I would also make sure to read the fine print with any Medicare plan. The term “covered” doesn’t mean services won’t be costly. For example, one of these plans may offer a pair of free eyeglasses, but that is not the same as care for uveitis, which requires a specialist.
TR: How and when should a rheumatology provider start the conversation with a patient about Medicare coverage options?
Mr. Turkas: Clinic time can be tight with so many patient care decisions to cover, but taking time to let patients know they can broach the Medicare conversation can also be an important care discussion, especially as a patient is approaching age 65. Try opening the conversation in a humorous way, such as asking if their mailbox is overflowing with Medicare coverage information. Let them know there are restrictions with plan choices that could introduce delays in their care. This is a true statement that provides context around insurance plan choices. Let them know about important resources for assistance. For example, within traditional Medicare plans, there is extra payment help for Part B supplements through Social Security.
It’s also important to prepare your patient to become savvy about sources of information to avoid because there are many third parties that promote Medicare plans offering perks to sign up that aren’t valuable in the long run. For example, I’ve heard providers say their patient’s plan was switched in a grocery store parking lot because they received a free grocery coupon.
In the end, it comes down to making the right Medicare choice for individual needs. If you are healthy and don’t have any major health challenges into your golden years, you will save money on a Medicare Advantage plan. However, if you need care for chronic conditions, those Advantage plans can start to manage you vs. you managing your health.
Reliable Medicare Information
Here are two sources Mr. Turkas shared that rheumatology providers can confidently share with patients seeking information about different Medicare options:
- State Health Insurance Assistance Program (SHIP): Each state has a SHIP website and helpline that provides free, unbiased Medicare insurance plan information. For example, a person living in Colorado would access the Colorado SHIP website.
- Arthritis Foundation helpline at (800) 283-7800: Anyone can call the hotline to get individualized help with fielding Medicare insurance plan questions.
Through ACR/ARP Access in Rheumatology on demand, get more tips from Mr. Turkas’ education session, Traditional Medicare vs. Medicare Advantage, and be prepared to help your patients make informed Medicare choices.
