Choose the Medicare Plan for You

If you are new to the world of Medicare and are trying to choose the right Medicare plan for you, it is normal to feel some confusion and frustration.

This article will walk you through the main choices in plans, the factors you should consider when making your choice and most importantly, where to get help if you need help choosing the Medicare plan for you. 

Medigap Vs. Medicare Advantage

There are two types of Medicare coverage and they work very differently from each other: Medigap Plans and Medicare Advantage Plans.

Here are some things that you should consider when trying to choose between the two types of coverage:

• Do the doctors you want to see belong to the same Medicare Advantage network? 
• Are you renting any medical equipment from a company?
• Do you travel frequently? If you answered yes, Original Medicare with a Medigap Plan is probably a better fit because it is accepted across the United States anywhere Medicare is accepted. If you travel internationally, there are some Medigap and Medicare Advantage plans that will even cover some emergency expenses while you are abroad. 
• Do you have enough in your budget to cover the out-of-pocket maximum that any advantage plan you might consider has? 
• Do you prefer a lower or zero premium and paying a small copay for your services as you need them? If so, choosing a Medicare Advantage Plan is probably going to feel more comfortable. 
• Do you feel more comfortable with a fixed monthly charge you can plan for? If this sounds more like you, then Original Medicare with a Medigap supplement will likely be the best fit. 

Traveling Abroad? Know Your Medicare Options!

Due to the monthly costs of the Medicare supplement and drug plan option, less and less of the Medicare eligible population are enrolling into a Medicare supplement plan.

After factoring your income, it will depend on how many doctors you see and if they are all local or not.

If you’re simply traveling for short periods of time and only wish to have nationwide urgent and emergency coverage in addition to the world-wide emergency coverage, Medicare Advantage may be an option to consider when speaking with a local Medicare insurance Agent. 

What You Need to Know about the F Plan

Since we are discussing Medicare supplements, we should mention the F Plan. We get the question all the time, “What is Medicare Part F supplemental insurance?.”

There is no Medicare Part F, so it’s not possible to be enrolled in Medicare Part F.

It’s called plan F or the F plan, and it is one of the options for a Medicare supplement plan.

This is the most popular Medicare supplement plan due to its coverage. Hence, many Medicare insurance brokers and health plans market this plan everywhere.

With the F plan you pay your monthly premiums, then all of your Medicare copay and coinsurances are covered. You would essentially pay nothing out-of-pocket for any Medicare covered service. This is what makes the plan so attractive.

Now, it is the most expensive option in terms of premium with prices starting at around $120 a month at age 65 and go up as you get older. However, if you became eligible for Medicare after January 2020 then you would not be able to enroll into the F plan.

You would still be able to enroll into any other Medigap plan, it’s just that they are phasing out the plan F. 

If you are ineligible for Plan F then the next best plan is Plan G.

There are numerous plan to choose from with various levels of coverage. We recommend you work with a broker to help you choose the right one for you.

There are many options for those on Medicare. As you hone in on your research, you may also be curious as to how to change my Medicare plan from one to another?

It’s quite simple.

Any one of our local Medicare insurance agents can support you by enrolling you into the plan you choose and ensure it’s processed without any issues.

Choosing a Medicare Supplement Plan

Medicare Supplement Plans (also called Medigap Plans) are all standardized.

That means that you will get the same coverage from the plan that you choose no matter which company you buy it from. 

Medicare Supplement Plans don’t have any network issues and can be used nationwide without hardly any restrictions.

For this reason, many who travel often will choose to enroll into a Medicare supplement.

They allow coverage in every state within the united states and its territories. If you travel out of country, then you will want to speak with a local Medicare insurance agent and choose a plan that covers emergency care for foreign travel.

So, what is the best way to choose a Medicare supplement plan? 

The Medicare supplement plans that cover this are Plan C, D, F, G, M and N. Any of these will allow you to have world-wide emergency coverage.

The price of a Medigap plan will vary based on tobacco use, gender, age and where you live. In some cases, you may also find that your household is eligible for certain discounts.

The easiest way to find the best price on the plan that you want is contact a Medicare Broker.

• They will be able to quote multiple sources and find the best companies with the best prices for you.
• They can also tell you about the company you are choosing and what types of rate increases they have had in the past.

This lets you make the most informed decision possible without all of the confusion. 

Choosing a Medicare Advantage Plan

Many Medicare Advantage Plans have a $0 monthly premium.

They also do a great job of adding coverage without eating into the fixed income that many retire on.

Plus, with large networks in many of the more populated regions, it’s possible to have all your doctors under one simple network.

3 Ways to Find a Better Medicare Advantage Drug Plan

If you decide that having a Medicare Advantage Plan is better for you, there is a great online tool offered at www.medicare.gov that can help you sort through the drug costs for Medicare Advantage plans for you.

We have found that this tool does not do a good job of comparing out of pocket costs, networks, and specialized plans that may be available for those with Medicaid or chronic conditions.

There are three common types of plans that are offered: 

• Medicare HMO plans
• Medicare PPO plans
• Special plans offered in some counties (Medicare Cost plans, Special Needs Plans and PFFS plans are examples)

Choosing a Medicare Plan – Consider the Network

Many people begin comparing Medicare advantage plans by comparing benefits. This may lead you to a dead end.

The single biggest factor that affects your experience with a Medicare Advantage plan is what network/medical group you are assigned to.

The Medicare plan you choose may not be accepted by any or all of your doctors. You will need to find out what networks all of your doctors accept.

Once you have narrowed your search to a single network that all of them accept, you can choose from the set of plans that participate with that network. 

The good news is, with large networks in many of the more populated regions, it’s possible to have all your doctors under one simple network.

If you aren’t sure how these plans work or how to identify networks, just like with a Medigap supplement, a Medicare Broker will be able to explain all of the differences, show you what is available for you, and help you choose the Medicare plan for you. 

A Medicare Broker in Your Corner

If you need someone who will look out for your best interest and help you navigate the world of Medicare supplement plans, make an appointment with a Medicare Broker who knows all the ins and outs of the system.

They can help you choose the Medicare plan you want and need. 

• As independent local Medicare insurance agents, we are not tied to any one provider or product. Instead, we work with all of the major providers that offer Medicare plans in our area and can help you select the plan that best fits your needs and budget.
• We will also help you compare these plans so that you can make the best decision possible when it comes time to choose one.

Biggest Advantage Of Working With A Local Medicare Insurance Agent

Medicare insurance agents get paid by the health plans, not you.

Many of those who are eligible for Medicare aren’t aware that Local Medicare insurance agents exist to help guide them through the Medicare process and with Medicare insurance.

Some of the most common questions we get asked are:

• “What is a Medicare Agent?”
• “How do Medicare agents get paid?” 

In short Medicare agents are individuals licensed by the state to support you with exploring your Medicare health insurance options like, prescription drug plans, Medicare advantage plans, and Medicare supplement plans.

They also support with enrolling to Medicare by educating you not only on the process but also the expectations moving forward.

Medicare insurance agents get paid by the insurance plans they enroll you into.

You should never pay a broker fee or have to personally compensate the agent that assists you.

Medicare has made it such that all Medicare plans pay identical to each other, so the incentive is to enroll you into the plan that is best fit for your needs, not the plan that pays the best.

Options Available In Your Community

Some agents will only represent one or two plans. Local medicare agents offer all medicare insurance options

Our affiliated Local Medicare Insurance Agents are what you call an Independent Medicare Insurance Agent.

What this means is that they serve your county by offering all Medicare insurance options available to your community.

When deciding to sign up for part C or a Medicare supplement there can easily be over 10 options available to you.

Depending on your circumstances, the option that fits best may vary from that of your friends and family. This makes the question “What is a good insurance to supplement my Medicare?” a little more complex, but it’s something they can get to the bottom of. It will depend on your income, doctors, medications and more. 

Which is the best Medicare plan? Aetna, Humana, Anthem or Others?

Many assume that the name they recognize most is going to be the best choice. This can sometimes be a good place to start but has no relation to better benefits or price.

This is because unlike employer plans and individual health insurance plans, Medicare plans are applied for by county.

This means that each insurer decides which counties they specifically want to participate in. This generates variety and can increase quality due to a health plan being designed specifically for your area.

Due to variety there will often be names that many will never have heard of that could be a popular and high-quality plan in your area.

For example, there are companies like Care 1st, Inter Valley, Alignment, Brand New Day and more that many may have never heard of before starting to research their options with Medicare.

Yet, each of these names are huge competitors in various counties across the state.

Care 1st has been so competitive that Blue Shield of CA purchased them and have now transitioned their name from Care 1st to Blue Shield Promise.

Popular and high-quality plans can vary by county, and for this reason, you may want to partner with an Independent Local Medicare Insurance Agent to figure out if there’s a “Care 1st” in your county.

What is better, a Medicare supplement or a Medicare Advantage?

As stated earlier, it’s going to depend on your finances and where you live among other factors. If you can afford a Medicare Supplement plan and will utilize its perks, then it’s a great option.

Even if you can afford a Medicare supplement, you may not see yourself capitalizing on what you’re paying for and end up liking a Medicare advantage plan instead.

Depending on where you live, you may be able to find a Medicare advantage plan with a large network and great benefits that makes paying the monthly premium for the Medicare supplement plan rather unnecessary.

Those who live in different states for extended time periods will often find the Medicare supplement the better option for them due to capability to use nationwide for all Medicare accepted services.

Overall, the biggest factor between the two will be your finances.

Do I need Medigap Insurance?

Medigap is another name for Medicare supplement. You do not “need” Medigap insurance, but you may find that it is the most suitable option to manage your Medicare coverage based on your specific healthcare and lifestyle needs.

How to choose which Medicare Advantage Plan is best for you?

The first misconception people make when choosing a Medicare Advantage plan is to compare benefits first.

If it’s not important to see particular doctors and you’re not taking any prescriptions at the moment, then go ahead and compare benefits.

Not all doctors accept all Medicare advantage plans in each county, and Medicare Advantage plans have different prescription drug coverage.

For this reason, we recommend starting with finding out which plans are accepted by your doctors and then find out which of those plans cover all your medications.

People will often choose a plan because of its benefits and neglect to consider what we mentioned above, then have hurdles to climb when they’re not able to see a specialist or are asked to pay out-of-pocket for a medication.

So, when choosing a plan follow these steps:

1. Find out which plans all your preferred doctors accept
2. See which of those plans cover all your medications
3. Compare coverages of the remaining plans to fit your needs

This process can be tedious and stressful at times. It helps to partner with an Independent Medicare Insurance Agent to do this leg work for you AND help you understand your options that have been narrowed down, so you can confidently choose a plan that works for you.

Where can I apply for Medicare?

Many people don’t actually apply by paper anymore. Most Apply for Medicare either online at social security or by calling into social security at 1-800-772-1213 (TTY 1-800-325-0778).

If you would still like to apply by paper, you can find an application in any Social Security office.

Can I sign up for Medicare online?

Yes!  Save time from having to drive and wait at the Social Security office or wait on hold for a representative by phone.

Once submitted online, someone at Social Security will review your application and call you to confirm any additional information needed or if anything seems incorrect.

So, you can apply online with the peace of mind that someone is going to review your application with the intention of making sure your application is accepted.

You can begin your online application for Medicare HERE.

What is the Medicare enrollment period?

For most, you can enroll into Medicare as early as 3 months before your birth month.

So, if your birthday is May 15th, then you can apply as early as February 1st.

This enrollment period will extend until 3 months after your birth month. In our May 15th birthday example, you would have until August 31st to apply for Medicare.

Important Note: if you are keeping employer coverage, then you will be able to apply for Medicare once you leave the employer coverage and will have two months from the time the coverage ends to do so (please check with your HR department that you have Creditable Coverage).

Do I have to apply for Medicare Part B?

It depends. With Medicare you never “have” to do anything; however, you may be penalized financially for failure to do certain things.

If you do not apply for Part B when you are first eligible, then you will receive a penalty when you finally decide to enroll for not doing so initially.

An exception to this rule is if you are keeping employer coverage after you are eligible for Medicare.

Then you don’t have to apply for Part B as long as you have Creditable Coverage through the employer plan.

What is my Medicare eligibility?

Eligibility for Medicare is determined by meeting at least one of the following qualifications:

1. You are 65 years of age or older
2. You have been disabled and receiving SSDI for 24 consecutive months
3. You have ALS (Lou Gehrig’s Disease)
4. You have ESRD (End-Stage Renal Disease)

Is it mandatory to sign up for Medicare at age 65?

Similar to the above Part B question, it depends.

With Medicare you never “have” to do anything; however, you may be penalized financially for failure to do certain things.

If you do not apply for Part B when you are first eligible, then you will receive a penalty when you finally decide to enroll for not doing so initially.

An exception to this rule is if you are keeping employer coverage after you are eligible for Medicare. Then you don’t have to apply for Part B as long as you have Creditable Coverage through the employer plan.

How to apply to Medicare in my area?

Applying for Medicare is a universal process.

It is the same whether you’re in Orange County or Fresno County.

You can apply for Medicare either online at social security or by calling into social security at 1-800-772-1213 (TTY 1-800-325-0778).

If you would like to apply by paper or in person you can visit any Social Security office in town. To find an office near you CLICK HERE.