In Chester County, PA MEDI local coordinator Sarah Milam encourages older residents to seek out counseling appointments and bring with them all their current insurance information, a list of their prescription drugs and the names of doctors, nurses and health care systems they go to.
“Then, we can get a good idea of what plans are good for them, the cost of the drugs, your primary care physician, what that cost is going to be, if they go to the hospital, if they’re getting an MRI or something like that, just kind of to get a general idea of what it’s going to cost them for the next year,” she said.
Just because a doctor or a prescription drug is covered by their Medicare insurance this year, that doesn’t mean that same plan will cover the same health care providers and medications next year, Milam said.
“Providers can go in and out of the network anytime during the year, which is not great, but you definitely want to look at that for sure,” she said.
Milam is also warning people this year of changes to telehealth options. During the COVID-19 pandemic, Medicare plans and providers were allowed to provide certain health care services virtually or over the phone for the first time.
But those telehealth flexibilities were tied to a pandemic-era federal policy that expired on Sept. 30 after Congress did not extend them. Milam said a lack of telehealth options going forward could affect the kind of Medicare plan someone chooses, depending on how far they must travel for primary or specialty care in their region.
When people get Medicare counseling on these nuanced circumstances and situations, Milam said it can be helpful for people to bring someone with them.
“Some of the people are really older and it is nice that they bring a family member who’s going to help them, family members who are helping their parents,” she said.
Budgeting for Medicare health insurance
People 65 and older may be retired and living on limited fixed incomes, which can make paying for health insurance challenging no matter what plan they choose, said Widelo.
AARP provides a Medicare assistance program, but it also has long-term financial planning services that can help people figure out how to budget for health care, housing and property taxes, utilities and energy costs and other lifestyle needs.
“They’re so intertwined,” Widelo said. “When we think about retirement, we think about things like Social Security and your personal savings and retirement savings, and health care is really that fourth leg. If you’re healthy, hopefully your costs are going down. And we know that health care is expensive, so the healthier that we can make sure people are, hopefully that helps contribute to financial stability.”
