So You Have Medicare - Now What?
Getting the most of your Medicare benefits.
According to CMS.gov, Medicare enrollment is almost 64 million in the nation. This is a huge program with a sizeable impact on the health of its beneficiaries. Understanding the ins and outs of the Medicare program is important in order to get the most out of your benefits and there is a lot to it! Here are some ways to maximize your benefits:
Take Advantage of the Services with No Co-Payments
There are many services available to beneficiaries that have zero co-payments! This includes:
• Cardiovascular disease screening
• Screening for depression
• Counseling to quit smoking
• Flu & pneumonia vaccines
• “Welcome to Medicare” preventative visit in the 1st 12 months of enrolling in Medicare Part B
• Planning for end-of-life care – if done within an annual wellness visit
• Some Advantage plans offer SilverSneakers gym membership at no cost
• And more!
Look into the Medicare Savings Programs
Don’t miss out on the multiple programs that can help cover Medicare Part B premiums if you are a senior on a fixed income. If you are enrolled in a Medicare Savings Program, you automatically qualify for “Extra Help,” for assistance paying for Medicare Part D costs. Want to see if you are qualified for one of the savings programs? Reach out, I am a qualified “Extra Help” coordinator!
Pick the Right Providers
It isn’t as simple as knowing whether your provider accepts Medicare. To save money, there is another consideration: Does the provider accept the Medicare-approved amount as full payment for services (known as “assignment”)? Knowing this can keep you from getting an extra bill because you will be responsible for the charges beyond the approved amount. You can find doctors who “accept assignment” HERE!
What About Drugs?
Here are a few things to consider when you have to fill your prescriptions:
• Medicare Part D doesn’t put a cap on out-of-pocket spending. Once their spending has reached a specific threshold ($5,000 in 2019), you will typically still pay 5% of most of the covered prescriptions.
• Sometimes it’s less expensive to just pay out of pocket. Often pharmacies have a large pool of generic medicines they can offer for just a few dollars. The only thing is, the cash payments don’t count toward your deductible.
• You may pay less if you use the plan’s list of “preferred” pharmacies.
• Pay attention to the cost-sharing tiers. If you are approved for a drug that’s on a less-expensive tier than what you are currently using, find out from your provider if that will work for you.
Medicare can be complicated and confusing. But, it is an amazing resource and you can experience a lot of savings if you educate yourself or get guidance on the free programs, pick the right providers and understand prescription benefits.
To get unbiased help with your Medicare decisions, feel free to reach out any time!
Brenda Gilliam, Your Medicare Insurance Agent & Extra Help Coordinator
* Not affiliated with any government agency.
*We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.