Things to look for before enrolling in a Medicare Plan

It does not matter that whether you are enrolling in the Original Medicare, Medicare Plans, or in the Aetna Medicare Supplement plans. There some things which you should try to find in all of the mentioned plans.


Hospitals, providers, and some other services

  • First and foremost thing to look for is that will you be able to use your family doctor? Is he or she in plan’s network?
  • Do doctors whom you wish to visit for your problems accept Medicare enrollees?
  • Does plan provide coverage even if your doctor does not fall in plan’s network?
  • What sort of doctors, healthcare facilities, specialists, nursing facility etc. comes in plan’s network?

Getting healthcare

  • Does plan provide any service in your area?
  • Will you be covered if you visit any out-of-area healthcare facility which falls in plan’s network?
  • Is there any restriction in choosing Primary Care Provider?
  • Is a referral need from Primary Care Provider if you want to visit a specialist?

Charges

  • What are charges for coverage (deductibles, copays, and premiums)?
  • Find out maximum limit of out-of-pocket costs because it varies from one plan to another.
  • Also, find out deductible (amount which needs to be paid until coverage starts).
  • Don’t forget to check for copayments of services which you are going to use often like drug coverage, or seeing a specialist etc.
  • cost of seeing an out-of-network doctor or using an out-of-network facility.
  • What are copayments for institutional care like hospitalization or home health care?

Perks

Do look for following benefits before enrolling yourself:

  • Whether plan provides supplemental benefits such as hearing, vision, or dental checkups.
  • What are terms and conditions of using supplemental benefits? (If any are provided)

Drugs

Most people tend to forget asking about prescription drugs that whether plan covers their drugs or not? Because a lot of people enroll them in a plan which offers drug coverage and think that these plans will cover their drugs but later on they find out that plan does not offer coverage for their prescription drugs. However, if the plan used to offer your drug’s coverage when you enrolled but now they have stopped coverage then you should not worry because plan will offer coverage for your drug till next enrollment period comes and you can make a switch to another plan which offers your drug.