The 4 P’s of Choosing a Medicare Advantage Plan
11/13/2017 • Posted by Fidelis Care in Medicare

The Annual Election Period (AEP) for Medicare plans is going on right now. If you want your Medicare Advantage coverage to start on January 1, 2018, you must select a Medicare plan before AEP ends on December 7. After that, you will only be able to shop for a Medicare plan during specific lifetime events, such as when you turn 65.

There's a lot to consider when choosing the right Medicare plan. If you're not sure where to start, keep these four areas in mind:


The overall cost of a Medicare Advantage plan can vary, based on needs and income. Create a “health care budget” that outlines expected health needs, and compare overall costs.

Key questions:

  • What is the plan’s monthly premium?
  • Is there a deductible you must meet first before coverage begins?
  • Are there copays for doctor or specialist visits?


Find out if the plan’s covered services will help lower the cost of managing your health conditions, or if you will need to pay out of pocket for certain health care needs. Sometimes, the least expensive Medicare plan (or even the most expensive one!) may not necessarily be best.

Key questions:

  • Is there dental or vision coverage?
  • Can members receive help managing their chronic conditions?
  • Are in-home services or care covered?


A Medicare plan should ideally allow you to keep seeing the doctors you prefer. Many health plans require members to see doctors within a provider network. Other plans allow members to see any doctor, but these plans usually cost more.

Key questions:

  • Are preferred doctors “in network”?
  • If the primary care provider is in network but specialists are not, is it possible to still get specialist visits covered by referral?
  • How close to home are the nearest in-network doctors?

Prescription Drugs

It's important to know which medications are covered. Make a list of your medications, then check the Medicare prescription drug formularies of the plans being considered. A formulary is a list of medications covered by a health plan.

Key questions:

  • Which prescriptions do you need?
  • Will the Medicare plan cover these prescriptions, or will they cost more?
  • If any medications are not covered, is there an acceptable alternative in the formulary?

Do you have questions or need more information? Fidelis Care's Licensed Sales Representatives are available to meet with you in the comfort of your own home or at any of our Community Office locations. For more information, call 1-800-860-8707 or visit


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