How to Choose Your Medicare Coverage

4 minute read

By Editorial Staff

The Medicare enrollment process can be intimidating, but breaking it down into steps will help you understand what plan makes sense for your lifestyle and your budget. Start an online search today to learn more about what’s covered under Medicare.

Medicare sure does have plenty to offer seniors over the age of 65. All the more reason to take the time to learn about the enrollment process to ensure that you’ll be able to enjoy comprehensive health coverage at reasonable rates.

What Type of Coverage Do You Want?

There’s a lot to consider when deciding on a Medicare plan. You have different options for coverage that will ultimately determine your premium, out-of-pocket costs, and even the doctors you can see. Here’s a breakdown of the coverage options.

Medicare vs. Medicare Advantage

Seniors have two main options for health plans: Original Medicare (Medicare Parts A and B) or Medicare Advantage (Part C). Original Medicare covers you for costs involving hospital care, home health care, clinical research, and other standard things. With Medicare Advantage, you will get everything that’s covered with Original Medicare along with some additional coverage.

It’s important to carefully read the details of each plan to determine whether or not you need to buy extra coverage. If you think you need more than what Original Medicare offers, you might want to sign up for a Part C plan.


You can also add supplemental coverage. Adding Medicare Supplemental Insurance, also known as Medigap, to your plan will give you more comprehensive health coverage. Private insurance companies will help cover things that Medicare won’t pay for such as copayments, coinsurance, or deductibles.

It’s important to note that you have to be enrolled in Original Medicare (Part A and Part B) to qualify for supplemental coverage. A supplemental plan will also require a monthly premium. Depending on your chosen plan, you may still have additional healthcare costs.

Do You Want Prescription Coverage?

Unfortunately, prescription medication isn’t widely covered on regular Medicare plans. That’s why you should consider enrolling in Medicare Part D. There is an extensive list of prescription drugs covered on this plan.

Part D categorizes each drug into four tiers. If your necessary medication is labeled under Tier 1, which includes most generic prescription drugs, you will pay the lowest copayment. Policyholders will have to pay higher copayments if their medication falls under a Tier 2, Tier 3, or Specialty tier category.

You can also get drug coverage by enrolling in a Medicare Advantage Plan. Before deciding whether to enroll in Part D or a Medicare Advantage Plan, find out where your medication is covered and how much it will cost you under each plan.

How Much Do You Want to Spend?

While Medicare is more affordable compared to other health plans, you still have to set a budget. This will help you choose a concise plan and prevent overpaying for services you don’t actually need.

Understanding the Costs

While some Medicare Advantage plans are available with $0 premiums, that still doesn’t guarantee you’re covered for all costs. Some costs you may be responsible for on an Original Medicare, Medicare Advantage, Part D, and Medigap plan include the:

If you want drug coverage, the price will depend on the drugs you use and the plan you choose. It will also be based on whether you go to a pharmacy in your plan’s network and if the drugs are on your plan’s formulary.

Think about how much you’re willing to pay out-of-pocket for uncovered medical costs. If you’re content with paying out a certain amount of money when necessary to obtain a lower monthly rate, it could be worth it in the long run.

Who Will Your Doctors Be?

When you’re under Medicare, you can only go to doctors that accept Medicare. The good news is the majority of primary care doctors accept Medicare. For Medicare Advantage policyholders, you’ll have to find out whether your doctor or pharmacies participate in the plan’s network.

This is because Medicare Advantage involves private insurers, but some plans do offer out-of-network coverage. Doing your research ahead of time will let you know whether you’ll have to switch doctors to be part of your health plan’s network.

You’ll also want to consider the quality of care you’re receiving from Medicare health providers. Since service can vary, you should do your research by comparing plans and providers to find one that will meet your needs.

Will You Be Traveling?

Those looking to travel short or long-term need health coverage. Since Original Medicare or Medicare Advantage plans do not cover care outside the U.S., you’ll have to look into supplemental insurance policies that offer travel coverage.

Travel insurance will cost you extra and coverage can range. That’s why it’s important to read the fine print to find out exactly what is covered and compare the different types of plans available to you.

Learn More About Medicare Online

Taking the time to research Medicare will help you choose a plan that’s right for you. Make sure to understand the difference between Original Medicare, Part D, Medicare Advantage, and Medigap. Each has its own designated coverage and associated costs. You can learn more about what Medicare has to offer by searching online.

Editorial Staff