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Key Lifestyle Factors When Choosing Medicare Coverage Skip to content

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Four Key Factors To Consider

Take a close look at your circumstances and needs as you plan for Medicare

collage of four images - a man in a doctor's office,  couple sitting on their front porch, stethoscope and calculator on top of currency, and an insurance claim form

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En español | Viewing your Medicare coverage decisions through the following four categories can help you zero in on which plans will work best for you. 

Your health

  • Do you want to keep your doctors or are you open to changing? Original Medicare allows you to maintain your current provider – if they accept Medicare – while Medicare Advantage relies on specific networks of doctors and hospitals.
  • Do you have a preexisting condition? Medicare will cover your preexisting conditions, whether you choose Original Medicare or Medicare Advantage.
  • Are you taking medications regularly? If so, you’ll want to make sure the prescription drug plan you’re considering covers all your medicines.
  • Are you willing to change pharmacies? Some prescription plans have preferred pharmacies where you’ll pay less for your medicines.

Your home

  • Do you expect to travel around the country or abroad? Original Medicare will cover you wherever you live but Medicare generally does not provide coverage outside the United States.
  • Do you plan to spend more time at your second home? You may not be able to find a Medicare Advantage plan that covers you in both your primary residence and a vacation home.
  • Do you live in a rural area? The availability of Medicare Advantage plans is generally more limited in rural areas.   

Your costs

  • Are you worried about what you can afford, from premiums to out-of-pocket expenses such as copays, coinsurance and deductibles? When considering whether to select Original Medicare or Medicare Advantage, you’ll want to take into account all these costs and consult the federal government’s out-of-pocket cost calculator, which can help you compare your estimated out-of-pocket expenses.
  • Are you eligible for Medicaid or other assistance programs? Medicaid helps low-income Americans get medical coverage and four Medicare Savings Programs also help beneficiaries who cannot afford their out-of-pocket Medicare costs.  

Your coverage

  • Do you have health insurance through your job or are you covered by your spouse’s plan? If so, you may be able to delay enrolling in Medicare.
  • Are you insured through the Affordable Care Act individual marketplace, a retiree health plan, military plan or COBRA (the temporary coverage that people can buy when they leave a job)? If so, you probably still need to enroll in Medicare as soon as you turn 65.

Our guide can help you fully answer these questions and navigate the Medicare landscape so that you can make the best choices for your health, your lifestyle and your pocketbook.

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