Many Medicare beneficiaries don’t take full advantage of their coverage. Using a plan finder to compare networks, out-of-pocket spending caps and premiums is an easy way to improve your value.
Savvy consumers look for discounts at the grocery store, so why not apply those same principles to your Medicare benefits? Here are 6 tips to help you maximize your coverage.
1. Make Sure You’re Eligible
The most important thing you can do to maximize your Medicare benefits is make sure that you are actually eligible for them. If you are, then you can get the most out of the program by enrolling on time, choosing a plan that suits your needs and making the most of screenings, telehealth services and wellness benefits.
You should be automatically enrolled in Medicare Parts B and D when you turn 65, but you should double-check to make sure. If you’re still working and have employer-provided healthcare coverage or are serving as a volunteer abroad, then you may be able to delay enrolling in Medicare without penalty.
Medicare Advantage plans offer different options, including monthly premiums, copays and deductibles, and they typically include Medicare-covered benefits like doctor visits, hospital stays and prescription drugs. You can also choose from up to 10 types of Medigap policies that cover what traditional Medicare doesn’t.
It’s important to review your Medicare Advantage and/or Part D plans each year, as prices and benefits can change. For example, annual out-of-pocket maximums can increase or decrease, and your provider may have a new agreement with the insurance company that impacts your cost. In addition, Medicare’s leverage as a national program allows it to negotiate prices with healthcare providers on behalf of all beneficiaries, and those lower costs are reflected in your copays and deductibles. It’s a good idea to consult with a licensed professional to ensure that your plans are in line with your health care needs and budget.
2. Look for the Right Plan
Medicare’s benefits are a major financial consideration for many people in retirement. The average traditional Medicare beneficiary enrolled in Parts A and B spent $6,150 out-of-pocket on premiums, doctor visits and prescription drugs in 2013, according to a new report by the Kaiser Family Foundation. Getting the most bang for your buck starts with knowing what you’re eligible for and selecting the right plan. It’s best to check out reviews of different plans before deciding like the aetna medicare supplement review.
It’s important to understand that enrollment in Medicare isn’t automatic and you could face penalties if you sign up late. Fortunately, there are ways to minimize those penalties and make sure you get the best plan for your needs.
For example, some Medicare Advantage plans offer lower premiums than Traditional Medicare, and some Medicare Advantage PPO (preferred provider organization) plans allow you to visit doctors outside your network without referrals. It’s worth comparing these differences to find out what’s right for you.
Additionally, it’s a good idea to review your Medicare coverage annually. Some plans change from year to year, dropping or adding drugs and changing deductibles and copays. You may also be able to save money by switching to an alternative drug that’s less expensive, or one on a lower tier of your Medicare prescription drug plan’s formulary. You should talk to your doctor about the drug options available for you. Also, check to see if your plan offers any fitness and wellness benefits, as many do.
3. Stay Active
As you age, it’s important to maintain an active lifestyle to keep your mind and body healthy. Medicare can help you stay on track with your fitness goals by providing a variety of fitness-related benefits and services.
Gloria uses her Medicare Advantage plan’s Silver Sneakers fitness benefit to pay for her membership at 30 and Out, an all-women gym in her area. The classes she attends help her improve her balance, flexibility and strength. They also provide a sense of accountability that she doesn’t get from going to the gym on her own.
In addition to fitness programs, some Medicare Advantage plans also offer weight management support and other wellness services, such as smoking cessation assistance or stress reduction classes. It’s important to research what your Medicare Advantage plan offers before choosing a plan.
It’s also important to review your prescription drug coverage and determine what you’ll have to pay each month. You may be able to find a Medicare Advantage plan that covers your prescription drugs with a $0 monthly premium*. However, it’s best to check your prescription drug list annually to ensure that the drugs you take are still covered by your preferred plan. If they’re not, it might be time to switch to a different one.
4. Make the Most of Screenings and Telehealth Services
You may be the type to take advantage of two-for-one deals at the grocery store and always check for discounts before making online purchases. Or, you might be the kind of person who keeps a rainy day fund so that you don’t get caught off guard by an unexpected bill. Then, why not apply the same savvy to your Medicare benefits?
For instance, Medicare offers several free screenings as part of its wellness visits. These can help you identify potential health concerns before they become serious, and the earlier a condition is diagnosed, the more likely it is to respond to treatment.
Also, telehealth services can save you time and money. With these virtual visits, you can meet with a doctor without driving to the clinic or office, and you don’t have to worry about parking fees, child care or leaving work.
Another way to save is by visiting doctors who participate in Medicare’s network. Medicare pays these providers a fixed amount for their services, and they can’t charge you more than that amount. However, non-participating providers can charge you up to 15% more.
Medicare Advantage plans often offer a wide variety of coverage options, so you should be sure to choose a plan that meets your needs and budget. To do so, consider using a Medicare plan finder to compare the offerings available in your area. Also, review the Evidence of Coverage for each plan to see what benefits it covers and how much you can expect to spend in a year.
5. Take Advantage of Wellness Benefits
Taking care of one’s health is important for both physical and financial well-being. With Medicare, people can take advantage of a variety of resources that help keep them healthy and on track for retirement savings. However, many people are unaware that there’s more to Medicare than just coverage for medical emergencies.
For instance, Original Medicare offers beneficiaries an annual wellness visit and several preventive healthcare screenings, such as mammograms. These services can catch issues early, which is crucial for lowering overall healthcare costs. In addition, the annual wellness visit is a great time to discuss any concerns with a doctor.
Some employers also offer a range of wellness benefits. These can include fitness stipends, nutritionists, and stress management programs. These benefits are important to attract and retain employees. Studies show that healthy employees are more productive and have a lower rate of absenteeism. Offering a wellness reimbursement program is a way to show employees that their company cares about their health and wellbeing.
A wellness reimbursement program is a great way to increase employee satisfaction and morale. A survey by the CDC found that workplaces with healthy employees experience higher productivity, fewer sick days and are more efficient. A wellness program can also help employees stay focused and motivated throughout the workday and improve their quality of life. For these reasons, a wellness reimbursement benefit is a great option for any business.
6. Take Advantage of Discounts on Medicines
Whether you enjoy two-for-one sales at the supermarket or scour online coupon sites for savings, chances are you’re a savvy consumer. Apply those same practices to your Medicare benefits to help you save money and make the most of your coverage.
Some Medicare Advantage plans offer prescription drug discounts, so you may pay less than the standard co-pay for medications covered by your plan. And if you get your medication through home delivery, you’ll also save on shipping fees and avoid trips to the pharmacy. However, if you use a prescription-drug savings card instead of paying through your Medicare insurance, the money you save won’t count toward meeting your deductible.
You can also try to save on medications by asking your doctor for a less expensive option or switching to a different drug on the lower tier of your plan’s formulary (the list of covered drugs). Many doctors have access to prescription-drug discount programs, which can reduce costs. And you can check with your health-insurance company or look for free prescription drug-saving apps like GoodRx and WebMDRx.
And, if you’re taking insulin, be sure to inquire about your health plan’s prescription-drug coverage. You may be able to take advantage of a program that caps the cost of the medicine at $35 per month for Medicare Advantage members. This is especially important because the price of insulin has been on the rise.