Six tips for choosing Medicare coverage


If you’re eligible for Medicare, be sure that your fall to-do list includes reviewing your health coverage. This year’s annual enrollment period is changing and runs from October 15 to December 7—it is starting and ending earlier than usual.

It’s a good idea to consider if your current Medicare coverage is still the best option or if a new plan might work better for your health needs and budget. Blue Cross & Blue Shield of Rhode Island offers six tips to help you make this important decision:

1. Know your options. You have two basic ways to get Medicare coverage—by choosing Original Medicare (with optional supplemental coverage) or choosing a Medicare Advantage Plan (also known as Medicare Part C). Original Medicare includes Part A, which is hospital coverage, and Part B, which is medical coverage. With Original Medicare, you can add a standalone Medicare Part D Prescription Drug Plan or a Medicare Supplement Plan that provides additional coverage.

Medicare Advantage is a plan from a private insurer that provides the same coverage as Original Medicare Parts A and B and may include additional benefits or lower co-payments. You may be required to get care within a network of doctors or other healthcare providers. Often, prescription drug coverage (Medicare Part D) is included as part of a Medicare Advantage plan.

2. Make a list of your doctors and pharmacies. Check to see if they are participating in the networks of any plans you’re considering.

3. Make a list of your health care needs. What healthcare services do you use regularly? How often do you see your primary care physician? How many specialists do you see a year? Are you anticipating any special needs, such as surgery? After you’ve made your list, check to see if these services are covered in the plans you’re considering and compare out-of-pocket costs such as co-payments, coinsurance and deductibles.

4. Make a list of your medications. This list will help you determine which Medicare Prescription Drug Plan is best for you. Check each plan’s formulary to make sure your drugs are covered and compare out-of-pocket costs.

5. Consider choosing a plan with out-of-network benefits if you travel. If you spend a significant part of the year in a second home, you need Medicare coverage that will travel with you. Check to make sure the plans you’re considering allow you to receive coverage outside of their network. If you plan to travel outside the United States, make sure that your plan provides coverage for emergency care outside the country.

6. Choose a plan that will fit your budget. If you don’t have many medical expenses, you may benefit from a plan with a low premium or no premium at all. These plans often have higher out-of-pocket expenses than plans with premiums but may be more cost-effective if you don’t use many services. Be sure to compare all the costs of the plans you’re considering, including premiums and out-of-pocket expenses, before making your decision.

If you need help finding the right plan for you, Blue Cross & Blue Shield of Rhode Island is here to help. We offer Medicare Advantage plans—including a new $0 premium plan—as well as Medicare Supplement and Medicare Prescription Drug Plans. You can learn more about our plans by calling (401) 351-BLUE or visiting You can also talk to us in person by visiting our walk-in Customer Service Center at 500 Exchange Street in Providence or by attending a BlueCHiP for Medicare informational presentation in your area. To find an informational presentation near you, please call (401) 351-BLUE.

Ray Brown, Blue Cross & Blue Shield of Rhode Island assistant vice president is the company’s resident Medicare & Government Programs expert.


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