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HOW TO GET THE COVERAGE YOU NEED While SNPs and some other plans offer extra benefits for chronic conditions, check your overall coverage during open enrollment and also when choosing
between original Medicare and Medicare Advantage. Consider the following before making a decision. BE SURE YOU CAN SEE YOUR OWN DOCTORS. If you’re choosing between original Medicare and
Medicare Advantage, keep in mind that original Medicare gives you flexibility to use any provider or hospital that accepts Medicare. You don’t need a referral from a primary care provider,
as you do with many Medicare Advantage plans. This may be particularly important for people with chronic conditions who may want to see an expert outside their plan’s network. Medicare
Advantage plans also tend to have more prior authorization requirements before covering certain services than original Medicare does. COMPARE OUT-OF-POCKET COSTS. In 2024, the average
premium is $18.50 a month for a Medicare Advantage plan in addition to the Part B premium. Most plans include prescription drug coverage. The plans’ out-of-pocket costs increase as you use
more medical services. In 2024, Medicare Advantage plans have an out-of-pocket spending limit for medical expenses, not counting premiums, of $8,850 for in-network services and $13,300 for
covered in-network and out-of-network services combined. For original Medicare, you usually need to get a separate Part D prescription drug plan — premiums average $55.50 a month in 2024
— and Medigap coverage or retiree health insurance to help cover Medicare’s deductibles and copayments. But with original Medicare and a Medigap plan, you may have few out-of-pocket costs
other than the Part B deductible, which is $240 in 2024. THINK TWICE BEFORE SWITCHING from original Medicare to a Medicare Advantage plan. If you have Medicare Advantage but want to switch
back to original Medicare, you may have a difficult time getting a Medigap plan unless you’ve moved out of a plan’s service area or meet other requirements. If more than six months passed
since you enrolled in Medicare Part B, Medigap insurers in most states can charge more or deny coverage for preexisting conditions. People with chronic conditions may have an especially
difficult time getting new coverage. These rules vary by state — contact your SHIP for details.