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What to Look for When Choosing a Medicare Plan And Insurance Company

It’s no secret that choosing a Medicare plan and insurance company requires a lot of research and consideration. With the sheer number of insurance companies and Medicare plans available, you need to know what company and plan will be best for you, particularly during enrollment.

Because of this, there are some things you need to think about when making this important decision. We’ve outlined considerations you should keep top-of-mind as you start your search.

  • Type of coverage: Ask yourself this question: What services do I need? Then seek out the plans that include those services in their coverage. To evaluate what services you may need, think about the following: 
  • Medical expenses: There’s a lot that goes into this. What medical expenses do you anticipate needing? Consider items such as physician services, medical and surgical services or supplies, physical and speech therapy, diagnostic tests, medical equipment and others. Determine what you think you’ll need and ensure that the coverage you choose includes these things.
  • Out of state and/or out of country coverage: This is important for those who plan on living in or traveling to different areas of the country at different times of year. Understand if your plan provides access to participating providers in the areas you plan to live or travel to. If you travel overseas, you may want to be covered for emergency situations.
  • Prescription Drug needs: Do you have health care needs that require certain medications? Make sure the pharmacies participate in the plan and that your prescriptions are included in the plan’s formulary (a list of covered drugs).
  • Network Restrictions: Some plans provide coverage only if you use a doctor or hospital in the insurance company’s network. Other plans cover you for any doctor or hospital that participates in Medicare. You should figure out if a plan has network restrictions and whether or not a plan covers the doctors and hospitals you may want to use.
  • Customer Service: At the end of the day, you want to be sure that the company you are considering provides quality customer service.

Ask yourself these questions:

  • Does the company provide excellent customer care and have a seamless claims processing?
  • Are their customer service representatives easily reachable?
  • Is their web platform easy to navigate to reach your claims and documents?

Another way to determine quality of care in your Medicare insurance company is by using Star Ratings. If you are considering a Medicare Advantage plan, the Star Rating system measures the quality of the plans within various categories, including quality of care and customer service.

The scale ranges from 1 to 5 stars. 

  • The insurance company’s reputation: Before you even consider the type of coverage you’ll need, you need to narrow down your options among a sea of companies that offer Medicare plans in your area. Read each company’s history section or “About Us” page on their website, and look for reviews, ratings, and customer testimonials. You can even dig deeper by using online resources and asking trusted friends and family about their experience with Medicare companies you’re considering.

The best company and plan for you isn’t one that includes one or two of these features. It’s one that encompasses all of them. Putting the time in up front to learn about your options when choosing a Medicare plan or provider will pay off in the long run, especially for something as important as your health insurance.