What to consider when changing or switching your Medicare plan in 2025
It is no secret that Medicare does not cover all the medical services you may need, nor pay for all the health care expenses you may have in 2025. Therefore, instead of relying on your original Medicare plan, many people select to add supplemental insurance or a prescription drug plan, or opt for a ‘Medicare advantage plan’. These additional insurance options are approved by the government and run by private insurance companies. Adding coverage may help you to receive better benefits, lower your premiums, or reduce your out-of-pocket expenses.
If you are currently thinking about improving or changing your Medicare insurance, here are some things to consider:
Look at the total cost of your insurance
Remember not only to compare premiums, but also include deductibles and other costs such as co-payment or co-insurance? How much do you pay in case you need to see your doctor for a routine visit or illness, or to get surgery at a hospital? What is the yearly limit on what you have to pay out of your own pocket? Note that your costs may vary and be different if you don’t follow the plan’s rules and, for example, see a health care provider that is not part of the plan’s network.
Can you select the doctor or hospital of your choice?
Is the health care provider you want to consult accepted and paid for by your plan? Do you need a referral to see your doctor?
Prescriptions
Is the medication you need covered under the plan’s formulary? Are there any rules that you need to follow in order to get your prescriptions, such as buying it at a pharmacy that belongs to your plan’s network? Can you use a close-by pharmacy of your choice to fill your prescription? Can you order your medication by mail? At which rate are you covered for brand name or generic drugs?
Health care quality
Are your health issues, or any issues you may expect in the future, covered by the plan? Are treatment, equipment, services you need included in the care of the plan?
Medical care while traveling
If you are traveling in 2025, will the plan cover you in another state or the country you visit outside the United States?
Although there is a variety of Medicare options available, one plan may be ideal for one person but fall short of covering another one’s needs. Use the internet, a licensed health insurance broker, or contact Medicare.gov to understand all your options in order to get the Medicare coverage that fits your situation at the best rate.
