Shopping for Medicare: Understanding Your Options
There’s a lot of talk in the news about Medicare — and so much information out there that it can seem daunting to navigate. Don’t worry: we’re here to help you stay informed, and choose the coverage that’s right for you.
Key considerations include cost, prescription drugs, doctor and hospital choices, and quality of care. If you need additional care while managing a chronic condition, you’ll want to consider that too. Our comprehensive “New to Medicare” guide for those turning 65 will help you sort through some of the questions you might have about plans, eligibility criteria, and the signup process.
With the Medicare Annual Enrollment Period (AEP) right around the corner (October 15 to December 7), this is the perfect time to think about your health care needs for 2021.
As you shop around for a plan, there are a number of important questions you’ll want to ask yourself in terms of what your needs are, and how they might shift over time. After all, there’s nothing more important than your health care.
What is Medicare, exactly?
Medicare is a federal health insurance program for people aged 65 and older, and people with certain disabilities. It is divided into four parts, known as A, B, C, and D.
Part A and Part B are together referred to as "Original Medicare.” These two parts complement each other to provide coverage both in and out of the hospital.
- Part A (Hospital insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. It does not cover regular doctor visits or prescription drugs.
- Part B (Medical insurance) covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Parts C and D include additional coverage and benefits:
- Part C (Medicare Advantage) is an “all in one” alternative to Original Medicare, with bundled plans that include Part A, Part B, and sometimes Part D. It combines everything you get with Original Medicare while sometimes offering extra benefits such as dental, vision, and hearing services, as well as prescription drug coverage.
- Part D (Prescription coverage) covers prescription drugs. Part D plans are offered by private companies approved by Medicare.
If you’re receiving Social Security benefits, you’ll most likely be automatically enrolled in Parts A & B. If you’re not yet receiving Social Security benefits and would like to enroll in Medicare, you will need to sign up. You can do this at www.ssa.gov or visit your local Social Security office.
You can also enroll in a Medicare Advantage plan to receive the same coverage you get with Original Medicare, plus additional coverage. To enroll in a Medicare Advantage (Part C) plan, you must have Medicare Parts A and B; and live in the Medicare Advantage plan’s service area. For more details, you can visit resources such as the Medicare.gov site and the AARP’s Medicare Question & Answer tool. And again, as you consider your Medicare Advantage options, you’ll want to examine issues such as cost, coverage, and quality of care.
You may also choose to enroll in a Medigap (Medicare Supplement) policy in addition to Medicare. A Medigap (Medicare Supplement) policy is a supplemental insurance policy that fills the gaps in your Medicare plan coverage.