6 Key Things to Look For When Choosing a Medicare Health Insurance Provider

health insurance

Unless you get your health insurance from your employer, you need to start shopping for Medicare on your own. However, there are so many choices regarding insurance that the decision-making process can be complicated unless you opt for Original Medicare.

6 Tips for Choosing the Right Medicare Provider

When it comes to picking the right insurance provider for your needs, preferences, and budget, you need to compare companies based on their reputation, coverage, network, and more.

1. How Well-Regarded is the Insurance Provider?

Your insurance provider of choice should be well-regarded in your community, state, or country. That means they consistently receive high reviews from their patients and policyholders. You can search for reviews for any insurance provider online or by reading J.D. Power studies.

J.D. Power studies are helpful because they grade providers based on metrics like provider choice, cost, and customer service. Most small insurers will pay attention to customer service, but that doesn’t mean large companies don’t, as reviews of Aetna Medicare insurance show.

2. Does My Insurance Provider Cover What I Need?

If you’re looking for basic coverage, Original Medicare is a great option. Original Medicare combines Medicare Part A (hospital) and Part B (medical) and markets itself as a no-frills coverage. If you want to add dental, vision, or medication, you’ll need to pay extra.

Alternatively, you could try Medicare Advantage, which combines Parts A, B, and sometimes Part D (medications) and includes dental, hearing, vision, and health and wellness programs. However, no insurance provider will include the same benefits in all of their plans.

3. Does My Provider Offer Cost-Effective Plans?

As a rule, policyholders will pay more for coverage from large companies with large networks. However, some providers will charge you more based on quality care metrics and/or your pre-existing health conditions. To avoid surprise fees, consider your health before applying.

Remember that your insurance won’t cover everything, even in best-case scenarios. You may still be charged for outpatient surgeries, X-rays, and hospital care if you exceed your yearly limit.

4. Are There Plenty of Doctors in My Plan Network?

The biggest difference between Original Medicare and Medicare Advantage are their plan networks. Under an Original Medicare policy, you can visit any doctor that accepts Medicare. Under Medicare Advantage plans, you’re limited to doctors from the insurers’ network.

If you’re applying for Medicare Advantage, you need to research the doctors in their network to ensure they’re high-quality professionals who practice close to your home. Otherwise, you may be charged a premium for seeing a medical professional out of your network.

5. What Fees Will Incur if I Switch Medicare Plans?

Medicare plus supplemental insurance can cover costs that Medicare or Medicare Advantage doesn’t, but you need to be careful when purchasing it. There are reasons Medicare plus is a great thing. For example, you can go to any practice that accepts Medicare without a referral.

However, these plans can be incredibly expensive when you get older, and switching off of supplemental insurance could make it impossible for you to apply for it in the future. But some insurers and states, like New York and Connecticut, have more liberal switching policies.

6. Does My Insurance Cover my Healthcare if I Travel?

People who frequently travel state-side should purchase Original Medicare, as you’ll be able to find a doctor or hospital that accepts this coverage. On the other hand, Medicare Advantage plans won’t cover you if you’re outside of its coverage area unless you opt for broader coverage.

While Medicare Advantage seems bare bones, you can add overseas coverage for emergency or urgent care. Original Medicare will only pay for your treatment in a few limited circumstances.