How to Choose A Medicare Advantage Plan

There are four types of Medicare: Part A (hospital insurance), Part B (medical insurance), Part C (Advantage), and Part D (prescription drugs). You may need to combine multiple parts of Medicare to create the right plan for you.

How to Choose Medicare Advantage

Medicare’s Annual Enrollment Period (AEP) happens every year, but it can easily pass you by. Did you feel unprepared to consider your Medicare choices this year? Take a look at our tips on how to choose a Medicare Advantage plan so you’ll be better equipped with the knowledge you need when next year’s AEP comes around.

What are the four types of Medicare

As you’re considering how to choose a Medicare plan, we will cover the four types of Medicare plans as outlined below. It’s important to note that Original Medicare (Parts A and B) is provided by the government when you qualify. A Medicare Advantage plan is not provided by the government but by private insurance companies and it may offer additional benefits that are not included with Original Medicare.

  • Medicare Part A — covers inpatient care
  • Medicare Part B — covers outpatient care
  • Medicare Part C (Medicare Advantage) — combines the benefits of traditional Medicare plus more and is obtained through private insurers not the government.
  • Medicare Part D — prescription drug plan

Medicare Parts A and B (sometimes called hospital insurance and medical insurance, respectively) make up Original Medicare.

Medicare Part A

Together, Medicare Parts A and B cover most standard medical services. Medicare states that Part A (hospital insurance) covers:

  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Some home health care

If you or your spouse paid into Medicare taxes while you were working, you likely won’t have to pay a monthly premium for Medicare Part A. If you or your spouse did not pay Medicare taxes, you might be able to buy Part A (as long as you’re 65 or older).

Medicare Part B

Medicare Part B (medical insurance) covers services such as:

  • Doctors and other care providers
  • Outpatient care
  • Home health care
  • Medical equipment (like walkers, wheelchairs, or beds)
  • Preventive and screening services

According to Medicare, you will need to pay a monthly premium for Part B even during months when you don’t receive any relevant medical services.

Medicare Part C
Medicare Part C, Or Medicare Advantage plan, is an alternative to Original Medicare. Participants receive many of the same benefits of traditional Medicare
but may offer additional coverage. Coverage is provided by private health insurers approved by the program.

In addition to your hospital insurance and medical insurance, the U.S. Department of Health and Human Services explains that Medicare Advantage plans might offer extra coverage as well. 

The cost of Medicare Part C varies based on the plan you choose. If your Medicare Advantage plan doesn’t cover prescription drug coverage you can add a Medicare Part D plan, which covers most prescription drugs.

(Not all plans offer all of these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays, coinsurance, limitations, and exclusions may apply.)

Medicare Part D
Medicare Part D covers prescription drugs. Part D is optional coverage that you can purchase if you so choose. However, Original Medicare explains that you must have Medicare Part A and/or Part B to join a separate drug plan. Another option is to find a Medicare Part C (Medicare Advantage) plan that offers drug coverage.

Medicare drug coverage sorts medications into different “tiers” to determine the cost you’ll have to pay. In some cases, your plan might not cover a specific drug you need. But a similar option may likely be available.

How to choose the right Medicare Advantage plan for you

With so many Medicare Advantage plans available, it can feel confusing to figure out the right choice for you. Here are a few things to keep in mind.

Consider coverage
First and foremost, consider the coverage of your Medicare choices. For instance:

  • What type of medical services are available with Original Medicare
  • Will you be able to continue seeing your current doctors?
  • Will you have travel coverage?

If you’re unsure, you may need to look into supplemental insurance, too. This is called Medigap. Medigap may help cover “gaps” in Original Medicare.

It’s also important to consider any existing other health coverage you might have and how that coverage will work together with Original Medicare.

Consider finances
In addition to anticipating your potential medical needs, you’ll want to take into account  some financial considerations associated with Medicare. For instance:

  • Will you be responsible for paying a premium?
  • How much is your deductible, and what percentage of your cost for care will you be responsible for after meeting it?
  • Is there a yearly limit on your potential out-of-pocket costs for medical services?

How to get Medicare

If you’re 65 and getting Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Original Medicare (Parts A and B).

 If not, you’ll need to apply. You can apply for Medicare three ways:

  • Via online application
  • By visiting your local Social Security office
  • By calling Medicare at 1-800-772-1213

Annual Enrollment Period is the time of year when you can assess how well your current plan meets your needs and then make any changes needed.

(Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a Special Enrollment Period. )

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PLEASE NOTE: Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. and K.F. Agency, Inc. are not connected with or endorsed by the United States government or the federal Medicare program.

 Callers will be directed to a licensed insurance agent. Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a Special Enrollment Period

 The Company and its producers do not provide legal or tax advice. Each individual should seek specific advice from their own tax or legal advisors. The general and educational information presented in this material is a sales and marketing piece for insurance products offered by K.F. Agency Inc.

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