The Ultimate Checklist for Choosing Your Medicare Advantage Plan

The cool, crisp breeze in the air. The leaves changing color and falling to the floor. You know what time of year it is. Autumn has arrived.. If you are 65 or older, autumn is also a time for you to make any desired changes to your Medicare coverage. Officially, the Medicare Open Enrollment Period — which is when you can join, switch, or drop a plan — runs from October 15 – December 7 each year.

Visit Medicare.gov for more details on the Medicare Open Enrollment Period.

If you’re shopping around for a Medicare Advantage plan this year, you may be wondering what the best plan is for you. Or you might be asking yourself, “What the heck is a Medicare Advantage plan and how does it differ from Original Medicare?” Let’s take a look, shall we?

It’s the medical industry, so you know there’s going to be plenty of medical lingo. However, the most important ones you must know when picking a plan are just four letters. (A, B, C, D). Seems simple enough, right?

Here they are:

  • Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
  • Medicare Advantage Plans (Part C) provide all your Part A and Part B benefits through a plan offered by a private company. These plans must cover all Medicare services and may offer extra coverage. Compare costs of Advantage plans carefully. Each year, the plans set the amounts they charge for premiums, deductibles, and copayments.
  • Part D covers prescription drugs. Part D plans are offered by insurance companies and other private companies approved by Medicare. You may not need a separate Part D plan if you have a Medicare Advantage Plan because most advantage plans include drug coverage. Check the plan’s drug formulary to make sure it covers your prescriptions.

According to Medicareinteractive.org, most recipients choose to receive their Part A and B benefits through what’s called Original Medicare, which is offered directly through the federal government. With Original Medicare, you can see a full list of doctors and hospitals that takes Medicare (and most do) anywhere in the country.

Medicare Advantage Plans, often called “Part C” or “MA” Plans, are offered by Medicare-approved private companies that must follow rules set by Medicare. Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Most Medicare Advantage Plans include drug coverage (Part D).

In most cases, you’ll need to go with health care providers who participate in your plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services.

Most people need to enroll in Medicare Advantage through Social Security when they turn 65. We understand it could potentially be a confusing process but knowing the facts can help you decide on the best plan to go with. Note: You can also change Medicare plans during open enrollment each year.

Now, before you go clicking away at different plans, you must evaluate several areas to make sure you’re choosing the right plan for you. Here’s a checklist to help you pick your ideal Medicare Advantage Plan.

Learn the Types of Plans

When starting off your search, obviously it’s important to know the differences between each type of plan. Here are some you might see when checking out your options:

  • Health Maintenance Organization (HMO) plans. These plans are primarily focused around in-network healthcare services.
  • Preferred Provider Organization (PPO) plans. These plans charge different rates depending on whether the services are in network or out of network. (A “network” is a group of providers who contract to provide services for the specific insurance company and plan.) These may provide more options to receive out-of-network care.
  • Private Fee-for-Service (PFFS) plans. These plans let you receive care from any Medicare approved provider who will accept the approved fee from your plan.
  • Special Needs Plans (SNPs). These plans offer additional help for medical costs associated with specific chronic health conditions.
  • Medicare Savings Account (MSA) plans. These plans combine a health plan that has a high deductible with a medical savings account.

Paying for Your Medicare Advantage Plan

Having the funds to pay for all your medical needs is essential. While digging into your social security and retirement account is an option, you should also consider a powerful home loan option specially designed for homeowners 62 or older. We’re talking, of course, about a Home Equity Conversion Mortgage (HECM) loan, commonly called a reverse mortgage loan. If you need to access funds to cover medical expenses, a reverse mortgage is a viable solution.

If you have substantial equity in your home, borrowing from a HECM via a single-disbursement lump-sum payment, line of credit, or fixed monthly advances can help you to pay for your health care insurance and related costs over a lengthy retirement.

How to Find Top-Rated Plans

The Centers for Medicare & Medicaid Services rates Medicare Advantage and Part D plans based on several quality measures. Five stars are the best.

For Medicare Advantage plans, here are the main categories for the health plan quality rating:

  • Staying healthy: screenings, tests & vaccines
  • Managing chronic (long term) conditions
  • Member experience with health plan
  • Member complaints and changes in the health plan’s performance
  • Health plan customer service

If the Medicare Advantage plan includes prescription drug coverage, it will also have drug-plan star ratings in several categories:

  • Drug plan customer service
  • Complaints and changes in the drug plan’s performance
  • Member experience with the drug plan
  • Safety and accuracy of drug pricing

To find Medicare plan information or compare plans, be sure to call 1-800-MEDICARE or visit Medicare.gov.

If you are considering a reverse mortgage for yourself or someone you care about, Fairway Independent Mortgage Corporation is here to help. Please contact us today to learn more.

Copyright©2022 Fairway Independent Mortgage Corporation (“Fairway”) NMLS#2289. 4750 S. Biltmore Lane, Madison, WI 53718, 1-866-912-4800. All rights reserved. Fairway is not affiliated with any government agencies. These materials are not from HUD or FHA and were not approved by HUD or a government agency. Reverse mortgage borrowers are required to obtain an eligibility certificate by receiving counseling sessions with a HUD-approved agency. The youngest borrower must be at least 62 years old. Monthly reverse mortgage advances may affect eligibility for some other programs. This is not an offer to enter into an agreement. Not all customers will qualify. Information, rates and programs are subject to change without notice. All products are subject to credit and property approval. Other restrictions and limitations may apply. Equal Housing Opportunity.

Find Out More About Our Loans, Like How Much You May Qualify For.

Please Fill Out The Form Below And We Will Be In Touch!

I am a

This site is not authorized by the New York State Department of Financial Services. No mortgage solicitation activity or loan applications for properties located in the State of New York can be facilitated through this site.
This is default text for notification bar