The process of selecting the right Medicare coverage for your unique needs and preferences can be difficult and overwhelming, to say the least. Many people simply give up and guess, or they choose the wrong plan out of frustration. The wrong decisions can cost you hundreds, if not thousands, of dollars every year! Knowing just a few things before you compare plans can make it simpler.
1. Use Roman Brokers Insurance at No Cost to You
Roman Brokers Insurance in Mesa, AZ represents a wide range of Medicare plans and options. We are dedicated to helping you develop an understandable Medicare strategy that best suits your needs. No one strategy is best for everyone. We can help you better-understand Medicare as it applies to you and your local Medicare options.
Located in Mesa, AZ, I am local, and I am a licensed, insured, independent broker. I am certified to represent most major Medicare Advantage, Medicare Supplement and Medicare Prescription Drug Insurance plans in Arizona. I help you compare companies and plans for the best possible combinations of cost, coverage and compatibility for your unique needs. I will walk you through the process and give unbiased and accurate information about your choices in. Contact Roman Brokers Insurance today at 480-834-7447. We can provide guidance at no cost and no obligation to you!
2. Count the 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.
- Costs in Original Medicare – In addition to your Medicare Part B premium, there is no limit on how much you pay out-of-pocket per year unless you have supplemental coverage and a Medicare Prescription drug plan.
- Costs in Medicare Advantage – Plans have a yearly limit on your out-of-pocket costs. If you join a Medicare Advantage Plan, also called Part C, once you reach a specified maximum of out-of-pocket costs (total of any deductibles, copays and coinsurance for hospital and medical expenses), you will pay nothing more for covered services for the rest of the year. This option may be more cost effective for you.
Helpful Plan Documents – Each year, your plan may change its benefits and network of providers for the coming year. It is a good idea to review any changes to decide whether the plan will continue to meet your needs in the next year. The 2 documents below are helpful for determining the suitability of your plan going forward. If you don’t get these important documents, contact your plan.
- Evidence of Coverage (EOC) – If you are already in a Medicare plan, you should receive this document each year, usually in the fall. The EOC gives you all the details about what the plan covers, how much you pay, and more.
- Annual Notice of Change” (ANOC) – Another important document your plan sends you each year around September or October. The ANOC lists any changes in coverage, costs, or service area that will be effective in January.
3. Check the Coverage
How well does the plan cover the services you need?
- Coverage in Original Medicare – Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under Part A (hospital coverage) or Part B (Medical coverage). It does NOT cover prescriptions or additional benefits, like dental, vision, hearing.
- Coverage in Medicare Advantage – Plans must cover all of the services that Original Medicare covers. Some plans offer benefits not covered under Original Medicare, like vision, hearing, dental, over-the-counter items, gym memberships, transportation and more.
4. Consider Your Other 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 or insurer before making any changes.
- Supplemental coverage in Original Medicare – You can add a Medigap policy to help pay your out-of-pocket costs in Original Medicare, like your deductible and coinsurance .s.
- Medicare Advantage (Part C) – It may be more cost effective for you to join a Medicare Advantage Plan because your cost sharing is lower (or included). In addition, many Medicare Advantage plans offer vision, hearing, dental and more.
5. Plan Your Prescription Coverage
Do you need to join a Medicare Prescription Drug Plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What’s the plan’s overall star rating? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions? Are you eligible for a free Medication Therapy Management (MTM) program? All of these are important questions to answer when considering prescription drug coverage.
- Prescription drug coverage in Original Medicare – Not covered under original Medicare, you’ll need to join a Medicare Prescription Drug Plan (Part D) to get drug coverage.
- Prescription drug coverage in Medicare Advantage – Most Medicare Advantage Plans include drug coverage. If yours doesn’t, you may be able to join a separate Part D plan.
6. Don’t Forget Your Doctors
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?
- Doctor and hospital choice in Original Medicare – You can go to any doctor that accepts Medicare.
- Doctor and hospital choice in Medicare Advantage – You may need to use health care providers who participate in the plan’s network. Some plans offer out-of-network coverage.
7. Question Quality of Care
Are you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. How have Medicare and other people with Medicare rated your health and drug plan’s care and services?
Your insurance agent can educate you All About Medicare Star Ratings, and help you compare plans and providers using this Medicare quality comparison tool.
8. Talk About Travel
Before you travel outside the U.S., talk with your insurance agent to get more information about your Medigap or Medicare Advantage plan coverage while traveling.
- Travel coverage in Original Medicare – Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy Medigap supplemental insurance that offers travel coverage. Most Supplement plans but not all:
- Cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care.
- Pay 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.
- Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.
- Travel coverage in Medicare Advantage – Increasingly, Medicare Advantage (Part C) plans include Foreign travel emergency coverage with a lifetime limit of $50,000, similar to Medicare supplement plans. But check your plan to confirm coverage.
9. Understand Enrollment Periods
There are several key time-periods when you can enroll in Medicare, and each of those periods has specific rules for applying, affecting when your coverage will begin. Understanding when you can enroll and the best time to do so is an important part of your Medicare experience.
We’re here to Help You Navigate Your Medicare Options
Roman Brokers Insurance in Mesa, AZ represents a wide range of Medicare plans and options. We are dedicated to helping you develop an understandable Medicare strategy that best suits your needs. No one strategy is best for everyone.
Roman Brokers Insurance compares companies and plans for the best possible combinations of cost, coverage and compatibility. A licensed, insured, independent agent will walk you through the process and give unbiased and accurate information about your choices in. Contact Roman Brokers Insurance today at 480-834-7447. We can provide guidance at no cost and no obligation to you!
Roman Brokers Insurance in Mesa, AZ represents a wide range of Medicare plans and options that will best suit your specific needs and wants. We can help you apply for the Medicare Extra Help Program and the Medicare Savings Programs.
Roman Brokers Insurance compares companies and plans for the best possible fit to meet your needs and preferences. Dan Roman, a licensed, insured, independent and experienced agent will walk you through the process and give a detailed explanation of the differences in each plan. Contact us today or at 480-834-7447