How to choose the right Medicare coverage for you


A senior man sits on a stoop talking on a cell phone with a cup of coffee in hand.

As you approach retirement, planning ahead for your healthcare insurance needs is a top priority. Enrolling in Medicare may seem like the obvious choice if you're 65 or older, but if you’re used to being covered under an employer's plan, you may not know where to begin. Continue reading to learn more about choosing a Medicare option that’s right for you. It may closely reflect your current employer's coverage.

Medicare plan types

Medicare can appear to be an alphabet soup.

  • Original Medicare is composed of Parts A and Part B
    • Original Medicare is managed by the federal government, and Part A is typically premium-free for many, while Part B requires a monthly premium. 1,2
  • Part A is hospital insurance.
  • Part B is medical insurance, covering doctor's visits, outpatient care, and certain home health services.
  • Part C, also known as Medicare Advantage, covers all of the same benefits as Original Medicare except hospice care.
    • Medicare Advantage plans are offered by private insurers and the costs for premiums, deductibles, copays and coinsurance can vary based on the plan you select.3
  • Part D is prescription drug coverage, is often included with Medicare Advantage plans.

If you opt for Original Medicare, however, you'd need to enroll in Part D coverage separately. Part D has its own premiums, copays, coinsurance and deductibles separate from those for Original Medicare.4

Finally, Medigap plans offer supplemental coverage for individuals that have Original Medicare. These plans are designed to help with costs that aren't covered under Parts A and B, but again, that doesn't include prescription drugs.

You can have Original Medicare, as well as a Medigap policy and Part D coverage, but you can't combine a Medigap policy and a Medicare Advantage plan.5

Picking a plan

When choosing coverage you’ll need to choose between Original Medicare and Medicare Advantage. Of the two, Medicare Advantage plans may be the most similar to the type of group health plan you may have enjoyed as an employee. They tend to be more comprehensive, in that many often include vision, dental and hearing coverage, as well as prescription drug coverage.

If you believe that Medicare Advantage is a better fit for your needs, the next step is choosing a plan. When comparing Medicare Advantage options to your employer's coverage, carefully consider:

  • Which doctors and healthcare facilities are included in the plan’s network
  • The list of services covered
  • The cost of premiums, copays and coinsurance
  • The deductible amount
  • The out-of-pocket maximum and coverage limits, if any
  • Potential for major health events in the future

Choosing a Medicare Advantage plan that closely resembles the same type of health insurance you've always had may make the shift to Medicare plan less stressful. Just remember to review your plan choices each year during the Fall Open Enrollment Period (October 15 through December 7) to ensure that it continues to meet your healthcare needs.

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