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  • Predict Health Team

5 Key Facts You Should Know About Getting Medicare Coverage

Updated: Oct 20, 2021

Are you considering private Medicare health insurance plans (also called Medicare Advantage or Medicare Part C) in this month’s open enrollment and are confused about which plan to select? Here are 5 key questions and answers to help you make a better decision.

Fall Open Enrollment Period: Between October 15th to December 7th. During this time you can:

  • Join a new private Medicare (Medicare Advantage) plan or choose private Medicare for the first time

  • Add a stand-alone prescription drug plan (Part D) plan

  • Switch between Original Medicare with or without a Part D plan and Medicare Advantage

Your plan selections will take effect on January 1, 2021.

1. What are the copays, coinsurance, and deductibles for the plan?

It is important to be aware of all the costs associated with your plan. The main costs are:

  • Deductible

  • Coinsurance

  • Copay

*For more details on these components see this blog post.

2. Do you have a chronic condition that requires specific prescription drugs or special care?

If yes, make sure the plan covers all your needs. Compare a Specialty Needs Plan (SNP) with Original Medicare and Medigap to see which plan suits your needs.

3. Do you currently visit a specific healthcare provider?

If yes, ensure that your healthcare provider is in network.

4. What is the plan’s quality?

The Center for Medicare and Medicaid services (CMS) provides a rating from 1 to 5 stars depending on the quality of the plan (with 5 stars being the best rating). Plans with 4 stars and above receive special rebates and benefits like dental, vision and hearing. You should check the rating of the plan before signing up for it.

5. Do you travel frequently?

Frequent Domestic travel: You need a more flexible plan whose network you can use while travelling.

Frequent International Travel: Look for international travel insurance coverage in your plans.

For more information on Medicare plan options, you can visit the Medicare website here.


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