"He who has health, has hope; and he who has hope, has everything."
-- Thomas Carlyle
About 58 million people are currently enrolled in Medicare -- roughly 18% of the U.S. population. If you're not one of them now, you'll probably be one of them in the future. Take some time to understand Medicare better so that you can make smart decisions regarding it -- ideally spending less and getting a lot of coverage for your bucks.
Here are three smart Medicare moves:
Medicare move No. 1: Enroll on time -- or pay
If you're late enrolling in Medicare, your Part B premiums -- which cover medical services, but not hospital services -- can rise by 10% for each year that you were eligible for Medicare and didn't enroll.
So when, exactly, should you enroll? Well, you're eligible for Medicare at age 65, and you can sign up anytime within the three months leading up to your 65th birthday, during the month of your birthday, or within the three months that follow. Those seven months are your Initial Enrollment Period.
The thought of missing that period may be worrisome, but there's a helpful loophole: If you're among the many Americans who are already receiving Social Security benefits by the time they reach age 65, you should be enrolled in Medicare automatically. You might also avoid the late-enrollment penalty and be able to skip the deadline if you're still working (with employer-provided healthcare coverage) at age 65, or if you're serving as a volunteer abroad.
Medicare move No. 2: Choose the best plan for yourself
Next, you'll want to make sure you've signed up for the Medicare coverage that suits you best. Medicare is more complicated than it may seem, with two main choices: "original" Medicare and a Medicare Advantage plan. Original Medicare consists of Part A, Part B, and very often Part D. Part A covers hospital inpatient care, skilled nursing facility care, and some home healthcare and hospice care. Part B covers physicians' services, service from other healthcare providers, certain therapies, lab tests, home healthcare, durable medical equipment (such as blood sugar monitors, wheelchairs, or crutches), and some preventive services such as screenings and vaccines. Part D offers prescription-drug coverage. There are also "Medigap" plans available, to supplement coverage.
Medicare Advantage plans are newer and are sometimes referred to as Part C. Offered by private organizations such as health insurance companies and regulated by the federal government, they must offer at least as much coverage as original Medicare (i.e., Part A and Part B benefits). They often sport more than that, though, such as vision care, dental care, and/or prescription drug coverage, to attract customers. The extras they offer can be in the form of lower copayments for services, or broader coverage. These plans can cost you less and provide more coverage, so definitely give them some consideration. (Favor plans rated with four or five stars.)
What's best for you will depend on your needs and preferences and which Medicare Advantage plans are offered in your area. When assessing your options, don't just compare premiums, because Medicare Advantage plans may offer different co-payments, deductibles, and so on. Look at the big picture. Think about the doctors you want to be able to see, the healthcare services you need, and the prescriptions you take. Compare total expected out-of-pocket costs -- and note that while original Medicare will often have you footing 20% of many bills, a Medicare Advantage plan might charge you a low copay per doctor visit or service -- and will have an out-of-pocket spending cap, too, something original Medicare doesn't feature. (The average out-of-pocket cap was $5,223 in 2016, but many plans feature caps below $3,000, and the limit for 2017 is $6,700.) Another key consideration is travel, because Medicare Advantage plans typically limit you to a local network of doctors, though the networks can be large. If you plan to travel a lot in the U.S., original Medicare plans may be preferable, as they're honored by providers nationwide.
Once you decide, know that you can change your mind and choose a different plan each year. In fact, it's a good idea to review all your options and their costs every year.
Medicare move No. 3: Make the most of your coverage
Finally, make the most of the coverage you have -- don't just go to the doctor when you're very sick or injured.
Both original Medicare and Medicare Advantage plans offer lots of preventive screenings at no extra cost to you -- such as mammograms and colonoscopies. Get screened for cancer, diabetes, and anything else your doctor deems sensible. You're also entitled, at no extra cost, to an annual wellness visit, at which you and your doctor can discuss your health, your goals, and how you might reach them. You may be able to access smoking cessation or weight-loss counseling, too, at little to no extra cost, and some plans may offer discounts on gym memberships or other wellness benefits, too.
Find out whether your plan offers "telemedicine" benefits, which give you access to doctors and other providers via the telephone or Skype-like video calls. You may not want to haul yourself all the way to your doctor's office if you're not feeling well -- and a telemedicine consultation may be a good solution, or at least a starting point. Telemedicine is becoming more widespread, so look into it.
Being smart about Medicare can keep more dollars in your pocket and enhance your health, too -- possibly even adding years to your life.
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