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Important Considerations When Changing Your Medicare Coverage

Written by Evens Stevenson

While there may be times when it makes sense to change your Medicare coverage, there are some important factors to consider prior to doing so. This holds true whether you currently have Original Medicare (Medicare Part A and Part B) or Medicare Advantage (Medicare Part C).

One of the biggest criteria that must be considered is whether or not the plan you are considering will cover all of the services that you need. If it does not, you could run into a “gap” in coverage – or worse, a deep financial deficit if you end up paying for certain services out-of-pocket.

Other important considerations should include the following:

  • Cost – Comparing your current cost with the cost of your new plan is important. This doesn’t just include premium expenses, but also the cost of your deductibles, copayments, and coinsurance. When considering your expenses, be sure that you are aware of what you need to pay for services such as doctor visits and hospital stays. In addition, ask if there are any limitations on your out-of-pocket pay.Considerations when Changing your Medicare Coverage
  • Choice – Choice is another important factor. For example, can you see your current doctors with the new coverage that you are considering? Are the doctors in the new plan willing to accept you as a new patient? Likewise, does the new plan require you to choose hospitals and doctors from a list or a network, and will you need a referral in order to see a specialist for various types of injuries or illnesses?
  • Prescription Medications – Will your prescription drugs be covered, or will you need to join a stand-alone Medicare Part D prescription drug plan? In addition, will there be any additional rules regarding coverage that will apply to your prescription medications in the new plan?
  • Care Quality – Are you currently satisfied with the medical care that you are receiving or would you like to get a new doctor and / or health care providers? The quality of care and the services that you receive can vary a great deal from one health care plan to another, so it is important to be aware of this prior to making a change. Medicare provides help with comparing how well certain plans work with providers in offering patients with the best health care possible.
  • Other Coverage – If you are still actively working or you are covered by another type of health care insurance, will your Medicare plan be able to work in conjunction with this plan? Likewise, if you were to drop your current health insurance coverage, would you be able to get it back if you so chose to? These are also important questions to ask prior to moving forward with making any type of change to your current health insurance situation.

As you can see, so many issues can arise when you think about your health care coverage.  Without the proper Medicare plan, you could end up with significant gaps that leave you paying thousands of dollars in out-of-pocket expenses.

Once you look at all of your coverage, you may find that it doesn’t stack up against what you would like it to be. If you decide that you need to make a change in coverage, one of those changes could be to purchase more of it. Additional insurance is available if you enroll in a Medicare Supplemental Insurance policy. These policies are sold by insurance companies, unlike Advantage plans that are offered through the government, and help fill in the holes left behind from Original Medicare. These plans are excellent tools for giving you the health care coverage that you deserve. Every year we hear stories about Medicare enrollees that have experienced financial struggles because of expensive hospital bills and treatment costs.

With ten different Medigap plans available, you can fill in different expenses and costs that Medicare doesn’t pay for. There are all denoted by a letter of the alphabet, Plan A has the least coverage, and Medigap Plan F being the most inclusive. Just like with your Medicare coverage, there are important considerations when deciding which supplemental insurance policy that you need.

You’ll need to take a long and hard look at your health, budget, and all of your options. If you’re in poor health and are expecting to have serious health complication in the future, you should consider investing in a policy that provides more coverage.

Additionally, take the time to consider your budget and finances. While everyone would prefer to have an all-encompassing Plan F, not everyone can afford one of those plans. Before you start looking for any supplemental plan, consider how much you can afford to spend every month for that coverage. A supplemental insurance policy shouldn’t put any additional strain on your finances.

You also need to consider all of your options. Do you want to go with basic Medicare Part A and Medicare Part B? Do you want to purchase a Plan D or a Medicare Advantage plan? You need to consider all of your coverage options before you make any decisions on which one works best for you.

Whether you are currently enrolled in Medicare or Medicare Advantage, or you are new to Medicare health care coverage, it is a good idea to have all of your questions answered so that you know exactly what you can expect when it comes to the health insurance that you are receiving in the future.

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