Now that the Medicare AEP is over, are there any year-end items I need to take care of for my Medicare benefits and Medicare insurance? Does Medicare allow for a fourth-quarter carryover provision?
That gives you a nice three-week period to wrap up the year with a little Medicare housekeeping.
Here’s how I’d use the time before the end of the year.
All Medicare Benefits Reboot on January 1
Whether you’re on a Medicare Advantage plan, “Bare-with-Medicare” Original A and B with or without a Medicare Supplement, all Medicare benefits – deductibles, copays, coinsurance, annual Maximum-Out-Of-Pocket (MOOP) totals start over at the beginning of the year.
That means it’s important to time your doctor’s appointments, surgeries or outpatient procedures and if possible, get them done before December 31. Don’t forget, your Medicare Part D Prescription Drug benefits start over, too. Be sure to fill your prescriptions before the end of the year, if you can. This applies to stand-alone Medicare Part D Drug Plan cards or Part D benefits embedded within a Medicare Advantage plan.
No Fourth Quarter Carryover
If you have or previously had health insurance through a plan provided by an employer, you may have enjoyed a feature called a “carryover provision.” A carryover provision is a nice feature to have, as it applies any amount paid in the fourth quarter of a year (October 1-December 31) toward your MOOP and oftentimes, your deductible. The provision “credits” your expenses towards meeting the deductible or the MOOP for the next year.
If you liked that feature on your employer-based health insurance plan, I have bad news. There is no fourth quarter “carryover” feature like some employer-based health insurance plans have. So, if you were used to getting credit for this, it’s not a “thing” in Medicare-land.
Hypothetically, you could pay a Medicare deductible on December 31 and then pay it again on January 1. So if you have a high-cost medical procedure or specialist visits to make, I’d do them before January 1, if possible, especially if you’ve already reached your MOOP or paid your deductible(s) for the year.
New Medicare ID Cards
If you switched Medicare Advantage or Medicare Part D Prescription Drug Plans during the AEP, be on the lookout for your new ID cards arriving in the mail.
Make sure you remember to take these new ID cards along on your first visit to your primary care physician and any visit with a new doctor. Your doctor’s office will want copies of the cards on file. This will ensure that there is no confusion when it comes to billing. You’ll also want to make sure your pharmacy has the new ID cards on file.
Due to US Post Office cost-cutting measures, mail delivery has significantly slowed down. That means the “normal” ten (or so) days it takes to get your new Medicare Advantage or Part D Prescription Drug Plan ID cards might stretch to two weeks or more.
If January 1 arrives and you still don’t have your ID cards, call the Medicare insurance company customer service phone number and ask them to verbally tell you what your ID number is, and any other pertinent information you’ll need if you have a doctor’s appointment or have to fill a prescription before the actual ID card arrives. Remember, the best time to call any insurance company or agency is in the middle of the week, either early in the morning or after 4:00 p.m. That’s because people generally get their mail between noon and 3:00 p.m. and then immediately pick up the phone to call. Avoid calling on Mondays—hold times on Mondays are the longest of any day of the week.
Virginia, I hope that helps! Happy Holidays!
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To your wealth, wisdom, and wellness!
Author Bio: Matt Feret is the author of the Prepare for Medicare book series and launched prepareformedicare.com to help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development and strategy for over 20 years. Matt holds a BA from Virginia Tech and an MHA from Washington University in St. Louis.