For those considering Medicare Advantage plans, be sure to research whether your doctors are included in their network as well as if any prescription drugs covered under their drug formulary.

Ultimately, the ideal plan will meet both your healthcare and financial needs. To make an informed decision about Medicare plans, consult an expert in Medicare.


Selecting a Medicare plan can be a complex and intimidating task, yet with guidance you can select one that best meets your needs. From Traditional Medicare (Parts A and B), Medicare Advantage plans or drug prescription coverage plans – before making your selection, make sure to understand what each one entails before committing yourself.

Medicare Advantage plans are offered by private insurance companies under contract with Medicare to provide specific benefits at set prices, while also taking in some profit for each member they insure. They receive payments from Medicare but retain some as profit; this helps keep costs low for all involved. Your plan may require that only doctors within its network or allow you to choose any doctor outside. It is vitally important that when selecting any plan that your list of providers includes all the doctors you visit regularly as networks may change with time.

Cost-effective choices usually include plans that cover all the services you need at an affordable cost, including premium, deductibles and copayments for services like primary doctor and specialist visits, lab tests, diagnostic radiology such as MRIs or X-rays, outpatient hospital stays or physical therapy sessions. You should also take into consideration monthly and yearly premium costs to determine which plan best meets your budget needs.

Focus groups provided seniors an opportunity to express their desire to easily compare plan costs and provider networks; however, they frequently found available information confusing or hard to comprehend. Many also felt unqualified to make well-informed decisions without assistance from agents or plan representatives.

An increase in transparent, comparative information regarding costs and provider networks would empower consumers to make better-informed choices that align with their health and financial goals, encouraging more plan switches that lead to lower costs for both Medicare beneficiaries and themselves.


In 2023, 65 million people will make decisions about which Medicare plan best meets their healthcare needs and which Medicare Advantage plans offer additional coverage beyond Original Medicare. Selecting an ideal plan requires extensive research; however, several key indicators will help guide this decision process.

Consider first whether your doctors are part of the plan’s network. Medicare Advantage plans often contract with specific providers to keep costs down; while this might not be a deal breaker for everyone, it’s still worth checking to make sure all your preferred doctors are included before making your enrollment decision.

Prior to choosing a plan, it is also wise to explore its coverage for drugs, hospitalizations and home health services. This consideration becomes especially crucial if you suffer from chronic illnesses; some plans may exclude certain services or limit how long a stay in hospital/rehab facilities lasts.

Consider which benefits might be essential, like travel coverage or dental and vision care coverage. Most Medicare Advantage plans already include these features; before making your enrollment decision, make sure it does.

Once you’ve narrowed down your Medicare Advantage options in your area, it’s time to look at Medigap policies – private policies that cover uncovered Medicare expenses like deductibles and coinsurance payments – including Medigap plans standardized by region with similar letter designations offering similar basic benefits.

Keep in mind that each fall during the annual open enrollment period (Oct 15 to Dec 7) you can review your Medicare Advantage and Medigap options during open enrollment (Oct 15 through Dec 7). Now is your opportunity to switch plans if they no longer suit your current needs, or switch back to Original Medicare – but take your time making this important decision, since its outcome could change the rest of your life! Explore your options carefully to select one that best meets your lifestyle before sitting down with your physician to discuss costs and coverage details of plans offered during open enrollment (Oct 15 to Dec 7).


Transitioning from private health insurance to Medicare can be daunting. You have numerous choices and terms to learn, including choosing an Advantage plan type and prescription drug coverage as well as whether or not Medigap insurance will be needed – decisions made now could impact your costs for years to come, so be mindful of any decisions made now!

Step one of Medicare advantage is becoming familiar with its components. Traditional Medicare includes Parts A (hospital coverage), B (doctor coverage) and D (prescription drug coverage). Medicare Advantage plans combine parts A and B with additional services like dental, hearing and vision care and often come equipped with their own provider network – this should all be carefully considered when making your decision.

A plan’s network is essential as it will determine which doctors are covered and how much medical care you pay for. If a provider falls outside their network, their fees or deductibles could become more costly if he or she leaves your plan altogether. Medicare Advantage plans usually contract with networks to keep costs under control and will regularly shift which doctors are in and out.

Find out which doctors are in a Medicare Advantage plan’s network, especially if you have a preferred physician. While some plans require you to stay in-network and obtain referrals before seeing specialists, others allow more flexibility; such as Medicare Advantage PPO plans which allow patients to see doctors outside the network without referral but usually cost more.

Consider how far and wide you travel and whether or not your preferred providers are available there. For instance, if visiting family in Philadelphia requires you to visit a doctor there who is part of your Medicare Advantage plan network; otherwise you may have to select another plan altogether; additionally, many Medicare Advantage plans only cover out-of-network health services if they’re approved by your primary care physician first.

Out-of-pocket expenses

Consideration should be given when selecting Medicare coverage, with one key aspect being annual premiums, deductibles, coinsurance and copayment payments. Other important aspects include how frequently you visit physicians and need prescriptions as well as whether any chronic health conditions require ongoing attention.

Your budget will dictate which plan best meets your needs; to help determine this, use Medicare’s Compare Plans tool to gain an idea of your annual costs by viewing costs for various Medicare Advantage and traditional Medicare plans in your area.

One key decision when choosing Medicare coverage is if you wish to maintain your current physician or switch. Some Advantage plans require you to only visit doctors in-network while others allow you to choose any provider, making switching later difficult and potentially frustrating if traveling often.

Researchers recently conducted a study wherein they discovered that only 21% of physicians could accurately estimate out-of-pocket costs for their patients, leading them to experience frustration, confusion and miscommunication, which in turn can create additional financial burdens. Therefore, authors of the study suggest physicians spend more time discussing out-of-pocket costs with patients as well as helping them navigate Medicare’s system.

Traditional Medicare includes Part A for hospital services and Part B for doctor’s visits, and you can add an supplemental coverage plan such as Part D to cover prescription drugs or enroll in a Medicare Advantage plan with additional features like vision, hearing and dental benefits.

If you need assistance paying your Medicare expenses, income guidelines and assistance programs may provide assistance. Medicare Supplement Insurance policies offer another solution by helping pay Medicare deductibles and out-of-pocket expenses; their premiums vary by state; you can search “Medicare Supplement insurance” online in your area to locate plans. Ideally, open enrollment season each fall provides the perfect time for shopping these policies.