By Elizabeth Steele Medicare Insurance February 5, 2020

Deciding Which Medicare Advantage Plan is Right for You

Medicare Advantage Plans, which are offered by approved private insurance companies, provide coverage for both Part A (Hospital Insurance) and Part B (Medical Insurance). Sometimes, these Plans are also referred to as “Part C.”

Whatever term you choose, the fact of the matter is that it’s essential for you to select the appropriate Medicare plan at the appropriate time—not just for your current needs, but into the foreseeable future as well.

In this article, the IHS Insurance Group team has assembled eight questions you can ask to narrow down which Medicare Plans you might want to focus on.

1. How Much Do You Want to Pay?

Just like traditional health insurance, Medicare Part C plan premiums can vary widely based on:

The coverage you choose (including vision, hearing, and dental)
The services you receive (hospital stays, doctor’s visits, etc.)
Copayment and coinsurance amounts
Annual out-of-pocket limits (after which you’ll pay nothing for covered services for the remainder of the year)
Deductibles
Other coverage rules

2. Which Coverage is Important to You?

Like Original Medicare, third-party Part C plans cover hospital, doctor’s office, and health care supplies. However, many Advantage Plans also include vision, hearing, or dental benefits, which isn’t always offered by Original Medicare.

As one option, you can choose to add a Medigap policy to your Medicare coverage, which will help pay some of the related out-of-pocket costs (deductible, coinsurance, etc.).

On the other hand, Medicare Advantage Plans could offer broader coverage than Original Medicare and a Medigap policy, while also remaining friendlier on your wallet.

A final consideration is whether or not you also have employment-related insurance in place, which could duplicate some of your coverage, whether you choose Original Medicare or a third-party Advantage Plan.

IHS Insurance Group understands that balancing your coverage and budgetary needs can be difficult, but we’re here to help!

3. Do You Need Prescription Drug Coverage?

Most Medicare Advantage Plans include coverage for prescription medication, but if yours doesn’t, you might be able to purchase a separate Part D plan to make up the difference.

Here are some questions to ask to help make a determination:

Do I have creditable prescription drug coverage in place?
Will I pay a penalty if I join a drug plan after enrolling in an Advantage Plan?
What will my prescription drugs cost under this plan?
Are my medications covered under the plan’s formulary?
Are there any coverage rules that apply to my specific prescriptions?
Do I have complex health needs? And if so, am I eligible for a free Medication Therapy Management (MTM) program?

4. Do You Have a Hospital or Physician in Mind?

If you want to maintain access to your current physician(s) and/or hospital(s), you’ll want to triple check to ensure that the Advantage Plan you’re considering considers them in-network. Otherwise, your out-of-pocket expenses could significantly increase after switching.

If you’re OK switching doctors according to who your new Plan classifies as in-network, you’ll also want to make sure these new physicians are accepting new patients. Furthermore, find out if you need to get a referral to see them.

A final consideration—one that many enrollees overlook—is to find out how close the network’s doctors or pharmacies are to your home. After all, if you have to drive far out of your way to visit your physician or pick up prescriptions, it could reduce the value you receive from your Advantage Plan, even if it costs less than your current coverage.

5. Do You Travel Frequently?

Do you travel outside of the United States on a regular basis?

If so, it’s essential to keep in mind that, in general, neither Original Medicare nor Medicare Advantage Plans provide coverage for care obtained in other countries. However, if this is important to you, you may be able to purchase supplemental Medigap insurance that adds back some of this coverage.

6. When is the Enrollment Period?

Each Medicare Advantage Plan comes with its own enrollment period, so it’s ultra-important that you understand when this occurs, and when you can shop around for new plans that might better meet your needs.

7. What Do Other Medicare Enrollees Say About Your Advantage Plan?

Just like when shopping around for any other goods or services, it’s crucial that once you narrow down your Advantage Plan options, you search online to find out what other enrollees say about their experiences. What’s the plan’s overall star rating?

After all, what others with your Plan report about their experiences could speak volumes about what you might expect after enrolling.

8. Do You Have Additional Questions About Choosing Your Best Medicare Plan?

As a brokerage, IHS Insurance Group has offered many of the top Medicare Advantage Plans to Texas residents for more than a decade. We’re also licensed in Oklahoma, New Mexico, and many other states as well.

IHS Insurance Group offers a variety of “A-rated” plans from national carriers, which we carefully comparison shop. Then, we deliver a list of options that can meet just about every budget and coverage need.

Our top priority is to educate customers about their Medicare plan options, discuss the differences between each one, and deliver one that meets your individual needs and leaves you 100 percent satisfied!

Need a FREE Quote or have questions regarding Medicare Coverage? We have three convenient ways to reach us:

If you prefer to talk to a licensed agent directly, please call (866) 480 5063.
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Also, check out our Medicare FAQ’s here.