Choosing the best Medicare plan for you is an important decision. There are a lot of aspects to consider, whether you are enrolling for the first time or thinking about changing your plan. Below are a few basics to keep in mind before choosing a plan, as well as some resources to help answer your coverage questions.
Compare your options to your current plan and make sure your selection covers the primary and specialty services you need. You can’t foresee a sudden illness or injury, but you can anticipate some medical needs.
For example, if you have a family history of heart disease or diabetes, your plan should include the necessary screenings and prescriptions. And if you need help managing chronic conditions such as arthritis or asthma, make sure you have access to doctors who specialize in those conditions.
If you already, or are eligible for, other types of health insurance through an employer, union or other source, research how Medicare will impact that coverage. Your benefits or plan administrator can help answer your questions.
Determine your share of the costs for any plan before you enroll. This includes deductibles and yearly limits, as well as your co-pay for primary care and specialist visits, hospital stays and services.
Decide what primary care doctor and network of care is best for you. Think about what you want in a doctor, including your preferences on gender, philosophy of care and location. Be sure your physician can refer you to the specialists and hospital you need. Scripps physicians and hospitals are available through several Medicare Advantage plans in San Diego.
Make sure the plan you are considering covers any current prescription medications you take and that you can get them filled at the pharmacy you prefer.
Research quality and patient satisfaction data for potential primary care physician groups and health networks to determine what plan best meets your needs.
Make sure care is convenient and accessible. Consider a primary care doctor and network of care that is close to you and offers the hours you need.
If you are retiring, you may be planning to travel more. Check to see how your coverage applies in another state or outside of the country.
- If you’re still employed — or covered by your former employer’s retiree plan — and you have questions about how your benefits may change when you turn 65, talk to your company’s human resources department.
- For information about Medicare enrollment, benefits, and deadlines, visit medicare.gov or the Centers for Medicare and Medicaid Services (CMS) website, cms.hhs.gov. You can also call 1-800-MEDICARE ( 800-633-4227) 24 hours a day, 7 days a week. TTY users should call 877-486-2048.
- If you have questions about your retirement benefits, contact the Social Security Administration; visit socialsecurity.gov or call 800-772-1213. TTY users should call 800-325-0778.
- For information on law and advocacy, call the Health Insurance Counseling and Advocacy Program at 858-565-8772 or toll-free at 800-434-0222.
- For information on Medicare for active and retired military personnel, call the Department of Defense TRICARE for Life office at 866-773-0404.
- For information about insurance for veterans, call the office of Veterans Affairs at 800-827-1000.
- For questions on the federal employee benefits program, call the Office of Personnel Management at 888-767-6738.