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Choosing a Medicare Plan


Now that you you’re familiar with the different types of Medicare coverage and their enrollment timelines, it’s time to choose a plan. It may seem like a lot, but we’ve broken down this process into 3 steps to help keep you focused on what’s important – your health.

Step 1: Assess your health

Talk to your doctor, take a look at your family history, and ask the important questions, like:

How is my health? 

Chronic medical conditions, like diabetes, can require daily prescriptions and regular doctor visits. Since Medicare Parts A and B don’t cover prescriptions, you’ll probably want to find additional coverage for those expenses. Things like eyeglasses and dental exams may not be covered by every Medicare Advantage plan in your area.

Do I need surgery?

Nobody can predict the future, but you can always get a physical and talk to your doctor about outstanding risk factors. Things like knee and hip replacements, heart valve repairs – all require lengthy hospital stays and probably physical therapy. Without proper health coverage, those kinds of services can lead to a lot of out-of-pocket costs. If you think you’ll need surgery after retirement, make sure as much of those costs are covered as well as things like home health care and skilled nursing facilities.

Do I plan on keeping an active lifestyle?

Medicare Advantage plans often come with added benefits, like SilverSneakers®, and discounts at local health clubs. Whole Health Balance allows you to purchase dental, vision, and additional fitness coverage as well for one low, monthly payment.If you travel frequently, you’ll want to be mindful of your health plan’s network. If you have a summer home or you want to spend your retirement traveling across the globe, an unexpected hospital stay could result in high medical bills. Most health plans have you covered in the event of an emergency, but you may find that a Medigap plan offers more flexibility and helps you get health care in more places.

Step 2: Compare plans in your area

Benefits and costs of Medicare Parts A and B are the same nationwide. But Medicare Advantage plans, Medicare Part D, and Medigap can vary quite a bit, depending on where you live. When choosing Medicare coverage, keep the following things in mind:

Premiums for Medigap can vary - Although the benefits for Medigap plans A - N are the same from state to state, private insurance companies set their own premium rates.

Private Medicare plans differ by region - Medicare Advantage (Medicare Part C) and Medicare Part D benefits and pricing can vary by state, county, and even locality. When choosing your Medicare plan, make sure you use the ZIP code for where you’ll be living and using your insurance when comparing plans. That will give you the most accurate way to estimate your Medicare costs and help you determine if the health insurance plans in your area cover the things you need.

Not all plans cover the same things - If you’re looking at Medicare Advantage plans in particular, your network and benefits can differ from plan to plan. If you have a doctor that you prefer, make sure they are in-network when choosing a plan — if they aren’t, your out-of-pocket costs will probably be much higher. Some Medicare Advantage plans come with prescription drug coverage, while others do not. So, while you’re comparing plans, make sure the prescriptions you need are also covered.

Medicare Advantage and Medigap are different - If Original Medicare doesn’t cover everything you need after you retire, then you may need to purchase additional health coverage. Remember that you can get a Medicare Advantage Plan or a Medigap Plan, but not both – so figure out which one suits your lifestyle the best. These two health care options have different out-of-pocket costs, network restrictions, and monthly premiums. To learn more about the differences between Medicare Advantage and Medigap, visit Medigap vs. Medicare Advantage page.

We have tools to help – We help you quickly and easily compare plans in your region online.

Step 3: When in doubt, ask an expert

We offer a variety of ways to get help from a Highmark expert. You can talk to a Licensed Medicare Advisor over the phone, sign up for one-on-one consultations at a location of your choosing, attend a seminar, and more.

Ready to enroll?

When you're ready, shop for and enroll in a Medicare plan online.

Talk to a licensed Medicare advisor

To enroll in a Highmark plan or learn more call
1-844-614-0343 (TTY users call 711)
8 a.m. - 8 p.m. ET, Monday to Friday
9 a.m. - 5 p.m. ET, Saturday 
Or visit our Reservations site

Talk to a licensed Medicare advisor

To enroll in a Highmark plan or learn more call
1-844-614-0343 (TTY users call 711)
10/1 - 3/31: Sunday - Saturday 8 a.m. - 8 p.m. EST
4/1 - 9/30: Monday - Friday 8 a.m. - 8 p.m. EST;
Saturday 9 a.m. - 5 p.m. EST

Hours are subject to change. Holidays may impact these hours.

Or visit our Reservations site