Medicare changes every year – but many Medicare subscribers don’t even realize just how significant these changes can be. If you’re a woman, these Medicare changes can greatly impact both your healthcare and how much you’re paying each year.
Women suffering from a number of serious medical conditions will be affected by Medicare’s latest changes when 2019 arrives. Here are the important changes coming for female Medicare subscribers once open enrollment ends for the 2019 coverage year.
If You’re Suffering from Rheumatoid Arthritis, Your Medication Should Be Covered
While Medicare coverage for prescription drugs has been lacking and limited for decades, women who are living with rheumatoid arthritis don’t need to worry – your medications may be covered by Medicare, with no significant expense on your part.
According to BoomerBenefits.com, Medicare covers some rheumatoid arthritis drugs under Part B and others under Part D. If you receive your medication in a clinical setting, such as your doctor’s office or at a hospital, your medication will be covered under Part B. If you take your medication as an outpatient, or on your own, it’ll be covered under Part D.
Most rheumatoid arthritis drugs falls under Part D coverage – this includes non-steroidal anti-inflammatory drugs (NSAIDs) that are both over-the-counter and prescription, as well as corticosteroids. However, if you don’t have Part D coverage or a Medicare Advantage plan (an alternative to Part D), you could be paying a lot for your medication. You’ll have to pay the entire cost of your medications. A Part D or Medicare Advantage plan can significantly reduce these costs, as you’ll have an annual maximum for your out-of-pocket expenses.
If You’re Diagnosed with Breast Cancer, Parts A, B, and D Offer Coverage
Women living with and treating breast cancer can rely on Medicare throughout their diagnosis and treatment without much worry: Medicare offers wonderfully comprehensive breast cancer coverage. Whether you need inpatient or outpatient treatment, you’re covered. And according to the Breast Cancer Resource Center, women with breast cancer often don’t have to pay much out-of-pocket when they’re on Medicare.
Here’s what Medicare covers when it comes to breast cancer, according to the Breast Cancer Resource Center:
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- Part A covers all hospital visits, from inpatient stays to blood transfusions to nursing care to even some home healthcare services. You’ll be covered for up to 60 days of a hospital stay.
- Part B covers the medical attention you need regularly, like doctor visits, lab work, diagnostic imaging, and any medical equipment. For cancer patients, surgeries (including reconstructive surgery), chemotherapy, and radiation are all covered, with Medicare handling 80 percent of the costs.
- Part D covers your prescription drugs. Any medications you need that aren’t administered by a doctor will be covered by Part D, or by a Medicare Advantage plan if you have one.
If You’re Living with Osteoporosis, Medicare Covers Bone Density Tests
Women who face osteoporosis have somewhat limited coverage for their condition under Medicare. Although osteoporosis is common in senior women, it’s a condition that Medicare offers more preventative and diagnostic care for than everyday care.
As Medicare Made Clear writes, Medicare covers only bone density tests. You won’t have to pay anything – as long as your doctor accepts Medicare, you don’t even have to pay a copay for your bone density tests. However, in order to get approved for a covered bone density scan, you need to be an “at risk” patient for osteoporosis or currently undergoing treatment for osteoporosis.
And you’re only covered for one test every two years. If your doctor wants to check your bone density more often to see if treatments are working, you’ll have to pay for those. This is where supplemental insurance may be able to help, as a supplemental or “gap” plan may be able to offer you more thorough coverage when you’re living with osteoporosis.
If You’re Suffering from Heart Disease, Only Preventative Care Is Covered
Heart disease is a serious condition that takes the lives of many – millions – of people each year. Yet if you’re living with heart disease and on Medicare, you may find yourself lacking coverage and paying for much of your care out-of-pocket.
While prescription medications can be covered by Medicare Part D, little is covered by Original Medicare (or Parts A and B). You have to subscribe to Part D in order to have any prescription medication covered, and even then you may be left paying for your medications.
Medicare simply doesn’t offer much coverage when it comes to heart disease. As My Medicare Matters explains, the focus is more on preventing heart disease – which is why heart disease and diabetes screenings are both covered under Medicare. Medicare subscribers are eligible for a free annual heart disease screening, which includes blood pressure and cholesterol testing, and a covered diabetes screening. While both of these screenings are important for all women, women who are currently living with heart disease may find themselves needing supplemental or gap insurance.
What If You Need Additional Coverage?
These Medicare changes introduce new benefits, challenges, and coverage gaps for all women – but they could affect you even more if you suffer from any of the mentioned conditions or illnesses. That’s why you need to take action right now in order to adjust your coverage before the new year begins.
You can easily change your Medicare coverage during open enrollment. You can review your current subscriptions and coverage level, as well as your premiums and what you’ll pay out of pocket for your healthcare needs over the next year.
And if you realize that the newest Medicare changes mean you need a new plan or additional coverage, you can take action during open enrollment. The open enrollment period is the perfect time to research new coverage options, like Medicare Advantage plans.
You can easily compare different plans, premiums, costs, and coverage levels and find the right balance of Medicare coverage for your needs and your budget – but if you wait too long, you may wind up having to stick with coverage that’s less than perfect for a while.