October 17, 2023 | Aging Life Care
If you’ve already enrolled in your Medicare coverage for next year, you get a gold star! Every year, there are many factors to consider before you make your choices. Of course, your health and medication needs are a biggie. But you also need to consider things like whether you plan to travel outside the U.S. and who your preferred doctors and hospitals are. (In fact, as KPBS reported on Oct. 16, “more than 30,000 Scripps Health clients who have Medicare Advantage plans are now facing a difficult choice: either get new doctors or different coverage.”)
Fortunately, the Medicare website provides lots of helpful information and tips. One of their articles outlines these seven things to consider when you’re making your choices:
- Costs. How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you could pay out-of-pocket for medical services? Make sure you understand any coverage rules that may affect your costs.
- Coverage. How well does the plan cover the services you need?
- Your other coverage. If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your benefits administrator or insurer before making any changes.
- Prescription drugs. Do you need to join a Medicare Prescription Drug Plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What’s the plan’s overall star rating? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions? Are you eligible for a free Medication Therapy Management (MTM) program?
- Doctor and hospital choice. Do your doctors accept the coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?
- Quality of care. Are you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. How have Medicare and other people with Medicare rated your health and drug plan’s care and services?
- Travel. Original Medicare generally doesn’t cover medical care outside the U.S. You may be able to buy a Medicare Supplement Insurance (Medigap) policy that covers emergency care outside the U.S.
You can read the complete article at Medicare.gov.
How Windward can help
At Windward Life Care, our goal is to improve overall quality of life by helping clients to not only live comfortably, but to thrive while aging. Helping ensure clients have the best possible healthcare coverage is key to aging well. Our Aging Life Care Professionals® (care managers) can guide their clients through the open enrollment process.
For those who prefer to enroll on the telephone, we can sit with them and/or a responsible party (e.g., a family caregiver), and provide assistance as needed. If they have a computer and internet connection, we can either help them navigate the internet and input data, or do it while the client and/or responsible party observes.
The care manager will use their knowledge of the client’s Medicare usage and medication changes from the previous year to quickly help the client find plan comparison information.
We’ll also ensure our clients are using official Medicare and related websites or phone numbers to prevent scams.
Please contact us if you’d like to hear more.