There comes a point when your current Medicare Coverage isn’t enough to cover your health needs. When this happens, it means that it’s time to review your Medicare Coverage to see if changes on your Medicare Plan is necessary.
1. Coverage – Are the services you need covered?
2. Other Health and Prescription Coverage – If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your benefits administrator, insurer, or plan before making any changes.
3. Costs – How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you could pay out of pocket for medical services? Make sure you understand any coverage rules that may affect your costs.
4. Doctor and Hospital Choice – Do your doctors accept the coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?
5. Prescription Drugs – What are your drug needs? Do you need to join a Medicare drug plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary (drug list)?
6. Quality of Care – The quality of care and services given by plans and other health care providers can vary. See the “Resource Locator” for more help comparing plans and providers.
7. Convenience – Does your current plan include the doctors you see and the pharmacies you use? Can you get your prescriptions by mail? Do the doctors use electronic health records or E-prescribe?
8. Travel – Will the plan cover you if you travel to another state?
The following resources are available if you need help or want more information about Medicare:
- Visit www.medicare.gov/Publications/Pubs/pdf/10050.pdf to view the “Medicare & You” handbook.
- Visit http://www.medicare.gov, and select “Compare Health Plans and Medigap Policies in Your Area” to learn more about Medicare Advantage Plans and other Medicare health plans, as well as Medigap (Medicare Supplement Insurance) policies. You will also be able to compare plans.
- Visit http://www.medicare.gov, and select “Compare Medicare Prescription Drug Plans” to learn more about Medicare drug plans and to compare plans.
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048 if you want to talk to a Medicare representative to get more information regarding Medicare Plans.
- Get free, personalized counseling about choosing coverage from your State Health Insurance Assistance Program (SHIP). You can call a SHIP counselor or you can meet in person to inquire about Medicare enrollment plans, claims and billing problems, long-term care insurance, referrals on public benefit programs and other medical insurance-related issues. To contact your State Health Insurance Assistance Program, visit: http://www.medicare.gov/contacts/staticpages/ships.aspx
- Medicare Plan Choices
- Understanding Medicaid
- Medicare Prescription Drug Coverage
- Medicare Advantage Plans
- Understanding Medicare
- How To Make Changes To Your Medicare Coverage
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