Choosing a Plan

Medicare is divided into various plans with different features and coverage options. Before you enroll in a plan, there are some important factors you need to consider.

These will affect your choices and will help you to choose the most suitable plan for you. Below are the factors to consider when choosing a Medicare plan.


This is highly important when choosing a Medicare plan. Enrolling in a plan only to discover the plan does not cover your healthcare needs can result in a waste of money. This is why it is highly necessary to check the coverage features of each plan before you enroll. For example, Original Medicare covers inpatient and outpatient hospital and medical services such as skilled nursing facility care, hospice care, etc. If you need any of these, then Medicare Part A and Part B may be right for you. 

If you need coverage for your prescriptions, then you may need a plan such as Medicare Part D because Original Medicare does not cover most drugs. It also does not cover dental, vision, hearing, and other services. If you prefer to have your Part A and Part B coverage bundled into one plan, in addition to prescription drug coverage and other services, then a Part C plan may be the best option. 

If you are enrolled in other health plans such as a group health plan, ensure you find out how the plan works with Medicare and what type of Medicare coverage is suitable for you. This is because Medicare could either be the primary or secondary insurance to your group health plan.

As you can see, there are many Medicare options available, but choosing the one with the coverage that suits you best is what matters most. That’s why using Medicare experts, like Scott Sims Insurance, can help make comparing these options much easier.

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Plan Costs

This is another important thing to consider when choosing a Medicare plan. After checking the coverage features and confirming if the plan covers your healthcare needs, you still need to confirm if the cost is within your budget. Each Medicare plan has its own premiums, deductibles, copayments, etc. Some plans have high premiums while some have a $0 premium. 

You should also check if you can afford the out-of-pocket costs from each plan before you enroll. Plans such as Original Medicare do not have a limit on annual out-of-pocket costs, while Part C plans have an annual limit. There are also programs that can help you cover plan premiums, deductibles, etc. Examples of this include Medicare Savings Programs and the Part D Extra Help Program.

Plan Policy

Each Medicare plan also has specific policies. Some plans may allow you to visit any provider that accepts Medicare while some have a list of network providers that you will need to see in order to get coverage. This is another important factor to look at because this will help you determine just how much flexibility you are looking for in a Medicare plan when it comes to healthcare providers.

At Scott Sims Insurance, we are prepared to help you choose the best plan for your healthcare needs. Call us today at (541) 915-0939.