Making the Medicare Decision

 In Advice, Medicare

When you turn 65, you have a lot of choices to make. Whether you want to retire … Where to travel when you do … One big decision that can’t wait is how you will pay for your healthcare as you age. For most of us, Medicare is the answer to that question, but we won’t all need the same coverage.

Here are some tips on how to distinguish one plan from another, and advice on how to plan ahead for your wellness needs.

Start with a visit to your doctor

If you’ve had the same primary care doctor for a while, and you are comfortable with their office and staff, go ahead and schedule a visit or call the office to discuss whether they accept Medicare. Some providers choose to opt out of Medicare altogether; others may only be in-network for certain Medicare Advantage plans. If you want to stick with your provider without paying out-of-pocket, it’s essential to note (if and) which form of Medicare they are willing to take.

Consider your overall cost

The total cost of your healthcare coverage does not stop with your monthly premiums. You will need to get familiar with deductibles, co-pays, benefit periods, coinsurance, and a host of other terms to help you decipher your actual Medicare expenses. It can get confusing, but there are resources that will help you speak Medicare’s language. Medicare.org’s list of common Medicare terms is a great place to start, and can help you begin to understand how coverage rules work and how medical services are charged.

Look at supplemental coverage options

According to Medicare.gov, a Medigap policy may be available to those who subscribe to Original Medicare. This is kind of like a safety net that allows you to pay a monthly rate but then covers most of your extra expenses, like your deductibles and coinsurance. However, the site goes on to explain, “It may be more cost effective for you to join a Medicare Advantage Plan because your cost sharing is lower (or included).” Further, since many Advantage plans offer extra benefits, like dental and vision coverage, which you would have to pay for separately under Original Medicare, the right Advantage plan can eliminate the need for piecing together insurance products.

Know your health history

Anytime you’re trying to plan for the future, it pays to know your past. Before making any major insurance decisions, take a quick look at your family tree. Many diseases that cause disabilities are hereditary. Parkinson’s disease and dementia are two conditions that can be handed down from your parents and grandparents, although your personal lifestyle choices play a bigger role in your late-life health. Talk to your doctor honestly about your unhealthy habits since, according to the University of Pittsburgh Medical Center, the actions you take throughout your life may dictate how much time you spend being disabled as a senior. If you smoke, drink, eat unhealthy foods, and engage in otherwise unhealthy habits, it’s likely you will need more intense medical care than your healthy-living contemporaries.

The takeaway: Original Medicare offers hospital and doctor coverage (through Parts A and B) but may be a more expensive option when compared to Medicare Advantage (Part C, which is available through private insurance companies). Medigap is no guarantee that you’re getting the best deal when it comes to your health coverage. Make an informed decision by doing your research. Talk to your doctor, look at your family and personal health history, and then do the math.

Your health is your most valuable asset, but also one of the most expensive things to maintain as you get older. Choose a Medicare plan that fits your lifestyle and budget and remember, your healthy choices can save you money.

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