It’s a New Year and one of your resolutions should be to make the most of your Medicare benefits in 2025. Whether you kept the same coverage or changed plans during Annual Enrollment, there are most certainly some changes to your benefits. In order to take advantage of everything your plan offers, you need to know what it covers.
Here’s how you can utilize your benefits to stay healthy and minimize your healthcare expenses:
Understand your out of pocket costs
In order to utilize your benefits to their fullest you need to understand your out of pocket costs. These are determined both by the plan you have chosen and some of the choices you make. Knowing what you are expected to pay and what you can do to minimize these expenses can help you manage healthcare costs.
If you have a Medicare Advantage plan, your plan’s monthly premium, deductibles, copays, and coinsurances are all determined by your insurer and the plan you chose. You can help reduce your costs by choosing providers within your plan’s network. Even if you have a plan that offers out of network benefits you will pay more to see out of network providers.
Medicare covers many preventive services and screenings
Prevention and early detection of disease is key to staying healthy as you age. Take advantage of these benefits, which are covered in full and not subject to any out of pocket costs:
Preventive Services:
Annual Wellness Visit- while different from your annual physical, this visit allows your primary care doctor to monitor your health and identify any changes or potential health risks. You will complete a health risk assessment and work with your doctor to develop a personalized prevention plan to help you stay healthy.
Vaccines- this includes flu, pneumonia and Covid vaccines.
Preventive Screenings:
These screenings are covered for diabetes, glaucoma, and heart disease, as well as breast, colon, cervical and prostate cancer. Early diagnosis leads to better treatment and long term outcomes. Talk to your doctor about which screenings are appropriate for you.
Also covered are screenings for depression, alcohol misuse and counseling sessions to help you quit smoking. Nutritional therapy is also covered for those with qualifying health conditions such as kidney disease and diabetes.
Supplemental benefits
If you have a Medicare Advantage plan you may have additional wellness benefits. These are offered by insurers to help keep their members healthy. Check your plan to see what is included since benefits vary by plan and insurer.
The most common of these supplemental benefits is vision, dental and hearing coverage. These are all vital to maintaining good physical and mental health as we age, as well as preserving quality of life and independence, Regular checkups can help spot other potential health issues early on and help avoid serious complications.
Some plans include additional benefits such as gym memberships, acupuncture, massage or chiropractic benefits, transportation to medical appointments, over the counter allowances and home delivered meals after a hospital stay.
Make sure you understand which services are covered and if you will have any financial responsibility through copays or coinsurances as well as whether you are required to use in network providers.
Know where to find important information about your plan
You can’t be expected to remember everything about your coverage, so knowing where to look for information is also key to maximizing your benefits. The best source of information is your insurer’s website. If you set up an online account you can view your plan information 24/7. This includes an overview of your benefits, access to the provider search tool and drug formulary for prescription coverage. You can also view your processed claims. It’s always a good idea to double check your claims to ensure they processed accurately and reflect the correct amount you are responsible to pay based on your benefits. Your insurer’s customer service department is also a good resource for information and their phone number can be found on the back of your ID card.
Understanding your healthcare coverage allows you to be proactive in managing your health which can lead to reduced health risks, improved quality of life, and lower out of pocket healthcare costs.
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