Are You Getting the Most Out Of Medicare?


As healthcare costs continue to rise, especially for senior citizens, it’s more important than ever to understand your individual needs so you don’t expose yourself to unnecessary costs in retirement. According to the Centers for Medicare & Medicaid Services, the U.S. spent roughly $3.5 trillion on healthcare in 2017, which is an average of almost $11,000 per person and an increase of 4.6% from 2016.1


While many people are lucky enough to have employers that cover the majority of our healthcare costs, retirees are often stuck paying hefty out-of-pocket expenses. While some of these costs are unavoidable, many are eligible to be covered or supplemented by Medicare. For example, if you are one of the roughly 12 million Americans age 65 or older suffering from diabetes, Medicare will pay 80% of the costs of your doctor’s visits that are related to diabetes. If you don’t have diabetes, but have other related health conditions that put you at higher risk of acquiring diabetes, Medicare Part B will cover 100 percent of the cost for two diabetes screenings per year. In addition, since April 2018, the Medicare Diabetes Prevention Program enables Medicare patients who have been diagnosed with pre-diabetes to enroll in lifestyle change programs with healthcare professionals for no additional costs. For good reason, prevention services are becoming more of a focus than ever before for healthcare professionals and insurance companies. Medicare beneficiaries should take advantage of any prevention services that are available to ensure they’re receiving the best and most affordable service option. Taking the necessary preventive measures can not only lead to a longer and healthier life, but they may also save you money.(2)

The simplest way to check if your medical test, item, or service is covered by Medicare is to check the website, but to give you a general idea of what is available and what is not, Medicare Part A covers things like inpatient hospital care, nursing facilities and hospice, lab tests, surgery and home health care. Part B covers outpatient care such as doctor visits and other health care providers’ services, as well as some additional preventive services. Services that aren’t covered by Medicare Part A or Part B include things like long-term or custodial care, dental care, vision and hearing, cosmetic surgery, acupuncture and foot care. You’ll have to pay for these items yourself unless you have additional insurance or a Medicare health plan that covers them. (3) Medicare health plans are contracts offered by private companies to provide Medicare Part A and Part B to beneficiaries with additional coverage. Medicare Advantage Plans cover all Medicare Part A and Part B services and most offer extra coverage for things like vision, dental, hearing, and wellness programs.There is usually a monthly premium associated with Medicare Advantage Plans in addition to your Part B premium and the majority include Prescription Drug Coverage (Medicare Part D). All Medicare Advantage Plans cover emergency services and urgent need care. (4)

Additionally, if you have low income and can’t afford your Medicare out-of-pocket costs, you may be eligible to receive help through the Medicare Savings Program or through the “Extra Help” program which assists beneficiaries of Medicare Part D with their medication expenses. (3)

The bottom line is, whether you’re your suffering from serious health conditions or not, it always pays to understand your coverage and take advantage of all available coverage. It may not seem like the best way to spend your time or money at the moment, but as the old adage goes, an ounce of prevention is worth a pound of cure. Never is this more true than when it comes to your health!,,,

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