Understood Care
Choosing a health plan is about more than premiums. It is about access to the right doctors, predictable costs, drug coverage that actually matches your prescriptions, and benefits that support your daily life. A skilled advocate researches the plans in your area, translates the fine print, and organizes your choices so you can make a confident decision.
This guide explains how an advocate works with you, what choices you will compare, and how to prepare for a plan review. It also weaves in the key points from the video script on this page so you can follow along while you watch.
To connect with our team at any point, visit https://understoodcare.com/healthcare-info/how-our-care-team-assists-you
Our approach mirrors the plain language from the video
Throughout the process, your advocate gathers plan documents and checks provider directories and drug formularies. You get a clear side by side summary instead of a stack of confusing brochures.
For help with related needs like transportation or lowering drug costs, see
https://understoodcare.com/care-types/transportation-help and https://understoodcare.com/care-types/lower-costs-of-medication
Original Medicare includes Part A hospital insurance and Part B medical insurance. You can see any clinician who accepts Medicare. There is no yearly cap on your out of pocket costs, which is why many people add other coverage.
A Medigap policy from a private insurer helps pay your share of costs for services covered by Original Medicare. Depending on the specific plan, Medigap may cover part or all of your Part B coinsurance and other approved amounts. You still use Original Medicare and you keep the freedom to see any Medicare participating provider. Medigap policies do not include Part D drug coverage, so you would usually add a separate Part D plan.
Medicare Advantage is another way to receive your Part A and Part B benefits through a Medicare approved private plan. Most Medicare Advantage plans include Part D drug coverage and set an annual limit on what you pay out of pocket for Part A and Part B covered services. Costs vary by plan and service. Many plans use in network providers and may require prior authorization for some services. Extra benefits such as limited dental, vision, hearing, fitness, and transportation may be included.
Drug coverage can be included in a Medicare Advantage plan or purchased as a stand alone Part D plan with Original Medicare. Each plan has a list of covered drugs, preferred pharmacies, and specific rules such as prior authorization or quantity limits. Your advocate verifies how your current medications are covered and estimates your yearly costs.
Some people also have Medicaid, retiree coverage, or coverage from a current employer. These can change how costs are paid and which plans you can join. Your advocate checks coordination rules so you are not surprised by bills.
When the research is complete, your advocate presents an organized summary with plain language notes. You can talk through tradeoffs live or by phone. If you decide to switch, the advocate can prepare a checklist for you to complete enrollment directly with Medicare or with the plan.
To see more ways advocates can reduce daily hurdles, visit https://understoodcare.com/healthcare-info/what-is-a-patient-navigator
Every year there are windows when you can enroll, compare, or make changes.
As these dates approach, your advocate can review next year’s premiums, changes to your plan’s network or drug coverage, and new options in your county. For a personalized review with our team, start here https://understoodcare.com/
The right plan is a foundation, but daily life still brings tasks. Advocates can arrange rides, coordinate refills, and set up follow up care so your plan benefits are actually usable.
Medigap works with Original Medicare to help pay your share of approved costs such as coinsurance and copays. You keep access to any clinician who accepts Medicare. Medicare Advantage is an alternative way to get Part A and Part B through a private plan that often includes drug coverage, has an annual out of pocket limit, and usually uses a network. You cannot have both at the same time.
Yes. You continue paying the Part B premium. Some plans offer a partial giveback, but you should look at the full picture of costs and benefits.
No. Some services may have zero copays and others may have copays or coinsurance. Your advocate checks the specific costs for the services you use.
Many Medigap plans cover Part B coinsurance either fully or at a set percentage, depending on the plan you buy. Your advocate reviews the plan chart for your state and explains what each option covers.
Your advocate looks up your drugs on each plan’s formulary, notes any coverage rules, and estimates yearly costs with your preferred pharmacies.
Medicare Advantage plans include a yearly cap on what you pay for Part A and Part B covered services. After you reach that limit, the plan pays for covered services for the rest of the year. Original Medicare does not have a yearly cap unless you add supplemental coverage.
Yes. If you enroll in a Medicare Advantage plan and change your mind, the Medicare Advantage Open Enrollment Period from January 1 to March 31 lets you switch to another Medicare Advantage plan or go back to Original Medicare. Special Enrollment Periods may also apply after certain life events.
State Health Insurance Assistance Programs provide unbiased counseling in every state and territory. They are not connected to insurance companies and can help you compare options.
No. Your advocate prepares research and walks through your choices so you can enroll directly with Medicare or the plan you choose. This keeps the decision in your hands.
Start in early October when most changes are available to review. This gives time to compare options before the December deadline.
Call if you receive a plan notice you do not understand, a bill that seems wrong, or a letter about prior authorization or network changes. Early action prevents gaps in care. You can reach our team at https://understoodcare.com/
This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.
We know navigating Medicare and care needs can feel lonely, but you don’t have to do it alone.
Our caring team takes care of the paperwork, claims, and home care so you’re always supported.
