How To Choose A Medicare Advantage Plan

A Medicare Advantage Plan provides you with a different way to receive your Original Medicare benefits. It typically includes Medicare Parts A and B plus prescription drug coverage (Part D). While Medicare Advantage Plans must offer the same benefits as Original Medicare, they can do so with varying rules, costs, and coverage restrictions. Guide To Selecting A Medicare Advantage Plan include preferred provider organization, or PPO, plans; medical savings accounts; private fee-for-service plans; and special needs plans.

You can use the Medicare Plan Finder to find a Medicare Advantage Plan that best fits your needs and preferences. Enter your zip code, select Medicare Advantage, and click “Search.” You can then view a list of Medicare Advantage Plans available in your area along with information about each plan. The Plan Finder also gives you an estimate of your total annual cost, including your premium, deductible and out-of-pocket maximum.

Out-of-pocket costs are one of the most important factors to consider when selecting a Medicare Advantage Plan. The amount you pay for healthcare throughout the year can add up quickly, especially if you visit your doctor frequently or have to fill many prescriptions. Choosing a Medicare Advantage Plan that offers low or no deductibles and copayments is essential for minimizing out-of-pocket costs.

It’s also important to evaluate the network coverage and accessibility of a Medicare Advantage Plan. Most Medicare Advantage Plans will only cover care if it’s received from providers that are part of the plan’s network. While it is possible to see non-network doctors, you’ll usually pay more for out-of-network services.

Some Medicare Advantage Plans limit enrollees’ out-of-pocket expenses to a certain amount each year, regardless of whether you receive in-network or out-of-network care. Others do not have out-of-pocket limits, and you’ll pay the full cost of any service that exceeds the annual limit.

You’ll want to compare the annual deductible and out-of-pocket max with your projected healthcare needs, budget, and preferences. Also take into account any potential copayments for medications you need. Plans with lower or no premiums may be more expensive if you have to pay large copayments for your medications.

Each year during open enrollment from Oct. 15 to Dec. 7, you have the option to switch from your current Medicare Advantage Plan to a different one. You can also enroll in a Medicare Advantage Plan during this period if you haven’t previously done so.

A Special Enrollment Period, or SEP, is an exception to the annual open enrollment period that allows you to change your Medicare Advantage Plan. These periods are generally reserved for individuals who are:

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