5 Steps to Choosing a Medicare Plan

If eligible for Medicare at age 65, there is an Initial Enrollment Period (IEP) which is a seven-month period to sign up. The IEP begins three months prior to turning 65, the month turning 65 and the three following months. There are hundreds of choices and information to sort through to make an informed decision. Here are 5 simple steps to get started.

1. Know what to do — and when

Medicare has specific windows of time to make decisions known as Enrollment Periods. Even if 65 and still working review the options and consider enrolling in Parts B and D. Our Age Well assessment provides free Medicare advice and a personalized report on actions needed and timing for each.

2. Check for Extra Help

There are programs that can help pay for prescriptions and health insurance. Examples include Medicare Savings Programs, Extra Help for prescription drug coverage, Medicaid and state pharmaceutical assistance programs. Our assessment can help you find what’s available– by screening for public and private benefits programs. You can also contact the local State Health Insurance Assistance Program (SHIP) for help.

3. Decide between Original Medicare and Medicare Advantage

Start by making a list of both health and prescription drug needs throughout the year. Original Medicare is two parts: Part A covers hospitalization and Part B covers medical expenses. Many people find that Parts A and B together still have gaps in what covered, so they purchase a Medicare Supplement (Medigap) plan. These plans can cover things like Part A deductible, coinsurance, skilled nursing facility care, and foreign travel emergencies.

Instead of Original Medicare, a Medicare Advantage (MA)/Part C plan is also an option. These plans act more like an employer-provided group health plan and are sold by agents working for insurance companies approved by Medicare. Often MA plans include prescription drug coverage and cover more services than basic Medicare, such as vision care and wellness programs. There is a premium for an MA policy on top of the Part B premium.

To evaluate the best choice for medication coverage, look at your prescription drug needs, if there is an out-of-pocket maximum and which doctors are covered.

4. Compare policy coverage and price

If choosing only Original Medicare (Parts A and B), the premiums and coverage will be the same as others across the nation. However, which doctors and hospitals are covered by Medicare will differ depending on location. If choosing a Medicare Advantage, Medicare Part D or Medigap policy, there will be hundreds of options to consider. It pays to shop around; the least expensive policy may not be the best value for your situation.

For personal assistance in selecting a plan, consider contacting a State Health Insurance Assistance Program (SHIP) for guidance, or get free help from a licensed benefits advisor through our Age Well Planner.

5. Select and enroll on time

Selecting and enrolling in a Medicare plan is not a one-time decision. Insurance plans — and personal needs — change each year. Medicare has an Open Enrollment Period annually. Take the time to evaluate changing needs and coverage options to ensure the best coverage at the best rates.

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