There’s quite a lot to know about a Medicare plan, which Americans are eligible for when they turn 65. So, it helps to either take time reviewing your options or work with Medicare experts who can help you make the right decisions. Here are a few important tips to keep in mind when you revisit your Medicare plan this year.
- Understand the difference between Original Medicare and Medicare Advantage
Over 40 percent of Americans eligible for a Medicare plan choose Medicare Advantage, a combination of Parts A and B. These plans typically offer extra coverage for prescription drugs and dental, hearing, and vision services. A Medicare Advantage policy can also include home visits and much more.
Another difference between the two plans is Original Medicare allows you to go to the doctor or hospital of your choice. A Medicare Advantage plan typically requires you to only use doctors and hospitals within the plan’s network, except for emergencies. With an Original plan, you usually won’t need a referral to see a specialist, whereas, with an Advantage plan, you may need a referral.
- Understand what your plan covers
Insurance companies typically present the basics of their healthcare plans on their websites. Compare the benefits of different insurance plans with what’s covered in your Medicare Advantage plan. Some plans offer added benefits for improving your health, such as personalized fitness programs and gym memberships. Keep in mind that out-of-pocket costs may vary for different Advantage plans.
- Utilize Medicare preventive care benefits
Original Medicare offers preventive care benefits such as annual wellness visits and preventive screenings such as mammograms and colonoscopies. The more you learn about preventive care, the better chances you’ll have at maintaining good health. A Medicare Advantage plan includes similar preventive care services in the comfort of your home. Its HouseCalls program includes food, transportation, and other resources to assist members.
- Save money on prescription drugs
Prescription drugs are not covered in Original Medicare Parts A and B. Part D covers prescription drugs. You can, however, enroll in a stand-alone plan. One of the reasons Medicare Advantage plans are popular is that they usually include prescription drugs. They also often cover home delivery of pharma products that include options for buying medication in bulk at a lower cost.
Another way to save money on pharma drugs is if your plan has a preferred pharmacy network. You may also consider switching to a lower-cost drug prescribed by your doctor as an alternative.
- Plan yearly expenses while paying more out of pocket
Since Medicare costs differ from person to person based on coverage and situation, all policyholders need to understand what their plan covers. Original Medicare usually covers about 80 percent of costs for Parts A and B. These expenses include hospital visits and stays. Each member must pay the other 20 percent with their own cash.
Once you’ve paid the maximum amount out-of-pocket, your Medicare plan pays the rest of your medical costs throughout the year. You’ll be able to cap your out-of-pocket expenses with a Medicare Advantage plan, which also provides consistent copays. If you have Original Medicare, check into Medigap to help pay for out-of-pocket costs.