Understanding the Different Types of Medicare Plans

When you are first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. During this time, you can also sign up for a Medicare Advantage Plan. If you delay signing up for Part B during your Initial Enrollment Period, you’ll have to pay a late enrollment penalty. You may have other options for getting health coverage if you missed your Initial Enrollment Period and Compare Medicare plans.

If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), in most cases you’ll be automatically enrolled in Part A and Part B starting the first day of the month that you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.

You can choose to enroll in a Medicare Advantage Plan instead of Original Medicare. If you have End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease (amyotrophic lateral sclerosis/ALS), different rules apply. Read more about signing up for Medicare if you have ESRD or ALS.

Comparing Plans

The best way to compare plans is to think about what’s important to you and use that as a starting point. For example, here are some things people commonly consider when choosing a plan:

How much does the plan cost? This includes your monthly premium, any deductibles, and copayments or coinsurance. Note that some plans require higher premiums even if they have $0 deductibles.

What doctors and other health care providers can I see with this plan? All plans must provide coverage for emergency care anywhere in the world. However, they don’t all cover the same doctors and hospitals. Most plans have a network of providers from which you can choose. Some plans require that you get care only from providers in their network except in an emergency. Others give you more flexibility to see out-of-network providers but may charge more if you do. You should also find out how easy it is to get referrals to see specialists within the network. Check with your doctor or other health care provider to make sure he or she is willing to accept patients in the plan’s network before enrolling in a plan. Also note that some specialists may only be available in certain areas.

What extra benefits does the plan offer? These might include dental care, vision care, hearing services, prescription drugs, over-the-counter medications, wellness programs, and more. Not all plans offer extra benefits so if this is important to you be sure to check before enrolling in a plan.”

Can I keep my same pharmacy? You will want to check on this especially if you take maintenance medications.”

Conclusion: 

There are many factors to consider when choosing a Medicare Advantage Plan including costs, networks, extra benefits, and whether your current providers participate in the plan. Be sure to do your research so that you can make an informed decision about which plan is right for you.”