A New Bill Seeks to Expand Medicare Coverage

Millions of seniors rely on Medicare to pay for healthcare in retirement. But coverage gaps in the program inevitably leave countless enrollees on the hook for extensive out-of-pocket costs.

Thankfully, there’s a new bill on the table that looks to change that. The bill, H.R.3, would allow the federal Centers for Medicare and Medicaid Services to negotiate prices for certain drugs, like insulin, that currently can’t be negotiated.

It also seeks to have original Medicare provide dental, vision, and hearing services to enrollees. Currently, those services are typically only covered by Medicare Advantage plans. And the bill would limit annual out-of-pocket spending on prescriptions to $2,000, offer more enrollees access to Medigap plans, and expand drug subsidies for low-income seniors.

All of this is good news for Medicare enrollees, who often spend thousands of dollars a year on non-covered services and co-pays. But while the aforementioned measures would no doubt make healthcare more affordable to seniors, there are steps enrollees can take right now to lower their spending and retain more of their limited income.

1. Choose the right drug coverage

Each year, Medicare enrollees can choose a new Part D drug plan during open enrollment. It pays to review your plan choices each year, because you may find that there’s a more affordable option than what you’re currently paying for. All Part D plans have a formulary that places specific drugs into different tiers. The higher your drug’s tier, the more you pay. Finding a Part D plan where your drug falls into a lower tier could therefore save you a bundle.

2. Be smart about ordering medications

If there are prescriptions you fill on a recurring basis, switching from 30-day to 90-day supplies could shave your costs substantially. You can generally order 90-day supplies by mail or through your local pharmacy. Along these lines, it pays to ask if any of your medications are available in generic form; your co-pays could be much less if they are.

3. Use Medicare’s free preventive health services

Much of the care you’ll receive under Medicare isn’t totally free, but there are certain preventive care services you can use at no cost. These include annual wellness visits, mammograms, diabetes screenings for high-risk enrollees, and flu shots. Capitalizing on these services could help nip brewing health issues in the bud, thereby preventing them from escalating and costing you more.

4. Consider Medicare Advantage

Because Medicare Advantage covers a number of key services (like the ones mentioned above) that original Medicare does not, it pays to explore your plan options and see if switching to an Advantage plan will ultimately save you money. Keep in mind that with Medicare Advantage, you’ll be limited to a narrower network of providers than with original Medicare, so that’s one significant drawback. But you may find that your out-of-pocket costs are lower on the whole under an Advantage plan.

With any luck, the House-approved H.R.3 bill will gain Senate approval, too. Until then, seniors on Medicare should make every effort to minimize their costs. The savvier you are about managing your healthcare expenses under Medicare, the less financial stress you’re apt to face.

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