How do you choose a Medicare plan?
To choose a Medicare plan, you first need to understand a bit about Medicare. What types of plans are there? Part A, Part B, Part C, Part D—what do they all mean and how do they work together? And what about Medicare Supplement Insurance (also called Medigap)—is that a type of Medicare coverage, too?
What are the different Medicare plans?
There are 3 different types of Medicare coverage:
Part A and Part B, also called Original Medicare: Part A covers hospital care and Part B covers medical care. Part A and B cover the costs for many inpatient and outpatient medical services, as well as hospice care, some skilled nursing facility care, home health care, and durable medical equipment. Your out-of-pocket expenses can include annual deductibles, coinsurance, and copays.
Part A and B does not include dental, vision, or prescription coverage.
Medicare Advantage: This is also known as Part C. Medicare Advantage plans are offered through private insurers like Cigna.1 They bundle all of Part A and B (hospital and medical care), and usually include Part D prescription drug coverage, too. Many of these plans include dental and vision care.
Medicare Supplement Insurance Plans, or Medigap: These plans are also offered through private insurers, like Cigna. Medicare Supplement plans are just that—they supplement or offer additional coverage to help pay some of the costs that Original Medicare doesn’t pay. Medicare Supplement plans come in many different options, from those that cover basic costs to those that offer more comprehensive coverage for deductibles, as well as copays and coinsurance.
Medicare Supplement plans only work with Original Medicare or standalone Part D Prescription Drug plans. They do not work with Medicare Advantage plans.
What factors should you consider when choosing a Medicare plan?
Choosing a Medicare plan means taking a few moments to consider what would best fit your needs and lifestyle. You may want to consider the following factors when comparing Medicare plans:
- What are your health care needs?
- Do you see your primary care provider once a year for your annual checkup? Do you also need to see specialists for additional care?
- Do you expect to be hospitalized for a surgical procedure or need outpatient surgery?
- Do you take any prescription medications? If so, do you take specialty medications, things like insulin or other injectables, or do you take generic medications?
- Do you have a chronic condition that puts you at risk for needing more care?
- Do you have a chronic condition or disability for which you are already receiving Medicaid or disability benefits?
- Do you need dental care or vision care?
- Do you want coverage to include access to behavioral health providers such as therapists and counselors?
- Are you okay seeing a doctor in a network or do you want to have the flexibility to see any doctor?
- If you travel, do you want coverage wherever you go?
Having the answers to these questions, and others like it, may help guide you when deciding which type of Medicare coverage is right for you.
3 Steps to Choosing a Medicare Plan
This graphic shows the steps you might take when choosing Medicare coverage that’s right for you. It’s a great place to start if you want to compare Medicare plans or need a quick review of Medicare and all its parts.
You’ll see the main features of each Medicare coverage option side-by-side to help you understand how the different parts of Medicare work with each other.
Confused by Medicare terms?
Step 1: Decide if you want Original Medicare OR Medicare Advantage
Original Medicare (Part A and Part B)
You can enroll in Medicare Part A once you turn 65. If you’re already collecting Social Security disability benefits, you'll be automatically enrolled in Part A.
Medicare pays 80 percent of approved charges and you pay about 20 percent. Part B is optional because you have to pay a monthly premium and meet a deductible before Medicare will pay benefits.
Medicare Advantage (Part C)
Medicare Advantage Plan
These plans are part of the government's Medicare program, but are offered and managed through private insurers, like Cigna, and may offer plan extras not found in Original Medicare. You must be enrolled in Medicare Part A and Part B to join.
Step 2: If you choose Original Medicare, decide if you need to add supplemental coverage
Skip this step, if you choose Medicare Advantage—Medicare Supplement doesn’t work with Medicare Advantage Plans (Part C).
Medicare Supplement Insurance
A Medicare Supplement policy (also known as Medigap) is private health insurance that adds on to Original Medicare. It helps pay about 20 percent of the Medicare expenses that Original Medicare doesn't cover, after the Part B deductible has been met.
Step 3: Decide if you need to add prescription drug coverage to either Original Medicare or Medicare Advantage
Prescription Drug Coverage
Part D plans are part of the government’s Medicare program, but they’re offered and managed through approved private insurers, like Cigna. Enrollment in a separate Part D plan is not automatic. You need to select and enroll in a plan.
Where are you in your Medicare journey?
1Insured by Cigna Health and Life Insurance Company, American Retirement Life Insurance Company, Loyal American Life Insurance Company, or Cigna National Health Insurance Company.
2In some cases, a referral is required by Medicare. Choose any doctors who accept Medicare.
Notice for persons eligible for Medicare because of disability:
In the following states, all Medicare Supplement plans are available to persons eligible for Medicare because of disability: California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, New Hampshire, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont, and Wisconsin.