For example, you may want to check if out-of-network care is covered or even if the plan has a copay for prescription medication. Programs such as the federally funded State Health Insurance Assistance Programs are excellent resources. Working with a broker has a lot of benefits, including experience and connections with a huge array of insurance companies.
Many brokers maintain an ongoing relationship with you to help you as your needs change. There are very specific rules to protect you regarding brokers, so keep these in mind as you reach out and research. Do not pay a Medicare broker directly for their assistance.
They are paid by the insurance company to sell their insurance. To enroll in a Medicare Advantage Plan, sign up during your initial enrollment period, which starts three months before the month you turn 65 and ends three months after, or during the annual Open Enrollment for Medicare Advantage , which runs from October 15 through December 7. The difference between a Medigap plan and a Medicare Advantage plan boils down to two main factors: cost and coverage.
The Medicare Advantage plan can be cheaper, but the Medigap plan offers the ability to pick and choose the coverage you want, whereas in most cases, the Medicare Advantage plan has a set coverage scope. Medicare Advantage is still a Medicare plan ; it just offers a bit more all at once than Original Medicare does, as it includes prescription coverage, and in most cases, coverage for vision, dental, or hearing. Medigap coverage has more individual options, but the prices can rack up for each type of supplemental coverage.
The biggest benefit of buying a Medicare Advantage plan is the "bundling" concept. Some plans also allow for further coverage, such as dental or vision. There are some disadvantages of Medicare Advantage Plans to keep in mind before rushing into a Medicare Advantage plan. With Medicare Advantage, you'll trade some of the flexibility you have when you piece together supplemental coverage, and you'll have to live by the insurance company's rules.
So make sure you do your research and think about whether convenience and cost are more important to you than flexibility. They pass those savings on to you by offering a premium at no charge. You will, however, still have other monthly costs. At the basic level, Medicare Advantage plans do not cover dental or vision, but many plans offer those and other extra benefits, such as gym memberships or wellness programs. Some also offer hour nurse hotlines to answer medical questions.
Part of the reason Medicare Advantage plans are popular is that they are comprehensive and all-encompassing. You can apply for Original Medicare Parts A and B three months before you turn 65, the month of your birthday, and up to 3 months after you turn Some of those plans have higher out-of-pocket costs or copays depending on the insurer , but it would likely be far less expensive for you in the long run versus Original Medicare, especially since Original Medicare would require an extra plan to include prescription medications and has no cap on out-of-pocket costs.
We reviewed 10 of the most commonly used insurance companies in the United States and selected companies that serve the majority to provide the best selection for most consumers. We also considered whether companies offer extra bonuses for enrollees, such as membership in health plans or automatic withdrawal from your Social Security for premiums. Investopedia requires writers to use primary sources to support their work.
These include white papers, government data, original reporting, and interviews with industry experts. As of Jan. Medicare Advantage Health Plans are similar to private health insurance. Most services, such as office visits, lab work, surgery, and many others, are covered after a small co-pay. Each plan has different benefits and rules. Most provide prescription drug coverage. Some require a referral to see a specialist while others do not.
Some may pay a portion of out-of-network care, while others will cover only doctors and facilities that are in the HMO or PPO network. There are also other types of Medicare Advantage plans. Selecting a plan with a low or no annual premium can be important. But it's also essential to check on copay and coinsurance costs, especially for expensive hospital stays and procedures, to estimate your possible annual expenses. Head to the Find a Medicare plan page at medicare. The National Committee for Quality Assurance NCQA , an insurance rating organization, also compares what consumers think of Medicare Advantage plans' services and physicians, and whether the plans meet certain quality standards.
Top ratings in were garnered by an impressive 43 Aetna Medicare Advantage plans sold in 37 states plus the District of Columbia. Be sure to check the ratings for plans available in your state. Your lifestyle, health condition, and finances may all influence what you determine is best for you: traditional Medicare plus Medigap or Medicare Advantage.
Here are some things to consider:. Medicare Advantage plans might save you money, but be sure to check whether prescription drug benefits are included. Also check the cost of any premiums, copays, and other out-of-pocket expenses, and whether there are any limits in their coverage.
If extra benefits are included, such as help with hearing aids and dental bills, be sure to find out how much of these expenses will actually be covered. Compare these costs to those of purchasing Medigap and stand-alone Medicare Part D prescription drug policies. Calculate the premiums, as well as the amount of any out-of-pocket expenses deductibles, copays, coinsurance the policies may require. Yes, these can be complex calculations, but an insurance broker can help by doing the math for you and making cost-saving recommendations.
Original Medicare allows you to use any U. Most Medicare Advantage plans restrict you to using physicians in their network and may cover less, or none, of the expenses of using out-of-network and out-of-town providers. A plus of Medicare Advantage managed care plans is that care is coordinated and your primary care doctor will be in the loop about the findings of specialists. Often this is best done by developing a relationship with a primary care physician and letting them refer you to specialists.
Are the doctors accepting new patients? Will you have to travel far to see a provider or be treated in an emergency room? Advice from local professionals, neighbors, and licensed insurance brokers can help you find Medicare Advantage plans that do business in your area.
Compare plans to find one that may suit your needs. Frequent travel, dual residences, and currently having physicians whom you would like to keep are some of the factors that may make regular Medicare a good choice. Ask your current physicians if they participate in any Medicare Advantage plans or accept regular Medicare.
For frequent fliers, choosing regular Medicare plus a Medigap insurance policy that covers emergency care in foreign countries may be a good bet. Similarly, people who spend part of the year in a different geographical area may find it difficult to stay in-network for medical care and might be better off with regular Medicare and a Medigap insurance policy.
People with chronic diseases and those who develop a serious health condition should look deeper into the choices available. Coinsurance under Original Medicare is based on the actual cost of your services. Medicare Advantage plans typically charge a flat copayment at the time of service, regardless of the total cost of the visit. MarketWatch Logo Go to the homepage. Learn More. Finding the best Medicare plan for you Choosing the best Medicare plan for your insurance needs is about more than just cost.
Find out what to look for in top-rated Medicare plans. What is the best Medicare plan? Original Medicare is a two-part plan offered by the federal government : Part A covers inpatient stays at a hospital, hospice or skilled nursing facility Part B pays for your outpatient services such as doctor visits, diagnostic tests and medical therapies You have separate deductibles and coinsurance for each part of Original Medicare.
Kaiser Permanente earned points out of 1, in J. Medicare Advantage Study, netting it the top spot for customer satisfaction out of nine providers measured. Only four Medicare health plans received a 5 out of 5 rating from the National Committee for Quality Assurance, and three of them are Kaiser Permanente plans. Kaiser Permanente plans are available only in eight states and Washington, D. Service area: Available in 50 states, Washington, D. Humana plans offer access to the Humana Pharmacy mail delivery service, which tops the list in customer satisfaction for the fourth year in a row, according to J.
Humana comes in only slightly above the industry average in J. Service area: Available in Pennsylvania and West Virginia. Standout feature: Highmark gets solid Medicare star ratings from the CMS and high customer satisfaction scores from J. Highmark is a member of the Blue Cross Blue Shield family, which includes 35 independent companies that together form the third-largest provider of Medicare Advantage plans.
Medicare Advantage Study, scoring out of 1, points. There are no Special Needs plans for people with certain diseases or chronic conditions. The right Medicare Advantage plan for you will depend on your health history, prescription medications and where you live, among other things. Here are some strategies for selecting the best plan:. Check star ratings. The CMS collects data on Medicare Advantage plans from member surveys, the plans themselves and medical providers, and then assigns a star rating based on the results.
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