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Health Insurance Basics

What You Need to Know Before Choosing Medicare Options

July 28, 2017

If you’re Medicare eligible, you’ll want to carefully assess costs and benefits when choosing your Medicare options. If you’re already signed up and using Medicare, open enrollment allows you to change your Medicare options each year if you want. Let’s look at some of the options you need to consider.

Understanding the ‘Parts’ of Medicare?

First, remember that Original Medicare includes two components:

  • Medicare Part A: Hospital Insurance
  • Medicare Part B: Medical Insurance

Both “parts” provide coverage by the government to ensure these two big needs are met. But because they don’t cover all costs, you may also choose these plans to enhance your Original Medicare coverage:

If all these parts seem like a lot to manage, maybe you'd like a few of them all under one roof. In that case, choose Medicare Advantage, which includes all Medicare Part A and Part B benefits, and usually includes…

Original Medicare alone doesn’t cover prescription medications but almost everyone needs them. There are different ways to get Part D. You can get drug coverage through Medicare Advantage Plans, or you can add a plan separately to your Medicare Supplement plan or Original Medicare.

Another option to consider are Medicare Supplement plans (Medigap) that cover coinsurance, copays, or your deductibles for Part A and Part B.

What Questions Should I Ask Before Choosing Medicare Options?

If you are turning 65 soon and reaching Medicare age, ask yourself these important questions before choosing Medicare options:

  1. Coverage: Does the plan cover all the services you need?
  2. Additional coverage: If you have additional coverage, how will that work with Medicare?
  3. Cost: What's the cost of insurance premiums, deductibles, physician visits, and stays in the hospital?
  4. Choice: Do you have to choose your providers from a network or do you have freedom to choose?
  5. Prescriptions: If you don’t already have creditable prescription drug coverage, will you need a Medicare Prescription Drug Plan? Check the prices of your current medications under the plans you’re considering. Then find out whether your drugs are covered under the plan’s formulary—a list of prescription drugs, both generic and brand name, that practitioners use to select drugs they feel offer the best value.
  6. Ratings: What’s the quality rating of the plans you have chosen?
  7. Travel: Are you covered if you travel to another state or out of the country?

Make sure you do your homework and ask questions. Medicare.gov is a great place to start.

Y0114_17_32137_I  07/28/2017
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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