6 Tips You Need to follow When Shopping for Medicare Insurance

Nov 22, 2022

With time, the options for Medicare insurance have expanded significantly. Most recipients get to choose from more than 25 plans, each associated with different pharmacies and medical providers offering unique premiums and copays.
This is because health insurance can’t be a one-size-fits-all solution. Everyone is offered a unique plan based on where they live, their lifestyle, medical needs, and of course, budget.
With so many choices at hand, it’s natural for you to get confused and overwhelmed. Still, you can pick a plan that best suits your requirements, circumstances, and expectations with little effort and due diligence.
Here are six critical tips you must follow when shopping for Medicare insurance.

  1. Know Who to Talk to for Advice and Guidance

Not exploring your Medicare insurance options could cost you a lot of money. 

Unfortunately, this fear pushes many people to dial one of the 1-800 numbers they see flashing on their television screens. A complimentary review for a Medicare Advantage plan sounds tempting, after all.   

But guess what?

Each Medicare agent or broker on the toll-free line pays upwards of $75 to have your call transferred to them. This gives them a high motivation to try and switch your coverage no matter what. In other words, they may have high quotas and ulterior motives.      

Most counties offer plans from 10 to 30 insurance carriers, and almost all of them offer biased advice. Besides, calling them all could take all day. So, unless you want to waste your time and take advice from someone who doesn’t have your best interest at heart, you should steer clear of those toll-free numbers. 

Researching on your own isn’t a great idea, either, as most consumers are introduced to 20 or as many as 50 Medicare insurance plan options at a time. 

The only proper way to go about this is by reaching out to a local Medicare agent at a reputable company who’ll respect your time and have a genuine concern about your interests. You should ask them about your premiums, deductibles, and other fees, along with any coverage rules affecting your cost. It’s also a good idea to get a rough estimate of how much you may have to pay for doctor visits and hospital stays and if it will have a yearly limit. 

A professional Medicare agent will have no trouble answering these questions. In fact, they’ll go the extra mile to ensure you make a well-informed decision.   

2. Have Clear Requirements and Preferences

Knowing what you want from a Medicare insurance plan will make it easy to compare different coverage options

Here are a few questions you need to ask yourself: 

  • Will I keep my current doctors?
  • How often do I expect to see a doctor or get other medical services? 
  • Do I take prescription drugs daily?
  • Will I travel often or spend time in another country for several months?
  • Are there any existing health insurance plans that I intend to continue using?

Your answers to these questions will influence your decision when choosing a Medicare insurance plan. A good Medicare agent will be by your side to eliminate any confusion. 

   3. Compare Costs

Medicare Part A (for hospital care) is often provided to recipients for free. On the contrary, Medicare Part B, which covers medical care, has to be elected and paid a monthly premium. The same goes for Medicare Part D plans.

This premium will be deducted automatically if you have a Social Security card or are entitled to the benefits offered by the Office of Personnel Management or Railroad Retirement Board. You’ll receive a bill if that’s not the case with your payments.

That said, the final cost of any coverage will depend on the Medicare insurance plans available in your area. 

4. Think Beyond Premiums

While the monthly premium of a Medicare prescription drug or Medicare Advantage plan varies significantly across the country and even within a particular market, you should make up your mind according to the average monthly premium for a Part D drug plan ($33) and a Medicare Advantage plan ($19).

Even if your plan doesn’t come with a premium, you’ll have to pay your Part B premium separately after enrolling in Medicare Advantage.

Many times, the plans with the lowest premiums turn out to be the most cost effective. That’s why you should explore and weigh your options to figure out just how much you’ll get for the extra premium and how much you’ll have to use the plan to get the most value. Most consumers don’t want to pay a $50 copay for a specialist doctor’s visit and would rather go for one that charges $35 per visit. However, insurance plans offering the latter often charge a premium of $35-$50 per month just to show a lower copay. 

Depending on how often a Medicare recipient uses it, the service ultimately decides the end value. Most consumers won’t go to a specialist more than 24 times a year, making a plan with a $0 premium and a $50 copay of better value.

Remember that chasing low copays isn’t the goal here. There’s a good chance a low monthly copay plan will cost you more in the long run. Instead, you must focus on a plan’s premiums, deductibles, coinsurance, and coverage or benefits modification. This will give you a good idea of your yearly spending.   

5. Check The Preferred Doctor and Pharmacy Network to Make Sure Of Provider Participation

Your medication cost will be reduced at an in-network pharmacy, so you should always check the preferred networks on an insurance plan. Moreover, if you tend to use a particular hospital, you’d want it to be in-network too.  

Lastly, don’t forget to double-check that your doctor is on your plan whenever Medicare announces open enrollment because it’s not uncommon for health provider networks to change frequently. While most insurers do offer to help you find a new physician if your doctor’s contract is terminated mid-year, it’s still a hassle. 

6. Check the Plan Star Rating’s 

Medicare’s quality rating system, called Medicare STARS, rates all Medicare Advantage and Medicare Part D plans on a scale of 1 to 5. The higher the stars, the better the plan’s quality will be. 

With this in mind, you wouldn’t want to sign up for a Medicare insurance plan with three or fewer stars.

Final Words

We’re a full-service insurance brokerage that provides 100% reliable, efficient, and cost-effective services related to Medicare insurance, Medicare Advantage plan, Medicare Part D coverage, or Medicare Supplement plan. 

To select the right Medicare plan for you or your loved one, get in touch with one of our local Medicare agents today.