Did you recently enroll in Medicare for the first time? Did you change your Medicare coverage during the Medicare Annual Enrollment Period last fall? Or, did your plan provider make changes to the benefits on your plan? No matter which situation applies to you, understanding your Medicare coverage is important for getting the most of your health care benefits.
Below are tips for how to help you better understand your Medicare plan and make the most of your benefits this year.
If You Enrolled in Medicare for the First Time
When you first enroll in Medicare it can take some time to learn all the ins and outs of your coverage. You may have chosen a Medicare Advantage (Part C) plan or opted to go with Original Medicare (Parts A & B). You may also have added a Part D prescription drug plan.
Medicare Advantage: Tips to help you understand your new coverage:
Review and learn how your plan covers hospital and medical items from Medicare Parts A & B.
Look at the list of prescription drugs covered by your plan and be sure your drugs are covered. You also will want to review how the costs change with different tiers and in the various Part D coverage stages to help estimate your financial needs for the year.
Review the unique benefits offered by your plan such as coverage for vision, dental, hearing, fitness, a 24/7 nursing hotline and more.
Look at the plan’s network to understand which areas and providers are covered by your plan.
Review how your costs may change if you get out-of-network care or from a provider not included in your plan.
Use any available online learning tools to help understand your plan better and reach out to your plan’s provider if you have any questions.
Medicare Part D and/or Medicare Supplement: Tips to help you understand your coverage:
Review how Medicare Part A (hospital) and Part B (medical) may cover certain drugs and in which specific situations.
Look at how costs work with both Parts A & B. If you have a Medigap plan, understand how your Medigap plan may help in covering some of the out-of-pocket costs of Parts A & B.
Review your Part D plan’s formulary and make sure all the drugs you need are listed, which brands are and aren’t offered, as well as the tiers and costs of each.
If you have questions about your Part A and/or Part B coverage, or about how a specific item is covered, you can contact Medicare directly at 1-800-633-4227 or you can also search online at www.medicare.gov.
If you have questions about your Part D plan, contact your plan provider directly.
If Your Medicare Coverage Changed
There are three ways your Medicare coverage may have changed during the previous year.
Your former Medicare Advantage or Part D plan was ended by your provider and you had to enroll in a new plan.
Your plan provider made changes to your Medicare Advantage or Part D plan that took effect January 1st.
You left your former Medicare plan and enrolled in a new Medicare Advantage or Part D plan during the Medicare Annual Enrollment Period.
If you enrolled in a new plan during Annual Enrollment last fall because your plan was discontinued or you decided to switch to a different Medicare plan, be sure to review the new plan’s benefits, costs and if it has a network or not. Use the tips above for “If You Enrolled In a New Plan” to help understand your plan better.
If last year you already had a Medicare Advantage or Part D prescription drug plan, your plan provider may have made some changes. Any changes your plan provider made go into effect January 1st. It’s important to review these changes more closely again to make sure you understand how your plan works, which benefits you have and to help you plan financially for the year.
Understanding the health care coverage your Medicare plan offers and how your plan works is important. Take advantage of available online resources to learn more and manage your plan. Doing so will help you stay organized and make healthy choices through the year.
Learn More About Coverage for Your Prescriptions, Providers, and Other Benefits