Maximize Your Medicare Benefits

How to Maximize Your Medicare Benefits

Choose the Right Healthcare Provider

The first step in maximizing your Medicare benefits is choosing the right healthcare provider. Of course, you should choose a doctor who treats Medicare patients, but you should also ensure that they accept your Medicare payment as the full payment for services.

Some doctors may be considered non-participating providers, which means that they can charge you up to 15% more than your Medicare payment covers for services. You are responsible for the additional charges. Some doctors may also be “opt-out” providers, meaning they can charge whatever prices they outline in their private contracts with patients.

When searching for a Medicare provider, check the Medicare provider search to find one that accepts your Medicare payments.¹ People with Medicare Advantage plans should also use the Medicare provider search to confirm their doctor accepts Medicare. Make sure your provider is in-network so you aren’t hit with any additional charges for services.

Compare Your Prescription Options

As a Medicare participant, you have different options when it comes to prescription drug coverage. You can opt into Medicare Part D prescription drug coverage, which may help reduce your prescription co-pay. But, don’t write off cash payments as an option, as well. Sometimes, paying cash can actually save you money versus the Part D copayments because you can choose generic options. Also, some pharmacies and drug companies may offer coupons for certain prescriptions.

Speaking of generic drug options, also consider whether or not you can take a preferred generic medication instead of a brand name. Talk to your doctor to see if there is a comparable drug in a lower tier. Medicare Part D has four tiers: Tier 1 includes most preferred generic prescription drugs; Tier 2 includes preferred, brand-name prescription drugs; Tier 3 includes non-preferred prescription drug brands; Tier 4 is for specialty drugs.² Tier 1 (preferred generic) is usually the most affordable tier.

Take Advantage of Free Benefits

In addition to prescription and medical coverage, your Medicare plan may also include a number of free services and benefits that many Medicare patients might not even be aware of. According to Medicare.gov, here are some of the many preventative services that you may be eligible for³:

• Yearly wellness exams
• Flu shots
• Diabetes screenings
• Depression screenings
• Cardiovascular disease screening and behavioral therapy (tips from a doctor about how to lower your risk for cardiovascular disease)
• COVID-19 vaccines
• Mammograms

These are just a few of the free preventative services that Medicare may include. To truly maximize your Medicare benefits, take advantage of these services if they make sense for you.

Check Your Medicare Summaries

Every quarter, you will receive a Medicare summary that shows all the services and supplies that your healthcare providers billed to Medicare. If you notice that a claim has been denied, you have the right to investigate the charge. First, contact the provider to make sure that the claim was submitted correctly. If it was, you may consider filing an appeal if you think the cost is an error. You can also contact Medicare to verify the charge.

If you’re paying for Medicare, you probably want to get the most bang for your buck! From examining your options for prescription drugs to taking advantage of free services, there are a number of things you can do to maximize your Medicare benefits. Make the most of the resource by knowing your benefits.

If you would like help navigating your Medicare benefits, feel free to,,,