Local experts share the to-do checklist for finding the best Medicare health plan for you.
As the saying goes, an ounce of prevention is worth a pound of cure. That’s why the population health department at JCMG is on a mission to ensure every Medicare recipient age 65 and older receives an annual wellness visit, making them aware of the lifesaving health screenings and services available to them.
“Here in the population health department at JCMG, we focus on delivering annual wellness visits to Medicare patients at no out-of-pocket expense to the patient,” says Barbara Cremer, director of population health and medical services at JCMG. “The focus of the visit is that the patient leaves with a personalized prevention plan to ensure that any Medicare service that is available to them has been scheduled.”
During an annual wellness visit, patients meet with a nurse for a limited physical assessment and to update or create a current list of providers and prescriptions. During this visit, they also review the patient’s medical history and schedule or discuss preventative screenings to make sure that this vital information isn’t overlooked during a regular office visit.
“The focus of the visit is that the patient leaves with a personalized prevention plan to ensure that any Medicare service that is available to them has been scheduled.”
Barbara Cremer
“We all understand that provider time is limited during visits,” Cremer says. “If a patient is having trouble breathing, the provider may not be focused on telling them they need a bone density screening. We pull that out from a regular visit so the focus can be on those preventative screening measures.”
Oftentimes, patients will schedule their annual wellness visit just before their visit with their physician. That way, a nurse can update the information in their chart and send it to the provider ahead of the patient’s visit, making the process easier for both patient and physician.
“The whole focus of the department is to ensure that our patient population is getting the care they need and the care they are eligible to receive through Medicare,” Cremer explains. “There are a lot of preventative services that are available to them that, a lot of times, patients aren’t aware of.”
The list of screenings available through Medicare is long and includes routine vaccinations and immunizations; screenings for a variety of conditions like diabetes, glaucoma, heart disease, lung cancer, HIV, and depression; smoking cessation counseling; bone mass measurements; medical nutrition therapy; and more.
In addition to wellness visits, Population Health also provides chronic care management to those who have been diagnosed with two or more chronic illnesses, such as diabetes, hypertension, or depression. With a physician referral, those patients are then assigned to a nurse who reaches out every one or two months to help the patient develop a comprehensive plan to manage their conditions and reach their personalized goals.
Who Can Sign Up?
At age 65, any American who has earned 40 tax credits is eligible to enroll in Medicare Part A, premium free, and in Medicare Part B, for which most people pay, says Tracey Wetzel, the lead trainer of the Missouri CLAIM program.
“The easiest way to sign up for Medicare is to sign up through the Social Security Administration website by establishing an account through the site,” Wetzel says. “I encourage everybody to do this. You can then take a look at your Social Security earnings, how many tax credits you’ve earned, and estimate what your retirement would be.”
Those concerned about navigating the Medicare system and evaluating the various options and plans will find The Missouri CLAIM program to be an invaluable tool. By contacting the CLAIM program, enrollees can be connected to a volunteer in their local area who has been trained to navigate the Medicare system. That volunteer is able to educate and counsel Medicare recipients, friends, and family members on coverage options.
“We also help beneficiaries who may have limited income find resources that can help them pay for benefits, like the Medicare Savings Program, which helps pay the Part B premium and pays for prescription drugs,” Wetzel says.
When considering which Medicare option is the best fit, Wetzel says she encourages people to think of their benefits on an individual basis. Comparing plans with a neighbor or friend will not be an apples-to-apples comparison.
“Your benefits are specific to you,” she says. “Your plan is your choice and is picked based on your information, what prescriptions you’re on, what doctors you see, what pharmacies you shop at. You’re going to be in a plan or coverage that is associated with you and how you live.”
Wetzel also encourages Medicare recipients to compare plans annually, with the help of a Missouri CLAIM program volunteer. Key details like which services they cover, what costs are associated, and which providers, pharmacies, and hospitals are in-network can change from year to year.
“You may be happy with your plan, but they may raise your premium $20, and there may be another plan that is $15 cheaper,” Wetzel says. “It’s worth spending a little time running a comparison on different options available to you.”
To reach the Missouri CLAIM program, call 1-800-390-3330.
To reach the Population Health Department at JCMG, call 573-556-1774
To reach the Social Security Administration www.ssa.gov, call 877-405-9803
