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Your Medicare healthcare plan should meet your needs

There are a number of factors to consider when choosing a Medicare plan for the first time or changing your Medicare plan.

If you have current health or prescription drug coverage, get a clear understanding of how it works with Medicare. If you’re covered through your employer, Indian Health, or Tribal Health Program, talk to your benefits administrator or insurer before making any changes in your plan.

When you’re ready to enroll in a new Medicare coverage plan, you can do so during designated enrollment periods.

 

When choosing any healthcare plan, ask yourself:

  • Are you in good health?
  • How often to you see your doctor?
  • Do you take prescription drugs?
  • How much can you afford each month?
  • Are you willing to change doctors if it means lower healthcare costs?

Medical costs

  • How much are your premiums, deductibles, and other costs?
  • How much do you pay for services like hospital stays, or doctor visits?
  • Is there a yearly limit on what you could pay out of pocket for medical services?

Prescription costs

  • Do you currently have prescription drug coverage?
  • Will you pay a penalty if you join a drug plan later?
  • What will your prescription drugs cost under each plan?
  • Are your drugs covered under the plan’s formulary?
  • Are there any coverage rules that apply to your prescriptions?
  • Is your pharmacy in the plan's network?

Medical care

  • Do your doctors accept the coverage?
  • Are the doctors you want to see accepting new patients?
  • Do you have to choose your hospital and healthcare providers from a network?
  • Do you need to get referrals?
  • Are you satisfied with your medical care?

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What to Consider