Maximize Your Medicare

My Comments: The ideological fight now gripping much of the country includes healthcare and whether it’s a privilege or a right. It is moving rapidly into the arena of a ‘right’ as opposed to a ‘privilege’.

Some of this is driven by demographics; the number of people qualifying for Medicare is growing daily. Some of it is driven by expectations and the reluctance of old people to simply roll over and die.

A hallmark of society from day one has been to look after children and elders. As an elder myself, and unwilling to roll over and die just yet, I’m happy to add my voice to the argument that as a very wealthy nation, we can, and must, find a way to make sure the elderly are properly taken care of.

Selena Maranjian May 20, 2017

These five ways to maximize your Medicare can help you keep costs down while getting good care. They might even help you live longer and better.

With healthcare costs now making up about 17% of our country’s entire GDP, it’s become a challenge for many of us to be able to afford care. Companies and individuals are looking for ways to keep costs down — and for most folks aged 65 and up, Medicare is an important piece of the puzzle.

Indeed, there are close to than 58 million enrollees in Medicare, as of March 2017. Considering that there are roughly 325 million people in America, that’s a hefty 18% of the population — nearly one in five. Since it’s in the cards for most of us, here are five valuable ways to maximize your Medicare.

Enroll at the right time — being late can cost you

If you’re late enrolling in Medicare, your part B premiums (which cover medical services, but not hospital services) can rise by 10% for each year that you were eligible for Medicare and didn’t enroll. Yikes!

When, then, should you enroll? Well, you’re eligible for Medicare at age 65, and you can sign up anytime within the three months leading up to your 65th birthday, during the month of your birthday, or within the three months that follow.

There’s a helpful loophole, too: If you’re among the many Americans who are already receiving Social Security benefits by the time they reach age 65, you should be enrolled in Medicare automatically. You might also avoid the late-enrollment penalty and be able to skip the deadline if you’re still working, with employer-provided healthcare coverage, at age 65, or if you’re serving as a volunteer abroad.

Choose wisely between “original” Medicare and Medicare Advantage plans

There isn’t a single Medicare plan for everyone. Each enrollee needs to make some decisions — with the primary one being whether you opt for “original” Medicare or a Medicare Advantage plan.

Traditional or “original” Medicare features Parts A and B that respectively cover hospital expenses and medical expenses. If you opt for it, you’ll likely add Part D, which offers prescription drug coverage, including insulin supplies. Instead of opting for parts A, B, and D, though, you can choose from among available Medicare Advantage plans, sometimes referred to as Part C. Offered by private insurance companies, they are required to provide at least as much coverage as Parts A and B — and they usually offer significantly more. They cap your out-of-pocket expenses, too.

While original Medicare doesn’t cover hearing, vision and/or dental care, many Medicare Advantage plans do — and they generally include prescription drug coverage, too. While original Medicare will often have you footing 20% of many bills with no end in sight, a Medicare Advantage plan might charge you a low copay per doctor visit or service, with the total amount you’ll pay limited. (The average out-of-pocket cap was recently $5,223, but many plans feature caps below $3,000, and the limit for 2017 is $6,700.) While original Medicare lets you see any healthcare provider who accepts Medicare, Medicare Advantage plans will typically limit you to a network of doctors — though these networks are sometimes very big.

To help you zero in on your best choice, make a list of the prescription drugs you take and the doctors you see. Also list the kinds of healthcare services you need and use, noting any upcoming surgeries or big-ticket expenses. When you review the plans you’re considering, see which drugs they cover and which doctors are included — and how much you’ll likely spend out of pocket with each one. The Medicare Plan Finder at the Medicare website can help you compare and choose. Note the star ratings of your candidate plans and favor four- or five-star plans. Note, too, that you can change your mind once a year, during the annual enrollment period, and can switch between plans.

Get screened

Once you’re in a Medicare plan, make the most of the screenings and preventive care that are available — typically at no cost to you. Doing so can help identify problems early, before they grow worse and more costly. (A polyp caught early via a colonoscopy can prevent lots of heartache and costs down the road.) Screenings can keep you healthier and living longer and better, while keeping your healthcare costs down.

Here are some of the services that should cost you no additional dollars (though some require doctor’s orders) include: abdominal aortic aneurysm screening, alcohol misuse screening and counseling, bone density measurement, cardiovascular disease screenings, cervical and vaginal cancer screenings, colonoscopies and other colorectal cancer screenings, depression screenings, diabetes screenings, flu shots, hepatitis B shots and hepatitis C screenings, HIV screenings, some home health services, lung cancer screenings, mammograms, nutrition therapy services, obesity screenings and counseling, pneumonia vaccine, prostate cancer screenings, sexually transmitted infection screenings, and smoking and tobacco-use cessation counseling.

Try telehealth services if you can

Many plans these days offer enrollees telehealth services. These permit patients consult with doctors and other healthcare professionals electronically, often via a Skype-like video connection. These consultations can cost less than an in-person visit to your doctor and can be more convenient, too, saving you from having to make an appointment a few days away, travel to your provider, and spend time in a waiting room. You can typically have a consultation immediately or within hours. This can be especially useful if you’re traveling when you need a doctor or medical help.

Telehealth services aren’t available to every original Medicare enrollee, but it’s available to some. And some Medicare Advantage plans offer it, too.
Make the most of wellness benefits

Finally, aim to get well and/or stay well via wellness benefits included in your Medicare coverage. For starters, all enrollees are entitled to one wellness visit annually at no extra cost to them. That’s when you can see your primary care doctor to review your health. Don’t skip this, as it gives your doctor a chance to discuss ways to get you healthier instead of just ways to treat the illness or injury you walked in with. You may have access to other health benefits and perks, too, such as discounts on gym memberships. Find out what your plan offers and make the most of those benefits. When you’re shopping for a Medicare plan, review available wellness perks, too, to see which would serve you best.

To maximize your Medicare, don’t just wait until you’re not feeling well to visit your healthcare provider. Instead, take advantage of all the care you’re entitled to, such as preventive screenings and your annual wellness visit.