Are You Missing Out on Any Medicare Benefits That Might Save You Money This Year?

Key Takeaways:

1. Many Medicare benefits go unused each year, potentially costing you money. Understanding what you’re entitled to can help reduce out-of-pocket expenses.

2. Reviewing your Medicare coverage annually ensures you take full advantage of available savings, from preventive care to prescription drug benefits.

Are You Missing Out on Medicare Benefits That Could Save You Money?

Medicare is designed to provide health coverage, but many beneficiaries fail to use all the benefits available. Whether it’s preventive screenings, wellness programs, or prescription drug savings, overlooking these benefits can lead to unnecessary expenses. If you haven’t reviewed your Medicare plan this year, you might be leaving money on the table.

Preventive Care: Free Services That Keep You Healthy

Medicare covers a wide range of preventive services at no additional cost. These benefits help detect health conditions early, allowing for timely treatment. Here’s what you should be taking advantage of:

• Annual Wellness Visit: This yearly checkup helps assess your overall health and risk factors.

• Screenings and Tests: Medicare covers screenings for cancer, heart disease, diabetes, osteoporosis, hepatitis, and more.

• Vaccinations: Flu shots, pneumonia vaccines, shingles vaccines, and COVID-19 boosters are fully covered.

• Counseling Services: Medicare provides counseling for smoking cessation, alcohol abuse, and obesity management.

• Bone Mass Measurements: If you’re at risk for osteoporosis, Medicare covers bone density tests to help detect bone loss early.

• Cardiovascular Screenings: Blood tests for cholesterol, lipid levels, and triglycerides are covered to help prevent heart disease.

Skipping preventive care can result in costly medical bills down the line. Make sure to schedule your appointments and stay proactive about your health.

Prescription Drug Savings: Are You Paying More Than You Should?

Medicare Part D and certain Medicare Advantage plans offer prescription drug coverage, but not all beneficiaries maximize their savings. In 2025, changes to Medicare Part D have eliminated the coverage gap, meaning your out-of-pocket prescription drug costs are now capped at $2,000. Here’s how to make sure you’re not overspending:

• Review Your Plan Annually: Drug formularies change every year. Your medications may be covered at a lower cost under a different plan.

• Utilize Generic Drugs: Ask your doctor about switching to generics, which can be significantly cheaper than brand-name prescriptions.

• Check for Extra Help: If you have a limited income, you may qualify for financial assistance to reduce drug costs.

• Mail-Order Pharmacies: Some plans offer savings if you receive medications through mail-order services.

• Medication Therapy Management: If you take multiple prescriptions, Medicare offers programs that help you manage medications and identify potential savings.

Medicare Advantage Perks: Are You Using All the Benefits?

If you’re enrolled in a Medicare Advantage plan, you might have access to additional benefits beyond Original Medicare. These may include:

• Fitness Programs: Many plans offer free or discounted gym memberships and online fitness programs.

• Hearing, Dental, and Vision Care: Some plans cover routine services Medicare does not, such as dentures and hearing aids.

• Transportation Services: A growing number of plans provide non-emergency medical transportation for doctor visits.

• Meal Delivery Programs: Some plans offer temporary meal delivery services after hospitalization.

• Acupuncture and Chiropractic Care: Certain Medicare Advantage plans now include alternative medicine options for pain management.

• Caregiver Support Services: Some plans provide caregiver support and resources for those assisting Medicare beneficiaries at home.

Since these benefits vary, it’s essential to review your plan’s details to ensure you’re using everything it offers.

Out-of-Pocket Cost Protection: Know Your Limits

In 2025, the maximum out-of-pocket (MOOP) limit for Medicare Advantage plans is $9,350 for in-network services and $14,000 for combined in-network and out-of-network services. Once you hit this limit, your plan covers 100% of your Medicare-covered services. Here’s how to minimize your expenses:

• Track Your Spending: Keep an eye on your out-of-pocket costs throughout the year.

• Choose In-Network Providers: Staying in-network helps avoid higher costs.

• Look Into Cost Assistance Programs: Programs like Medicaid and Medicare Savings Programs can help reduce medical expenses.

• Compare Plans Annually: If your costs are increasing, switching plans during Open Enrollment may save you money.

• Medigap Plans: If you’re enrolled in Original Medicare, a Medigap policy can help cover costs like deductibles and copayments.

Home Healthcare and Telehealth: Convenient and Cost-Effective Care

Medicare covers certain home healthcare services if you qualify. This includes skilled nursing care, therapy services, and home health aides. Additionally, telehealth services have expanded, providing an easy way to consult with doctors without leaving home. Consider these options if you:

• Have a chronic condition requiring frequent checkups.

• Need post-hospitalization care but want to recover at home.

• Prefer virtual doctor visits for routine health concerns.

• Require mental health support, as telehealth now covers virtual therapy and counseling sessions.

• Have mobility issues that make in-person visits difficult.

• Need remote monitoring for conditions like diabetes or heart disease.

Get a Second Opinion: Ensuring the Right Care at the Right Price

Medicare covers second opinions for medically necessary procedures, yet many people don’t take advantage of this. If you’re facing a major surgery or treatment plan, a second opinion can help confirm whether it’s the best option for your health and finances. Talk to your doctor about your options and explore alternative treatments when available.

Maximizing Your Medicare Benefits Before the Year Ends

The Medicare calendar year resets annually, meaning benefits such as deductibles and covered services renew. To make the most of your coverage:

• Use Your Annual Benefits: Schedule necessary medical appointments before the year ends.

• Check Your Deductibles: If you’ve already met your deductible, consider scheduling additional treatments before costs reset in January.

• Review Your Plan for Next Year: Open Enrollment runs from October 15 to December 7, allowing you to switch plans or adjust coverage.

• Utilize Remaining Benefits: If your plan includes allowances for over-the-counter medications, vision, or dental care, use them before they expire.

• Claim Available Discounts: Some plans offer wellness incentives and discounts on health-related products and services.

• Know Your Special Enrollment Periods: If you experience a life change (such as moving or losing employer coverage), you may qualify for a Special Enrollment Period to adjust your coverage.

Don’t Leave Money on the Table

Many Medicare beneficiaries don’t use all the benefits they’re entitled to, resulting in higher out-of-pocket costs. A quick review of your plan and available services can help you save money while ensuring you receive the care you need. Take the time to explore your options and make the most of your Medicare coverage this year.