Choosing Medicare Coverage During the Pandemic

Guest

Last Updated: December 3rd, 2020

Guest Post by Lindsay Engle

COVID-19 has made an impact on the world over the last couple of months, especially here in the United States. 

As if choosing a Medicare plan before wasn't complicated enough, we now have a new monkey wrench — a global pandemic. It's time to pay attention when choosing Medicare coverage to ensure you’re making the decision that’s best for you long-term. 

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Choosing coverage

Understanding your Medicare coverage can be cumbersome. Like all major life decisions, there are a plethora of considerations to take, especially now with the pandemic looming overhead. 

While it’s easy to impulsively choose the plan that seems to provide the best coverage at the lowest cost, you'll want to remember these seven things when beginning your Medicare journey and weigh all options thoroughly:

  • Cost  
  • Quality of care
  • Coverages
  • Prescription coverage
  • Extra coverage
  • Travel
  • Doctor and hospital choices

Costs

Like most people, you’ll need to budget your finances accordingly. Health insurance is generally known to be costly, and many people who enroll in Medicare are on fixed incomes due to retirement. Cost becomes an even larger factor now, considering the drastic changes we’ve seen with our economy over the last several weeks and millions of Americans have lost their income as a result. 

But with the continued spread of the coronavirus, health insurance costs are incredibly crucial right now. You'll want to consider how much you'll be paying in copays, deductibles, and premiums, and if you’ll have an annual limit.

To help reduce some of your expenses, you can opt into buying a Medicare Supplement plan. Another option is looking into a Medicare Advantage policy — once you reach a specific limit each year, you won't be responsible for extra charges for the rest of the year. 

However, there is a drawback to buying into an Advantage policy. Medicare Advantage plans have their own networks of doctors and hospitals, and if you end up seeing a doctor out of network, you could be on the hook for all costs. 

Considering all possible costs before making a decision can help save you hundreds of dollars.

Quality of care

Another important thing to consider in times like these is the level of care you'll be receiving. You'll want to work with an insurance company that is taking the initiative to help its members.

Many insurance companies are waiving fees for COVID-19 telehealth appointments right now, and doctors and hospitals are also taking many steps to help protect their patients. The quality of the care you receive can make all the difference in a stressful situation. 

Coverages

How comprehensive is your Medicare coverage? With many different plan options, this will be one of your biggest considerations. 

COVID-19 can have a detrimental effect on people of all ages, but particularly those who are over 65. Should you wind up getting seriously ill, will your coverage be able to cover days or weeks in the hospital? 

By choosing a plan with comprehensive coverage, you'll likely save yourself money. If you need a two-week stay in your local hospital, you could quickly rack up tens of thousands in bills. Part A and B don't generally cover everything you may need coverage-wise, so it’s usually a smart investment to buy a supplemental plan.

Prescription coverage

While there may not be any medications available for COVID-19 right now, that could change. Plus, you may already be on certain medications that need coverage.

Medicare won’t cover your prescription costs, so there are a couple of different routes you can take. 

You may choose to buy a Part D prescription drug plan, or you may decide to buy a Medicare Advantage plan with drug coverage. Perhaps you decide to forego a prescription plan. But if you end up skipping the drug coverage, you may regret that decision.

Prescription drug costs can be abundant — some of the medications in today's market end up costing thousands every single month. If you're not in the position to pay enormous amounts in drug costs, a drug plan is the best way to go. 

Extra coverage

Not everyone who joins Medicare only has Medicare health coverage. Many people have prescription or health coverage through their employers. 

If you are still working, there is the option to remain on your employer’s group health insurance plan, and how your Medicare benefits coordinate with this coverage depends on the size of the company. If you work for an employer with over 20 employees, your group plan will be primary, meaning they pay first, then Medicare, and if you work for a company with less than 20 employees, your Medicare plan will be primary.

Regardless, it’s advised to enroll in Part A once eligible as the premium is free if you’ve paid enough Medicare taxes and it can help keep costs lower if a hospital stay becomes necessary. If you have small group insurance (fewer than 20 employees), you’ll also want to enroll in Part B to cover any outpatient costs.

You’ll always want to compare the cost of your group insurance to the cost of Medicare + Medigap + Part D to see what makes the most sense in terms of coverage and price, and keep in mind that it’s illegal for employers to contribute to Medicare premiums. For additional information on choosing between Medicare and group insurance, visit this resource.

Travel

Traveling right now isn't what it used to be with the requirement of face masks, sanitizers, and temperature checks. While many have halted their travel plans for the foreseeable future, it’s a matter of time before we’re able to travel comfortably again. 

When that time comes, it’s important to ask yourself if your health coverage will help to cover you if you were to get sick overseas. Medicare doesn't cover health care out of the United States, but that's not to say that supplemental coverage won't help ease some of those costs. 

Doctor and hospital choices

Finding a doctor that accepts your health coverage is paramount. In addition to doctors who take your insurance, health facilities need to accept it as well. 

When you have a Medicare Supplement plan, you can go to any doctor that takes Medicare. If you have a Medicare Advantage plan, you'll have to stay within the network. 

Despite being in the middle of a health crisis, doctors are continuing to see their patients. But it may not be in a traditional appointment setting. Many doctor's offices are implementing telehealth appointments, and although you may not be physically going to see the doctor, you'll still need to be sure they take your insurance.

Preparing for the future

For most of us, 2020 is unlike anything we've ever imagined, much less seen before. You may take some comfort knowing that many insurance companies are waiving fees. 

Companies are going the extra mile to ensure all Americans have access to medical care, but hospitalizations can quickly deplete any health savings you may have. By considering a few things, you can prepare yourself for any turns this pandemic may bring. 

COVID-19 is proving its strength every day. Arming yourself with excellent health coverage can make all the difference to the future of your health.

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare space since 2017. She is featured in many publications and writes regularly for other expert columns. She has a passion for sharing her expertise on Medicare to beneficiaries so they can be better prepared for healthcare costs after retirement. You can find her on YouTube where she has a featured channel for Medicare beneficiaries to become educated on all their options.

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