Which parts of Medicare do you need? What do they cover? How much do they cost? How do you get coverage? Many people have these same questions, and in this blog series, we are taking a closer look at Medicare to make it easier for you to navigate the journey.
We’ll cover Part A and B — also known as Original Medicare — as well as Medicare Advantage coverage (Part C), Medigap plans and prescription drug coverage (Part D). We’ll also address how and when you should sign up for Medicare and how to help a loved one understand their Medicare options.
Let’s be honest: Health care is expensive, even when you have health insurance.
There are premiums, deductibles, copays, coinsurance and procedures that may not be covered that create out-of-pocket costs, and as you age, you may find yourself seeing the doctor more than you did in your youth. There are ways, however, that you can save time and money when it comes to your care.
If you are a Highmark Medicare Advantage member, for example, there are several benefits and programs associated with your plan that are designed to save you money and keep you on course for healthy living. (Many of these tips may be helpful for you even if you’re not a Medicare member.)
You’ll want to be sure to enroll for Medicare coverage as soon as you’re eligible, to avoid penalties. Many people are automatically enrolled in premium-free Medicare Part A when they turn 65. If you’re someone who needs to sign up, you’ll need to contact Social Security at least three months before you turn 65 to avoid any penalties.
For most Highmark Medicare Advantage plans, choosing where you have blood work can affect your copay amount (if applicable). Blood work performed in a hospital lab can be considerably more expensive than at other free-standing facilities. You can save money on your copay by choosing your doctor’s office or a neighborhood outpatient lab for your lab tests.
If you need medical attention when your doctor’s office is closed or you are unable to schedule an appointment immediately, you have several options. If you believe your condition is life threatening, however, you should always call 911.
Outpatient surgery, sometimes called same day surgery, does not need to be performed in a hospital setting. For most Highmark Medicare Advantage plans, a freestanding ambulatory surgical setting is a lower-cost option if you won’t require hospitalization after a surgery. Outpatient surgery facilities are staffed with doctors and nurses, just as if you were having a procedure in a hospital.
Another way you can save money is to take advantage of your plan’s preventive care benefits. By getting routine exams, screening and shots, you’ll stay healthier and independent longer.
Getting regular preventive care can also help you avoid or delay the onset of illness, which can save you money in the long run. Also, Medicare preventive care benefits are fully covered, so you have no out-of-pocket costs.
Whether you choose to be covered by Original Medicare and a Medicare Part D plan or a Medicare Advantage Plan with prescription coverage, the high cost of prescriptions can put a strain on your budget, but here are some cost-saving tips.
By using these tips, you can keep your costs down without compromising the quality of your health care. For more details, Highmark Medicare Advantage members can refer to the evidence of coverage (EOC) booklet or medical benefits chart, depending on their plan.
You may also contact Highmark Member Service for more information about any information related to these cost-saving benefits.
If you have a member service question that involves personal health or insurance information, do not use the "comments" feature; please call the number on the back of your Member ID card.