Seven Tips for Selecting a Health Plan

Tuesday October 20th, 2020

New to Medicare? Start here.

Unsure what your Medicare options are? Read this

Selecting the right healthcare plan for your needs is an important decision just like selecting your PCP. We’ve pulled together a list of things to consider when you’re deciding on a Medicare plan. Let’s dive in.

1

Examine your health needs

  • Do you have one or more chronic conditions? If so, you may want to consider a Medicare Advantage plan that could give you access to additional health coverage and benefits that could help you better manage your condition(s).
  • How often will you need to go to the doctor? If you see your PCP regularly, you may want to select a Medicare Advantage that offers a $0 PCP copay.
  • Are you anticipating any surgeries or procedures? You may want to opt for a Medicare Advantage plan that limits your out-of-pocket costs.
2

Consider costs

Figure out what you’re currently paying for health insurance premiums, copays, deductibles and out-of-pocket expenses including prescription drug costs and over-the-counter products and supplies. Are these costs affordable? If not, try to figure out what dollar amount would be more affordable.

You may be eligible for additional government programs if you’re struggling to pay Medicare costs. For example, if prescription drug costs are posing a problem, you may be eligible for Social Security’s Low-Income Subsidy or Extra Help program. A Medicare Advantage plan could also help with low-cost and zero-dollar premiums, reduced copays and limits on maximum out-of-pocket costs.

3

Determine what coverage you need

Dental and vision health are important to overall health. When you have healthy eyes, you can maintain your independence and perform daily tasks from reading to driving, meal prep to watching television. A strong, full set of teeth give you a great smile and help you speak clearly, show facial expressions and chew healthy foods. Medicines can help to cure, stop, prevent and treat disease. If you live with a chronic illness, medicines play a critical role in your health. A Medicare Advantage plan could help you get or stay healthier by treating your whole-person health needs.

4

Think about provider and facility choice

Original Medicare, as mentioned earlier, allows you the freedom to see any provider or facility enrolled in Medicare whereas a Medicare Advantage plan typically offers a network of providers as discussed in the HMO versus PPO section.

5

Review quality of care

Medicare Advantage plans are rated by the Centers for Medicare & Medicaid Services (CMS) to measure the quality of health plans. The more stars, the higher the plan rating. In 2020, 92 percent of Humana Medicare Advantage members were in 4-star and above quality plans.

Quality of care also applies to providers and hospitals in addition to plans. Learn more about PCP quality of care here. Humana’s Find a Doctor tool with Care HighlightTM can help you find a quality, effective doctor that meets your needs. You may want to explore selecting a value-based care provider to address your health needs. Learn more about value-based care here.

6

Look at prescription drug needs

About 89 percent of adults aged 65 and older take prescription medicine, yet 76 percent think the cost is unreasonable. A Medicare Advantage plan with prescription drug coverage can help cover drug costs through preferred cost sharing at select pharmacies. A monthly over-the-counter allowance could help cover costs of medical supplies and equipment like a blood pressure monitor or fitness device.

7

Decide if travel is a factor

About 89 percent of adults aged 65 and older take prescription medicine, yet 76 percent think the cost is unreasonable. A Medicare Advantage plan with prescription drug coverage can help cover drug costs through preferred cost sharing at select pharmacies. A monthly over-the-counter allowance could help cover costs of medical supplies and equipment like a blood pressure monitor or fitness device.

Putting it all together

You have choices when it comes to your healthcare. You have the power to choose the right plan and the right provider for you. The more time and energy you spend thinking about your healthcare needs and wants up front, the better informed you’ll be when it comes time to select a Medicare plan and a provider. The good news is you don’t have to figure it out on your own. Medicare.gov is a great place to start learning. You might want to get in touch with a local, independent, licensed insurance Agent who can walk you through plans that could be a good fit for you.

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