Enjoy and consider following some of the sage advice during the Medicare open enrollment.
By Guest Blogger, Ross Blair From Plan Subscriber
1. Missing the Fine print: not reading the fine print in your annual plan Notice of Change about which benefits have changed and which have remained for your plan.
2. Going on Auto-pilot: not doing anything and simply auto-enrolling in the same plan. Many plans change cost and drug coverage annually. What worked last year for you may not work with the same plan this year and could cost you money in terms of higher prescription drug costs and other out-of-pocket expenses. Changes in medication usage can also change what plan offers you the best economic value.
3. Stable premiums = stable coverage: just because your Medicare Advantage or Part D premium hasn’t gone up doesn’t mean that you are getting the same plan for the same price next year. Deductibles, co-pays, and prescription drug coverage are just a few of the benefits that may have changed. Research and find out what the total out-of-pocket cost will be for this plan.
4. Not asking for help: not asking for help from qualified professionals in understanding and selecting a plan or using tools to evaluate prescriptions. You can get help through your State Health Insurance Assistance Program (SHIP), PlanPrescriber, licensed health insurance agents who are certified to sell Medicare, family members or by calling 1-800-Medicare.
5. Not getting a second opinion: by not shopping around and seeing what other plans are out there, you may be costing yourself more money in 2011. This is an important decision, so take the time you need to make the right choice and understand all of the options available in your area.
6. Extended care: don’t assume nursing home care is a covered benefit; it is not. Medicare does not provide coverage for custodial care, assisted living facilities or long term care. However, skilled nursing facilities may be covered following a related hospital stay.
7. My drugs are covered: don’t assume your doctor knows what is in your network or what prescriptions are in your formulary. You can enter your current medications on a website like www.PlanPrescriber.com to see which drugs are covered on your current plan and compare the projected costs with other plans available in your area. You can print out this comparison and take it with you to see the doctor. Make sure your doctor knows your in-network labs, physical therapists, or durable medical providers.
8. Medigap has me covered: don’t assume Medigap plans will pay claims that Medicare won’t. Medicare only pays for medically necessary claims. If Medicare doesn’t pay either because the service rendered is not ‘medically necessary” or a Medicare covered benefit, neither will the Medigap plan.
9. I’ll qualify: don’t assume you will automatically be accepted in a Medigap plan outside of Open Enrollment or Guaranteed issue qualifying events. Medical underwriting does occur.
10. I’m covered world-wide: don’t assume Medicare covers you when traveling outside of the United States. Medicare will not pay any medical claims outside the US and its territories. However, certain MediGap plans might extend emergency coverage outside of the U.S.
Source: PlanPrescriber, Inc. ( www.planprescriber.com )