Questions to Ask When Choosing a Medicare Advantage Plan
Medicare Advantage (Part C) plans are not one size fits all – here are some questions to keep in mind when exploring your options for Medicare Advantage (Part C) plans.
Provider & Hospital Questions
- Are my current doctors in this plan’s network?
- Does this plan cover providers I may need to see in the future?
- Will this plan cover out-of-network visits?
- Which facilities (hospitals, home health, skilled nursing) are in this plan’s network?
Access Questions
- What is the plan’s service area?
- Does the plan have any coverage for care outside of the service area?
- What are my options for choosing a Primary Care Provider?
- Does the plan require approval before I am admitted to a hospital?
- Do I need referrals from a Primary Care Provider to see a specialist?
Cost Questions
- What costs are associated with this plan (copayments, deductibles, premiums)?
- What are the maximum out-of-pocket costs?
- What is the deductible? (How much do I have to pay before coverage begins?
- What are the copayments for regular services like seeing a PCP or specialist?
- What are the copayments for hospital stays and home health?
Benefit Questions
- Does this plan cover dental, vision, or hearing aids?
- Are there restrictions or rules to be aware of when accessing my benefits with this plan?
Prescription Drug Questions
- Are outpatient prescription drugs covered under this plan?
- Does this plan cover my current prescriptions?
- Are there any coverage restrictions?
- What are the premiums, deductibles, and copayments?
- How much will I pay for generic drugs? Brand name drugs?
- What will I pay for drugs during the coverage gap?
- Is my current pharmacy covered?
- Can I use a mail-order pharmacy?
- Will I be able to refill my prescriptions when I travel?
