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8 Things to Consider When Choosing or Changing Your Coverage

  1. Coverage

    Are the services you need covered?

  2. Your other coverage

    Do you have, or are you eligible for, other types of health or prescription drug coverage (like from a former or current employer or union)? If so, read the materials from your insurer or plan, or call them to find out how the coverage works with, or is affected by, Medicare.

    If you have coverage through a former or current employer or union or other source, talk to your benefits administrator, insurer, or plan before making any changes to your coverage. If you drop your coverage, you may not be able to get it back.

  3. Cost

    How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? What’s the yearly limit on what you pay out-of-pocket? Your costs vary and may be different if you don’t follow the coverage rules.

  4. Doctor and hospital choice

    Do your doctors and other health care providers accept the coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?

  5. Prescription drugs

    Do you need to join a Medicare drug plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions?

  6. Quality of care

    Are you satisfied with your medical care? The quality of care and services given by plans and other health care providers can vary. Get help comparing plans and providers

  7. Convenience

    Where are the doctors’ offices? What are their hours? Which pharmacies can you use? Can you get your prescriptions by mail? Do the doctors use electronic health records prescribe electronically?

  8. Travel

    Will the plan cover you in another state or outside the U.S.?

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