How your Medicare plan can help you manage chronic conditions
A chronic condition generally is defined as one that requires ongoing medical attention, limits daily activities or both. It’s not surprising that most Medicare beneficiaries are likely to have two or more chronic conditions, such as diabetes, hypertension or congestive heart failure.
If not treated properly, many chronic conditions can lead to other health complications, so it’s important to work with your doctor to manage them. But did you know that your health plan can work with you to make sure you are getting the right care at the right time?
When choosing a plan, here are some questions to consider:
- Does your insurer offer a free medication review? Chronic conditions often require multiple medications, and most medications have specific instructions that need to be followed. Managing this process can be challenging, and not following the proper dosage and timing instructions can result in unnecessary hospital stays. Insurers have teams of medical professionals on staff, so look for an insurer that offers a free medication review, in partnership with your doctor, to help you understand exactly which medications to take and when.
- If you have diabetes, will your insurer help you manage this condition? Diabetes can have serious complications if not treated properly, so look for an insurer that offers 24/7 personalized support, which might include unlimited testing supplies. Some insurers offer cellular-enabled blood glucose meters that make it easy to share your blood glucose readings with your doctor and family members in real-time. This enables those responsible for your care to see if you are in distress and act immediately.
- Does your health plan offer reduced copays on insulin? People with diabetes depend on insulin, which can be quite costly. Thanks to a pilot program developed by the Centers for Medicare & Medicaid Services, or CMS, a limited number of insurers (including HAP) are offering Medicare plans that cap the copay of insulin at $35 per 30-day supply. This can result in a significant cost savings.
- If you are hospitalized for a chronic condition, does your insurer offer additional post-discharge support, such as home-delivered meals? For example, HAP arranges to have fully prepared refrigerated meals delivered to the homes of those with certain chronic conditions who recently have been discharged from the hospital. For two weeks following discharge (two meals a day for 14 days), these members get the nutrition they need at a time when they might not be able to leave their homes.
- Does your health plan offer an over-the-counter benefit? If so, this benefit can be used on items that help manage your chronic condition, such as aspirin, a blood pressure monitor, diabetic socks, or even face masks and hand sanitizer.
Additional questions to ask include:
- Does your health plan offer free home delivery of medications?
- Does your insurer offer a fitness benefit that can be used to help manage your chronic condition, such as gym memberships or at-home video classes?
- Does your health plan offer telehealth visits at no cost to you? This can help you get the care you need without leaving home.
Research has shown that those who manage their chronic conditions enjoy better health outcomes and an improved quality of life. That’s reason enough to ask your insurer about its health care management programs and how they can work for you.
ABOUT THE EXPERT
Dr. Charles Bloom is chief medical officer of Health Alliance Plan (HAP). He has more than 20 years of experience in the medical field, with multiple leadership roles in emergency medicine. He received his medical degree from Michigan State University’s College of Osteopathic Medicine.