Kate is not an actual member. This is for illustrative purpose only.
Medicare will help pay for care in and out of the hospital. And, depending on the type of coverage you have, maybe some other services as well. But no plan covers everything. Even on Medicare, smaller unexpected out-of-pocket expenses can add up quickly.
“A local broker can be an invaluable resource,” says Kelly J., an Aetna® Medicare broker manager in the Northwest Mountain market. “They’re local. They’re independent. They represent several companies that are out there,” she explains. “They’re going to be able to look at your needs and bring those plans to you that are likely the best fit.”
You should also think about the factors that go into your overall picture of health. For instance, your doctors, expanded care, medications, lifestyle and finances. Let’s take a closer look at what you need to consider when evaluating health care costs in retirement.
Avoid higher out-of-pocket costs by choosing the right doctors
Avoid higher out-of-pocket costs by choosing the right doctors
Your doctors are an important part of your health care team. Having a good relationship with them can do wonders for your health. If you’re happy with yours, you’ll want to make sure you can still see them after you get Medicare coverage. This is really important if you have any ongoing or chronic health issues that require frequent checkups during the year.
You’ll want to avoid paying higher out-of-pocket costs or changing doctors. So make sure your health care providers accept your insurance. Original Medicare lets you to go to any doctor or hospital in the country that’s enrolled in Medicare and accepts new Medicare patients. Some types of Medicare Advantage (MA) plans, such as Health Maintenance Organization (HMO) plans, require you to see doctors in their network.
Kate* visits her primary care provider a few times a year and sees a cardiologist twice a year. Here are some questions she should ask herself as she explores Medicare plans:
- Are my doctors in the plan’s network? Do they accept Medicare?
- How many times a year do I expect to visit my primary care provider?
- What specialists do I see? How often do I see them?
- Do I have chronic or ongoing health issues?
Dental and vision coverage, holistic treatments and fitness plans
Dental and vision coverage, holistic treatments and fitness plans
In addition to ensuring your doctors accept your insurance, Kelly J. recommends asking yourself whether the plans you’re considering cover the care you might need. For instance, prescription eyewear, hearing aids, routine dental visits and fitness classes. MA plans may cover these benefits. Original Medicare (Parts A and B) does not.
If you prefer alternative care, such as acupuncture, massage therapy or chiropractic care, check if the plan covers it. In most cases, Original Medicare doesn’t cover holistic care. But MA plans may cover certain treatments, therapies and medicines.
Paul* had a root canal last year. He’s also noticed things seem blurrier lately. Taking care of his health is a priority, but so is protecting his savings. As he gets ready to choose his Medicare coverage, here are some questions he can think about:
- What dental care services does the plan cover?
- What vision care services does the plan cover?
- How much would I pay for eyewear? Hearing aids?
- Do I want a plan that covers over-the-counter items?
Choosing the right Medicare drug plan to lower prescription costs
Choosing the right Medicare drug plan to lower prescription costs
Prescription drugs can help keep you healthy. But they can also be costly, especially if you have ongoing health issues.
Prescription drug coverage helps keep drug costs in check. There are two ways to get coverage. You can purchase a stand-alone Medicare Prescription Drug Plan (PDP), also known as a Part D plan, which you can combine with Original Medicare. Or you can get prescription drug coverage as part of a Medicare Advantage plan, which would replace Original Medicare.
Prescription drug coverage will help pay for much of the expense of your medicines. But there are other ways you can help lower the price of drugs.
- Ask your doctor if a generic version of your medicine would be just as effective.
- Find out if the plan covers mail-order prescriptions.
- Consider switching to 90- or 100-day refills. Over time they usually cost less and are more convenient than 30-day refills.
- Find the formulary (the plan’s list of covered drugs) that’s right for you. You can search for a drug using an online formulary lookup tool or work with an agent.
- Once you’re enrolled in a plan, review the plan's formulary each year. Doing so will help to avoid surprise costs.
- If you’re concerned about how you’ll afford your medicine, help may be available to you. Find out if you qualify for Medicare Extra Help. It’s a federal program to help people with limited incomes pay for prescription drug costs. Also, some drug companies have programs to help those who qualify pay for their medicines.
Harold* takes three medicines to manage his high blood pressure. Keeping prescription drug costs low is top of mind for him. Here are some things he should consider:
- What medicines do I take? Does the plan cover them?
- Is my pharmacy in the plan’s network?
- Do I need a plan with a more robust formulary?
- Can I get my prescriptions refilled by mail?
- Are 90- or 100-day refills an option?
Planning health care costs in retirement for long-term financial health
Planning health care costs in retirement for long-term financial health
Your doctors and your medicines may impact your health care expenses. But so can your lifestyle. Consider your past history of health care. Is there a family history of health issues you need to keep in mind?
At the same time, it’s helpful to think about how you envision your retirement. Then you can find a plan with the right benefits for you. Do you plan on being physically active? Will you spend half of the year traveling or living in another part of the country?
Finally, if you’re about to retire, ask yourself what your income level will be after retirement. “That’s a very important question,” says Jeremy B., an Aetna Medicare broker manager in the MidSouth market. “Now you’re limiting what your income potential may be and you need to mitigate the costs that may come up at a later date, if there’s an emergency.”
Eleanor* is about to retire and is shopping for a Medicare plan. Her neighbor, who enrolled last year, suggested she pick a plan that fits with her everyday life. Here are some factors she should keep in mind:
- What kind of care do I need right now?
- What is my family health history?
- How physically active do I plan on being after I retire?
- How often do I plan to travel during retirement?
- What is my income level going into retirement?
If retirement is right around the corner, consider these Medicare tips and your Medicare options now. You can choose a plan that can cover the care you need and prevent surprise bills. In other words, a plan that will help keep you physically and financially healthy and maximize your Medicare savings.
*For Kate
*For Paul
Paul is not an actual member. This is for illustrative purpose only.
*For Harold
Harold is not an actual member. This is for illustrative purpose only.
*For Eleanor
Eleanor is not an actual member. This is for illustrative purpose only.