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How to Choose a Medicare Health Plan


6 Facts To Consider Before Choosing a Medicare Health Plan

As a senior citizen, choosing the right health plan may be the most important decisions you make. We’re here to help make sure you make an informed decision.  For a FREE no obligation Wisconsin Medicare Health Plan quote you can reach us at 920-545-4884. Please continue reading for some information you need to consider when entering Medicare.


If you are receiving Medicare, you can choose a supplemental health plan to fill in the gaps that basic Medicare leaves open.

These plans are sometimes called Medigap plans. In choosing any health plan, you should look at all the options and choose the plan that is best for you.

There are ten standard Medicare supplement plans, labeled A-N. The deductibles, co-pays, and networks are standard as well. So, you decide which plan is right for you.

Some of you may not be retired just yet. If so, your employer-offered insurance is among your choices.

Here are six factors to consider before choosing your health plan.

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1. Costs

Take a look at the costs for each plan. Determine how much you will pay for doctor visits, hospital stays, or other services.

There is no limit to how much you will pay out-of-pocket unless you have Medigap coverage.

A Medicare Advantage plan does have a yearly limit. Once you reach that limit, you pay nothing for services for the rest of that year.

2. Existing Coverage with New Coverage

A Medigap policy can help pay your out-of-pocket costs in Original Medicare, such as coinsurance and your deductible.

Original Medicare covers services and supplies in hospitals, doctors’ offices, and other healthcare facilities. Services are either covered under Part A or Part B.

Medicare Advantage Plans

Medicare Advantage Plans must cover the same services that Original Medicare covers. Some do offer additional coverage that Medicare doesn’t, such as vision, dental, and hearing.

A Medicare Advantage Plan may be cost-effective because your cost sharing will be lower. Though, you can’t use a Medigap policy if you’re in a Medicare Advantage plan.

Other Supplemental Health Plan

You may already have another type of health plan. If you do, be sure you understand how that plan works with Medicare.If you have employer-provided coverage, have a conversation with your benefits administrator before you make any selections.

3. Prescription Drug Coverage

If you do not have a separate prescription drug plan, you will need a Medicare Prescription Drug plan (Part D) if you want coverage. Most Medicare Advantage plans have drug coverage.

Some things to consider:

  • Does the plan have a high rating?
  • Are your current prescription medications covered?
  • Are there any plan restrictions for your medications?

4. Doctor and Hospital Choice

Medicare Supplement Plans will not have a network, you can go to any doctor in the United States that accepts Medicare.

For any Medicare Advantage plans, check that your preferred doctors accept that coverage.

See if you can choose your doctors and hospitals from a network. Also, check to see if out-of-network coverage is offered. Will you need a referral to see a specialist?

In a Medicare Advantage plan, you need to stay within a network. Be sure those doctors and pharmacies are near you.

5. Quality of Care

Consider the quality of care you are receiving now. Do you want better quality services than you are receiving? If so, check the ratings for the providers on the plans you are considering.

6. Traveling Abroad

Many of us have plans to travel outside of the country.

Original Medicare and Medicare Advantage plans don’t cover care outside the United States. If you intend to travel abroad, look into a supplemental health plan that offers travel coverage.

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Supplemental Health Plan in Wisconsin

Wisconsin is one of a few states that has a “base” offering that covers 20% certain costs. You can add a series of “riders” to the base to cover the other gaps, or holes, of Medicare.

This adds another layer to your decision. For assistance and to find out more about plans and rates for your supplemental health plan, fill out our form.

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