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How to Evaluate a Medicare Plan

How do you effectively evaluate a Medicare plan? Today we break down some common questions people have when enrolling in Medicare.

3 mins read
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In today’s article, we will answer some of the most basic questions about selecting a Medicare plan, including:

  • What’s the best place to start the process of selecting a Medicare plan?
  • How can you know if a Medicare Advantage or a Medigap plan is best for your situation?
  • Is a zero-premium plan a good thing or are there hidden costs that make them a bad choice?
  • What online tools are available to help you select the plan that is best for you?

After reading today’s article, you will know the answers to those questions – and have a much better understanding of how to evaluate plans and pick the one that is best for you.

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What Is the Best Place to Start the Process of Selecting and Enrolling in a Medicare Advantage or Supplement Plan?

Remember that before you can enroll in a Medicare Advantage or a Medicare Supplement plan (which are the two types of additional Medicare coverage) you must first be enrolled in Medicare Part A and Part B which make up “original Medicare.” You’re eligible for those parts when you turn 65 – or if you’re younger than 65 and have certain disabilities or special needs.

How do most people enroll in these forms of coverage? They visit the Social Security website or call Social Security directly. They then fill out some forms and sign up for Medicare Parts A and B.

Remember, you don’t need to sign up for both Part A and Part B at the same time. For example, some people only sign up for Part A and then they continue working for a period of time before they sign up for Part B.

What About Medicare Part C?

Medicare Part C is also known as a Medicare Advantage Plan. You can choose to enroll in Medicare Advantage or select a Medigap/Medicare Supplement Plans. How can you decide which kind of plan is a better choice for you?

This is a big topic with many considerations to weigh. But for the purposes of this article, let’s boil it down to only two important considerations to keep in mind:

  • Your budget. If you want to minimize unexpected expenditures, opt for a Medigap plan. If you are able to pay a higher amount for your health care and you don’t want to worry about your health care costs when you see a doctor or go to the hospital, then a Medigap plan will probably be a better option for you. But if you have a lower monthly budget and you’re happy to pay for your health care costs a little at a time as you go, then a Medicare Advantage plan will probably be better for you.
  • How your care is delivered. If you prefer to see a doctor of your choice without referrals then a Medigap/Medicare Supplement is your better choice. If you’re OK using a network of doctors and service providers (HMO/PPO) then a Medicare Advantage plan will suit you well.

Can’t You Wait and Sign up for Medigap plan after Age 65?

You can always sign up for a Medigap/Medicare Supplement plan later in a future year when you are older than age 65. But remember, you only get one Medicare Guaranteed Issue period which occurs the 6 months following your Part B enrollment. If you miss this window you will probably have to go through underwriting (some exceptions apply- watch this video for more details).

And What about Plans with a Zero Monthly Premium?

A lot of people hear about Medicare Advantage plans that have a $0.00 monthly premium and they think, “That’s just too good to be true.” And then they look elsewhere. What these ads don’t tell you is you still have to pay your Part B premium.

But these plans really are being offered, and they could be good choices for you. Just be aware that you will probably encounter unexpected costs later on. After all, there is no such thing as a free lunch and the truth is that if you opt for one of these seemingly free Medicare Advantage plans, you will have to pay out-of-pocket costs for certain services, like seeing specialists or having tests.

It’s another instance where you really need to consider the health care services that you think you might be likely to use. Always read the coverage details to understand the coverage you are getting and the associated costs for seeing doctors or a hospital stay.

Are There Good Online Tools that Can Help You Select the Right Plan?

There is a search tool on Medicare.gov that is designed to lead you to the plan that is best for you.

However, most users who have tried this tool report it is hard to use and doesn’t lead them to the best plan choices. This is a self service tool. If you have questions there is no one available to assist.

We suggest that you will have a better experience and be led to a better selection of appropriate plans if you use the Medicare Planner here on CoverRight.com.

CoverRight is on a mission to make the Medicare plan selection process easy to understand and help you find the best Medicare plans suited to your specific situation.

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Barry Lenson

Barry’s is an experienced writer who's most recent book projects have included "The Digital Health Revolution" and "Connecting Health Care," for which he served as writer and editor for the author Kevin Pereau. Barry’s own books include the Amazon.com self-help bestseller "Good Stress, Bad Stress." Barry writes blogs for Tortal Training, Ingage Consulting, Specialty Metals Smelters and Refiners, and other clients.