If you are planning to shift from the original Medicare plans or this plan does not suit your needs. You have to decide the best private insurance options for you. Although many people feel choosing health insurance is complicated. Before you choose Medigap or Medicare advantage plans 2021, there are few things you need to know before you compare these plans and to make your work easier. In this article, are 7 factors that will help you choose the best private insurance options like Medicare advantage that you might need.
- Medical conditions
It is vital to consider the medical conditions that you have as you choose private insurance. For instance, Medicare advantage has special needs plans that are a great choice for people with specific medical conditions. Also, this applies to institutionalized individuals, and they can benefit from this plan. Thus, when you have a parent, friend, or relative with a specific medical condition. Medicare Advantage is a preferable private insurance option to get.
- Extra benefit
Another factor that can help is if there are extra benefits to the coverage. The benefits that you may find are hearing aids, dental, vision, and gym memberships that you can find in Medicare advantage health plans. However, in Medigap, there is no coverage for gym memberships. Also, most Medicare Advantage plans will cover prescription costs, while for others, you have to buy a part D coverage to get prescription cost coverage.
- Network size
The network size is a concern for most people. Thus, it will still be when you need to choose the best private insurance options. Keeping in mind that up to 90% of the doctors who give Medicare coverage services do so with original Medicare. While for Medicare advantage plans, they have their networks and it is, in most cases, limited to a specific locality. Consider the network size to figure out the best choice of private insurance options.
How does living with a disability affect the private insurance option you choose when original Medicare does not cut it? So, if you are under 65 and you are on Medicare due to disability. As you choose an alternative private insurance option, there is no guarantee to access the Medigap plan. However, if you are Medicare-eligible even though you are under 65, and you do not have end-stage renal disease, you can get an advantage plan.
- Plan change flexibility
Consider this factor so that in the future, when you need to change plans, the insurance option you go for is a flexible one. For instance, Medicare advantage and others that have an open enrollment are good options as they allow those enrolled to switch plans. Consider also the state you are in and the insurance you are opting for if changing the plans is flexible.
- Plan availability
How available is a Medicare plan in your area? How can you benefit from one that is not in your area? These are some of the questions that will come in handy as you choose a private insurance option for you. Fortunately, if you are a Medicare beneficiary, then you have access to a wide range, including Medigap, Advantage, Part D plans. However, the options may vary especially due to your location.
- Out-of-pocket exposure
Sometimes the out of pocket exposure may lead you to see no need of getting particular insurance. Hence you must know the out-of-pocket exposure. Although with most advantage plans, you get to pay copays and coinsurance that have a maximum out of the pocket of almost $7000. However, some Medigap plans pay first-dollar coverage for all services that are covered. In this way, you have no or just little out of pocket exposure.
To sum up, there are various reasons why you need to choose a Medicare health plan. However, sometimes the original Medicare may not be what you need, and you have to consider other private insurance options. So depending on your needs, you should choose wisely, and the above factors are a guide to help you know how to pick the best. If you travel a lot too, also consider plans that favor travels.