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Picking a Medicare Plan That’s Right for You

About The Author

Tom Hitchcock

VP of Sales

Network Health

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The annual Medicare enrollment period is upon us – October 15 through December 7 – which means it’s time to start thinking about enrolling in a plan or making changes to your current coverage.

Before making a decision, it’s helpful to know the basics. Medicare is made up of four parts.

  • Part A is typically provided at no cost to you and covers hospital stays, home health hospice and skilled nursing care. You’re automatically enrolled when you turn 65 if you collect social security.
  • Part B is medical coverage and covers doctor visits and outpatient services. The cost is set by the government and varies from year to year.
  • Part C covers both hospital and medical coverage, and is administered through a private insurance company. The cost of a Part C plan depends on which plan you select, the types of services included, and whether prescription drugs are covered.
  • Part D covers prescription drugs (it’s often called a stand-alone prescription drug plan) and is offered by private insurance companies. You can choose a stand-alone drug plan or you can opt to add Part D coverage to a Part C plan.

When you hear the term Original Medicare, it includes Parts A and B whereas Medicare Advantage is Part C. Original Medicare is available to people who are 65 years of age and older, disabled, or have end-stage renal disease. Medicare Advantage plans are available to people who live in the plan’s service area and are eligible for Part A and enrolled in Part B and continue to pay their part B premium every month. Individuals with end-stage renal disease are not eligible for a Medicare Advantage plan.

There are several plans to pick from, which makes it challenging to know which will be the right one for you. Here are a few things to consider when picking a plan:

  • Your doctors – Some plans allow you to see any doctor who accepts Medicare, while others restrict your options. If you have a particular provider you prefer to see, make sure he or she is covered under your plan.
  • Your drug coverage – Every day, 10,000 Americans turn 65 and the majority of them take prescription medications. When considering a plan, write out a list of your current medications and check the plan to make sure those drugs are covered. Avoid the common and costly mistake of not getting prescription drug coverage. Doing so can result in a late enrollment penalty.
  • Customer service – At Network Health, we understand Medicare insurance can be confusing, so we go the extra mile to help our members. We have a team of dedicated Medicare concierges located right here in Wisconsin to make sure every member has a personalized experience when they call us.

To learn more, visit where you can brush up on Medicare basics and learn about different types of plans. You can also use our three-question interactive tool to find a plan that fits your lifestyle.

You can also give us a call at 866-393-7668 (TTY 800-947-3529). We’re here to help so feel free to reach out to us with any questions you may have about Medicare or the enrollment process.

Network Health Medicare Advantage plans include MSA and PPO plans with a Medicare contract. NetworkCares is a PPO SNP plan with a Medicare contract and a contract with the Wisconsin Medicaid program.

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