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How to Pick a Medicare Advantage Plan

Posted on March 20, 2024 By Jeff Snyder

You’ve just reached the age where you’re eligible to enroll in the Medicare program, and now you’re looking at your options or you’re considering a change from Original Medicare. Perhaps it’s time to give Medicare Advantage, also called Part C, a try. These private plans combine Medicare Parts A and B into a single plan and may include additional benefits.

You start your search for a Medicare insurance plan, but there are so many options to choose from. Some with premiums, some without. Some with drug plans, others without. Each plan has so many features to sift through, that it can become a tough task. Luckily, there are a few key factors to look for that’ll help you figure out how to pick a Medicare insurance plan for Part C that fits your needs.

Does Your Medicare Advantage Plan Cover Your Needs?

Above all else, you know what you need covered. Do you need drug coverage? Make sure it’s in the plan. Will you need inpatient care? If you’re unsure of what coverage you may need under your plan, a trip to your physician shouldn’t be out of the question. This is especially true if you haven’t taken advantage of your Welcome to Medicare or Annual Wellness visit. What good is a plan if it doesn’t meet your needs?

Beyond what’s covered, you’ll want to see where it’s covered. Many Medicare Advantage plans have some sort of network, which is a group of health care facilities, providers, and suppliers that have contracted with your plan to provide care at a reduced cost. If you like the doctor you have, you’ll want to verify whether your physician is in the plan’s network.

Are the Plan’s Out-of-Pocket Costs Right?

Finances are rarely too far from the discussion when it comes to health insurance. The consideration is even more important if you’re retired and living on a fixed income. Plan costs vary depending on a few different factors like location, coverage, and additional benefits. There are a few primary figures to consider with a Medicare Advantage plan: The premium, the deductible, the out-of-pocket costs, and the maximum out-of-pocket, or MOOP.

Premium — This is a recurring cost you pay each month for enrollment in your plan.

Deductible — This figure is what you’ll need to pay out of your own pocket for health care services before your plan begins covering a portion of the costs. A low premium is often balanced by a high deductible and vice versa.

Out-of-pocket costs — Your plan may require a copay for doctor visits and will likely charge more for specialists or providers outside of the network.

Maximum out-of-pocket (MOOP) — This is the limit of eligible payments, like copayments and coinsurances, that you’re expected to pay that year. Once you’ve reached your limit, your plan will typically cover 100% of your expenses for the remainder of the plan year.

As with most things, the more research you put into your plan, the better.

Want Professional Help Picking a Medicare Insurance Plan?

Speaking of research, it’s better with licensed help. Sometimes, your search may come down to a few plans that fit your needs exceptionally well or none seem to fit what you need. Choosing the right Medicare insurance plan can be difficult. If you ever need help finding a Medicare Advantage plan, for any reason, an insurance agent can be a valuable asset.

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Much like a plan, it’s important to find professional help that you can work with and trust. Luckily, we have you covered in that regard. After all, finding the right insurance agent can make or break your plan search, and we have years of experience guiding clients to plans that fit their unique needs.

This entry was posted in Medicare Insurance and Tagged Chastain Agency LLC, Gainesville GA

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