Medicare changes every year – but if you’re a woman facing any kind of serious health condition, those changes can affect your coverage and your finances. While some Medicare subscribers may not even realize these changes happen, it’s important for women on Medicare to know how every change impacts both healthcare and annual costs.
Women will be affected by Medicare’s latest changes when 2019 arrives. If you’re suffering from rheumatoid arthritis, breast cancer, osteoporosis, or heart disease, the following are the important coverage details women need to know once Medicare open enrollment ends for the upcoming coverage year.
Rheumatoid Arthritis: Prescription Medication Coverage Is Improving
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 about their out-of-pocket expenses as much as they did in years past. Now, thanks to changes by Congress, your medications may be covered by Medicare, with no significant expense on your part.
According to BoomerBenefits.com¹, Medicare covers some rheumatoid arthritis drugs under Part B and others under Part D. If you receive your medication at your doctor’s office or 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, in the past, Medicare subscribers were left paying thousands out-of-pocket thanks to a “donut hole” that left a coverage gap.
In 2019, female rheumatoid arthritis sufferers won’t have to pay the same high costs. As AARP² reports, the “donut hole” is closing. You’ll have no coverage gap for brand-name prescription medications over the next year, cutting your costs greatly.
Breast Cancer: Treatments and Care Are Covered
Women living with and treating breast cancer can rely on Medicare to keep them as healthy as possible – and you won’t have to worry about paying for your treatments and care. Medicare offers for both inpatient or outpatient treatment. And according to the Breast Cancer Resource Center³, women with breast cancer often don’t have to pay more than copays or their deductible on Medicare.
Here’s what Medicare covers when it comes to breast cancer, according to the Breast Cancer Resource Center⁴:
Part A covers all hospital visits and care for stays up to 60 days.
Part B covers doctor visits, lab work, diagnostic imaging, and any medical equipment you need at home. Cancer patients’ surgeries (including reconstructive surgery), chemotherapy, and radiation are all covered, meaning you’ll pay just 20% of the cost.
Part D or a Medicare Advantage plan covers prescription drugs and any medications that aren’t administered by a doctor.
In order to ensure you’re getting the most coverage possible when going through breast cancer treatment, you may want to consider a supplemental plan or a more extensive Medicare Advantage plan with lower premiums and deductibles.
Osteoporosis: Regular Bone Density Tests Are Covered
Women who face osteoporosis have somewhat limited coverage for their condition under Medicare. Although osteoporosis is a common condition, it’s one that Medicare offers more preventative care for.
Aside from any medications that may be covered by Medicare Part D or Medicare Advantage, as Medicare Made Clear⁵ writes, Medicare covers only bone density tests. You won’t have to pay anything for these scans as long as your doctor accepts Medicare. However, in order to get approved for a bone density scan under Medicare, you need to be an “at risk” patient for osteoporosis or currently undergoing treatment for osteoporosis and in need of regular scans.
Once you meet the conditions to qualify for a scan, women should know that you’re only covered for one scan 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 out-of-pocket. This is where supplemental insurance may be able to help, as these plans may be able to offer you more coverage for osteoporosis management and treatment.
Heart Disease: Preventative Care Is Covered
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. Prescriptions, as mentioned above, can be covered by Part B, Part D, or Medicare Advantage plans, but beyond that there’s little covered by Medicare. Women living with heart disease may find themselves paying for treatments beyond prescription medication.
However, if you have yet to be diagnosed with heart disease and you want to reduce your risk, you need to know that Medicare aims to prevent more cases of heart disease before needing to coverage the costs of treating this disease. My Medicare Matters⁶ explains that both heart disease and diabetes screenings are covered under Medicare, giving women the opportunity to check their risks regularly and prevent heart disease altogether.
Medicare subscribers are eligible for a free annual heart disease screening, which includes blood pressure and cholesterol tests to check for signs of the condition, and a covered diabetes screening, which can also lead to heart disease. And both of these screenings are important for all women.
Expand Your Medicare Coverage with a Supplemental Plan
These Medicare changes and coverage details introduce a few new benefits, some challenges, and potential coverage gaps for all women. That’s why it’s so important to understand what, exactly, your Medicare coverage includes each and every year.
Of course, these changes could affect your health and your financial well-being even if you’re happy with your current Medicare plan. And this can especially be the case 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, review your current subscriptions and coverage level, and see your premiums and out-of-pocket costs for the next year.
If you realize you need a new plan or additional coverage thanks to changes in your health or in Medicare coverage, you can take action during open enrollment. The open enrollment period, which runs through December 7, is the perfect time to research new coverage options, like Medicare Advantage plans. You can compare different plans, premiums, costs, and coverage levels to find the right balance of Medicare coverage – but if you wait too long, you may wind up with coverage that’s less than ideal.
