What to Consider When Choosing or Changing Your Coverage

Coverage:
When choosing between Original Medicare and a Medicare health plan, does the plan provide extra coverage you want that Original Medicare doesn’t cover?

Your other coverage:
Do you have, or are you eligible for, other types of health or prescription drug coverage? If so, read the materials you get from your insurer or plan, or call them to find out how the coverage works with, or is affected by, Medicare. If you have coverage through a former or current employer or union, talk to your benefits administrator, insurer, or plan before making any changes to your coverage.

Cost:
How much are your premiums and deductibles? How much do you pay for services like hospital stays or doctor visits? Your costs vary and may be different if you don’t follow the coverage rules.

Doctor and hospital choice:
Do your doctors accept the coverage? Are they accepting new patients? If you are considering a Medicare health plan, do you have to choose your hospital and health care providers from a network? Do you need a referral to see a specialist?

Prescription drugs:
What are your drug needs? Do you need to join a Medicare drug plan? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary (drug list)? Formularies can change.

Quality of care:
The quality of care and services given by plans and other health care providers can vary. Medicare has information to help you compare plans and providers.

Convenience: Where are the doctors’ offices? What are their hours? Which pharmacies can you use? Can you get your prescriptions by mail?

Travel:
Do you spend part of each year in another state? Will the plan cover you there?

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