Is Medicare Health Insurance Right for You?


Check out all of Beyond Type 2’s resources on health insurance and Medicare.

If you’re eligible to enroll in Medicare, you may not be sure how it stacks up to your current healthcare coverage.

Health insurance can be complicated. Understanding what exactly Medicare offers and how it compares to your other options is essential to deciding whether to enroll.

Are you eligible to enroll in Medicare?

Medicare is a federally-run health insurance program for Americans aged 65 and older. Medicare also covers younger people with certain disabilities or permanent kidney failure.

U.S. permanent residents may also be eligible for Medicare after five years of continuously living in the United States.

Understanding Medicare’s different coverage types

If you’re considering Medicare insurance, it’s important to understand the different types of coverage offered.

The options for insurance through Medicare are Original Medicare (Part A and Part B) and Medicare Advantage (Part C). Original Medicare offers separate hospital insurance (Part A) and medical insurance (Part B) policies.  Medicare Part D is stand-alone prescription drug coverage.

  • Part A covers hospitalization, skilled nursing and nursing home care, hospice and home healthcare services.
  • Part B covers things like medical services, preventative care, mental healthcare, ambulance services and durable medical equipment.

A Medicare Advantage Plan is Medicare coverage offered through a private insurer. Medicare Advantage plans typically combine medical and drug coverage, though that’s not always the case.

Which Medicare coverage is right for you will depend on your needs, preferences, budget and what healthcare coverage is available to you from other sources, like a job.

Consider your costs

What you’ll pay for Medicare will depend on a few factors including the level of coverage you chose and your income.

Part A has no premium for most people. Part B and Part D have premiums based on income, though most people are eligible for a $0 premium. Costs and income brackets are adjusted yearly. You can see updated costs on the Medicare website here.

Your total annual healthcare costs will include your premium, deductible, coinsurance and co-payments.

Doctor and hospital choice

Consider whether your current or preferred healthcare providers are in-network with the Medicare plans you are considering.

If you don’t have a primary healthcare provider, you can use the Medicare website to see how many in-network providers are in your area.

Your existing health coverage

It’s best to understand your other healthcare coverage options before deciding to enroll in Medicare.

If you are still eligible for commercial insurance through an employer or family member, you’ll want to compare your total costs (premiums, deductibles and co-payment and coinsurance) and how happy you are with the provider and service options.

You will not face Medicare late-enrollment penalties if you are enrolled in a comparable policy, such as a commercial plan sponsored by your employer. If, however, you go more than 63 days without any health insurance after you become eligible, you risk paying more when you go to sign up for Medicare.

Use all the information available about Medicare to avoid unnecessarily paying more for insurance or facing coverage gaps that impact your diabetes management.

The takeaway

Medicare provides low-cost health insurance for millions of people and ensures older Americans have access to comprehensive healthcare. If you are eligible, enrolling in Medicare may help you manage and afford your diabetes care.

By researching your options regarding your diabetes care and health insurance coverage, you’ll be empowered to make the best decisions for your individual needs.

Check out our guide on key dates and deadlines for enrolling in Medicare.

WRITTEN BY Philo Uwamaria, POSTED 11/04/22, UPDATED 11/07/22

Philo Uwamaria is a health content writer with a knack for breaking down complicated topics. She lives in Nairobi, Kenya.