How to compare Medicare plans

If yes: If you have a strong relationship with your current care team, you’ll want to make sure you choose a plan that includes them in its network. Also, make sure needed specialty care is covered by your plan and confirm whether you need a referral to see a specialist.

In addition, the more times you visit your doctor(s), the more coverage you may need. If you see your care team multiple times a year, it‘s worth looking for plans with lower deductibles and lower out-of-pocket maximums.

If no: You can be more flexible in the plans you choose.

If yes: Consider a Medicare plan that includes prescription drug coverage (Medicare Part D), like a Medicare Advantage plan.

When you find a plan you like, look through the plan’s drug list (formulary) to see how your medicines are covered, and look through the plan's pharmacy network to see if your favorite pharmacies are available.

If no: Even if you don’t use prescription drugs right now, you may still want to consider Medicare Part D to avoid a late-enrollment penalty later.

If yes: A plan with low out-of-pocket maximums might be better for you.

People who exceed their out-of-pocket maximums or deductibles tend to get care regularly. Though your monthly premiums may be higher in a plan with low out-of-pocket maximums, your copays and coinsurance amounts may be lower when you visit the doctor.

If no: If you stay well under your deductible or out-of-pocket maximum each year, a plan with higher out-of-pocket maximums could be a good fit.

People who stay under their deductible and out-of-pocket maximums usually do so because they don’t get care very often. A plan with low out-of-pocket maximums often means your copays and coinsurance amounts may be higher when you visit the doctor, but your monthly premiums will typically be lower.

If yes: You might be okay having separate plans for medical and prescription drug coverage. These plans usually come with separate member ID cards, additional paperwork and different service teams.

If no: You could find having all your Medicare benefits in one plan, like a HealthPartners Medicare Advantage plan, to be more convenient.

If yes: You may be able to sign up for a combined plan for people who are dual eligible for both Medicaid and Medicare Parts A and B. If you live in the Twin Cities or central Minnesota, our HealthPartners Minnesota Senior Health Options (MSHO) plan adds extra perks and benefits, too.

If you’re not eligible for Medicaid, you may still be eligible for Medicare’s Low Income Subsidy (LIS), also called Extra Help. The Medicare LIS helps cover some or all of Medicare Part D prescription drug plan costs, including premiums, deductibles and copayments.

Working with a broker can help you determine what kind of plans or programs you may qualify for.