Over 50 million Americans (five-sixths of those 65 and older) receive Medicare benefits. How can they ensure that they are getting the biggest possible benefit out of their Medicare plan? Check out four key steps you can remind your patients to take in order to make that happen.
The best approach for your patients to protect their health for the long term, from today into retirement and beyond, is multi-pronged. Searching for low-cost health insurance companies that combine valuable coverage with realistically affordable premiums is certainly a good first step. However, Medicare and Medicare Advantage will likely be additional elements of your patients’ overall plans for covering health expenses in their retirement years. In fact, over 50 million Americans (five-sixths of those 65 and older) receive Medicare benefits.
How can they ensure that they are getting the biggest possible benefit out of their Medicare plans? Here are the 4 key steps you can remind your patients to take in order to make that happen:
Medicare Parts A and B are basically the same for everyone every year, and there is no real need to “shop around” when it comes to those. However, if patients have Part D (prescription drug coverage), it is important to realize that Medicare has different contracts with individual insurers when it comes to Part D. Plus, the prices and coverage can change from year to year.
Thus, patients should not just auto-re-enroll into the same Part-D plan each year. Advise patients to look around at other options; they might be able to reduce out of pocket expenses on prescription drugs for the year ahead.
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Don’t let patients get confused by the term “Part C:” it refers not to a specific additional benefit but to a plan that enables them to buy Medicare insurance through a private insurance company. In fact, it is now more commonly called simply “Medicare Advantage” (MA).
With an MA plan, patients still get “original Medicare,” meaning Part A (hospital insurance) and Part B (medical insurance), but they also typically get Part D (prescription drug insurance). Plus, vision and dental insurance are often thrown in. But, perhaps the biggest advantage to Medicare Advantage is the annual cap on out-of-pocket expenses for Parts A and B. That gives patients peace of mind, which is worth its weight in gold!
For your patients with chronic/serious health conditions, it is often best to buy a supplemental health insurance policy that is specifically designed to cover the things that Medicare may not. This is called a “Medigap” plan in popular terminology.
If you have patients who expect persistent and exceptionally high medical costs in the years ahead, they may not be able to pay the 20 to 25 percent of medical costs that Medicare typically does not cover. An MA plan could prevent this problem, but for some people, an Original Medicare plan with a Medigap policy would be more cost-effective option.
Additionally, every Medigap policy is different, so here is another area where you should recommend that your patients to shop around and compare the overall value of each plan prior to purchasing.
Patients get far more out of their Medicare policy if they are vigilant about staying enrolled.
Finally, remind your patients to pay attention to the enrollment periods for each Part of Medicare (Part D, for example, can have different open enrollment dates than Parts A & B.) If they miss a deadline, they could face heavy uncovered, out-of-pocket expenses in the year ahead, unless or until they correct that mistake.
Plus, once they do re-enroll, there is a monthly premium penalty based on how long they skipped being covered. This can easily hit 10% or more added onto their premiums, and some penalties stay with them for years or even permanently.
Patients get far more out of their Medicare policy if they are vigilant about staying continuously enrolled. They’ll save money and avoid unnecessary risks as well–a win-win situation!