There’s only a week left: Medicare enrollment runs through Dec. 7.
Here are seven mistakes for your clients to avoid during enrollment, according to PlanPrescriber, a subsidiary of eHealth.
1. Overlooking prescription drug coverage and changes in those benefits.
Medicare Supplement plans (also called Medigap) don’t include prescription drug coverage. If your client gets coverage through a separate Part D plan, he or she needs to know that most plans change their pricing and benefits each year. You can use an online tool to see whether and how your prescriptions drugs will be covered in 2013. According to a study by PlanPrescriber.com, the average person could have saved $654 in 2012 by changing their coverage to a plan that covered their drugs at the lowest possible cost.
2. Picking the drug plan with the lowest monthly premium.
All drug plans are not created equal. While the average prescription drug plan covers about 70 percent of all Medicare-approved drugs, some plans cover as few as 49 percent, according to the PlanPrescriber.com study. That’s why it’s important to look beyond the monthly premium and see if the plan covers the drugs your client takes.
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3. Forgoing vision or dental care.
Original Medicare may pay for certain vision and dental services in an emergency, but routine care and check-ups are not covered. Historically, Medicare Supplement plans haven’t offered this coverage either, but a few supplement plans in select states have begun to include benefits like dental insurance. Your client also has the option to purchase separate “stand-alone” insurance policies for dental and vision coverage.
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4. Believing supplement plans cover everything.
Medicare Supplement plans are sold by private insurance companies and are designed to fill in some of the gaps not covered by original Medicare. Supplement plans cover some copays, coinsurance and deductibles. However, they don’t cover everything. With a few exceptions, if it’s not a benefit covered by Medicare, your client’s supplement won’t cover the copay for it either.
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5. Ignoring long-term care needs.
According to an Opinion Research survey sponsored by PlanPrescriber.com, paying for long-term care is a top concern for baby boomers. Original Medicare will only pay for care in a skilled nursing facility for up to 100 days, and beneficiaries typically have to pay for a portion of those costs out-of-pocket. And, in most cases, Medigap plans will only cover out-of-pocket costs for services that are also covered by Medicare. So, once Medicare stops paying, your client’s Medigap plan will stop filling in the gaps. But, long-term care insurance is available to help fill in the gaps.
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6. Assuming you’re stuck in Medigap.
When it comes to Medicare coverage, Medigap plans can include some of the most comprehensive benefits. The monthly premiums tend to be higher than Medicare Advantage, but they include fewer out-of-pocket costs. However, rates tend to increase as a person ages. If your client wants to try a Medicare Advantage plan, he or she is allowed to do so for about a year, and can then switch back to the Medigap plan if desired.
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7. Taking a trip without knowing what’s covered.
Medigap makes it easy for your client to travel around the country without worrying about coverage. But, Medicare will not pay medical claims outside the United States and its territories. Some Medigap plans extend emergency coverage outside of the United States, but not all of them. For this reason, it’s a good idea for your client to investigate travel insurance before taking an international trip.
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For more Medicare coverage, see: