It’s open enrollment season. Every other commercial asks us to trade in our traditional Medicare for Replacement Plans. The incentives include gym memberships, rides to appointments, and online health coaching.

Left unspoken are things these plans don’t cover very well. I have seen many patients face significant care challenges and financial difficulty because the plans they chose don’t provide what they need when facing more chronic or serious health challenges. (Things that are much pricier than rides and gym memberships). It’s heartbreaking. But I am also praying it is avoidable with a bit of education such as what I offer here.

Did you know that traditional Medicare covers as many home health visits as your medical team submits that you need at 100%? Managed care plans focus on preventative and outpatient care and dictate a minimal number of visits while Medicare Part A and/or Part B cover home health services when you are homebound during a major illness or after a surgery at no additional out-of-pocket cost to you.

If you (or your insurance client) are in perfect health needing only preventative care, it makes sense to go for the lower premium and the gym perks. But if, like many of us, you are fighting multiple chronic illness or anticipate some at-home recovery time after having some well-used joints replaced, please don’t let anyone talk you into giving up your traditional Medicare (Medicare Parts A and B) without doing your homework. From Medicare.gov to local Senior Centers, there are so many resources.

Please take the time to do your research homework based on your specific needs. “Future you” will thank you for a careful decision during Medicare open enrollment season.

Sincerely,

Tracy Cappelletti RN BSN MJ CPHQ

Home Health Care Transitions Nurse