Medicare Housekeeping Time!

A good practice to get into at the beginning of each year is to take a little time and do some annual Medicare housekeeping.  The following tips are also helpful if you have recently turned 65 or retired and you’re in first year on Medicare.

 1.  Schedule Your Check-up

Whether you have Original Medicare, Original Medicare with the addition of a Medicare Supplement or a Medicare Advantage plan, you are offered a yearly wellness exam.   Don’t forget to schedule this!  The earlier in the year, the better!  This is not only important for your general health but will also help make your overall healthcare run more smoothly.  If you happen to have a Medicare Advantage plan that requires referrals for specialist visits, you might be able to get any anticipated referrals taken care of at this initial appointment with your primary care provider.  For instance, if you know you need to see your cardiologist at least two times a year get those referrals while you’re already in your PCP’s office.   You can also find out what preventative care services and screenings you should take advantage of this year.  Medicare covers the following screenings along with many others – prostate cancer, colorectal cancer, mammograms, depression, diabetes – the list goes on.   Getting into the habit of scheduling these Medicare housekeeping “peace of mind” tests at the beginning of the year will make sure that it doesn’t slip your mind.

Complete list of screenings can be found by clicking here.

2.  Authorization Form

If you are brand new to Medicare or have never taken care of this in the past, you might want to consider filling out an Authorization Form to allow family or friends to call Medicare on your behalf.  You must give prior permission in writing for someone to be given access to your personal health information.   You can “revoke” permission or change the individual listed as authorized at a later date if you’d like.  It’s just important to make sure you take care of this before it’s needed.  Find the authorization form by clicking here.

3.  MyMedicare.gov

A convenient tool for those enrolled in Original Medicare or Original Medicare plus a supplement is MyMedicare.gov.  By signing up, you will be given access to a convenient, online service that puts your personal Medicare information at your fingertips anytime day or night.   After you sign up at Medicare.gov you can begin using the site’s services by completing an “Initial Enrollment Questionnaire” that will ensure your bills are processed correctly with Medicare.  With the click of their “Blue Button” you can easily download and save your health information and files to your computer, tablet or mobile device or print off an “On the Go” report to take with you to doctor appointments.   A few other things the site conveniently keeps track of is your Part B deductible status and a record of preventative services available to you.

4.  New ID cards

Recent enrollment in a Medicare Advantage plan, Supplement or PDP also means that you will have new cards arriving in the mail.  Make sure you remember to take these along on your first visit to your PCP and to any visit with a new doctor.  Your doctor’s office will want copies of the cards on file and this will ensure there is no confusion when it comes to billing.

5.  Prescription Medications

At the beginning of the year, try to get your medication prescriptions filled early.  Getting this taken care of early will make sure that you are made aware of any formulary changes in your plan.  You should receive a notification of changes in your insurance company’s drug list if it affects you, but in case you missed it or it hasn’t made it to your mailbox yet you will at least be aware of the situation before it becomes a problem.

The Takeaway:

There are a few Medicare housekeeping items to tick off every year you’re on Medicare to ensure smooth sailing.  Hopefully addressing these issues when you first sign up for Medicare will help eliminate any bumps you might run into down the road, but if you haven’t done all of these yet, making it a practice to do some of these things every year will keep things running smoothly.

Medicare Advantage Disenrollment Period: Having Second Thoughts?

January 1 through February 14 is the annual Medicare Advantage Disenrollment Period, also known as the MADP.  This time of the year is strictly for folks who have a Medicare Advantage Plan (MAPD) and wish to drop it and revert back to Original Medicare.

If you’re like most people and you’re satisfied with your Medicare Advantage plan and all is well in the world.   By now, you should have received your ID cards in the mail and probably filled some prescriptions and all is well.  But…

If all is NOT well, or if  you’ve had some unexpected changes to either your health or your healthcare providers, this time during the year may become more important to you.  As an example, let’s say you just opened your mail and opened a letter from your beloved that your primary care physician is moving out of the plan’s network.  Could be one of your necessary prescriptions disappeared from your plan’s formulary.  If you want to go back to Original Medicare at this point (A and B) you can, and you also have to enroll in a stand-alone Medicare PDP plan, too.

Essentially, for whatever reason you choose, if you have an MAPD plan, during this timeframe you can drop it, no questions asked.  Any other time during the year you generally have to keep it.  The same time period does NOT apply to those already on Original Medicare, or those with Medicare Supplements.

To enact your rights during the Medicare Advantage Disenrollment Period, you can contact your current plan or get in touch with the folks at Medicare by calling 1-800-MEDICARE.  Your disenrollment will occur as of the first day of the month following its acceptance and at that time you will be back on Original Medicare only.  Again, you will want to pick up a PDP plan so you have prescription drug coverage and might also want to consider picking up a Supplement, also referred to as Medigap.  Check Medicare.gov to see which companies offer Supplements in your area.  Each company offers the same Supplements as their benefits are dictated by the state but each private insurance company prices the product differently.  You can compare all the plans prices at Medicare.gov.

Before you go dropping your Medicare Advantage plan , it’s important to remember you are absolutely not guaranteed enrollment in most Medicare Supplement policies unless it’s during your 6 month Open Enrollment Period that takes place when you turn 65 and/or when you enroll in Medicare Part B, whichever happens last. During this time, you have guaranteed acceptance and the insurance company cannot turn you down based on preexisting conditions and they also cannot make you wait for any treatment that was prescribed prior to your enrollment.  Which means if you’re not in your OEP that there is the possibility that you won’t be able to medically qualify for a Supplement.  If this happens, you’ll l remain on Original Medicare.   only until the fall when the next AEP rolls around.  Make sure that this is an acceptable outcome to you prior to dis-enrolling from your current plan.

The Takeaway:

Medicare Advantage Disenrollment Period can be a benefit to exercise if you’re dissatisfied with your current MAPD plan.  It can allow you to leave a plan that is not a good fit for you.  Just make sure you’re aware of the implications of doing so and are content with the benefits offered by Original Medicare.  Also be sure to pick up that Prescription Drug Plan if you don’t want to pay a late enrollment penalty down the road.