Medicare Savings Strategies
7 min read •
30 sec brief
If you’re looking for ways to save on Medicare expenses, you’re in the right place! Medicare comes with some expenses, like Medicare Part B premiums and prescription copays. It’s vital to know how to save money, so you can spend your time doing what you enjoy most and not worrying about how to pay for…
If you’re looking for ways to save on Medicare expenses, you’re in the right place!
Medicare comes with some expenses, like Medicare Part B premiums and prescription copays. It’s vital to know how to save money, so you can spend your time doing what you enjoy most and not worrying about how to pay for healthcare. Here are a few ways to help cut your Medicare costs:
Select Your Medical Providers Carefully
If you’re on Original Medicare, choose your medical providers carefully. Medicare has set approved amounts for services known as “assignment,” meaning the medical provider accepts the amount as payment in full and can’t bill more than that amount. Though many providers accept assignment, some don’t.
Generally, there are two categories of medical providers who don’t accept assignment, including non-participating providers and those who opt-out.
Non-participating providers can charge up to 15 percent more than a reduced Medicare-approved amount for Medicare-covered charges, leaving you responsible for the extra expense. Those who “opt-out” can charge any amount they want as long as it is outlined in a private contract.
You can find medical providers who accept assignment in your area by visiting Find Medicare Physicians and other clinicians. For those who have Medicare Advantage Plans, be sure to choose medical providers within your plan’s network. It’s common for out-of-network providers to cost significantly more than in-network providers.
Utilize Medicare Free Services
They say “an ounce of prevention is worth a pound of cure,” and it’s true. There are several preventative services covered under Medicare Part B, at no cost to you. A few examples include cancer screenings, depression screenings, glaucoma tests, nutrition therapy services, flu and Pneumococcal shots.
In addition to the preventative services, you’re eligible for a “Welcome to Medicare” visit within the first 12 months you have Medicare Part B. Once you’ve had Medicare Part B longer than 12 months, you get an annual Wellness Visit to develop or update a personal prevention plan. To note, if your provider performs additional tests or services not covered under the preventative services, you may have to pay coinsurance and the Part B deductible. Some Medicare Advantage plans offer wellness benefits, such as gym memberships at no cost to you.
Know Your Medicare Home Health Benefits
Medicare home health coverage is an area that often confuses both Medicare recipients and medical providers.
While Medicare covers home health, the coverage criteria is very specific.
Medicare beneficiaries with Part A & B coverage are eligible for home health coverage if they meet several conditions including:
- You are under the care of a doctor and getting services under a plan of care that is regularly reviewed by a doctor.
- You must have a need, and a doctor must certify the necessity, of one or more:
- Intermittent skilled nursing care (other than blood draws).
- Physical therapy, speech-language pathology, or continued occupational therapy services.
- You are homebound, certified by a doctor.
You can leave your home for medical treatment or short non-medical reasons like attending religious services. You can also receive home health care if you attend adult daycare.
Once you meet the criteria for home health coverage, it’s essential to choose an agency that is Medicare-certified. Here’s a handy resource to find and compare Medicare-certified home health agencies.
Save on Prescription Drug Costs
Medications can be one of the highest expenses for seniors. Even with Medicare Part D (prescription drug coverage), you may face large out-of-pocket costs, as Part D doesn’t have a spending cap.
You can cut your medication costs by only purchasing from your plan’s list of “preferred” pharmacies.
Review your plan’s list of covered prescription drugs (formulary). Many Part D plans are divided into tiers, here’s an example, though your plan may differ:
- Tier 1 – most generic prescription drugs
- Tier 2 – preferred, brand-name prescription drugs
- Tier 3 – non-preferred, brand-name prescription drugs
- Specialty tier or Tier 4 – very high-cost prescription drugs
In this example, prescription drugs on Tier 1 have a lower copayment than those on the Speciality tier. If you see an approved medication for your condition on a lower tier (or higher, depending on your plan) that would be cheaper, ask your healthcare provider if it would work for you.
Paying cash is another way to save money on prescription drugs. Stores like Costco, Target, and Wal-Mart have several generic medications for very affordable prices, often just a few dollars. Many Medicare Part D plans come with a copay, typically at least $10 per prescription. One downside to cash is that it doesn’t count toward your deductible. You’ll want to pre-plan to see which option would be best in the long run.
Investigate Money Saving Options
There are Medicare Savings Programs to save money on your expenses. In some instances, these programs can help pay for Medicare Part A and B deductibles, coinsurance and copayments, if you meet the criteria.
- Qualified Medicare Beneficiary (QMB) Program
- Specified Low-income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program
- Qualified Disabled and Working Individual (QDWI) Program
If you qualify for the QMB program, SLMB, or QI program, you automatically get extra help paying for Medicare prescription drug coverage.
If you can say “yes” to the following three questions, contact your state Medicaid program to see if you qualify for a program in your state:
- Do you have, or are you eligible for, Medicare Part A?
- Is your income for 2019 at, or below, the income limits?
- Do you have limited resources, below the limits?
Visit Medicare Savings Plans to find income limits and more info on these programs.
There are several ways to cut Medicare costs. Armed with some knowledge, you can take steps to ease spending so you can concentrate on the fun things in life!
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