Now that Medicare’s Annual Enrollment Period has ended and you have chosen a plan for 2025, here are five things you should do to help you make the most of your benefits.
1. Check Your New ID Card
If you enrolled in a new plan, you should receive a new ID card for 2025. Check your card and make sure it accurately reflects the plan you enrolled in. You will need to give your new card to your doctors and pharmacy in January to ensure your 2025 claims process correctly. If you do not receive your new card by the end of December, call your insurer’s customer service department so they can assist you with getting a new card. If you enrolled through a Medicare agent or broker, they can verify your enrollment and check on the status of your ID card.
2. Understand Your Benefits
In order to maximize your benefits, it’s necessary to take a little time to fully understand what your plan covers, what it does not cover, and what you will have to pay. You should know if you have a deductible, as well as what the copays or coinsurances are for the different services you receive. Knowing how your benefits work will help you avoid surprises and unnecessary expenses.
If you have a Medicare Advantage plan you must use the doctors, hospitals, and pharmacies in your plan’s network otherwise your insurer will not cover your care. If you have out of network benefits you can see providers outside the network, but it will cost you more. You may also be required to obtain preauthorization for some medical services and prescription drugs. Your doctor should assist you in obtaining preauthorization and if you are denied a services or medication, your doctor can help you file an appeal with your insurer.
3. Set Up an Online Account
If you set up an online account with your insurer you will have access to information about your benefits and claims, as well as self-service tools. Online features vary by insurer, but most will include access to:
- An overview of your plan’s benefits
- Claims received and processed
- Your year to date out of pocket expenses
- The provider search tool
- The drug formulary
- The ability to order new ID cards
- The option to set up automatic payments for your monthly premium
- A chat or message feature with customer service agents
You can always call customer service for assistance but setting up an online account gives you access to your information 24/7 and allows you to be more informed and proactive in managing your healthcare.
4. Take Advantage of Free Preventive Services and Screenings
Medicare covers many preventive services and screenings that are designed to help keep you healthy and they are covered in full.
Preventive services include:
- Your annual wellness visit where your doctor will assess your health risks through routine measures such as blood pressure, weight, and bloodwork
- Flu, pneumonia, and Covid vaccines
Preventive screenings can help detect and diagnose more serious diseases early on, allowing for better medical outcomes. These include:
- Screening for diseases such as diabetes, glaucoma, Hepatitis C, heart disease and cancers such as breast, cervical, colon and prostate cancers.
- Nutrition therapy for those with qualifying health conditions such as diabetes and kidney disease
- Screening for depression
- Counseling sessions to help you quit smoking
- Alcohol misuse screening
5. Use Your Supplemental Benefits
If you have a Medicare Advantage plan, your plan may offer additional benefits such as dental, vision and hearing coverage. Check to see if you are required to use in network providers for these services, as well as what your benefit covers. Your plan may also include wellness benefits such as a gym membership, massage, or chiropractic treatment, and more. All of these benefits are offered to improve your well-being and help keep you healthy. Benefits will vary by plan and insurer.
If you have questions and concerns during the year, your Medicare agent can help. If your circumstances have changed suddenly or the plan you chose does not provide the coverage you expected, your agent can help you determine if you qualify for another Medicare Enrollment Period that will allow you to change plans.
The team at Healthcare Educators is here to help. Contact us today.