There is no universal solution to control the costs of health care for boomers and seniors, as countries of the developed world have universally adopted the idea of caring for the elderly, and over the decades, have begun to feel the financial strain of a growing retired population. Governments need new solutions to support retirees because of the shrinking number of caregivers and trained active workforce, lower fertility rates, and the fact that seniors live longer now than their predecessors did.

AARP’s Public Policy Institute has conducted extensive research on this modern problem, discussing the possible changes that could lead to greater financial health for funding of old age insurance in every country. They have even gone a step further and created a healthcare-costs-calculator to estimate the cost of premiums, deductibles and coinsurance requirements. The tool also considers costs associated with specific diseases that may come into play.

Discussions about healthcare go hand-in-hand with Medicare and how it affects your out-of-pocket expenses. Learning the ins and outs of Medicare coverage is worth your time, as mistakes, especially regarding Plan D coverage for prescriptions, can be costly. According to the Centers for Medicare and Medicaid Services (CMS), there are several things you should do prior to initiating coverage.

  • Fill out an “Initial Enrollment Questionnaire” (IEQ) so your bills are paid correctly and on time. You can also complete the IEQ online at mymedicare.gov.
  • Fill out an Authorization Form if you want your family or friends to be able to call Medicare on your behalf. Medicare can’t give personal health information about you to anyone unless you give permission in writing first.
  • Make a “Welcome to Medicare” preventive visit appointment during the first 12 months you have Medicare. The free, one-time comprehensive “Welcome to Medicare” preventive visit puts you in control of your health and your Medicare from the start.
  • Sign up for MyMedicare.gov, their secure online service allows you to access your personal Medicare information, including tracking your claims, viewing your eligibility information, summary notices, and to learn more about your Medicare plan or Medicare Prescription Drug Plan (Part D)
  • Choose and join a Medicare Drug Plan (Part D) during the 7-month period that starts 3 months before the month you turn 65 (this includes the month you turn 65, and ends 3 months after the month you turn 65).

Also, if you helped to cover health-related expenses for someone else, or received help financially, including the cost of insurance deductibles, prescriptions, home health care expenses, be sure to include out-of-pocket payments on annual tax returns to benefit from a potential Caregiver-tax-deductible. This subject is covered in more detail in another article on this website.

Check out my Medicare tips below, shared during an interview I did with Grandparents Magazine.

Tip No.1: Remember to Enroll for Part D:

There still are people who think enrollment is automatic, and while in some cases that may be true for Medicare Parts A and B, it is never true for Medicare Part D. Every year we have the option to update our Medicare Part D plan during open enrollment. If you haven’t finalized your decision for the Plan D coverage that will cover your prescriptions because you find the process overwhelming, you’re not alone. But taking the time to figure out which plan is for you, can save you hundreds of dollars.

Tip No. 2: Know what’s New

There are some exciting changes, including expanded coverage for obesity and diabetes screening to help many lower health care costs as you simultaneously improve the quality of your health.

Tip No.3: Ask for Help

Discuss your options with professionals, such as your regular care physician and his staff or your local pharmacist, who have first-hand knowledge of your prescription and coverage requirements. Contact your insurance provider for an appointment to review your coverage and ask a family member to sit in on the discussion. Request a detailed printout of your most recent medical receipts to anticipate the costs that may lie ahead. Research the advantages and benefits of specific plans and choose the one the most suites your health care needs.

Tip No. 4: Use a Plan Finder

Online search tools are your friends! They’re great for helping you sift through all the options out there to find the most cost-effective plan and they’re easy to use. You enter basic information, like your zip code and the medications you take, and the system will compare all the available plans for you. Medicare has one, as do other companies, like Walmart.

Tip No. 5: Understand the Importance of Preferred Pharmacies

A pharmacy accepted as “preferred” by a Medicare Part D Plan is a network pharmacy that offers covered drugs to plan members at lower out-of-pocket costs than what the member would pay at a non-preferred network pharmacy. This can make a huge difference in what you’ll pay. For example, Walmart is a preferred pharmacy on multiple plans, including the Humana-Walmart Preferred Rx Plan. They provide access to the top ten hypertension drugs for just one cent. So if you’re one of the 70% of Americans over the age of 65 who have high-blood pressure, you can get a month’s worth of the medication you need for just one penny!   Just one specific example of how it can pay to do your homework.

There needs to be a better acknowledgement that paying for health care in retirement is a pretty major issue. The next step is to do an estimate to anticipate the costs and incorporate it into the plan.

It’s certain there are many factors at work that will influence the future of health care. To keep pace with the insurance industry changes, do an annual check-up to seek out the best coverage and health care available and make sure you aren’t paying for extra costs, such as prescriptions and monthly premiums associated with a pre-existing condition, although technically that shouldn’t be the case. Also be aware that drug costs change drastically between plans. Switching coverage may also mean a change in care providers. If you’re committed to your personal physician or other specialists, make sure your insurance provider agrees before making a switch.

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DR. ALEXIS

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