Let’s face it – Medicare can be really confusing for people when they are brand new to it. However, once you get a handle on how it works, you’ll find that the coverage is actually pretty comprehensive. It also has some preventive care benefits that can help you detect health conditions early when they are more treatable.
Staying healthy is a challenge for everyone, especially for seniors so let’s review
five ways Medicare helps seniors stay healthy.
1. Yearly “Wellness” Visit
Medicare Part B offers a yearly “wellness” visit. You can receive this service once every 12 months. During this visit, your doctor will check multiple things such as your blood pressure, your family’s medical history, current prescriptions, and more. You will even be able to discuss your advance care plans. These are healthcare decisions set in place by you and your doctor. These decisions come into play if you are ever too ill to speak for yourself.
Your doctor will also provide you with a list of things you may be at risk for and your treatment options. In addition to the treatment options, he or she will let you know which preventive services you should schedule.
These visits are helping seniors maintain their health by keeping a close eye on it. Routine procedures such as this one, make it easier for the doctor to monitor your health. Therefore, the doctor can better recommend treatment plans, preventive screenings, and much more.
2. Preventive Screenings
Although the yearly “wellness” visit is a great preventive service, it is not the only one offered by Medicare. Medicare offers numerous services that help seniors keep track of their health. The list of covered services ranges anywhere from simple shots to extensive screenings.
These screenings can catch conditions and diseases early on. The odds of treating the condition are much higher if it’s diagnosed sooner rather than later.
Also, these services, including the yearly “wellness” visit, are covered 100% to anyone with Medicare Part B. As long as your doctor accepts Medicare assignment, and he or she doesn’t perform any other services that aren’t part of the visit, you won’t have to pay a dime.
3. Silver Sneakers Membership
Many insurance carriers that sell Medicare products have partnered with Silver Sneakers. With this partnership, they can offer than clients a very special incentive. Silver Sneakers is a fitness program that provides seniors with free gym memberships.
If you have a Medicare supplement plan or Medicare Advantage plan that offers a free Silver Sneakers membership, then you have access to thousands of gyms and fitness classes around the country. With this membership, you are able to practice healthy living every day by being active in the gym.
4. Part D Formularies
This is a small, yet beneficial way that Medicare helps seniors stay healthy. Every Part D drug plan has a drug formulary that lists every medication the plan covers. There is a legal requirement that each drug plan includes at least two medications in each drug category on their formulary. This allows doctors to have at least two options when prescribing medications.
It can be challenging to find a drug plan that covers every single drug you take, especially if you take quite a few. However, if you enroll in a plan that doesn’t cover one of your medications, the plan will be able to offer an alternative.
The easiest way to find the right Part D drug plan is to use Medicare’s Plan Finder Tool to analyze the available options in your area.
5. Medically Necessary Procedures
The rule of thumb with getting procedures covered by Medicare is that they must be considered medically necessary. If your doctor doesn’t state that your procedure is medically necessary, then Medicare won’t cover it. However, this can be a touchy subject, as some beneficiaries have experienced denial for a medically necessary procedure.
A popular reason as to why this could happen is if your doctor’s office coded the bill incorrectly. Basically, that means that the wrong identification number was chosen for the procedure that leads Medicare to deny it. In this case, you’ll need to have the doctor’s office resubmit your claim with the correct billing code so that Medicare will approve it. By covering medically necessary procedures, Medicare is helping seniors stay healthy.
There Is Always Room for Improvement
Since 1965 when the system began, Medicare has made many strides to better the way we care for our seniors. With that said, there is always room for improvement. Most would agree that there are certain areas of Medicare that could be altered for the better. We hope to see many improvements in the future from Medicare.