MAXIMIZE MEDICARE BENEFITS

Introduction

A laudable goal is to learn how to use the Medicare system to maximize the benefits Medicare offers. To do that, we must assume certain personal goals to strive for during our “golden” years. Medicare is actually working to create the framework and means for you to attain your goals by providing you with the tools and benefits. But like so many things, we must be personally responsible and implement the tools and benefits to achieve our personal goals.

Assumed Personal Goals

1. Live life to its fullest.

2. Quality of Life is more important than longevity of life.

3. Live life without outliving one’s finances.

4. We must deal with the unexpected challenges that can adversely affect Quality of Life.

5. We can devote time and energy into optimizing our Quality of Life.

The Perfect Medicare Plan

There is no one perfect Medicare plan that fits all people. I personally believe that the Medicare Part C (Medicare Advantage with integrated Prescription Drug Plan) can be the most cost-effective and beneficial health insurance coverage for most people. It tasks a Primary Care Provider to oversee and orchestrate in partnership with their patient a health maintenance program unique to the individual’s needs. Medicare financially rewards the PCP for providing preventative care shown to preserve and improve Quality of Life indicators. But it certainly helps if each individual takes proactive steps within the system.

Medicare Benefits

1. Annual Wellness Visit: Schedule this yearly, and it is free. You may not even see your PCP as this visit is to catalog what should be done. For more information: http://www.estatefs.com/preventative-health-wellness-visit and for the particulars, see: http://www.estatefs.com/preventative-health-wellness-visit/documentation-of-a-wellness-visit . Most of the preventative measures reviewed during the Wellness Visit can be ordered at no cost if you do the Annual Wellness Visit.

2. Annual Physical Exam: Medicare does not cover an annual physical exam but most Medicare Advantage plans will pay for it totally. If so, it is free for you. Your PCP gets paid as if it were an Evaluation and Management Level 4 exam. The Annual Wellness Visit and Annual Physical Exam should not be on the same day. The Physical Exam should include a brief review of the medical record, present history, and then a complete physical exam from head to toes.

3. Annual Home Nurse Visit: Most Medicare Advantage plans will send a nurse out to the house to review your medical history without charge and communicate their findings with your PCP. I strongly encourage clients to do this annually. These nurses can spot potential future problems like fall risks that are not apparent in an office visit. There are often special programs from the insurance company that your PCP is not aware of to give you extra benefits.

4. Low Co Pay costs for health maintenance: Even if you are in perfect health, it is best to see your PCP twice a year. It creates a stronger Doctor-Patient-relationship that will help to preserve Quality of Life and Health.

5. Low Co Pay costs for labs and diagnostic tests: I recommend the following tests annually.

a. Men & Women: Fasting Complete Metabolic Panel (14-18 items), Complete Blood Count; Fasting Lipid panel, Urine Analysis, Vitamin D level, HgbA1c, CRP. Every 2-3 years: TSH, EKG, Homocysteine. Magnesium level, optional DHEA-S, optional Bone Density, optional Exercise Stress test, optional EBCT.

b. Men: Every 2-3 years: PSA, Testosterone.

c. Women: Every 2-3 years: Estradiol, Progesterone, PAP-thin prep, Digital Mammogram.

6. Benefits not covered by Original Medicare but by most Medicare Advantage plans: Annual vision eye exam, Eyeglasses or contacts if indicated, Footcare, annual hearing exam, hearing aids if indicated. Nurse phone line 24/7: Call every time there is a question about whether you need to go to the ER, Urgency Care, or wait for PCP. Insurance will not pay if the ER visit is not for a medical emergency but will if their nurse directs you there.

7. Personal Healthy Lifestyle Habits: Healthy habits for diet, exercise, sleep, mental health, tobacco, alcohol, and recreational drugs go a long way to preserve and improve one’s health and quality of life. Allow me to refer you to Estate Financial Services Website for more detailed information: http://www.estatefs.com/responsibility-or-your-health/healthy-lifestyle-habits .

Summary

As your Medicare insurance agent, I am committed to providing you with ongoing direction and advice on accessing quality medical care and helping you take personal responsibility to optimize your health and quality of life. Ideally, a client-agent relationship is beneficial to both parties, and I shall be working to be available for your needs. Please contact me if there are any questions. And I am happy to meet with your friends and acquaintances regarding their health insurance needs.

Our focus is deep. Our perspective is wide. The landscape is rugged. Together we survey the entire landscape to pick the best route to your destination.