Anyone signing up for Medicare gets to choose either “original Medicare” or a Medicare Advantage plan. (They can switch between them at least once a year, too, during the annual enrollment period.) Close to 38 million people were recently enrolled in original Medicare — which consists of Part A (hospital services) and Part B (medical services) — while more than 23 million had chosen a Medicare Advantage plan (sometimes referred to as Part C).
Medicare Advantage plans are well worth considering. Offered by private insurance companies such as Anthem Blue Cross and UnitedHealthcare, they’re regulated by the U.S. government. This is key: They’re required to provide at least as much coverage as original Medicare — and they typically offer much more.
While original Medicare doesn’t cover vision, hearing and/or dental care, many Medicare Advantage plans do; they often include prescription drug coverage, too, which those in original Medicare have to pay extra for. Original Medicare will often charge you 20% of many bills, with no upper limit, while Medicare Advantage plans might charge you a low copayment for each doctor visit or service — and they cap your out-of-pocket spending.
There are some drawbacks, though. While original Medicare lets you see any health care provider who accepts Medicare, Medicare Advantage plans typically limit you to a network of doctors — though these networks can be large. Original Medicare usually won’t cover you outside the U.S., but some Medicare Advantage plans offer limited coverage abroad.
So, what’s best for you? Start by making a list of the prescription drugs you take and the doctors you see. Also list the kinds of health care services you need and use, noting any upcoming surgeries, travel or big-ticket expenses. When reviewing the plans you’re considering, compare how well each will meet your needs — and how much you’ll likely spend out of pocket with each option.
The Medicare.gov website offers a “Medicare Plan Finder” to help you compare and choose. Note the star ratings of your candidate plans and favor four- or five-star plans. ¦
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