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What should I consider when choosing or changing my coverage?




Where are the doctors’ offices? What are their hours? Do the doctors use electronic health records or prescribe electronically?Which pharmacies can you use? Is the pharmacy you use in the plan’s network? If it’s in the network and your plan has preferred pharmacies, is your pharmacy preferred? (You may pay more at non-preferred pharmacies.) Can you get your prescriptions by mail?


How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you pay out-of-pocket? Your costs may vary and may be different if you don’t follow the coverage rules.


How well does the plan cover the services you need?

Doctor and hospital choice

Do your doctors and other health care providers accept the type of coverage you have? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?

Prescription drugs

Do you need to join a Medicare drug plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions?

Quality of care

Are you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. Medicare has information to help you compare how well plans and providers work to give you the best care possible.


Will you have coverage in another state or outside the U.S.?

Your other coverage

Do you have, or are you eligible for, other types of health or prescription drug coverage (like from a former or current employer or union)? If so, read the materials from your insurer or plan, or call them to find out how the coverage works with, or is affected by, Medicare. If you have coverage through a former or current employer or union or other source, talk to your benefits administrator, insurer, or plan before making any changes to your coverage. If you drop your coverage, you may not be able to get it back.


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