certain times and dates when you can do this. There can also be some confusion as to whether or not there will be fees or penalties for adding certain coverage or dropping it from your plan.

How to use Medicare Plan Finder?

There are two ways to utilize the Medicare Plan Finder: Log in or create an account. Continue without logging in. There is also an option on the bottom of the page to compare Medigap policies in your area.

What is Medicare.gov plan Finder?

The Medicare.gov Plan Finder is a tool from the Centers for Medicare & Medicaid Services (CMS) that allows you to search for Medicare Advantage and Medicare Part D plans available where you live.

What is Medicare Part D?

A Prescription Drug Plan (Medicare Part D) provides coverage only for prescription medications. If you're looking for a Medicare Part D prescription drug plan, you can compare Part D plans in your area and enroll in a plan online in as little as 10 minutes when you visit MyRxPlans.com. 1.

What does an agent do for Medicare?

An agent can discuss your health care needs and compile a list of available Medicare plans in your area. Most importantly, an agent can help answer questions you are sure to have about costs, coverage, terms and conditions of plans and help you better understand exactly what it is you are shopping for.

Can you switch Medicare plans at different times of the year?

It helps to make sure that you are eligible for a Medicare plan prior to enrolling.

Does Medicare cover prescription drugs?

Medicare Advantage plans provide all the same coverage as Original Medicare, and most Medicare Advantage plans offer coverage for prescription drugs. Medicare Supplement Insurance, or Medigap, provides coverage for out-of-pocket costs that Medicare doesn't cover, such as deductibles, copayments and coinsurance.

Step 1: Decide on the Medicare Benefits That You Consider as Must-Haves

If you’re used to employer group insurance, you probably have been provided with benefits such as vision and dental coverage. But what most people don’t realize is that these routine services aren’t covered by Original Medicare.

Step 2: Think about how You Want to Manage Your Medicare Costs

Costs are a major determining factor in how to choose a Medicare plan. The fact is that most people don’t realize how unpredictable out-of-pocket costs can be with Original Medicare, and even with some Medicare Advantage plans.

Step 3: Consider Your Lifestyle and Travel Plans

Travel is one of the perks of retirement, and many seniors even choose a dual-resident lifestyle, living in warmer climates during the winter. The good news for this niche of retirees is that there are no provider restrictions with Original Medicare, meaning that you can use Medicare with any provider in the country who accepts it.

Step 4: Review Your Part D Prescription Drug Coverage Needs

There is generally no coverage for prescription drugs you take at home under Original Medicare. As such, if you want help with prescription drug costs, you’ll need a Part D prescription drug plan.

Step 5: Get Help Choosing a Medicare Plan if You Have Questions

The average person can choose from among 39 Medicare Advantage plans and 28 prescription drug plans. With so many options, it’s not surprising that people are perplexed about how to choose the best Medicare plan.

When is the best time to switch Medicare?

For those already enrolled, the annual open enrollment period, which runs from Oct. 15 until Dec. 7 each year , is the best time to consider switching plans or adding coverage. 2. Learn about your options. There are two types of Medicare plans: Original Medicare and Medicare Advantage.

What are the two types of Medicare?

There are two types of Medicare plans: Original Medicare and Medicare Advantage. According to Medicare.gov, Original Medicare is a government-provided, fee-for-service plan that is made up of two parts: Part A is hospital insurance and Part B is medical insurance.

What is Medicare Advantage?

Medicare Advantage is a plan offered by a private insurance company that contracts with Medicare. These plans include Part A and Part B coverage, and may be set up as an HMO, PPO, fee-for-service or other type of plan. They typically include prescription drug coverage and may offer vision, dental and other services. [.

Can you enroll in health insurance after your 65th birthday?

Patients may be responsible for late penalties and lapses in coverage if they don't qualify for a Special Enrollment Period, which allows you to enroll outside your 65th birthday window or during annual open enrollment, for unplanned events like losing a job and associated health insurance coverage.

Can an employer group health plan be the primary carrier over Medicare?

That is true except with people still covered by an employer plan," Omdahl says. Federal law says that an employer group health plan (sponsored by a company with 20 or more employees) can be the primary carrier over Medicare. "People working at 65 or past 65, that population makes the most of the mistakes with enrollment," she says.

Does Medicare change if you work with a different insurance company?

The premiums are set by Medicare or the insurance company if you select a Medicare Advantage or Medigap plan. Medicare premiums do not change regardless of who you work with, but the other plans vary among companies based on the state they are licensed to do business in.

Take advantage of your state's one-on-one counseling program

If you have a complicated question about Medicare, or just want some help talking through your options, you should take advantage of the free one-on-one counseling available through your state's State Health Insurance Assistance Program (SHIP)

See all our Medicare information

We've collected the information you need to manage your Medicare benefits. How to sign up for the first time. How to decide between Medicare Advantage and Medigap. How to pick the best Advantage or prescription drug plan.

Key takeaways

An agent or broker will need information about you and your providers to help you choose a Medicare plan.

What information does an agent or broker need to help me enroll in Medicare?

An agent or broker can help you with the process of selecting a plan and completing the enrollment. In order to best assist you, they will need to know the names and dosages of any medications you take, as well as your preferred pharmacies, so that they can narrow down the options based on how your medications will be covered.

Can a friend or family member help me sign up for Medicare?

You always have the right to have a trusted friend or family member present while you’re discussing your health coverage needs with Medicare, your state’s Medicare SHIP, or with an agent or broker.

How can I authorize Medicare to discuss my coverage with someone else?

If you want Medicare to be able to directly share your personal health information with someone else, there’s an authorization form that you’ll need to complete. Once you have it on file with Medicare, you can add names to it or update it through your MyMedicare.gov account.

Can someone help me sign up for Medicare if I'm incapacitated?

If you’re incapacitated and unable to participate in your own plan selection process, someone else can act on your behalf as long as you’ve created a power of attorney (POA) and named that person as your legal representative.

Can a friend or family talk about my coverage with a private Medicare insurance company?

If you’re enrolled in a private Medicare plan (a Part D plan, a Medicare Advantage plan, or a Medigap plan ), the insurance company will have their own disclosure authorization form that you’ll need to complete so that they can discuss your coverage with a loved one.

How to find Medicare Advantage plan?

While you search for your Medicare Advantage plan, here are a few questions to keep in mind: 1 Do you have a favorite doctor you’ve been seeing for years? If you choose a plan with a network of preferred providers, make sure your doctor is on the list. The same is true of hospitals — if you have several in your region, it’s good to know that the one you prefer will accept your Advantage insurance. 2 Do you take medications on a maintenance schedule? If so, make sure that your plan includes drug coverage. Most Medicare Advantage plans do — but not all of them. 3 What is your chosen plan’s deductible? The higher the deductible, the more you’ll pay out-of-pocket before your plan kicks in. 4 Likewise, what are the copays? If you frequently need to see a healthcare professional for a chronic condition, a plan with lower copays makes sense, and may even make up for higher monthly premiums. 5 Do you have frequent vision, dental, or hearing issues? A plan that covers these health care needs may save you money.

What are the benefits of Medicare Advantage?

Medicare Advantage plans differ depending on the company that is overseeing them, but in general they offer benefits beyond what Medicare Part A and B offer, such as vision, hearing, and dental coverage, gym memberships, and drug coverage. Plus, the all-in-one nature of the plans makes them easy to manage. Choosing a plan that’s right ...

What is an HMO plan?

These plans feature a network of approved health care providers in your region, and in order for your insurance to pay for a doctor’s visit or other health care need, you must use the providers that are in your network. The exceptions are for emergency care, out-of-area urgent care, ...

Is a HMO POS plan the same as a PPO?

An HMO POS plan is similar in many respects to the basic HMO plans, and also bears some similarities to PPO systems. You’ll choose your health care providers from within an approved network, but can go out-of-network in certain circumstances.

Can you go out of network with Medicare Advantage?

But you can go out-of-network when needed, though there may be a higher copay or coinsurance cost.

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