Top 10 Considerations When Choosing A Medicare Plan

Top 10 Considerations When Choosing A Medicare Plan

If you live in North Carolina and you’re approaching retirement age, there are typically three options for Medicare coverage to consider:

  • Original Medicare Parts A and B.
  • Original Medicare Parts A and B plus a supplemental insurance plan to help cover any costs Medicare doesn’t, along with a separate Part D prescription drug plan.
  • Medicare Advantage, that gives you a variety of healthcare plans with additional benefits and usually includes coverage for prescription drugs.

It can be confusing to work out which plan is best for you. So here are 10 important considerations when choosing Medicare plans in North Carolina to help get the right Medicare plan for you

1. Original Medicare alone may not be enough

If you have no health complications and don’t require any medical care, Original Medicare may be the right choice. However, depending on your health care needs, enrolling in Original Medicare without Supplemental coverage to try and save money can end up costing you more over time.

The risk of Original Medicare plans is if you become sick or experience an injury that requires a long-term hospital stay. An extended hospital or skilled nursing facility will quickly become costly without a supplemental insurance plan or Medicare Advantage plan.

Original Medicare also doesn’t include Part D prescription drug coverage, which you may need as you get older. It’s also important to realize if you decide to wait to enroll in Part D, you may be subject to a late enrollment penalty when you sign up.

2. There are differences in Medicare Advantage plans

There are a variety of Medicare Advantage healthcare plans available to you as a resident of North Carolina. Each plan has differences in coverage and rules. 

If you’re a senior, in good health, and don’t mind staying in-network, Medicare Advantage is usually less expensive than Original Medicare with supplemental insurance. Most Medicare Advantage plans NC also include Part D prescription drug coverage. A licensed, professional Medicare health insurance agent NC, can help you choose the best plan for your individual needs.

3.  If you’re a senior in good health, Medicare Advantage is a great option

Medicare Advantage has many benefits for seniors with good health. Purchasing a Medicare Advantage plan in North Carolina is generally less expensive than Original Medicare with a supplemental plan. Nearly 650,000 people living in North Carolina have taken out a Medicare Advantage private plan, around 40% of the population over the age of 65.

Medicare Advantage plans are a popular choice because some offer $0 monthly premiums, although be aware that you’ll still be responsible for your monthly Part B premium which is separate from Medicare Advantage premiums. Additional benefits can include prescription drug coverage, dental, vision, and even gym memberships. However, it’s essential to realize that not every Medicare Advantage Plan offers all benefits. It’s good to check with your Medicare health insurance representative to find out more or contact one of our local Medicare agents in North Carolina.

Medicare Part B has a monthly premium based on your taxable income history. Original Medicare Parts A and B don’t offer prescription drug coverage or the other benefits a Medicare Advantage plan will include. When you select Medicare Advantage coverage, you must use in-network providers. If you choose to see an out-of-network provider, be aware that you will pay much more than using an in-network provider.

It’s essential to consider your health needs and budget when selecting the right plan. Our local licensed Medicare health insurance agents based throughout North Carolina can help discuss your options to find the best Medicare plan for you. 

4. The cost of supplemental plans increases as you age

If you’re choosing Medicare supplement plans in NC, be mindful that the premiums for most supplemental plans increase every year as you age. So it’s important to factor this into your Medicare costs. The additional cost of the premium is used to offset rising medical expenses.

5. If you have health issues, supplemental insurance is usually the best option.

Original Medicare with supplemental insurance provides the most coverage if faced with costly health issues. Medicare Advantage is generally less expensive if you don’t have a medical emergency or develop a health condition that requires out-of-network treatment and prescription drugs. Original Medicare with supplemental coverage seems more costly initially. Still, if you have health issues, it is actually less expensive in the long run and can end up saving you money. 

6. Switching to Medicare with supplemental insurance can be tricky.

If you’re looking to switch to Medicare with supplemental insurance, you need to be aware that you have six months from the time you enroll in Medicare Part B to purchase supplemental insurance. During the six months, you cannot be denied due to age or any pre-existing medical conditions. However, after the six-month window, the insurer has the right to ask you qualifying questions or deny coverage based on pre-existing conditions.

7. Supplemental plans are the best choice for travelers.

Many Medicare Advantage healthcare plans are county-specific and have a network of doctors that must be used for routine visits or chronic health concerns. So if you register for insurance in North Carolina, you can only see in-network medical specialists within North Carolina for your health concerns. In addition, coverage is provided for medical emergencies only if you travel out of the network area. So if you’re planning on doing a lot of travel, then a supplemental plan could be a better option.

8. In an emergency situation, a loophole for Medicare coverage exists.

If you need healthcare coverage and don’t live in a state with liberal change policies, there is a solution available. You can physically move outside of your Medicare Advantage service plan’s jurisdiction.

This has the effect of resetting your Medicare enrollment eligibility. In addition, if you move out of your current Medicare Advantage zone, it’s your right to select supplemental insurance coverage in your new area. 

You may not be charged more for your insurance due to existing conditions you may have. In addition, moving to a new Medicare service area in another county or state allows you to enroll in Medicare as newly eligible. Moving may be a drastic solution, but it can be a valuable option in certain extreme cases.

9. Supplemental health insurance may be the best option if you can afford the premiums

Supplemental health insurance offers added protection against costly medical treatment, chronic conditions, and hospitalization. Your Part D plan will help with the cost of prescription drugs. Although Original Medicare with supplemental insurance initially costs more than Medicare Advantage, supplemental insurance saves money if you develop significant medical issues. There is also more flexibility because you can select any doctor or hospital that accepts Medicare.

10. Getting professional advice can help you make the best choice for your needs

When choosing a Medicare plan, it’s essential to consider your current health and financial situation. Working with a local and experienced NC Medicare agent can help you get the right coverage for your lifestyle and health needs. Whether you need Medicare dental and vision or are interested in finding out more about Medicare supplement plans in North Carolina, we can help. Our expert and caring team are licensed to help you navigate the differences in Medicare plans. They can answer all of your questions to find the right plan for you. Compare plans online or get in touch with us today to see how we can help.

SEE ALSO: Am I Eligible for Medicare?, How to Get Medicare Dental & Vision Coverage, Medicare Enrollment Checklist: 6 Things to Know

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