Tips for Making the Right Medicare Choices

It’s Medicare open enrollment time, when most people aged 65 and older select their health insurance coverage for the following year. Now through Dec. 7, you can make the choices that you think will provide the best coverage for your needs in 2022. People who are younger than 65 also may be eligible to get Medicare if they have a disability, end-stage renal disease, or ALS (Lou Gehrig’s disease).

Even if you’ve enrolled in Medicare before, it’s always important to look closely at your options. “Taking your time during open enrollment to evaluate your needs and choose the correct plan could save you thousands of dollars,” notes Erin Bradshaw, chief of mission delivery at the Patient Advocate Foundation (PAF), a nonprofit that helps people diagnosed with a chronic, debilitating or life-threatening condition.

The experts at the PAF offer these tips for making your choices:

1. Know the deadlines, and don’t miss them. If you do, you won’t be unable to enroll in Part B until the next open enrollment period, and you’ll pay a higher premium going forward.

2. If you have employer or retirement benefits, check with your benefits administrator. Your employer’s plan may require you to also enroll in Medicare. You may discover that your current plan will only cover part of your costs even if you don’t enroll in Medicare.

3. Know the differences between different types of Medicare plans – there may be one that is better for your needs. Learn the differences between Medicare Part A, B and Part D, and the differences between a MediGap plan, a Special Needs Plan and a Medicare Advantage plan.

4. Look beyond your monthly premium. Your plan will inevitably require out-of-pocket spending beyond your monthly premium. Consider copay and coinsurance costs, along with potential out-of-network costs, particularly for Medicare Advantage plans.

5. Make sure you choose a prescription drug plan – it’s a separate plan with a separate premium. Base your choice on your current medications along with those you may need in the upcoming year.

6. If you’re new to Medicare, consider a Medigap supplement plan. New enrollees have six months to enroll in a supplement plan without being subject to restrictions or increased costs based on pre-existing conditions. These plans cover copays, coinsurance and deductibles. You’ll have to pay an additional monthly premium, but particularly if you have a serious health condition, you may save thousands of dollars over the course of your plan.

7. Don’t be fooled by advertising. Many patients assume that Medicare Advantage plans – particularly those labeled “Complete” – will cover 100% of costs, even though they will only cover the same 80% of costs as traditional Medicare. And Medicare Advantage plans may allow only a narrow network of providers.

8. Review, review, review! Medicare plans, much like an employer-sponsored or Marketplace plan, can change every year. Even if your plan stays the same, your own medical needs may have changed.

Don’t wait until the last minute. Choosing the right plan takes a lot of time, but with projected healthcare costs in retirement up to $390,000 for a couple on Medicare, it’s worth the effort.

Source: Patient Advocate Foundation (