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5 savvy-shopper tips to help you get the most from Medicare | Kentucky Health Solutions

5 savvy-shopper tips to help you get the most from Medicare

February 23, 2024 Pete Alberti Comments Off

Do you spend your Sunday mornings scouring the newspaper inserts for coupons at the local grocery store? Make it a point to confirm you get all possible discounts when booking hotel reservations. Love getting the senior discount at the movie theater?

If any of these sound familiar, you probably consider yourself a savvy consumer who likes to make sure you’re getting the most value for your money. So have you ever stopped to consider applying these same skills to Medicare? If not, it’s high time you start with Medicare Annual Enrollment right around the corner. Maximizing your Medicare benefits may help you save money and could help improve your health as well.

Here are five tips to help ensure you’re getting the most out of your Medicare coverage.

Tip 1: Understand Medicare’s preventive care benefits

Medicare covers a number of preventive screenings, such as mammograms and colonoscopies, usually at no additional cost to you. These kinds of services can help catch health problems early when they may be easier to treat. And your annual Medicare Wellness Visit is a good opportunity to sit down with your doctor and develop a plan to help you manage your health in the year ahead.

Many Medicare Advantage plans (Part C) provide extra benefits in addition to services covered under Original Medicare (Parts A & B), such as dental, hearing and vision coverage. Some plans may bring preventive care right into your living room, through in-home care or telemedicine appointments. These services offer a simple and convenient way to address minor health concerns.

Tip 2: Plan health care costs for the entire year

Medicare costs vary widely based on each person’s situation and coverage choices. Your total health care costs will be influenced by: (1) your Medicare premiums, (2) your copay, deductible and coinsurance rates, and (3) what health services and items you use and how often throughout the year.

Medicare Part B covers 80 percent of the cost for most medical services, such as doctor visits, lab tests and other outpatient care. You will be responsible for the other 20 percent, and there’s no limit on out-of-pocket costs. Some people buy a Medicare supplement insurance plan to help cover some of these costs as well as some costs that come with Part A (hospital insurance).

Medicare Advantage plans generally have set copays for most medical and hospital services, and plans must put a cap on your annual out-of-pocket costs. Once the limit is reached, the plan covers 100 percent of all additional costs for covered services for the rest of the plan year. Medicare sets the maximum out-of-pocket limit options for plans. The highest limit in 2024 is $8,850.

An annual out-of-pocket cap on health care costs could mean peace of mind if you have an unexpected illness or if you’re planning to schedule a medical procedure such as a knee replacement.

Tip 3: Take advantage of cost-saving drug benefits

Prescription drugs are not covered by Original Medicare (Parts A & B), so you may want to get the coverage elsewhere. There are two options: choose a Medicare Advantage plan, since most include drug coverage, or buy a stand-alone prescription drug plan (Part D). Either way, savvy shoppers may save money by using plan benefits wisely.

Some plans have a home delivery pharmacy benefit that can help save money and reduce trips to the pharmacy. For example, you may be able to order a 3-month supply of a medication for a lower cost than you would pay if you got the same supply at a local drug store – and have it delivered to you!

If you prefer to pick up your drugs at a retail pharmacy, check to see if your plan has a preferred pharmacy network. Plan members usually pay lower copays for their drugs when they use a pharmacy that’s part of the preferred network versus one that’s not.

Another cost-saving measure is to use generic or other low-cost drugs. Review your current medications with your doctor and ask if there are other options on your plan’s formulary (your plan’s list of covered drugs) that could work for you and save you money.

Tip 4: Use network providers

Medicare Advantage plans typically work with a network of providers, including doctors and hospitals. Plans contract with network providers to provide care to plan members at negotiated prices. This allows for lower out-of-pocket costs for plan members. Some Medicare Advantage plans offer out-of-network coverage, but the member usually pays more than for the same service from a network provider.

Tip 5: Look for extra plan discounts

Some Medicare Advantage plans offer discounts on things you already use or need, such as vitamins, hearing aids, fitness programs and alternative medicine services such as acupuncture. Hearing aid benefits alone could save you thousands of dollars a year. And saving money on your daily vitamins and a membership to your local fitness center could be the extra motivation you need to stick to a healthy lifestyle.

Sourced: UHC.com

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