Medicare Plan Questions

Medicare Plan Questions

When you are finally ready to decide on a Medicare Plan, you may have some Medicare Plan questions. These are the most common questions we see.

  • Is my doctor covered? This is answer really is based on the plan you choose. If you are on Original Medicare with a supplement, as long as your doctor accepts Medicare assignment, you can go see them, and your supplement will pay after Medicare. If you are choosing a Medicare Advantage plan, or Medicare Part C, you will want to make sure your provider is in the “network”. Most of the plans work in a traditional HMO or PPO model, so they will have a network of providers
  • Are my Medications covered? This question will be based on whether you go with a Medicare Advantage Plan or stand alone Part D or prescription drug plan. There are often dozens of either option available, and most cover the more commonly prescribed drugs on the market. It is important you look into your options to make sure the medication you are prescribed are covered.
  • Out of Network Coverage? Medicare itself does not really have a traditional network. As long as your providers accepts Medicare, you can go see them. That applies anywhere in the United States. Medicare Advantage on the other hand will typically tie you to a network and if you go outside of that, you may not have coverage. Traditionally, the emergency room is covered throughout the U.S., but other services may be limited or not covered based on your plan.
  • Dental & Vision coverage? If there is coverage for dental or vision, traditionally it will only be found as an extra benefit within a Medicare Advantage Plan. This includes eye wear, dental cleanings and other ancillary items. Medicare itself will cover items such as cataracts and glaucoma screening, but their dental coverage is limited at best.
  • Silver Sneakers. Many clients ask us about Silver Sneakers or a similar gym type benefit, where they can get a free membership to go to classes at the local gym or recreation center. These programs are typically included within a Medicare Advantage plan, but not on a Medicare Supplement plan. With that being said, we do have a few providers who offer this within the structure of their supplemental coverage. Often members will find that opting for the fancy extras of a Medicare Advantage plan, can leave holes in your coverage.

As you can see there are certainly pros and cons of each type of coverage whether Medicare Supplements or Medicare Advantage and it is important that you do your research of have a local licensed professional help you wade through all of your options. We would be happy to answer any questions and represent all the top Medicare Plans available in Utah.

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