Understanding Your Medicare Plan: Keys to Managing Health and Wellness

Are you new to Medicare or have you recently changed your coverage during the Medicare Annual Enrollment Period last fall? If so, you may have some questions about how to maximize your benefits and ensure your health and wellness needs are met while also managing any financial responsibilities. To help you make the most of your Medicare plan, here are some tips.

If you recently enrolled in Medicare, it can take some time to fully understand your coverage. You may have selected a Medicare Advantage (Part C) plan or decided to stick with Original Medicare (Parts A and B), possibly even adding a Part D prescription drug plan.

Medicare Advantage:

1. Start by familiarizing yourself with how your Medicare plan covers hospital and medical items through Medicare Parts A and B.
2. Check the list of prescription drugs covered by your plan to ensure that your current medications are included, and review the costs associated with different tiers and Part D coverage stages to estimate your financial needs for the year.
3. Take a close look at the unique benefits offered by your plan, such as vision, dental, hearing, fitness, and a 24/7 nursing hotline.
4. Examine your plan’s network to determine which providers are covered and which are not.
5. Consider how your costs may change if you receive care from a provider who is not included in your plan.
6. Utilize online learning tools to better understand your plan, and don’t hesitate to reach out to your plan provider if you have any questions or concerns.

For those with Medicare Part D and/or Medicare Supplement:

• Evaluate how Medicare Part A (hospital) and Part B (medical) cover certain drugs in specific situations.
• Understand how costs are managed through both Parts A and B. If you have a Medi-gap plan, a private health insurance plan that supplements Medicare, learn how it may help with some of the out-of-pocket costs of Parts A and B.
• Review your Part D plan’s formulary to ensure that all the drugs you require are listed, as well as the tiers and costs associated with each.
• If you have questions about your Part A and/or Part B coverage or specific items covered, you can contact Medicare directly 24/7 at 1-800-633-4227 or visit www.medicare.gov. TTY users can call 1-877-486-2048.
• For questions about your Part D plan, contact your plan provider directly.

If your Medicare coverage changed

Your Medicare coverage may have changed in one of three ways over the past year:

1. Your provider ended your former Medicare Advantage or Part D plan, and you had to enroll in a new plan.
2. Your plan provider implemented changes to your Medicare Advantage or Part D plan that became effective on Jan. 1.
3. You chose to switch from your former Medicare plan to a new Medicare Advantage or Part D plan during the Annual Enrollment Period.

If you enrolled in a new plan during the Annual Enrollment Period last fall because your plan was discontinued, or if you decided to switch to a different Medicare plan, it’s important to carefully review the new plan’s benefits, costs, and network (if applicable). You can use the tips provided earlier to help you better understand your plan.

If you already had a Medicare Advantage or Part D prescription drug plan last year, your plan provider may have made changes to it for this year, which took effect on Jan. 1. It’s crucial to review these changes again to ensure that you comprehend how your plan works, which benefits you have, and how you can financially plan for the year ahead.

To manage your overall health and well-being, it’s essential to understand your Medicare plan’s healthcare coverage and operations. Take advantage of online resources available to you to learn more, stay organized, and make healthy decisions throughout the year.