Decision: What's the Right Coverage for You?
WebMD Medical Reference
This information will help you
decide what Medicare coverage suits your health care needs best.
Key Points in Making Your
Decision
There are many choices for health coverage in the Medicare system. You are
eligible for Medicare Part A (hospital care) and
Part B (doctor visits) when you turn 65. But you can
opt out of Part B if you don't want to keep it. Consider
the following when making your decision:
- If you are covered by other health insurance now
(from your employer or a spouse's), there is no penalty if you defer Part B
(doctor visits) until you or your spouse retires.
- If you are not covered by other insurance, and you do
not keep Part B, you will pay more if you enroll later on.
- If you do keep Part B, you can buy extra
insurance to cover health care costs that the
traditional Medicare plan does not cover. Or you can
choose a Medicare Advantage (formerly called
Medicare + Choice) plan.
Information to Consider
Your choices for Medicare coverage are:
- Keep your employer's health plan if you are still
working, or
- Get Part A to cover only hospital costs, or.
- Enroll in the original Medicare plan (Parts A and B,
covering hospital and doctor visits), or
- Enroll in
Medicare Advantage, which are privately run
health plans sponsored by Medicare.
Medicare Part D will pay for prescription drugs in
2006. Until then, you may want to consider extra
coverage to pay for prescription drugs and services not
covered by Medicare. You can buy:
For more information, see What Does Medicare Cover?
| Reasons to buy extra
insurance |
Reasons not to buy extra
insurance |
You may want to consider buying extra insurance
if:
- Your medical needs go beyond what Medicare Parts A and B
cover.
- You expect your health care needs to increase in the
future.
- Your out-of-pocket expenses under traditional Medicare
would be too high.
|
Extra insurance may not be right for you if:
- You don't need much health care.
- You can easily afford to pay any out-of-pocket expenses.
- You absolutely cannot afford to buy extra
Medigap
insurance.
|
Making Your Medicare
Decision
Print out
and use this worksheet to help you make your
decision. After completing it, compare it to the
criteria above. This should give you a better idea of
what kind of Medicare plan suits you best.
Circle the answers that apply to you.
| I am working and covered by my employer's health plan. |
Yes |
No |
N/A* |
| My spouse works and I am covered by his/her health plan. |
Yes |
No |
N/A |
| The health coverage I have now will end soon. |
Yes |
No |
Unsure |
| I have high prescription drug costs. |
Yes |
No |
Unsure |
| I am in the hospital often. |
Yes |
No |
N/A |
| I need to see doctors often. |
Yes |
No |
N/A |
| I worry that my health will decline in the future. |
Yes |
No |
Unsure |
| I can afford to pay for anything not covered by Medicare
Parts A and B. |
Yes |
No |
Unsure |
| I already have high out-of-pocket expenses. |
Yes |
No |
N/A |
*N/A = not applicable
Use this space to list other important concerns you
have about this decision:
Reviewed by Cynthia Haines, MD, August 2005.
SOURCES: Centers for Medicare and
Medicaid Services. Medicare.gov web site. National Council on the Aging web site.
© 2005 WebMD Inc. All rights reserved.
For additional Medicare information, please read the following
articles:
Last Editorial Review: 12/9/2005
