By Nate Purpura and Nate Eilers
HAVING MEDICARE HEALTH insurance
provides peace of mind, but it’s also important to get the most out of your coverage.
Under Medicare, health and drug plans can
change each year, affecting costs, coverage
and which providers and pharmacies are in
According to the Kaiser Family Foundation
( kff.org), some Medicare enrollees may be
overpaying by thousands of dollars and can
benefit by comparing plans each year, including plan premiums, deductible amounts, drug
coverage and how their pharmacy is treated by
plans. Before making any decisions, learn as
much as you can about what is covered and the
types of coverage available to you.
Here are some issues to consider when
making choices about Medicare-related
Not all doctors are covered by Medicare.
Pretty much every visit to the doctor costs
money, even when you’re on Medicare. If you
Three things to know
about Medicare enrollment
have a favorite doctor, find out if he or she
participates in Medicare because you’ll almost
certainly pay less if that’s the case. The doctor
you see can make a big difference in the
amount you pay out of pocket each time.
Different Medicare plans cover prescriptions in different ways. Would you rather
pay $5 for a prescription at the pharmacy or
$50? Your Medicare coverage affects your co-pays and out-of-pocket costs for prescriptions. Original Medicare (Parts A and B) does
not provide drug coverage. So if you need Rx
drug coverage, these are your two choices:
• Stand-alone prescription drug plans
(Medicare Part D). These plans are sold by private insurance companies. They can be used in
conjunction with your Medicare Parts A and B
coverage, and with Medicare supplement plans,
to cover the cost of prescribed medications.
• Medicare Advantage prescription drug
plans (Medicare Advantage, or Part C). These
plans are also sold by private insurance com-
COSTCO panies. They combine Medicare Parts A and
B coverage with Part D prescription drug coverage to give you everything in a single plan.
Knowing your health care options is
important. Medicare beneficiaries can generally get health coverage in two ways: through
Original Medicare or through a private
Medicare Advantage plan. Original Medicare
comes in two parts:
• Medicare Part A (hospital insurance).
This covers inpatient hospital, skilled nursing
facility, hospice and home health care. If you
or your spouse paid Medicare taxes, you won’t
have to pay a monthly premium for Part A.
• Medicare Part B (medical insurance).
This covers outpatient medical care, including (but not limited to) doctor visits, durable
medical equipment, lab tests and preventive
services for a standard monthly premium, but
premiums can vary depending on income.
Certain types of Medicare coverage are
available only through private insurance:
• Medicare Advantage, or Part C.
Medicare Advantage plans provide Original
Medicare benefits through private insurance
companies. There are many types of Medicare
Advantage plans, such as Preferred Provider
Organization (PPO) plans and Health
Maintenance Organization (HMO) plans. In
addition to what’s covered under Original
Medicare, some Advantage plans offer other
benefits, such as routine dental and vision,
health wellness programs and prescription
• Medicare Part D (prescription drug
coverage). Original Medicare doesn’t include
prescription drug benefits, except in certain
situations. You can sign up for prescription
drug coverage through a separate Medicare
prescription drug plan, or through a Medicare
Advantage prescription drug plan, which will
have an average premium based on income,
according to the National Council on Aging
• Medicare Supplement (Medigap).
Medigap helps pay for out-of-pocket costs not
covered in Original Medicare, such as co-payments, co-insurance, deductibles and
overseas health coverage. These plans can be
used for Original Medicare only and cannot
be used with a Medicare Advantage plan.
You can find additional resources at
medicare.com and by contacting your state’s
Senior Health Insurance Benefits Advisors, or
by connecting with a knowledgeable Medicare
insurance professional. Costco has partnered
with eHealth to help provide you with information to compare Medicare plans at ehealth
medicare.com/CostcoConnection, or call
Nate Purpura is vice president of communications for ehealthinsurance.com. Nate Eilers is
director of third-party programs for Costco