Age Better by Maximizing Your Medicare Benefits with These Tips
By Dave Rich

For many adults, as we age, our lifestyles begin to change at a much faster pace than they did in our middle years. For some, that means retirement and newfound freedom, but for many, it means increased health risks and stricter health care requirements. Most of us 65 and older are facing one or more chronic condition that directly affects the way we live our lives.

Regular doctor visits and chronic care management are vital investments to our wellbeing, but it takes a whole health approach to live a balanced life despite the changes we face. For most, Medicare is a major line of defense in receiving the medical care you need, and in recent years, benefits have been expanded to help promote lifestyle changes that result in healthier habits. However, it requires a solid understanding of your individual needs and how to best to support them.

Read on to learn how to maximize your Medicare benefits to make meaningful lifestyle choices helping you age better.

Prioritize Preventative Care with $0 Copays

Proper preventative care is proven to reduce the risk of disease, disability and death. For most Medicare beneficiaries, preventative services like screenings, counseling and vaccines can be obtained essentially for free through Medicare Part B.

While you must pay your Medicare Part B premium to receive coverage, there are more than 25 different types of preventative services offered with $0 copays. This is true whether you receive your Part B benefits through Original Medicare or a Medicare Advantage Plan.

Some examples of $0 copay preventative services include (but are not limited to):

  • Screenings for chronic conditions like heart disease, diabetes and cancer
  • Vaccines for COVID-19, flu, Hepatitis B and Pneumococcal
  • Screening and counseling for alcohol misuse
  • Counseling to help you quit tobacco
  • Nutrition therapy services
  • Bone density screenings
  • Depression screenings.

You should talk to your doctor to find out which preventive services are right for you and how often you need them. Learn how to take advantage of free wellness visits for help below.

Take Advantage of Your Free Wellness Visits

Now that you know how important preventative care is, you might be wondering which preventative services are necessary for you.

To set yourself up for success, it’s important you attend a wellness visit within the first 12 months of joining Medicare Part B. This is called your “Welcome to Medicare” visit during which your doctor will help you build a personalized plan outlining which preventative services you need.

After the first 12 months, you should keep up with your yearly “Wellness” visits to update your personalized preventative care plan. During these visits, you’ll complete health risk and cognitive assessments.

Plan for Out-of-Pocket Expenses

Original Medicare generally covers approximately 80% of a beneficiary’s Part A and B expenses. That means, you’re responsible for paying the rest. Medicare does not limit these out-of-pocket costs, so there’s no way of truly knowing how much you may spend in a year.

There are private plans to help manage these costs. Most people choose one of these two options:

  1. Keep Original Medicare and supplement with a Medicare Supplement Insurance (Medigap) Plan.
  2. Replace Original Medicare with a Medicare Advantage Plan.

The right solution for you will depend on many factors; however, Medicare Advantage tends to be the more popular option. This is because plans come with extra benefits, low monthly premiums – some even starting at $0 – and annual limits on out-of-pocket expenses.

There are thousands of Medicare Advantage Plans on the market and up to 10 Medigap Plan types available. Regardless of which direction you choose to go, keep in mind that in the end, the out-of-pocket costs you pay depend on the plan you choose and how well it meets your needs based on your health and lifestyle.

Beware the Benefits Buzz

The private Medicare health and supplemental insurance marketplace is a competitive one. That’s good news for you, the shopper – it means a wide variety of choices. Unfortunately, this also means you'll face a lot of noise when shopping for plans.

You’ll likely be bombarded with Medicare commercials on TV, ads on social media, billboards on your daily drives and more. To get your attention, these ads will boast the most attractive benefits including cost-saving features like $0 premiums and money back on your Part B premiums. They may list additional benefits like free or discounted gym memberships, meal delivery, medical appointment transportation and more.

While it’s true that many plans offer these benefits, not all do, and even if a plan doesn’t offer these benefits, it doesn’t mean it’s not the right plan for you. To find a Medicare solution that matches your lifestyle, you must consider all plan features. This may include things like:

  • Network restrictions: Are your current doctors in network? If not, how much will you be charged (if at all) for going out of network?
  • Drug formularies: If the plan covers prescriptions, does the drug formulary include your prescribed medications at affordable copays?
  • Deductibles: Are there deductibles that need to be met before your coverage kicks in? Are these different for in-network and out-of-network services?
  • Out-of-pocket limits: Does the plan have an annual out-of-pocket limit low enough to balance your predicted copays, coinsurance, excess charges and deductibles.

Once you’ve considered the above, then it’s a good time to look at those extra benefits.

Look for Features that Support a “Whole Health” Approach

We have talked about some of the extra benefits that are boasted in Medicare Advantage Plans. Many of these benefits are a result of recent shifts in the industry. Health care for the aging population is moving from a service-based, reactionary approach towards a “whole health” preventative approach.

Health care providers and insurers are going beyond providing just medical services – introducing benefits like care planners, healthy food cards, gym memberships, transportation to medical appointments and more. Benefits like these can help promote lifestyle changes that result in healthier habits, and in turn, healthier people.

When shopping for a Medicare solution, take the time to consider your needs and which of these benefits will best support not just your current conditions, but your overall mental and physical health and wellbeing. Once in a plan, make sure understand these benefits and utilize them fully.

The Bottom Line

Medicare is a complex and highly customizable system. Finding the right coverage that works for you and then maximizing your plan’s benefits will make a world of difference in supporting a lifestyle that helps you age better no matter your condition.


Author Bio

Dave Rich, CEO of Ensurem, has held various positions over his 40-year career in the insurance industry. Experienced in both the home office environment and independent distribution companies, Dave has a unique understanding of agent and consumer preferences and the needs for insurance profitability and risk management.  For the 10 years preceding the founding of Ensurem in 2016, he held the positions of Chief Operating Officer and Chief Marketing Officer of AmeriLife Group LLC, one of the largest insurance marketing companies in the country. He also spent over two decades in executive positions within multiple national insurance carriers, including Great American Financial Resources, Manhattan National Life Insurance Company and Life Partners Group. 


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