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Understanding your needs

We’re here to help.

Look for coverage that works for you.

Consider these questions to help determine what kind of coverage may be right for you.

Frequent doctor visits can get costly. How often do you visit the doctor, in general?

  • With Original Medicare (Parts A & B), you pay 20% of the allowed amount for most doctor services after you meet the Part B deductible. Most Medicare supplement plans pay this cost in full.
  • With most Medicare Advantage plans, you pay a low copayment for each visit. Your plan may or may not have a deductible.
  • Medicare Advantage plans have an annual out-of-pocket limit that offers financial protection. There is no limit with Original Medicare.

Are the medications you regularly take covered?

  • Most prescription drug plans and Medicare Advantage plans that include drug coverage have a list of covered drugs, or formulary.
  • If your drugs are not on the formulary, you may have to pay more.

Do you have a particular doctor, hospital or pharmacy that you want to use?

  • Many Medicare Advantage plans contract with a network of providers and pharmacies.
  • You may pay more if your provider or pharmacy is not in the network.
  • Original Medicare and most Medicare supplement plans do not have networks and provide coverage nationwide.

Does your doctor accept Medicare assignment?

  • Doctors who accept assignment agree to the Medicare-approved amount as payment in full.
  • Doctors who do not accept assignment may charge more than the Medicare-approved amount for some services.
  • The additional cost is called “excess charges.”
  • Some Medicare supplement plans pay excess charges.

Do you have other health coverage, such as through an employer, a union or the military?

  • Medicare may work with your other health coverage.
  • Talk to your plan administrator before you make any decisions.

Would you rather pay less in monthly premiums or pay less out of pocket when you receive health care?

  • In general, when premiums go up, out-of-pocket costs like deductibles, copays and coinsurance go down.
  • The opposite is also true. Low monthly premiums could mean your out-of-pocket costs will go up.
  • Look at all the costs — not just premiums —when comparing coverage options.