Medicare ABC and Me

How Medicare can help you stay healthy: Answers to a few common questions

If you’re turning 65, chances are you’ve been thinking about how you can stay healthy as you get older. One great way to take charge of your health is to utilize the preventive care and benefits offered by Original Medicare or a Medicare Advantage plan. Let’s answer some common questions about how Medicare can provide the care you need for the life you lead.

How does Medicare keep me healthy?

Original Medicare (Parts A and B) and Medicare Advantage plans allow you to live life boldly by getting better overall care. HMO Medicare Advantage plans, like those offered by ApexHealth, connect you to a primary care provider (PCP) and a team of specialists who all work together to provide you with the best possible care. While these types of plans require that your PCP, hospitals, service providers and specialists are part of the plan’s provider network, a great network can make a big difference to your health!

At ApexHealth, we are proud to work closely with an integrated network of providers and hospitals. Anchored by Atrium Health and Atrium Health Wake Forest Baptist, our network ensures members get unmatched expertise and personalized care.

What if I have a chronic condition like diabetes?

If you have chronic conditions or need prescriptions, you may benefit from the extra support a Medicare Advantage plan provides. Many Medicare Advantage plans like ApexHealth offer a maximum-out-of-pocket limit (MOOP), which can protect you from paying too much for hospital stays or unplanned medical emergencies and procedures. Once you reach your MOOP, your insurance company pays 100% of covered medical services. 

Prescription drug coverage is available under Medicare for the medications you need to manage your conditions. Medicare also covers various medical services and supplies for diabetes, like blood sugar test strips. Some Medicare Advantage Plans, like those offered by ApexHealth, may offer a $0 copay for select maintenance medications for diabetes.

Can I get health and wellness benefits through Medicare?

Original Medicare doesn’t offer supplemental benefits, but when you enroll in a Medicare Advantage plan like ApexHealth, you can get access to ApexExtras designed to help you get more out of life. ApexHealth offers:

  • Dental, vision and hearing care
  • Chiropractic care, therapeutic massage or acupuncture
  • The Apex PayFlex card

Do I get gym coverage or classes with my plan?

Original Medicare doesn’t cover any kind of gym memberships or classes, but if you enroll in Medicare Advantage plan like ApexHealth, you can get fitness benefits like: 

  • Access to local fitness centers and YMCAs
  • Online workout classes
  • Wearable fitness trackers
  • Exercise kits for activities like Pilates, swimming and strength

Can Medicare keep me healthy while traveling?

Retirement offers a great opportunity to travel! If you have Original Medicare, you have coverage anywhere in the United States and its territories. However, if you’re abroad, coverage is little more limited. Original Medicare may pay for medical emergencies at foreign hospitals in three instances:

  • When a foreign hospital is closer than a United States hospital while traveling
  • When in Canada and a Canadian hospital is closer than the nearest United States hospital
  • When a foreign hospital is closest to your home while living in the United States

Some Medicare Advantage Plans, like those offered by ApexHealth, provide worldwide emergency services coverage outside of the U.S. and its territories. (Limits and cost-sharing applies.)

If you have any questions about your coverage, call our ApexAssistants before you schedule your trip!

How can I get assistance with Medicare costs?

Those with limited income may qualify for assistance on costs, like premiums or prescription drug costs. You can visit Medicare.gov to find out if you’re eligible and apply for assistance.

Where can I get more information?

We hope that with this information, you can get started making the most of Medicare! If you have any questions, please give our ApexAssistants a call at (844) 279-0508 (TTY: 711). Our hours of operation are Monday through Friday 8 a.m. – 8 p.m. (local time) from Apr. 1 through Sept. 30 and seven days a week 8 a.m. – 8 p.m. (local time) from Oct. 1 through Mar. 31. 

**The information presented is accurate as of January 26, 2023, and may change at a future date.

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ApexHealth

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