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How to Choose a Medicare Health Plan

How to Choose a Medicare Health Plan

As a senior citizen, choosing the right health plan may be the most important decision 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.

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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 You  Choose 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

While a Medigap policyholder will have access to the same medical care as anyone else covered by Original Medicare, there are a few things that they should expect in terms of quality of care.

First, a Medigap policyholder should expect to have more options when it comes to choosing healthcare providers. This is because Medigap policies allow policyholders to see any healthcare provider who accepts Medicare. This means that policyholders can choose the healthcare providers who they feel provide the highest quality of care.

Second, a Medigap policyholder should expect to pay less out of pocket for healthcare services. This is because Medigap policies can cover some or all of the out-of-pocket costs that Original Medicare does not cover. This can help policyholders to access the care that they need without worrying about the financial burden.

Overall, a Medigap policyholder should expect to have access to high-quality healthcare services, with the added benefit of more choice and lower out-of-pocket costs. However, it is important to note that Medigap policies do not cover all healthcare services, so policyholders should always review their policy carefully to understand what is and is not covered.

6. Traveling Abroad

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

Original Medicare generally does not cover foreign travel emergency medical costs. This means that if you are traveling outside of the United States and experience a medical emergency, you may be responsible for all of the costs associated with your care.

However, there are some exceptions to this rule. Some Medigap policies may offer coverage for emergency medical care while traveling abroad. However, this coverage is typically limited to a certain amount of coverage per year, and there may be restrictions on the types of medical services that are covered.

It is important to carefully review your Medicare coverage and any additional insurance policies you may have before traveling outside of the United States to understand what is and is not covered. If you are concerned about the potential costs of a medical emergency while traveling abroad, you may want to consider purchasing additional travel medical insurance.

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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.

Frequently Asked Questions

How do I choose a Medicare Supplement Plan in Wisconsin?

There are several factors you should consider before purchasing a Medicare Supplement in Wisconsin: > Think about the types of coverages you need now. > Consider your budget and remember you'll continue to pay Medicare Part B monthly premiums. > Compare each companies discounts. > Carefully compare all plans that are available in your area.

How much do Medigap plans generally cost ?

Although your Medigap plan cost in Wisconsin will depend on your area, you can expect to pay between $45 on the low side and $337 on the high side.

What Medicare Supplement Plans are available in Wisconsin?

Unlike most other states, Wisconsin is one of the 3 states that don't offer the standardized Medigap plans. In Wisconsin, you can choose from a Medigap 25% Cost Sharing Plan, Medigap 50% Cost Sharing Plan, Medigap Basic Plan, or Medigap High Deductible Plan.

Can I add riders to the Wisconsin basic Medigap plan?

Yes, there are several riders that you should consider adding to the basic plan. For example, to get coverage similar to Medigap Plan G which is a very comprehensive and popular plan, start with the Basic Plan. Then, add the following riders: Part A deductible, Part B excess charges, additional home health care, and foreign travel emergency.

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