By Wiley Long
MediGap Advisors

What’s In It for Me:
Over-65 Plans and
Wellness Benefits

Newsletter Issue #10


I’m Wiley Long, President of MediGap Advisors, and I’m back with this tenth edition of our “Guided Path to Medicare” newsletter, aimed at helping you navigate the sometimes confusing waters of health care options available to you in your senior years.

In our last newsletter, I gave you something of a “checklist” of all of the things you should be doing to get ready for enrollment in your senior health care coverage. This month we’ll talk about the features of these health plans specifically aimed at keeping you healthy.

According to the most recent World Health Organization (WHO) data (2016), the U.S. life expectancy worldwide was at 76 years for males and 81 years for females. That means Americans have it substantially better than those from Sierra Leone, who can plan on only about 38 years, but we’ve got a ways to go to catch up with Japan, whose citizens can expect to live 86.2 years, on average.

It’s my sincere hope that you have many happy, healthy and productive years left and that you celebrate many birthdays beyond number 79. Clearly taking care of your health has never been more important, and you should know about the provisions in your health care plan that help you to do so.

Take the first step with SilverSneakers to improve your fitness and overall health.

SilverSneakers is an innovative program that is offered by some Medicare supplement and Medicare Advantage plans. The program allows you to have a basic membership at any one of more than 13,000 gyms around the country. You’re entitled to all of the amenities and services afforded as part of a basic membership. Some locations even have social activities geared toward SilverSneakers members.

In addition, you’ll get a session with a trained program advisor, who will show you around the facility and get you started in a fitness program. The program includes access to web-based tools to help you track your fitness progress and special seminars that cover health topics of interest to seniors.

The SilverSneakers program not only offers access to free weights and cardiovascular machines such as stationary bikes and treadmills, but every SilverSneakers location also has special classes aimed at SilverSneakers members at least twice weekly.

The classes involve total-body conditioning and are designed to improve muscular strength, endurance, range-of-motion, flexibility, agility, and coordination. The program has been proven to help older adults manage their health and improve strength, balance, and endurance - and doing these things improves your overall health and well-being.

If you can’t conveniently access any of the locations, you can enroll in SilverSneakers Steps, which is a self-directed physical activity program you can do on your own. You’ll receive the tools you need to develop a plan to increase your physical activity.

My team can help you to find a plan that offers the SilverSneakers benefit, so you don’t miss out on this important feature of many of the Medicare supplement and Medicare Advantage plans we offer.

We talk a lot about what these plans pay when you’re sick, but it’s almost as important to consider what they pay when you’re well.

Knowing how your plan pays for wellness visits is crucial. First, let’s talk about your first visit with your doctor once you begin to be covered by Medicare - the Welcome to Medicare Preventative Visit.

Within twelve months of the start of your coverage, you should schedule this initial visit - it’s covered in full. The visit includes a review of your medical history; screenings for certain diseases, vaccinations, and referrals (if necessary); blood pressure, and height/weight measurements and body mass index determination; vision test; and screening for depression. If you choose you can even get counseling about end-of-life options.

After that, you’re entitled to a yearly wellness visit, during which you’ll discuss your medical and family history, and review of all of your providers and prescriptions, and get the routine height and weight measurements, as well as blood pressure. You’ll have a cognitive impairment evaluation and other preventive services as necessary. This visit is free. Your Medicare plan also covers certain preventive care services, like mammograms and colonoscopies, without the typical Part B coinsurance and deductibles.

A word of caution: make sure that your provider accepts the payment amount approved by Medicare for your wellness exam. If a more thorough exam is performed it might not be fully covered, and you’ll be left paying the difference.

I hope you’re finding the information in these newsletters helpful. Next month we’ll talk about taking steps to sign up for a plan, to ensure that you have coverage in place on the day you turn 65. If you can’t wait to read the next issue, you can now view it here.

Best regards,

Wiley P. Long III
President - MediGap Advisors