Insurance plans can be intimidating to navigate at any age, and, unfortunately, don’t become less complicated as we age. The good news is that there are resources available to help seniors effectively consider insurance options.
Medicare is a government-supported insurance initiative that provides plans for seniors to supplement the costs of medical care. In order to qualify, the applicant must be at least 65 years old, reside in the US, and be considered a US citizen or have been lawfully admitted to the US for at least five years in a row. Additionally, Medicare provides options for individuals who have been disabled (regardless of age) for over two years as well as people with end-stage renal disease or Amyotrophic Lateral Sclerosis (ALS). [1-2]
Basic Medicare Plans
Medicare programs were initiated as Medicare Part A and Medicare Part B. Part A provides coverage for hospital-based expenses. This includes services such as inpatient care, short-term stays in post-acute care, and hospice. A majority of seniors who qualify for Medicare Part A will not need to pay a monthly premium. [1-2]
Medicare Part B is meant to work hand-in-hand with Part A and provides coverage for some additional medical services, including preventative visits as well as diagnostics and visits to the emergency room. Unlike Part A, most seniors will need to pay a monthly premium for Part B. [1-2]
Enrolling the traditional Medicare Part A and Part B programs is a reasonable option for many seniors, given the cost-effectiveness and variety of services covered across the two plans. Traditional Medicare offers coverage throughout the US with access to benefits when traveling outside of your state of residence. These plans are accepted by any Medicare provider, which allows for a wide range of options for selecting preferred specialists. [1-2]
While Parts A and B provide important benefits for seniors, they are not without their shortcomings. These plans do not include coverage for prescription drugs, vision, or dental services. Seniors should also note that there is no out-of-pocket maximum, unlike many private insurance plans. Although Medicare is government-funded, the cost of healthcare can still be significant. [1-2]
A popular alternative to Parts A and B is enrollment in Medicare Part C, which is also known as Medicare Advantage. Medicare Advantage plans are offered by private insurance companies and include the services covered by Parts A and B, along with additional services, depending on the specific plan. Medicare Advantage is more expensive than traditional Medicare, but these plans often include important services such as dental, vision, and prescription drug benefits. These plans do have an out-of-pocket max, which can help save money over time. [1-2]
Although Medicare Advantage plans are very popular for seniors, they also have their drawbacks. Provider choice may be more limited compared to Parts A and B, and there are often additional payments that must be made with visits, such as copays and deductibles. Seniors who travel often will want to look closely at their plan, as Medicare Advantage plans generally do not include out-of-state coverage. [1-2]
Individuals looking specifically for prescription coverage may want to consider Medicare Part D. Part D plans are offered through private insurance companies and are added on in addition to a base Medicare plan. A benefit to this type of plan is that it pays a particular amount of the prescription cost, regardless of the cost. This can be useful for seniors who are on an expensive medication or numerous regular medications; however, there are some restrictions to the medications covered, and pre-authorization may be required prior to Medicare payment. Seniors who need prescription coverage but do not want all of the coverage offered by Medicare Advance may find Part D to be excellent add-on. 
Lastly, seniors have the option of enrolling in MediGap, which offers coverage for costs that are not covered by Parts A and B, including deductibles and copayments. These plans are able to be used internationally and can help supplement expensive medical needs; however, MediGap does not include coverage for vision, dental, or long-term care services. A senior cannot be enrolled in Medicare Advantage and MediGap simultaneously, but MediGap covers some of the same costs as Advantage and is generally less expensive. [1-2]
Enrolling in Medicare
One of the more challenging aspects of insurance is understanding how to enroll and doing so within the correct time period to avoid penalties. Seniors approaching 65 will want to consider Medicare plans within 3 months before or after their 65th birthday. The good news is that seniors who already receive social security will automatically be enrolled in traditional Medicare prior to their birthday; however, enrollment in any additional plans outside of Parts A and Part B is not automatic. [1-2]
Unfortunately, seniors who do not enroll during their birthday window will receive penalties if they enroll at a later time. Medicare offers enrollment periods (outside of the birthday window) from January 1st through March 31st. Medicare Part D enrollment is from April 1st through June 30th, and the open enrollment period for Parts C and D is from October 15th through December 7th. Although these enrollment periods are useful for seniors who did not sign up around their 65th birthdays, there are additional, ongoing penalties for enrolling after the birthday window has passed. [1-2]
Choosing the Right Plan
Insurance plans are confusing and complicated, making it challenging to select the plan that best suits your individual needs. Seniors will want to consider their current state of health as well as possible health conditions that may be relevant in the future. While no one can predict what will happen, there are genetic and lifestyle factors that will make some seniors more vulnerable than others.
Some factors to consider include the number and types of prescriptions needed, pre-existing benefits (for those who are still in the workforce), and anticipated health coverage needs. Some seniors may already know they will need a medical procedure in the future, such as a surgery, and can therefore anticipate the type of coverage they will need to be able to effectively manage costs. Seniors who like to travel may want to consider whether the plan will cover out-of-state or international health emergencies. 
It is recommended that eligible seniors approaching 65 take the time to consider the different Medicare options to avoid long-term penalties and to receive the most appropriate form of coverage. This article provides a basis of information to help you begin your research as you move forward with making your Medicare decisions.