When it comes to Medicare, one size does not fit all.
Whether you're enrolling in Medicare for the first time or thinking about changing your coverage, you'll want to look at your options and know what's important to you.
Will I have prescription drug coverage?
Prescription drugs aren't covered by Original Medicare. Once you've enrolled in Medicare, there are two ways to get Medicare prescription drug coverage:
Medicare Advantage plans and Medicare Prescription Drug plans cover a certain set of prescription drugs, so be sure to check each plan's drug list to see if the prescription drugs you take will be covered. If you already have prescription drug coverage, you'll want to make sure your prescriptions will be covered next year, too.
Medicare Prescription Drug (Part D) plan
You can purchase a standalone Medicare Prescription Drug (Part D) plan to help pay for your prescription drug costs. You can have a standalone Part D plan in combination with any of these plans:
Original Medicare plus a Medicare Supplement insurance plan
A Medicare Advantage Private Fee-for-Service plan that doesn't include drug coverage
A Medicare Savings Account (MSA)
Medicare Advantage (Part C) plan
To get the convenience of having your prescription drug coverage in the same plan as your hospital, doctor and other benefits, you can look into a Medicare Advantage (Part C) Prescription Drug (MAPD) plan.
Most Medicare Advantage plans include prescription drug coverage, and have a lower premium than a standalone Part D plan.
Remember: Each Medicare Advantage plan and Medicare prescription drug plan covers a certain set of prescription drugs. Be sure to check each plan's drug list (also known as a formulary) to see if the prescription drugs you take will be covered. If you already have prescription drug coverage, make sure your prescriptions will be covered next year, too.
Will I still be able to see my current provider(s)?
If staying with your current provider or doctor is important to you, check to see if a plan has a provider network. If it does, you'll want to know if your doctor is in that plan's network. Some plans will require you to stay in-network, other plans allow you to use providers outside the network, and still other plans don't have a network at all. And Medicare Supplement plans let you see any provider or specialist without network restrictions, as long as they accept Medicare patients.
When thinking about plans, find out:
Will I have to choose providers from a network?
Will my providers accept the plan’s terms? If not, are there providers near me who will?
Will I need a referral from a primary care provider to see a specialist?
Original Medicare (Parts A and B)
Providers: See any provider who accepts Medicare.
Specialist referrals: No referral needed to see a specialist who accepts Medicare.
Medicare Supplement (Medigap) plans
Providers: See any provider or specialist without network restrictions, as long as they accept Medicare patients.
Specialist referrals: No referral needed to see a specialist.
Medicare Advantage (Part C) plans
Network plans: If a plan has a provider network (for example, an HMO), you can save money by using a provider in the plan's network. Some plans allow you to use providers outside the network, usually for a higher cost.
Non-Network plans: This type of Medicare Advantage plan may not have a provider network and allows you to see any provider that accepts Medicare and the plan’s terms.
Some Medicare Advantage plans require a referral to see a specialist, some do not.
Remember: If a plan has a provider network, that network can change each year. If your current plan has a provider network, be sure to check if your provider will be in the network next year. You can switch plans during the Medicare Annual Enrollment Period if your provider won’t be in your plan’s network next year.
Will I have coverage for additional benefits like vision, dental or hearing aids?
Generally, Original Medicare won't cover routine vision or dental care, eyeglasses, or hearing aids. However, many Medicare Advantage (Part C) plans include these additional benefits. Keep in mind that costs and benefits can vary from plan to plan. Be sure to watch for the additional benefits you need in the plan you're considering.
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AARP® Medicare Supplement Insurance Plans
AARP endorses the AARP Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company.
Insured by UnitedHealthcare Insurance Company, Horsham, PA (UnitedHealthcare Insurance Company of New York, Islandia, NY for New York residents). Policy form No. GRP 79171 GPS-1 (G-36000-4).
In some states, plans may be available to persons under age 65 who are eligible for Medicare by reason of disability or End-Stage Renal Disease.
Not connected with or endorsed by the U.S. Government or the federal Medicare program.
This is a solicitation of insurance. A licensed insurance agent/producer may contact you.
You must be an AARP member to enroll in an AARP Medicare Supplement Plan.
THESE PLANS HAVE ELIGIBILITY REQUIREMENTS, EXCLUSIONS AND LIMITATIONS. FOR COSTS AND COMPLETE DETAILS (INCLUDING OUTLINES OF COVERAGE), CALL A LICENSED INSURANCE AGENT/PRODUCER AT THE TOLL-FREE NUMBER ABOVE.
Medicare Advantage plans and Medicare Prescription Drug plans
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan's contract renewal with Medicare. You do not need to be an AARP member to enroll in a Medicare Advantage plan or Medicare Prescription Drug plan.
This information is not a complete description of benefits. Contact the plan for more information.