Of the 60 million Medicare beneficiaries, 22.4 million are expected to enroll in Medicare Advantage Plans in 2020. If you are already on Medicare, you are probably breathing a sigh of relief. But even if your coverage worked well in 2019, the specifics of your plan might be changing, or there may be better options in 2020.
When reviewing your plan, be sure to look beyond premiums and instead consider your total out-of-pocket spending, no matter how you get your coverage.
Over the years, we have seen a few Medicare mistakes that we'd like to help you avoid:
Pitfall # 1 Failure to Pay Your Part B Premium
More and more people are working past age 65. Because of this, some may delay their Social Security income benefits because they are still receiving some type of consistent income. If Medicare is unable to deduct your Part B premiums from your Social Security check, they will instead send you a quarterly invoice.
It is easy to overlook a bill from Social Security because Medicare beneficiaries get a lot of mail from insurance companies. If Social Security revokes your Part B for non-payment, they will notify your Medigap carrier. Once your carrier is notified, your Medigap plan will be canceled. This will leave you without coverage for outpatient services (including doctor visits, lab-work, surgeries, chemotherapy, dialysis, as well as medical equipment, and other expensive services). What's worse is that you will have to wait until the next General Enrollment Period (GEP) to enroll.
Each year, The GEP runs from January 1 – March 31. Though you will be able to enroll during this period, your coverage will not start until the following July. A severe illness or injury during this uncovered time could result in thousands of dollars of unpaid medical expenses.
How to avoid this pitfall:
If you are already enrolled in Medicare Part B, before you begin taking Social Security, call them at 1-800-772-1213. You can ask them to set up a bank draft to avoid missing that crucial payment.
Pitfall # 2: You Leave Employment Without Notifying Medicare
When you reach 65 and decide to leave your employment, your former employer should notify Medicare that you are no longer employed. Once Medicare becomes aware that it is now your primary insurance, it will begin to pay as your primary insurance. If your employer fails to notify Medicare, your claims will be denied because Medicare expects the bills to go to your employer's insurance first.
How to avoid this pitfall:
A quick call to Medicare at 1-800-MEDICARE after you leave your employer to confirm that Medicare is your primary insurance can prevent denials and hassles.
Pitfall # 3 You Pay Your Part B Deductible Too Soon
The Medicare Part B deductible in 2020 is $198 (this will increase annually). Two of the most popular Medigap plans are Plan G and Plan N. In both plans, you will agree to pay the annual Part B deductible.
The proper procedure is for you to go to your doctor's visit, then let your doctor send the bill to Medicare. Medicare will pay your provider all but the deductible. Your doctor can then bill you for the $198 due.
Your doctor does not need to collect the deductible from you at the time of service. If you pay your provider, the deductible portion, it will only complicate matters. Here is an example: Let's say you went to the doctor and also went for lab work on the same day. When Medicare receives the bill from your lab facility and your doctor's office, it will apply the deductible to the first one received. So Medicare might pay 100% of your doctor's office bill, leaving you responsible for the full $ 198 lab bill. Your doctor's office, on the other hand, will be paid your $198 plus get paid by Medicare.
How to avoid this pitfall:
Tell your doctor to bill you, and when Medicare has paid the claim and sent you a notice, you will pay the balance.
Pitfall # 4 You Avoid Preventive Care
Medicare has numerous preventive care benefits. All of these are fully covered, and Medicare pays 100% of the claim. Preventative benefits include screenings for cardiovascular disease, diabetes, and aneurysms. It also includes cancer screenings such as colonoscopy, mammograms, and tests for lung cancer. In addition, vaccines, an annual wellness visit, bone mass measurements are covered. A full list of preventative benefits is on Medicare's website.
Keep in mind also that while some screenings are covered, related services may not be. We see this all the time on Medicare Advantage plans, where a colonoscopy might be covered, but the anesthesiologists' services during that exam may not be.
How to avoid this pitfall:
Continue to see your primary care doctor for your preventive care. If you seek out additional preventive/wellness care from another medical provider, confirm what you will owe as a co-pay, before your appointment.
Pitfall # 5 You Neglect to Review Your ANOC
The annual Medicare election period, also known as the open enrollment period, runs from October 15 – December 7. During this time, you can make changes to your Part D drug plan or your Medicare Advantage plan.
Because the benefits in the Medicare plans change from year-to-year, this open enrollment period is extremely important. Each September, you will receive an Annual Notice of Change (ANOC) that will list any changes to your plan. You should review this letter thoroughly.
How to avoid this pitfall:
To say cost-effective, review your ANOC letter annually. Since Part D plans and Medicare Advantage plans lock you in for a calendar year, you should stay abreast of any changes by setting an annual reminder on your calendar each September. Upon receipt of your letter, make an appointment to review your ANOC letter with your insurance agent. If you see a significant premium increase or the change in price for one of your vital prescriptions, you can use the Medicare Plan Finder to easily plugin your medications and shop for the best plan in your zip code.
While Medicare mistakes can happen, you can avoid the most common problems. Remember, even the most prepared person can miss a deadline or have a problem with a claim. It's in your best interest to work with an insurance agent who knows Medicare.
At Apron Agencies, we offer you a full team of accessible agents who are here to work with you and answer all of your questions. Call to schedule an appointment today at (504) 834-9280.
