State Medicare Information
Please click the link to your state to find out more about Medicare plans in your area.
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- Washington DC
- West Virginia
If you are a senior looking to enroll in a Medicare plan, you may have many more options than you might have thought. Depending on where you live, you can access Medicare Advantage plans as well as traditional Medicare. When you first get Medicare, you are in the Original Medicare Plan. You may want to consider a Medicare Prescription Drug Plan in order to add prescription drug coverage. You may want to consider a Medicare Plan, such as HMO or PPO, that provides all your Part A, Part B, and often Part D prescription drug coverage. If you choose the Original Medicare Plan, you may want to consider a Medicare Supplemental Policy, Medigap. You would have to make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall.
Your options include enrolling in traditional fee-for-service Medicare or the Medicare Advantage plan, which offers HMO, PPO, PFFS, and MSA plans through privately owned insurers. You can also select a Medicare prescription medication plan to ensure that your regular medications will be covered by insurance.
Here are a few tips that will help you find a Medicare plan well suited to your needs.
See what plans are available where you live
Remember, not every Advantage plan is available throughout the country. While many Medicare beneficiaries will have a choice of plans, some simply choose to remain on the traditional Medicare program. To find out what plans service your area, enter your zip code above or call the Medicare Solutions specialists at (800)-328-7305.
Think about what you need in a Medicare plan
When it comes to health insurance, every person needs something different. For many people, doctor choice and plan flexibility are two of the most valued features in a plan. For other people, cutting down costs through a plan with manageable payments is most important.
No matter what your preference, there is a plan out there for you. If keeping costs down is important, an HMO plan with a low monthly premium may be the plan for you. However, HMO plans tend to limit your physician choice to a network and require referrals for specialist visits. If you prefer more of a choice, a PPO, PFFS, or MSA may be a better option for you.
Compare the benefits, expenses, and other features of the available plans
Often, cost is a large determining factor during the Medicare selection process. What you will pay for Medicare varies based on the plan itself, any other insurance you may have, and the frequency of medical care you need.
If you opt to enroll in an Advantage HMO or PPO plan, it is not necessary to add a Medigap supplemental insurance policy. Most HMO and PPO plans already fill in the gaps left behind by original Medicare. However, if you do choose an HMO or PPO, you will be limited to the plan's network providers, and may have to pay to see a doctor outside the network. Many Advantage plans already include prescription medications, so it may not be necessary to enroll in a supplemental Part D plan.
However, cost alone does not determine the quality of the plan's coverage. For example, original Medicare and supplemental plans will often pay for health care as long as you are in the United States. HMO or PPO plans often limit you to regional or local provider networks. Most PFFS plans will pay for care regardless of location if your provider accepts the plan's terms of payment.
Every Medicare plan, whether it is the original program or an Advantage plan, must cover the same Part A and B hospital and medical insurance benefits. Medicare Advantage plans often offer additional benefits, like dental, vision, and prescription drug coverage. To see what benefits are associated with the plans in your area, search the Medicare Solutions web site.
Doctor and hospital choice also varies from plan to plan. If you are enrolled in the Original Medicare plan, you have the option of visiting any provider in the nation so long as it accepts Medicare. On an HMO, you are generally limited to the HMO's provider network. While you may be allowed to visit providers outside the network, you may face additional charges. You are able to visit the provider of your choice on a PPO plan, but you may have to pay more for the services. Finally, if you go the PFFS route, you can visit any doctor you want so long as the doctor agrees to the PFFS terms of payment.
Some people may also be concerned about seeing specialists without referrals. Most Medicare HMO plans require you seek a referral from your primary care doctor before you see a specialist. On Original Medicare, most PPOs, and PFFS plans, there are no required referrals for specialist visits. Before you make your final decision, review the plan's rules regarding network and referral services.
To learn more about the quality of care information about your plan, you can navigate through Medicare.gov, MedicareSolutions.com, or call us and speak to one of our trained experts.
Finding the Plan that Best Suits You
Collect information about your Medicare options and contemplate your financial and health care needs.
If you need help or have any questions regarding Medicare, feel free to surf our website MedicareSolutions.com or calling directly to (800) 328-7305. We will be glad to assist you by helping you find the best plan for you.