Shop smart for your Medicare plan

People with Medicare have several choices on how to manage their benefits. Some of the most common are:

• You can join a Medicare Advantage plan. These plans cover everything Medicare Parts A and B cover, and often cover Part D prescriptions as well as other benefits. If you enroll in a Medicare Advantage plan, you still have all of your Medicare benefits, but your benefits are paid through that plan. This is now the fastest growing Medicare option in America.
• You can use Original Medicare plus a Prescription Drug Plan. Your hospital and doctor claims are filed directly with Medicare, and you have a separate policy for your Part D prescriptions.
• You can use Original Medicare plus a supplement. Your claims are filed directly with Medicare, and you have a separate policy to pay for things not covered by Medicare.

Medicare has a lot of rules about when you can join or change plans, and what sales methods are acceptable. Most people with Medicare Advantage plans can only change their plan one time between January 1 and March 31, so an important deadline is coming soon. Some rules are different depending on the type of plan, but here’s some tips to consider when you’re choosing a Medicare Advantage plan. We hope they will help you find a plan that’s ethical, honest, and dependable, and keeps your best interests at heart.

Before you enroll

• Call your doctors to see if they accept the plan you’re considering, regardless of whether or not you see their names listed in the provider directory. Your doctors may have recently joined or left that plan, so it’s worth the effort to double check with them directly.
• Check what hospitals are part of the plan’s network. All Medicare Advantage plans cover emergency care anywhere in the United States (and many cover emergencies anywhere in the world), but if you need non-emergency hospital care, it may only be covered at a network hospital.
• Medicare Advantage plans are not allowed to charge you a fee to enroll. Plans may have a premium you have to pay each month, but never an enrollment fee.
• Agents or other representatives may not show up uninvited at your home — Medicare does not allow door-to-door sales, and agents may not come to your home unless you’ve asked them to.
• Sales agents may call you to tell you about their plans, but they may not ask for your Medicare ID, bank account, or credit card numbers, or enroll you over the phone. Agents may not call you if you’re listed in the federal Do Not Call Registry. (Call 1-888-382-1222 or visit www.DoNotCall.gov for more information about the registry.) If you want to enroll over the phone and know what plan you want, you can do it by calling Medicare directly — but you must make the call.
• Always safeguard your Medicare number (which is usually the same as your Social Security Number) as closely as you would your credit card or bank account numbers, or other personal information.
• When you join a plan, they are not allowed to ask you for payment over the phone, through a web site, or by e-mail. You may be able to enroll online, but if your plan has a premium, they must mail you a paper bill or a coupon book you can use to make your payments each month. They may also give you a form to fill out if you want to set up your bank account or credit card to automatically pay your premium each month.
• Be cautious if you cannot get current copies of all plan information before you enroll (Summary of Benefits, Provider Directory, and Formulary/drug list) or someone asks you to sign something before they can give you plan information. Medicare requires companies to provide you with all of these documents before you enroll, and you don’t have to sign anything just to get information. Medicare also requires all plans to have this information readily available, and there are several ways you should be able to get it — attend a public sales meeting or visit the plan’s office, or call the plan and ask them to mail it to you. Plans are also required to have all of this information posted on their web site.
• Read very carefully before you sign anything. If you don’t understand the form, ask a trusted friend or family member for help. Also, ask to get a copy of anything you sign.
• You can verify a Medicare provider, representative, drug plan or health plan is legitimate by calling Health Integrity, toll-free at (877) 772-3379. Medicare has contracted with Health Integrity to help prevent and detect fraud, waste, and abuse.

For more information

• Call Medicare toll-free at 1-800-MEDICARE (1-800-633-4227). They are available 24 hours a day, 7 days a week.
• To report suspicious activity, call the Federal Trade Commission Theft Hotline toll-free at 1-877-438-4338.
• Call Lynne Meagher at the local SHINE (Serving the Health Information Needs of Elders) office at (321) 752-8080.

  Learn more about Health First Medicare Plans

2/27/2008