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:
- Medigap plans A-L (add-on to Parts A and B)
- Drug Discount Cards (privately run drug discount plans intended to save you 10% to 25% on prescription drugs)
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
||Extra insurance may not be right for you if:
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:
- New Benefits At-a-Glance
- Enrolling in Medicare
- Medicare Coverage
- Drug Discount Cards
- Drug Benefits in 2006
- Retiree Benefits
- Long-Term Benefits
- Medicare for People with Disabilities
- Decisions: What's The Right Coverage for You?
- Filing a Medicare Claim
- Getting More Information