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5 Questions to Ask About Medicare

Sam Mutchie
  • Coverage
  • Enrollment
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Medicare can be confusing, and that confusion may continue as you consider your coverage options and how your health care needs change over time. Asking a few important questions before you first enroll in Medicare, and throughout your Medicare journey, can help give you clarity and confidence in your decisions.


What kind of coverage do I need?


Medicare gives you choices. That’s why it’s important to think about your health needs before you enroll in a plan. Consider the doctors you visit, the medications you take, your medical conditions and your health risks. There are a variety of different coverage options available, including Original Medicare (Part A and Part B), Medicare Advantage (Part C), Part D prescription drug coverage and Medigap plans. Don’t commit to a plan until you have listed out your needs and are sure the plan can meet them.


What are my enrollment options?


Medicare enrollment periods are based on a few different factors. If you are aging into Medicare at the age of 65, you have a seven-month period when you can enroll. If you are currently enrolled in a Medicare Advantage or Part D plan, you typically have to wait until the Annual Enrollment Period (AEP) to make changes to your coverage. If you have enrolled in a Medicare Advantage or Part D plan during AEP and discover you need to switch plans, you may do so during the Open Enrollment Period. Understanding when you can enroll in Medicare and change your coverage can help ensure you have the coverage you need, when you need it.


What is my budget?


Your overall Medicare costs will vary depending on a wide range of factors, including the coverage option you choose, your choice of health care providers and how often you visit them, your medications and even your annual income. Certain plans may cover all your needs, but be out of the range of what you can afford. Carefully review your budget and use available resources to help find a plan that fits your individual circumstances.


Can I keep my doctor?


Not every health care provider accepts Medicare, and some Medicare plans require you to use doctors and hospitals part of a provider network. Changing from a doctor or hospital you’ve known or used for a long time can be difficult. That’s why it’s important to know which providers are included with the Medicare coverage options you’re considering. It can help you avoid unpleasant surprises.


What helpful resources are available?


You don’t have to go through your Medicare journey alone. If you have questions about Medicare or need help choosing your plan, there are several resources available to you.

Our team of licensed insurance agents can answer your Medicare questions and help you enroll in a plan. Or you can do some research on your own using these resources:


-1-800-MEDICARE
-Social Security Administration
-State Health Insurance Assistance Program (SHIP)
-Medicare Rights Center

PlanEnroll is a brand operated by Integrity Marketing Group, LLC and used by its affiliated licensed insurance agencies that are certified to sell Medicare products. PlanEnroll is not endorsed by the Center for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency.

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PlanEnroll represents Medicare Advantage HMO, PPO, PFFS, and Prescription Drug Plan organizations that have a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment depends on the plan’s contract renewal. Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Every year, Medicare evaluates plans based on a 5-star rating system.

PlanEnroll is a brand operated by Integrity Marketing Group, LLC and is used by its affiliated licensed insurance agencies that are certified to sell Medicare products. PlanEnroll, PlanEnroll.com is a non-government website and is not endorsed by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (DHHS) or any other government agency.

We do not offer every plan available in your area. Currently we represent 0-78 organizations which offer 0-2,613 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

The exact carrier and plan counts are determined by your zip code and county.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance. If you are already a member, please contact your health plan to file a complaint.

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