Firstly, https://www.medicare.gov/ is a very helpful took in this regard where you can compare and analyze your but what you have to keep in mind is effective and feasible your plan will be.

It’s easier if we understand what are some of the ramifications we need to think of when selecting YOUR initial Medicare coverage.

Now, Medicare Advantage enrollment period is usually in the fall. Medicare plans don’t change benefits once you have made the decision.  Sometimes when you do want to change them, you might not be able to make a change if your health deteriorates.

But wait, let me share a checklist that I developed which you can print and use to record the answers yourself when you’re interviewing your broker about Medicare. You should ask these questions to him or her, and if they don’t know the answers to those questions then you really should find somebody that does, because although they are basic, they are critically important questions for you.

Pay attention to these critical questions – you should get each one answered. If you don’t, you could end up selecting the wrong Medicare plan. You’ve got to get this right the first time – and I’m going to give you some tips on making sure that you do just that.

By the way, this is when you’re comparing Medicare Advantage Program versus a Medigap program or Medicare Supplement.

1. 
   Is my doctor or hospital in the network?
   
   

You have got to know this! It’s changing rapidly. Some of these networks are shrinking. You could go to the doctor next door, but you can’t go to the doctor across the street, or you might want to go to a different hospital so is that hospital in the network? Fundamental question! And a good Medicare agent should definitely know the answer to this question.

2. 
   What if I need care at a different facility?
   
   

Let’s say, I go to the local hospital, but when I get there, they tell me “we can’t treat you here.” They say “We need to send you to a specialist, e.g. a cancer hospital or a hospital for heart procedures.” Will this new facility be in network? Again, you need to know those kinds of questions.

3. 
   Do I need a referral to see a specialist?
   
   

The number of people who think that their primary care can do it all is incredible. But what happens if they have a cardiac problem and need to see a cardiologist. Some of these plans require you to get a referral to see a cardiologist, and it may not be the cardiologist of your choice.

4. 
   Which Medicare Advantage program and what Medicare Supplement programs do you offer?
   
   

You see, if you call some of the folks that you see on TV all the time, they are only going to offer that particular product or that one insurance company. You need to get about five different carrier quotes from different companies. Some of the companies you may not ever hear of, some hopefully will be on the list, which are name brand companies or national companies that you’ve heard of. If you cannot receive quotes for five companies, then three for sure. And be sure to ask these questions on all three programs.

5. 
   Is there a premium charge, and if so, is dental covered? What about vision?
   
   

Don’t just ask if it is covered. You want to know what is covered in dental or what is covered in vision. Many companies say they cover dental and vision, whereas all they cover is an eye exam for $10, or they might give you dental cleaning once a year only. They don’t give you any glasses, lenses, or contacts. Make sure you know what exactly will be covered.

6. 
   Do you offer Silver Sneakers?
   
   

So, what is Silver Sneakers? It is a nationwide program specifically for senior citizens that offers free gym memberships around the country. You may not be a gym person, but it might come into play. Recommendations made by your healthcare administrator may include adding in exercise. Therefore, it’s worth asking about.

7. 
   Is there a household discount? What if my wife and I take a Medicare insurance plan with the same insurance company? Do we get a discount?
   
   

Many of them say the answer is yes, and the discount is substantial, 5%, or 7% of the premium forever. It does add up. Therefore, another important question to ask!

8. 
   What about my prescription medications? Are they covered?
   
   

Again, don’t just take a simple yes answer because you will get: “Oh yes, we cover prescription drugs!” Well, what prescription drugs? You need to have your list of medications already printed out from your pharmacy to check whether or not they will be covered.

Here’s why: Folks like me need the exact name of the medication, not just for example, the generic high blood pressure medication. We need to know precisely the medication name inside your bottle, the dosage, and the frequency. So, don’t just let them say yes,”your drugs are going to be covered.” Find out if your particular drugs are going to be covered.

9. 
   Who will answer my questions or service related issues that I might have? Will you be able to do that for me? What if it’s four months from now and I need to know something about my policy? Will you be there to help me?
   
   

Well, let’s just say, if you call a call center, you are probably going to be out of luck.  Make sure you will be receiving the assistance and guidance you deserve, now and in the future!

Medicare Advantage program is very clear about when you can change it. It is only once a year. With Medicare Supplement Plans, you might be able to change them as often as you wish to stay healthy or don’t have any major health needs or concerns.. So that is important to know.

• Will I have access to doctors and hospitals if I travel? Not just within the U.S., but what type of coverage will I have if I go to Mexico or Canada or Europe? Will I have any coverage whatsoever while there?
  
• What are the premiums? The co-pays, the deductibles, the out-of-pocket maximums? What will I have to pay? What am I going to be responsible for? How much is Medicare Part B going to cost me?
  
• How much will my plan pay out of my medical expenses?
  

If I get seriously injured or get sick, is there a limit to how much my plan will pay, or is there a limit to how much I have to pay out of my pocket? Some plans have a significant out of pocket expense, which you need to be aware of.

As a rule, these are the questions to ask. It would be best if you went through them in great detail with your broker. Give me a call- I have been doing this for thirty years! I am happy to go through it all. I will send you the rates. I even have a rating system where I can run all the rates for everybody.

Want to know the best part? I am here to help. I have had so many phone calls from other agents who didn’t know a lot of this stuff. I love the Medicare world. I offer a free consultation, so take advantage of that!