By Steven Buttice, Founder and PresidentLiving By Your Design, Inc.
I have now started looking through my 89-year-old mom’s mail. Wow, so much information on Medicare Plans. Being a college graduate, even I have problems making sense of these mailings. So, how in the world is my mom to make an intelligent choice from her options?
Medicare’s Annual Enrollment Period (AEP) will begin 10/15 and continue through 12/7. The AEP is when most people can change their Medicare Advantage (MA) and Medicare Drug Plans (Part D). So, you will see a flood of commercials, receive mail, and perhaps receive phone calls. What do you need to know?
Dos
If you have an MA or Part D plan, you have received a packet of information of coverage for 2019. These plans can change yearly, so do review your plan’s annual renewal information carefully. Some people may receive a letter from their MA or Part D company discontinuing their plan for 2019. If this happens to you, you will need to take some action or you will be put back into original Medicare by default. On the other hand, this letter will guarantee that you can move to a plan with any insurance company in the state — do keep this letter, do not throw it away.
After you review 2019 information, if you have an MA Plan, do review your benefits. They may have changed. Also, confirm your providers are still in the network of covered providers. If drugs are covered under your plan, do make sure your drugs are covered; look for any restrictions (i.e.: quantity limits, step therapy, and prior authorization). Especially look at your at the 2019 co-pays. Do contact your agent or insurance company if you have questions.
Don’ts
Don’t Make changes in your plans when you have not done research. Just because a friend or sibling has a certain company or plan, it does not mean that you should have the same company or plan. Don’t take incoming phone calls from people selling Medicare Plans. First, if they are not currently doing business with you and if they are calling about MAs or Part D plans — their call may be illegal.
Don’t give out personal information by phone. If someone is calling you and you do not know them, protect yourself. Don’t give them your Medicare number. Don’t provide them specifics like your date of birth or even your health issues. And don’t accept feeling pressured. Don’t buy a plan without seeing (in writing) that your providers or drugs are covered. In addition, don’t give an insurance company a check at time of enrollment/application. MA and Part D plans require the consumer to be billed and they should not accept any checks upon application (exception is a void check for electronic withdrawals). However, Medicare Supplements (also called Gap-fillers) may accept the first payment. Medicare Supplements are insurance plans to cover the gaps in Original Medicare. In which case make the check payable to the insurance company.
More dos
Protect your Medicare number. New Medicare ID Cards are coming. However, the old cards usually have you or your spouse’s social security number followed by a letter. In this writer’s opinion, do work with local insurance agents. They know the local environment and should be available, even in person, when you need them. An insurance company and agents from other parts of the country are not familiar with the local medical systems. Local agents can be researched through a local professional organization named Central IL Health Underwriters (www.CIAHU.org).
In addition, more dos
As a general practice, be an advocate for yourself. Usually, there is nothing “free.” Ask questions and understand why one insurance product may cost substantially less than another. Keep track of your medical appointment dates and bills. If something does not appear correct, call the provider. Watch your insurance explanations of benefits; match them up with your bills. If something does not look right, call your provider, Medicare, or insurance company. Medicare has a hotline: 1-800-633-4227.
Also, you can use the following resources: Medicare at www.medicare.gov and our website at www.MRMS-INC.com, for various issues including information on Medicare and Medicare plans. Most impotently, help mom with her AEP. As always, feel free to contact our office if you have questions at 309-285-8088.
For more information, contact Living By Your Design, Inc., focusing on the issues of the elderly: legal, financial, and free guidance for residential placement and healthcare issues. Call: 309-285-8088. Web: www.LivingByYourDesignInc.com. Location: 809 W. Detweiller Dr., Peoria.