Ask Your Doctor: Choosing the Right Medicare Plan

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Signing up for Medicare is a pretty big deal and it's likely you'll have a lot of questions. Did you know that Medicare has various parts? Or that your prescriptions might only be covered under Part D?

That's why it's critical to do your research and consult your doctor for some answers. Your primary care physician (PCP) can be a great resource. They'll welcome any questions you may have about Medicare.

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Need a Medicare refresher?

If you're eligible for Medicare, the Medicare plan you choose depends on your needs.

Medicare Part A covers your inpatient care in hospitals and Part B covers medically necessary services like doctors' services, outpatient care, and other medical services. Both parts make up what's known as Original Medicare, which is provided by the federal government.

Medicare Advantage plans from insurers like Aetna combine Part A and Part B benefits, and may include Medicare Part D (prescription drug coverage), in one plan. That's coverage for hospital and medical care, as well as prescription drugs.

Did we lose you yet? Medicare can be confusing, but rest assured, there are plenty of resources that can help simplify things. For now, just concentrate on questions you can ask your Primary Care Physician (PCP) about Medicare. Their answers can help guide your decision on which plan is right for you.

1. Do you accept Medicare?

It's important to check. If your doctors and providers accept it, your out-of-pocket costs may be less.

2. Do other providers in your practice accept Medicare?

You may be seeing specialists within your PCP's practice and should check if they accept Medicare, too. Your PCP might know offhand, but you can always reach out to your specialists. This is important, so you don't end up paying higher costs out of your own pocket.

3. Do I need a referral to see a specialist?

With Part A and Part B coverage, you typically don't need a referral. But once you choose a plan, you should check with your insurer to ensure your specialist accepts Medicare. However, if you enroll in a Medicare Advantage plan, you may need to get a referral to see a specialist.

4. Any specific tests or screenings that you think I'll need in the future?

Your doctor knows your health history and may be able to provide insight on any tests or screenings you may need in the future, especially if you're living with a chronic condition. Medicare Part A and Part B may not cover certain screenings. That's where Medicare Advantage plans come in. They provide Part A and Part B coverage, and may provide additional benefits. Knowing in advance if you'll need certain tests or screenings in the future can help you choose the best plan for you.

5. Does Medicare cover my medications?

It's important to check if your Medicare plan covers your medications, so you'll know what you have to pay out of pocket. Original Medicare doesn't cover Part D medicines. However, Medicare Part D or Medicare Advantage plans with prescription drug coverage have formularies (list of drugs covered). Before you sign up, make sure to check the plan's formulary. This can help save you money. It's likely that your doctor will suggest you check with the insurer of the plans you're considering. So make sure you do your research.

Be proactive with your health care

Remember to print these questions to take with you to your next doctor's appointment. It's important to know that no one can choose a Medicare plan for you. It's your decision. And if your situation changes, you can always change your plan during the annual enrollment period (October 15 to December 7 each year).

Amy Capomaccio is a health care writer at Aetna with experience in senior wellness, Medicare, Medicaid, and commercial health care. When she's not practicing new mindfulness techniques, Amy is spending time outdoors and traveling. Amy hails from Wakefield, MA and has a degree in Advertising and Public Relations from the University of Tampa.