Signing up for Medicare can be such a challenge that it’s understandable if you thought the battle was over once you received your Medicare card. In reality, it’s easy to make costly mistakes while using the program. In this post, we look at seven common Medicare mistakes and explain how you can avoid them.
1. Notify Medicare if You Leave Employer Coverage
Although Medicare is often associated with retirement, the reality is that many beneficiaries continue working after the age of 65. Or, you may have a health insurance policy through your spouse’s employer. In either case, you may have primary insurance through an employer, with Medicare as your secondary provider.
When coverage through an employer ends, the employer’s representative is supposed to notify Medicare. And usually, this is exactly what happens. Of course, employer representatives are only human, and humans sometimes make mistakes. Unfortunately, this mistake can cost you time and money.
If your employer forgets this step, Medicare doesn’t know it is now your primary insurance. This leads to denied claims, since Medicare still thinks invoices should go to your former insurance carrier first.
Avoid this confusion by calling 1-800-MEDICARE as soon as there’s a change to employment status. Even if you keep that insurance as part of retirement, Medicare becomes the primary insurer as soon as you are no longer ACTIVELY employed. In certain situations, failure to notify Medicare could result in penalties as well as denied claims.
2. Pay Your Part B Deductible After Medicare Processes Your Claim
Medicare Part B has a yearly deductible. Even though the proper procedure is for your doctor’s office to bill Medicare and then bill you for any amount Medicare doesn’t pay, providers often ask for the deductible before they treat you.
The reason for this procedure is simple: Medicare may not apply your yearly deductible to that doctor visit. What if you also have lab work that day? Medicare may apply your deductible to the bill from the lab instead of the one from your doctor. That leaves you with the task of trying to get your deductible back from your doctor.
If your doctor’s office asks you for the deductible, ask them to follow the procedure and bill you once Medicare has paid the claim.
3. Pay Your Part B Premium on Time
Changes to Social Security have many people enrolling in Medicare before they receive their Social Security benefits. That means that, instead of having their Part B premium come directly from their Social Security check, they receive a quarterly bill. If you fail to pay your premium, Social Security revokes your Part B coverage.
If you have a Medigap or Medicare Advantage plan, these will also be revoked. The only coverage remaining will be Part A (assuming you receive premium-free Part A).
You’ll have no coverage for outpatient services, such as doctor visits and lab work. And you won’t be able to enroll again until the Open Enrollment Period (OEP), from January 1 through March 31. What’s more, that coverage doesn’t begin until July 1. In the meantime, you’ve gone months without healthcare insurance, potentially racking up thousands of dollars in medical expenses.
Social Security allows you to set up automatic payment via a bank draft. This is a simple way to ensure your Part B premiums are paid on time.
4. Present the Correct Card
Most Medicare beneficiaries have more than one card. In addition to your red, white, and blue Medicare card, you may also have a Part D card, Medigap, and/or Medicare Advantage (MA) card. If you present the wrong card at the time of service, though, your claim will be denied, leaving you responsible for payment.
If you have a Medicare Advantage plan, the easiest way to guard against this is to store your Medicare card in a safe place. Carry only your MA and Part D cards in your wallet. That way, you never present the wrong card at the point of service.
For Part D, just remember that it is only for prescriptions supplied by a pharmacist.
5. Review Your Annual Notice of Change
If you have a Medicare plan besides Original Medicare, it sends you the Annual Notice of Change (ANOC) every year, typically in September. The intent is to help you prepare for Annual Enrollment (October 15 through December 7).
We’ve talked about the importance of reviewing the ANOC before and we will again. This is one of the most important documents your plan sends you every year. Unfortunately, it comes at a time when Medicare and private health insurance companies inundate you with mail. We write about the ANOC repeatedly because it so often gets lost in this pile of unsolicited mail.
The ANOC details any changes scheduled for your plan in the coming year. If you accidentally throw it out without reviewing it, you may miss important changes. For example, drug formularies nearly always change at least a little, adding and dropping medications. If one of those changes includes your prescriptions, that’s information you need to know before your Part D auto-renews in January.
Avoid this mistake by marking your calendar to set aside time to review your ANOC packet.
6. See Your Primary Care Physician for Preventive Services and Screenings
Medicare covers a wide array of preventive services and screenings under your Part B benefits. (Find the full list here.)
Coverage does include some limitations, though. Namely, your primary doctor must provide the services. This ensures correct coding is used.
Also, understand that services related to the covered screening may not be included, such as anesthesiologist charges for a colonoscopy. Talk to your provider about what’s covered. And, if you undergo a screening through any other provider, know that you bear sole responsibility for the cost.
7. Not Working with a Licensed Agent
Medicare is a confusing program. One of the easiest ways to avoid many of the more common Medicare mistakes, and compare your plan options, is to work with a licensed agent. The team at Medicare Solutions is only a toll-free phone call away. Call 855-350-8101 to get started.
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