On Medicare – Annual Enrollment Dos and Don’ts

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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 and perhaps receive phone calls.  What do you need to know?

DOs: If you have an MA or Part D plan you have probably received a packet of information of coverage for 2017.  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 2017. 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 any plan in the state – DO keep this letter, do not throw it away.

After you review 2017 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 2017 co-pays.  DO contact your agent or insurance company if you have questions.

DON’TS: Make non-researched changes in your plans. 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 – there 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 #.  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 pay an insurance agent.  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 or Gap-fillers may accept the first payment.  In which case make the check payable to the insurance company.

More DOs: Protect your Medicare #.  It is usually your 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 as resources: Medicare at www.medicare.gov and/our website at www.MRMS-INC.com for various issues including information on Medicare and Medicare Plans.   As always, feel free to contact our office if you have questions at 309-693-1060.

Written by

Steven A. Buttice is the president of Medical Reimbursement & Management Services, Inc., a firm specializing in issues affecting seniors, including seminars and consultation on Medicare Plans, Long Term Care and other types of insurance, claims issues, and sales/service of insurance products since 1984.

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