When you first enroll a Medicare, you’ll receive a “Welcome to Medicare” packet in the mail with your Medicare card.
If your Medicare card is lost, stolen, or damaged, you’ll need to request a replacement card immediately through Social Security. Be sure to request a new card quickly so that you don’t have to wait for coverage at your next doctor’s appointment.
Your doctor might be able to look up your Medicare number, but it will be easier and faster if you can present your card.
When you use the online service, you should receive your Medicare card in the mail within 30 days. It will be automatically shipped to the address on file with Social Security, so make sure the address in your account is correct.
1-877-772-5772 (TTY 1-312-751-4701, M-F, 9 AM to 3:30 PM)
Your local RRB office
What to do if you Lose Your Medicare Card
Have you lost or misplaced your Medicare card? A lost Medicare card can be very dangerous as it contains your social security number. Losing your Medicare card is similar to losing your social security card. That’s why starting this year, new Medicare cards will be slightly different. We’ll discuss that and show you a new Medicare card image in a bit.
If you need to order a new Medicare card because of a lost Medicare card or changed information (like if you change your name or address), your first step should be to contact Social Security and let them know. You can also print a copy of your Medicare card by signing into My.Medicare.gov (you may need to create an account). If you still have your old Medicare card or if you find your lost Medicare card, be sure to cut it up and throw it away so that no one can steal your information.
What is a Medicare Card
When you enroll in Medicare for the first time, you’ll receive a red, white, and blue Medicare card in the mail. If you are automatically enrolled in Medicare Part A, you will receive your plastic Medicare card about three months before your 65th birthday so that you will already have it when your plan becomes active.
Your plastic Medicare card proves that you have Medicare health insurance and will tell providers (doctors, pharmacists, hospitals, etc.) what type of coverage you have and what day your coverage begins. You should keep your plastic Medicare card with you at all times so that if you have to see a doctor for any reason, you can prove that you have Medicare coverage and avoid being overcharged.
New Medicare Cards 2018
In 2017, CMS (Centers for Medicare and Medicaid Services) decided to launch a new version of the red, white, and blue Medicare card. The big change is that instead of having your Social Security number plastered on your card, you’ll be assigned a Medicare number.
You should treat your “MBI” or Medicare beneficiary identifier number the same way you treat your Social Security number – don’t give it out unless you know it’s necessary and you trust the person you’re giving it to. However, it is much safer to carry a card with your Medicare number than your Social Security number!
Everyone should have received a new Medicare card by early 2019. The last batch was reportedly shipped in October 2018. If you never received one, be sure to contact Social Security right away (or ask your insurance agent for help).
The new plastic Medicare cards will not affect your benefits – it will only protect your security.
Unlike the old plastic Medicare card you may have, new Medicare cards will not be plastic. They will be made of paper to make it easier for providers to use and make copies. We recommend purchasing a cheap plastic cover for your Medicare card. You can buy a pack of card covers (like these) in bulk on Amazon or stop by your favorite local office supplies store, like Staples or Officemax.
If you have questions about your Medicare plan or these new Medicare cards, call your agent! If you don’t yet have an agent, call Senior Market Advisors at 1-844-431-1832.
Avoiding Medicare Card Scams
Scammers might try to get your Medicare number from you. Remember that Medicare will never call and ask you to verify your number – they already have that information. If someone calls you and asks for your Medicare number, and you weren’t expecting them to call, do not give it to them. The only people that should need your Medicare number are your doctors, your insurance agents, and your private health plan (if you have one).
Here are some tips for protecting your identity in regards to your new Medicare card:
A Medicare employee will never call and ask for your social security number or banking information. If someone does call you asking for that information, it may be a scam. Do NOT give out your social security number to someone who claims to be calling from Medicare unless you know you can trust the person on the line.
If someone asks you to pay for a Medicare card, it is a scam. Medicare cards are always free and you should receive one automatically when you enroll.
If someone tells you that your benefits will be revoked if you do not give information or money, it may be a scam. The only people that should ask you for money are your doctors or your plan’s billing department. Be sure to always know who you are talking to.
In fact, click through to our guide on Medicare scams to learn how to block unknown scam callers on your phone. Read about common scams to look out for so you can be as prepared as possible.
As of January 1, 2019, UHC no longer offers SilverSneakers® with Medicare Advantage plans in 11 states:
Along with Medicare Supplement (Medigap) plans in nine states:
Why Did UHC and SilverSneakers® Part Ways?
According to Sam Warner, who leads UHC’s Medicare Advantage product team, the company’s move away from SilverSneakers® is to “reach a broader portion of our membership” with a “wider variety of fitness resources.” Warner noted that “over 90 percent of policyholders who are eligible for SilverSneakers® “never step foot in a gym.”
Will UnitedHealthcare offer any fitness benefit in 2020?
Yes. Starting in 2020, UHC will offer new fitness benefits* with some plans. As plans can vary in every zip code, ask your licensed agent whether or not this benefit can apply to you!
Medicare beneficiaries with certain UHC Medigap plans may feature a fitness benefit that includes gym membership discounts and phone access to wellness coaches along with other health resources.
Medicare Advantage policyholders may be able to join a program called Renew Active™, which will replace SilverSneakers® in January 2020. The Renew Active™ benefit may include access to fitness centers, classes, and group activities along with tools to exercise your brain health.
*Always check with your doctor before starting any fitness program to make sure the program suits your individual needs.
How Does Renew Active™ Work?
The new Renew Active™ program includes a gym membership, an online “brain health program,” and access to local events. You can use the Renew Active™ website to find a facility close to you that participates in the program. Renew Active™ works with popular gym chains and local gyms. It may include some Planet Fitness locations, YMCAs, and more.
At no additional cost, Renew Active™ also comes with a personalized fitness plan. You’ll get an introductory one-on-one personal training session to set your initial goals and then you’ll be able to meet with your trainer at least yearly.
You’ll be able to work on strength, aquatic exercises, cardio, mind & body, and other specialty activities (like self-defense or Zumba®).
Renew Active™ can also coordinate with your Fitbit as well as your AARP® Staying Sharp program.
You can get Renew Active ™ if your UHC/AARP ™ Medicare plan supports it.
When Can I Enroll in a Medicare Advantage or Medicare Supplement Plan?
The Annual Enrollment Period (AEP) is from October 15 – December 7, which is the time of year many Medicare beneficiaries can enroll in new plans or make changes to existing ones.
Some members qualify for a Special Enrollment Period (SEP). Depending on your eligibility, you may have a lifelong SEP, which allows you to make one change per quarter for the first three quarters of the year — instead of only during AEP. Some people may only be eligible for a temporary SEP due to a life change, like moving to a new service area.
You can enroll in a Medicare Supplement plan at any time during the year as long as you meet the requirements for Original Medicare (Part A and Part B).
Note: Don’t wait too long to enroll in Original Medicare because once you’re out of your IEP you may require underwriting, because insurance carriers aren’t required to honor your “Guaranteed Issue Rights”.
Tennessee YMCA Locations Breaks Partnership With SilverSneakers ®
In related news, the Tennessee State Alliance of YMCAs decided to leave the SilverSneakers® network. The change is effective January 1, 2020.
The two organizations parting ways means that you must find different coverage if you want to continue exercising at Tennessee YMCA locations.
Tennessee YMCA locations still accept Silver & Fit®, and you may be able to use Renew Fit.
Other Supplemental Benefits With Medicare Advantage Plans
If you want a Medicare plan with a fitness benefit or any other supplemental benefit, one of our licensed agents may be able to help. Our agents are highly trained and they can help you sort through the plans available in your location. To set up a no-cost, no-obligation appointment, call 844-431-1832 or contact us here today!
This blog was originally published on October 1, 2019. The latest update was on November 26, 2019.
Good News: 2021 Medicare Advantage Plans Have Higher Ratings and Lower Premiums
It’s time to start making decisions for your healthcare coverage in 2021. The Annual Enrollment Period for Medicare beneficiaries is going on NOW and only lasts through December 7.
As you’re looking through your Medicare Advantage and Part D plan options for next year, you may notice that monthly premiums are shrinking and benefits are expanding!
CMS (The Centers for Medicare & Medicaid Services) released a statement earlier this fall that said the average monthly premium for a Medicare Advantage plan in 2021 will be the lowest it’s been in 14 years (since 2007!)
In fact, the average Medicare Advantage (MA) premium will see a decrease of 34.2% from 2017, while plan choice and benefits continue to expand. In some states like Alabama, Nevada, and Kentucky, the average premium decrease since 2017 will be closer to 50%.
Medicare Part D prescription drug plans (PDPs) will also have low premiums in 2021, with standard plans averaging around $30.50 a month. This marks a 12% decrease in PDP premiums since 2017.
Average star ratings increasing
The average star ratings for Medicare Advantage and prescription drug plans in 2021 are set to increase significantly. About 77% of Medicare Advantage enrollees will have a plan with 4 or more stars, and 98% of those in a standalone PDP plan will have a rating of more than 3.5 stars.
There will also be more plans with a 5-star rating than were available in 2020, including UnitedHealthcare, Cigna, and Anthem BCBS. Even the lowest-rated plans have improved to at least 2.5 stars.
CMS uses this Medicare star rating system for Medicare Advantage and Part D plans to determine whether or not a plan is doing its job, and whether or not it can stay on the market. Plans that consistently receive poor ratings (one or two stars) will eventually be removed from the market.
Plans are given a star rating between one and five, with one being “poor” and five being “excellent.”
Medicare Advantage plans are rated on the following factors:
How often members receive treatment for long-term conditions
Current member satisfaction
Plan performance in comparison to the previous year
Customer service quality
Part D plans are rated on the following:
Number of member issues with the plan
How many people left over one year
Patient safety while using prescriptions in the plan
Accuracy of pricing
Quality of care
Customer service quality
More and more Medicare Advantage and Part D plan carriers are entering the market every year, meaning there is more competition. More competition means that more plans are trying to be the most valuable to be able to compete. That’s why even though costs may be going down, plan ratings are still increasing.
If you plan on meeting with a licensed agent during this year’s Annual Enrollment Period, be sure to ask about four and five-star plans in your area!
Remind me: What is Medicare Advantage?
You can enroll in Medicare Advantage as an addition to your Original Medicare coverage. Since Medicare Advantage plans are owned and operated by private insurance companies and are not the same as the government Medicare program, the coverage is a bit different.
Medicare Advantage plans are able to cover things that Original Medicare is not, such as fitness programs, dental, vision, and prescription drugs.
Medicare Advantage plans might come with copayments, coinsurance, and deductibles, but the average premium for 2021 is expected to be $21/month.
If you can afford to add a Medicare Advantage premium, the benefits may save you from thousands of dollars in healthcare costs later on.
Expanded benefits for 2021
Earlier this year, CMS released the 2021 benefit and cost sharing information on Medicare.gov. In large part due to the coronavirus pandemic, they are offering expanded benefits in several key areas, and many health care providers are taking advantage of this flexibility.
There will be over 4,800 Medicare Advantage plans in 2021 for enrollees to choose from, a 76.6% increase since 2017. The number of MA plans per country is also growing in the new calendar year.
In response to the COVID-19 pandemic, 94% of all MA plans will provide added telehealth benefits. The current health crisis also drove CMS to develop the Part D Savings Model, which sets a $35 monthly copay rate for insulin. Over 1,750 MA and PDP plans are participating in this new model in 2021.Many health plans are also expanding their benefits for enrollees with chronic conditions. About 500 Medicare Advantage plans will feature either supplemental benefits or lower copays to those with specific chronic diseases or other conditions.
$0 Premiums and Special Needs Plans
Some people may even be eligible for a $0 premium Medicare Advantage plan. Others still may be eligible for low-cost Medicare Advantage Special Needs Plans.
CSNPs are Chronic Special Needs Plans and are for people who have certain chronic conditions and need additional coverage. ISNPs are Institutional Special Needs Plans and are for people who have been living in an institution such as an inpatient medical facility for 90 days or more. DSNPs are Dual Eligible Special Needs Plans and are for people who are dual-eligible for both Medicare and Medicaid.
How to Get a Low-Cost, Five-Star Medicare Advantage Plan in 2020
Our licensed agents across the nation are contracted and certified to sell a number of Medicare Advantage plans. An agent can sit down with you and show you all of the top-rated plans available in your area and help you select which one is best for you.
To get in touch with a licensed agent, call 844-431-1832 or click here.
2020 Medicare Changes & Trump’s Executive Order
Every year, CMS (Centers for Medicare and Medicaid Services) reserves the right to make changes to the Medicare program. Rules and regulations around enrollment periods, penalty fees, marketing, and plan benefits are released in late summer and early fall for the following year. Costs can rise, and brand new plans can enter or leave the market.
Medicare is confusing as it is. When you add these yearly changes into the mix, choosing the right plan can be stressful. Our goal is to make all of this less stressful for you. Our website is a great educational tool, and our licensed agents can provide free assistance!
Alex Azar, Health and Human Services (HHS) Secretary, said that Trump told HHS to take “specific, significant steps” towards improving Medicare funding and improving healthcare for American seniors. These steps include lowering Medicare Advantage costs, allowing savings accounts, and improving access to new medical technology. It also leaves room for more plan options, more telehealth, more wellness benefits, and a stronger financial model.
In his post-executive order speech given in Florida yesterday morning, Trump stated, “In my campaign for president, I made you a sacred pledge that I would strengthen, protect and defend Medicare for all of our senior citizens.” That was the intent of the executive order.
Is Medicare Going Up in 2020?
New 2020 Medicare premiums and costs for 2020 have not been released yet. The new numbers are usually released in early fall of the year prior, so we are expecting to see them over the coming months. The Wall Street Journal reported in April that 2020 Medicare Part B premiums are likely to increase by $8.80/month to a total of $144.30, but this is not final.
We will continue to update this post with new 2020 costs as they are released. Thank you for your patience!
2020 Medigap Changes
Just like the Original Medicare program, private plans like Medicare Advantage, Medicare Supplements, and standalone benefit plans can change every year.
Plan availability may not be the same for everyone. Medigap eligibility, in particular, can depend on your age when you enroll, preexisting conditions, and where you live. Plans can be different not only in every state but also in every county and zip code.
Starting in 2020, you will no longer be able to purchase Medigap Plan F or Medigap Plan C. Plan F was one of the most popular plans, and Plan C was fairly similar. The plans are going away because they include coverage for the Part B deductible (only $185 in 2019).
You might here plans C and F referred to as “first-dollar” plans because they virtually eliminate out-of-pocket costs. CMS decided that taking away the Part B deductible coverage was a smart move to discourage people from overusing their primary physician offices and costing the Medicare program a lot of money for unnecessary doctor’s visits.
If you already have Medigap Plan F or Medigap Plan C, you can be grandfathered in. That means that you will not lose your coverage in 2020. However, if you leave your Plan F or Plan C in favor of a different Medigap plan, you won’t be able to re-enroll in F or C.
Will Plan F Premiums Rise After 2020?
As Plan F sees less and less enrollees, Plan F premiums will likely begin to rise. We can’t say this for sure and we will certainly have to wait and see what happens, but generally less enrollees means higher costs for the companies, resulting in higher premiums.
Will There be a High Deductible Plan G in 2020?
Since people will not be able to purchase Plan F or Plan C in 2020, CMS did want there to be another option with similar benefits. Plan G was already that option, given that the only difference is that Plan G does not cover the Part B deductible.
The other difference is that previously, Plan G was not offered with a high-deductible. If you typically have low medical costs, you may prefer a high-deductible option. Having a high deductible often means that your premiums will be lower. This way, you don’t have to pay as much until you start experiencing health concerns. The high deductible Plan G option can replace the high deductible F option.
Donut Hole Closing in 2020
In addition to all of these plan changes, the infamous “Donut Hole” will be effectively closing in 2020. The Bipartisan Budget Act of 2019 closed the coverage gap for brand-name drugs in 2019, and the generic drug coverage gap will be eliminated in 2020. This basically means that, if you have a Medicare Part D plan, you will only be responsible for 25% of your covered prescription drug costs instead of 44%.
2020 Medicare Advantage Changes
There may be more Medicare Advantage plan changes to come in 2020, but we wanted to make sure you had heard about the changes from last year.
On October 12, 2018, the Centers for Medicare and Medicaid (CMS) announced the 2019 Original Medicare premium and deductible increase, but what about Medicare Advantage (MA) plans? Unlike Medicare Part A and B, beneficiaries enrolled in MA plans may see a decrease in their premiums in 2019 and 2020 compared to 2018.
2020Medicare Advantage Cost Changes and 2020 Premiums
In September of 2018, CMS announced that on average, Medicare Advantage premiums will decrease by 6%. This is great for beneficiaries interested in affordable vision, dental, and hearing coverage or even fitness classes like SilverSneakers®!
CMS estimated that 83% of beneficiaries would have equal or lower premiums for 2019 and 46% will have a $0 premium! Premiums for MA plans have steadily declined, and this is the lowest premium we’ve seen in three years. This is a perfect example of a private and public collaboration that allows beneficiaries to drive and define the value. The 2019 Medicare Advantage changes are a quick glance of what you can expect to continue in the future.
2020 cost changes for Part A and B premiums and deductibles have not officially been released yet but are not expected to increase by very much. We will continue to monitor this information and will update as soon as the cost changes are officially announced.
New Medicare Benefits 2020
Early in 2018, CMS (Centers for Medicare and Medicaid Services) released new rules that allow Medicare Advantage plans to offer a few benefits, like “daily maintenance,” transportation, telehealth, and durable medical equipment.
Some plans in 2020* are really going above and beyond, offering benefits like new air conditioners and pest control!
*These benefits are not included in all MA plans. Your agent may be able to help you find a plan that includes more.
The addition of the “daily maintenance” benefit means that Medicare Advantage plans are now able to offer at-home care items, such as wheelchair ramps and other home modifications. Tied in with that benefit are other forms of durable medical equipment, like hospital beds, oxygen equipment, blood sugar monitors, etc, as well as “non-skilled” services. Non-skilled refers to items that do not require a licensed doctor or nurse, such as aides who can assist with bathing and dressing or homemakers who can help with cleaning and cooking.
Non-Emergency Medical Transportation Coverage
CMS has also added the ability for MA plans to provide non-emergency transportation coverage, a service that several Medicaid plans provide. This benefit (if your plan covers it) will allow you to receive free or low-cost rides to medical appointments and pharmacies. In most cases, you can only qualify for this benefit if you do not have another adequate means of transportation. The appointment that you are requesting a ride to must be for a Medicare-covered service.
Telemedicine and Telehealth
MA plans can now provide coverage for telehealth. That means you can have live video interaction with your doctor through digital clinics like HealthTap, Teladoc, and MDLive. Telehealth can also include health alerts delivered to your phone, health education apps, electronic medical data transfers, mail-order prescriptions, digital appointment scheduling and exam reminders, and more.
New Enrollment Period (OEP)
Before 2019, most people were only able to switch into new Medicare Advantage plans during the Annual Enrollment Period in the fall. Now, if you already have a Medicare Advantage plan, you may be eligible to make a change during OEP. OEP, or the Open Enrollment Period, takes place from January 1 through March 31. During this time, you can switch from one Medicare Advantage plan to another or drop your Medicare Advantage plan in favor of Original Medicare (Part A and Part B only).
Future of Medicare Advantage Plans
According to the Henry J Kaiser Family Foundation, enrollment has tripled to 19 million beneficiaries since 2003 and continues to grow each year. CMS estimates that MA enrollment will hit an all-time high of 22.6 million beneficiaries in 2019 (an 11.5% increase)!
As enrollment continues to increase, plan selection and variety increase too, with approximately 600 new plans offered in 2019! 99% of seniors and Medicare-eligibles have access to a MA plan – and 91% can choose from 10 or more plan options. Beneficiaries will not only see more plans to choose from, but also new supplemental Medicare benefits!
Enroll in a Medicare Advantage Plan in 2020
Are you interested in getting coverage beyond Original Medicare? Along with the new benefits, many Medicare Advantage plans offer dental, hearing, and vision coverage.
Our agents at Medicare Plan Finder can contract with nearly every carrier in your state! This means that you can enroll in the MA plan that best fits your needs and budget.
The Annual Enrollment Period runs from October 15 through December 7. Start looking over your plan benefits now so that you’re ready to enroll before December 7!
Ready to learn more? Call us at 844-431-1832 or fill out this form to arrange a no-cost, no-obligation appointment with an agent in your area.
*This post was originally posted on November 8, 2018, and was last updated on October 4, 2019.
How Mail Order Prescriptions Can Save You Time and Money
Did you know that you can order your prescriptions online and save money? That’s right – no more rushing to get to the pharmacy on time or having to ask someone to pick up your prescriptions for you. You may even be able to schedule your prescriptions to deliver exactly when you need them with automatic refills!
Pros and Cons of Mail Order Pharmacy
Ordering prescriptions from a mail order pharmacy comes with pros and cons.
Time Saving: You can save hours by not having to make monthly, weekly, or daily trips to the pharmacy. All you’ll have to do is click a button and wait to receive your medications – no standing in line, no rushing to get to the pharmacy.
Cost Saving: You can save money on gas and help minimize wear and tear on your car. Using a mail order pharmacy eliminates the need to travel.
Automatic Refills: Most mail-order offer an automatic refill option. This is great for people who forget to have their prescriptions refilled or pick them up. Some pharmacies will even call your doctor to renew your prescriptions!
Waiting for Prescriptions: Even though you can order your prescriptions with the click of a button, you still have to wait for your prescriptions. That can be a drawback if you need your prescription immediately.
Prescriptions Can Be Lost: It’s rare, but sometimes prescriptions can be lost in the mail. However, most mail-order pharmacies will re-ship your medication at no additional cost. If you’re concerned about package theft, it may be in your best interest to pick up prescriptions in person.
Automatic Refills: Having your prescriptions refilled automatically can be both a pro and a con. If you’re someone who usually sets and forgets, you could end up with a lot more pills than you need!
The Delivery Fee
Contrary to popular belief, most mail order prescriptions can be delivered without a shipping fee! If delivery fees are what was holding you back from using an online pharmacy, you can check that off your list. Pharmacies don’t have to charge a shipping fee because mailing your prescriptions can actually save them money.
They don’t have to pay for the time and labor it takes to stock prescriptions in-store and they can ship to you directly from a warehouse. There may be shipping fees associated with medical equipment and supplies, but most prescriptions can ship free.
When Should I Stick to my Local Retail Pharmacy?
There are only a few downsides to mail order prescriptions. Mainly, you will lose out on the face-to-face interaction with your pharmacist. However, you can always call your pharmacist to ask questions or speak to your doctor instead.
Your local retail pharmacy, like a CVS or Walgreens, can delivery your prescriptions to your door as well. If you are comfortable using your local retail pharmacy instead of searching for a new mail order pharmacy, stick to it instead of trying to fix what is not broken.
When Should I Expect to Receive my Prescription?
Some prescriptions may take up to 14 days to arrive at your door, so you may still need to visit your pharmacy in person to get your cold medicine and other immediate needs.
Long-term prescriptions, though, can be automatically mailed when you need them. If you work with your pharmacy to set up auto-refills, you should receive your prescription in the mail well before you need it so that you never run out of your medication.
Top Mail Order Pharmacies
It’s always a good idea to start by checking if your health plan has its own mail order pharmacy. Many carriers do, and they can save you a lot of money that way! For example, Cigna just merged with digital pharmacy Express Scripts. You can also check with your favorite drugstore chain. CVS, Walgreens, and Publix are just three examples of chains that offer prescription delivery services. You can also consider the following:
Blink Health – What’s unique about Blink Health is that you can have your prescriptions delivered to your home, or you can pick them up from a local participating pharmacy. Either way, you can see the prices before you buy and choose the cheapest and easiest option for you.
EnvisionPharmacies – Envision is divided into three parts. Envision Mail is a typical mail order prescription service, EnvisionSpecialty provides patient, caregiver, and provider support, and Envision Compounding is quite different. The compounding sector creates alternative forms of medications and sends them to patients who cannot swallow pills or have unique allergies.
HealthWarehouse.com – Selling both brand name and generic prescriptions for both you and your pets! Over the counter drugs, diabetic supplies, and home medical equipment is also available. Just create an account and ask your doctor to send your prescriptions to HealthWarehouse.
PillPack – Not only does PillPack allow you to order your medications online, but they can also sort your pills by dose for you. For example, if you both Drug A and Drug B at 8 AM every day, and you take Drug C at both 8 AM and 8 PM every day, you’ll receive two packs for each day: one that contains Drug A, Drug B, and Drug C and is labeled “8 AM,” and one that contains Drug C and is labeled “8 PM.” They are dated so that you won’t lose track. PillPack is now owned by Amazon.
How to Find a Safe Online Pharmacy
Any pharmacy your Medicare plan recommends will likely be legitimate. However, there are many fake online pharmacies that will try to scam you. They appear to be legitimate pharmacies but they actually send fake drugs.
To help raise awareness about these fake online pharmacies, the Food and Drug Administration (FDA) launched BeSafeRx. According to the FDA, a legitimate pharmacy will:
Require a valid prescription from your provider
Be licensed by your state board of pharmacy, or equivalent state agency. (To verify a pharmacy’s licensing status, check your state board of pharmacy.)
Have a U.S. state-licensed pharmacist on staff and on call to answer your questions
Be located in the United States, and provide a physical street address, not just a post office box
How to Report Illegal Medicine Sales
If you become aware of unlawful medicine sales, you can report the rogue pharmacy with the FDA. Fill out the form here with as much detail as possible.
How is my Insurance Plan’s Mail Order Pharmacy Different From Other Online Pharmacies?
Excellent question! Not every insurance plan has its own Medicare mail order pharmacy, so it is important to check your coverage and be sure that you have access to mailed prescriptions.
Additionally, some insurance plan mail order pharmacies are limited in what they can offer, while private online pharmacies operate independently and can function just like a brick and mortar drug store.
Compare Prescription Costs
Even if you don’t want to use the internet for ordering prescriptions and having them delivered, you can at least use it to view drug prices. GoodRx is a leader in drug price tracking. All you have to do is type in the name of the prescription drug you need, and GoodRx can tell you what pharmacy has the best price! You can also use GoodRx to print free coupons and save as much as 80% on some drugs!
GoodRx Prescription Finder Tool
To use GoodRx’s prescription finder tool, click here. Then type your prescription in the search bar. We’re using atorvastatin (Lipitor) for demonstration purposes, but you can use any medication you want prices for. Then click “Find the Lowest Price” beside the red arrow.
Then you’ll come to the price list with several pharmacy options.
Prescription Savings Coupons
When GoodRx, mail-order prescriptions, and your Medicare coverage aren’t enough, there are prescription drug discount cards! Since these cards are not part of Medicare, you can sign up for a card at any time. Having a prescription drug savings card is sort of like having a coupon book.
There may be times when you don’t need your Rx card because your Medicare coverage gets you even bigger savings, but there are other times when your card can save you a lot of money!
Get Medicare Mail Order Pharmacy Coverage Today
Do you have a Medicare Advantage or a Part D prescription drug plan? Do you know if you qualify for LIS, a prescription drug savings program for Medicare beneficiaries? We can help answer your questions and make sure you are getting the best benefits at the best price, and make sure you are eligible for mail order prescriptions.Set up an appointment at no cost to you by calling us at 844-431-1832 or contact us here.
*This post was originally published on February 8, 2018 and last updated on September 23, 2019.
How to Protect Yourself from Medicare Scams, Fraud, and Abuse
The Annual Enrollment Period (AEP) will be here before you know it. AEP is the most popular time of year for beneficiaries to change or enroll in a new plan. However, this means Medicare scams, fraud, and abuse are at all all-time high. Medicare Plan Finder makes understanding these risks easy, so you feel protected year-around.
Medicare Fraud and Abuse
The government loses millions of dollars each year due to Medicare fraud and abuse. This causes Medicare prices to increase. The government has created laws to protect all parties involved in Medicare and Medicaid.
These laws promote healthy relationships between agents, carriers, and clients to prevent the insurance industry from becoming profit-based, instead of care-based. Your coverage should be more important than profits.
Medicare fraud includes:
Knowingly making false claims or misrepresenting data
Intentionally giving or receiving rewards for goods and services
Promoting one health service over another
Billing Medicare for appointments that never happened or for more than what actually happened
Medicare abuse includes:
Billing for unnecessary services
Excessive supply purchases
Medicare Fraud and Abuse Laws
The government has implemented the following:
False Claims Act (FCA) – Protects the government from being overcharged on goods or services. No proof of intent is required.
Anti-Kickback Statute (AKS) – Agents cannot knowingly reward referrals for health care programs.
Physician Self-Referral Law (Stark Law) – Doctors cannot make referrals to health care companies in which they have an interest.
Criminal Health Care Fraud Statute – Cannot defraud; bill for unnecessary medical goods and services (like drugs that are not needed or wheelchairs for those who are not impaired).
What Can You Do?
Don’t become a victim! If you aren’t sure about a health agent’s validity, ask for licensing information or work with Medicare Plan Finder. To help fight Medicare fraud and abuse, report any suspicious activity to 1-800-HHS-TIPS (1-800-447-8477). You can also report the activity online.
Common Medicare Scams
A licensed Medicare agent is required to abide by strict rules when contacting seniors and Medicare beneficiaries. It is illegal for anyone (including an authorized Medicare agent) to show up at your front door without permission.
Also, keep in mind that no one associated with Medicare will ever call you to update your information. The following are common Medicare scams you need to look out for:
One recent scam involves adults calling the elderly and pretending to be their grandchildren asking for money. They’ll say that they are in some form of trouble and need money.
To avoid this grandparent scam, be sure to ask for a personal detail that only your real grandchild would know the answer to. It is easy to assume you would recognize their voice, but if someone calls in a panic, your adrenaline may kick in, and their voice is the last thing you’re worried about.
Medicare Coverage Helpline Scam
In recent years, there has been a television commercial targeting current Medicare beneficiaries. The advertisement is from the “Medicare Coverage Helpline” and claims that if you have parts A and B, you are eligible for vision, dental, and prescription drug plans due to a recent Medicare health reform.
The commercial will provide a 1-800 number. Do not call that number. If you are interested in vision, dental, or prescription drug coverage, one of our licensed agents can discuss plans that are specific to your area. To get started, click here.
Medicareplans.com is an out-dated link that was a fake marketplace for those searching for a Medicare plan. While this link is no longer active, it is important to be careful when reviewing different companies and websites.
Look for websites that start with “https” instead of “http.” The “s” indicates a secure website. If you have doubts, a simple google search like “[Insert Company Name Here] Scam” can show any potential scam information.
Medicare Phone Scams
Medicare phone scams are probably the most common way that seniors and other Medicare beneficiaries are taken advantage of. In some cases, a scammer may call you and pretend to be from Medicare and offer you free services if you provide your Medicare number or Social Security number.
In other cases, a scammer who claims to be from Medicare may say that they need to validate your information to keep you from losing your benefits. The real Medicare program will never ask for this information. Never give these numbers away over the phone.
One phone scam in particular, the “can you hear me” scam, is easy to fall victim to. The scammers use this question to get a “yes” answer from people, which they would then edit to make it seem as though they were agreeing to purchase a product or submit information. If you answer the phone and someone you don’t know asks, “Can you hear me?” hang up right away.
Scammers will often try to catch your attention by saying you have Medicare refunds. The scammer’s goal is to get your bank information. Common reasons for Medicare refunds include changes or enhancements to Medicare or lawsuits with private insurance companies.
If for some reason you are entitled to a Medicare refund, a check will be mailed to you directly. No one will ever call asking for your bank information.
How to Avoid Medicare Scams
Medicare scams can be easily avoided. CMS (Centers for Medicare and Medicaid Services) suggests the following tips for avoiding scams and fraud:
Treat your Medicare card like a credit card. Keep it in a safe spot and never give out your number to anyone other than your doctors.
Do not accept an offer for free gifts or money in exchange for your Medicare information.
Don’t accept services that aren’t usually covered by Medicare unless a doctor that you trust tells you that it is necessary.
Will Medicare Ever Call You?
Medicare will never call you randomly and ask personal questions. If you are already covered by Medicare, they have all the information they need. If someone from Medicare needs to contact you, they will find a more official communication route.
If you have any additional questions about Medicare communication, or if who is contacting you is legitimate, contact a Medicare customer service representative at 1-800-MEDICARE (1-800-633-4227).
Free Stuff for Seniors From the Government
Seniors and Medicare beneficiaries can fall into specific categories that scammers will use to their benefit. Scammers will sometimes call pretending to be from the government and offer free health checkups or free medical supplies.
During these fake calls, they will use common senior health conditions to act like they know specific details about your health. The scammer has no idea you have diabetes or high blood pressure; all they know is that a handful of seniors have those conditions. Scammers are hoping you will also fall into that category.
Some scammers have been known to give names and addresses of your doctor. It is unknown how they receive this information. Even if the caller ID looks reputable, don’t trust them so quickly.
Technology has continued to evolve and faking caller ID has become easier and easier. Don’t trust if someone says they are providing free products or services from the government. Scammers will say all you have to pay for is shipping costs, then get access to your credit card information.
How to Stop Medicare Phone Calls
As we mentioned, Medicare will not call you without your permission. If you receive a phone call about your Medicare plan, but did not consent to a call, it is likely a scam.
To help prevent calls from unknown numbers, don’t answer unknown numbers unless you’re expecting a call from a legitimate company (like us!). You will receive a voicemail if the call is legitimate.
If you have a smartphone, you can download apps that detect scam calls and block the calls instantly. You can also put your number on the National Do Not Call Registry.
How to Block Specific Numbers
Both iPhone and Android users can block specific numbers from calling. This is a useful tool because many scam callers will cycle through phone numbers. Once you block a number, you will not receive calls from that number unless you unblock it.
How to Block Phone Numbers on an iPhone
First go to you to your most recent calls. Then find the number you want to block and tap the “i” icon. That will lead you to the contact information associated with that phone number.
That will lead you to your most recent calls. Then find the number you want to block and tap the “i” icon. That will lead you to the contact information associated with that phone number.
Then scroll down to where you see “Block this Caller” and tap on the words.
The final step is verifying that you want to block the caller.
How to Block Phone Numbers on an Android
First, go to your most recent calls. Then tap the “i” icon under the phone number you want to block.
Then tap the three dots as shown below.
Then select “Block.”
Protecting yourself from Medicare scams may seem like an impossible task. Now that you understand the common Medicare scams you will know what to watch out for.
If you are ever suspicious or have questions regarding Medicare fraud, call the Medicare Helpline. They can answer any questions you may have. The Medicare Helpline is a 24-hour toll-free line and can be reached at 1-800-MEDICARE.
Also, you can help eliminate Medicare fraud by reporting suspicious activity. Call the Medicare fraud line at 1-800-447-8477 or report the incident online.
Enroll in Medicare
The risks of Medicare scams does not lower the importance of proper Medicare coverage. We are dedicated to helping you choose the best plan from all of the options available in your area. Why do we need your information?
Zip Code: We need this because Medicare plans are different in every zip code.
County: We ask for your county because sometimes zip codes fall into more than one county.
Email and Phone Number: We ask for your contact information because we want to have a conversation with you about helping you find a great health plan.
Birthday: Sometimes we’ll ask for your birthday to help us ensure that you qualify for Medicare benefits.
Medicare Plan Finder and other legitimate resources will not ask for your Social Security Number or Medicare number before speaking with you. If someone who you do not know asks for your SSN or Medicare number, do not give out that information until you know that it is safe to do so.
We are here to discuss the best Medicare coverage for your needs and budget. If you’re interested in speaking with a licensed Medicare agent or scheduling a free no-obligation appointment, fill out this form or call us at 844-431-1832.
This blog was originally published on 10/1/18, and was updated on 8/21/19.
What is the Cigna and Express Scripts deal?
Cigna and Express Scripts announced their 54 billion dollar merger in March of 2018. Cigna provides coverage to 95 million beneficiaries around the world and Express Scripts helps fill 1.4 billion prescriptions annually. The goal of this merger is to create both affordable and personalized healthcare for consumers.
Cigna and Express Scripts Merger Close Date
On December 18, 2018, Cigna and Express Scripts received approval from New Jersey, the final state needed to move forward. The deal closed two days later on December 20, 2018. Cigna plans to start offering new products to its customers including access to Express Scripts pharmacy in 2019.
Cigna’s CEO, David Cordani, believes the deal with Cigna and Express Scripts will allow Cigna to offer additional benefits to customers while monitoring their prescription usage and medical costs. Cordani said in a statement that the addition of Express Scripts provides a “more integrated approach that addresses the whole person.” While doing this, Cigna strives to improve affordability and increase drug price transparency.
What is Express Scripts?
Express Scripts is a pharmacy benefit manager (PBM). A PBM acts as a middleman between pharmaceutical companies and consumers. They negotiate drug pricing from the pharmaceutical companies for pharmacies. Their role can also include operating mail orders, ensuring patient compliance, managing distribution, negotiating rebates, processing claims, and managing formularies.
PBMs are one of the largest proponents of lowering drug costs. PBMs started as a benefits card and mail-order pharmacy in the 1970s and are responsible for the shift in demand from brand-name drugs to generics. Express Scripts is the country’s largest PBM. OptumRx, CVS, and Express Scripts together control 72% of the U.S. pharmacy benefit manager market. OptumRx is a part of United Healthcare, and CVS purchased Aetna on November 28, 2018. Express Scripts was the final, stand-alone PBM at this size.
Express Scripts provides great benefits to beneficiaries like you. They allow you to pick up your prescription at your neighborhood pharmacy or have it shipped to your home quickly and conveniently. They can also alert you of any drug recalls, price out your medications, and schedule automatic refills for you. Plus, Express Scripts is more than just a PBM and pharmacy – they are a dedicated team of pharmacists, nurse, and advocates who work to give you the personal care you deserve.
How will the Cigna and Express Scripts deal impact you?
This deal was formed amid the CVS and Aetna deal which was finalized in November 2018. Insurance companies have started looking for alternative ways to adapt to the ever-changing health care industry. We expect to see many more deals like this over the next few years. Walgreens and Humana are already rumored to be in talks about merging. These deals are proof that health companies need to respond to customer demand.
It will take time for new plans to be implemented and the results are speculative at this time, but the Cigna and Express Scripts deal is a great example of how Medicare and the healthcare industry can evolve. Amazon has been rumored to be entering the pharmaceuticals business which could lead to increased competition. This may result in lower costs and streamlined services for you. As competition increases, companies will provide additional benefits to keep your business. If you have any questions or concerns about your Medicare coverage or prescription drug plan, our agents are happy to help! Call us at 844-431-1832 or fill out this form to get in contact with a licensed agent.
What is the CVS and Aetna deal?
Last year, CVS provided prescriptions to an estimated 94 million customers while Aetna provided coverage to an estimated 22 million. In a $69 million dollar deal, CVS officially purchased Aetna on November 28, 2018. The CVS and Aetna deal will strengthen the two companies, create better care coordination, and improve costs for beneficiaries like you.
CVS and Aetna Merger Status
CVS and Aetna had a long road ahead starting in December of 2017 when CVS first announced its plan to purchase Aetna. In March of 2018, shareholders for both parties approved the merger. In early October, the Justice Department granted approval. Finally, on November 26, 2018, New York was the last state to approve the merger. CVS completed the acquisition of Aetna on November 28, 2018.*
*There has been a delay in the integration of Aetna and CVS. We will update with more information as it becomes available.
Change in CVS Stores
Many CVS stores currently offer healthcare services through their Minute Clinics. The Aetna and CVS deal will allow CVS locations to become a one-stop-shop for all health and wellness needs. This includes clinical and pharmacy services, vision, hearing, etc. Aetna’s CEO, Mark Bertolini, has plans to create healthcare-focused hubs similar to Apple’s Genius Bars. Apple focuses on concierge-style support and CVS plans to follow suit. These hubs will provide basic healthcare products and information. If you have questions or concerns about health conditions, prescription drugs, or coverage, the hub can answer quickly and effectively.
Change in the Healthcare Industry
CVS plans to address several issues that surround the healthcare industry. They want to introduce competitive Medicare Advantage and Part D offerings and create more market access for beneficiaries. They also strive to promote lower-cost care and enhance their clinical care programs.
Both companies agree that the Aetna and CVS deal, with the help of their data, will lower costs and provide better care. When this data is combined with the expected changes to CVS stores, you may be offered new health products at lower prices. The data from the Aetna and CVS deal is also expected to create tech-focused projects like remote monitoring tools. For example, if you have diabetes, you could have your blood glucose levels monitored remotely and receive text messages if your levels are too high or low. This allows patients to have additional medical supervision beyond their average appointment.
How will this deal impact you?
The CVS and Aetna merger is a great example of how Medicare and the healthcare industry can evolve. However, it will take time for these new plans to be implemented and the results are speculative at this time. If you have any questions or concerns about your Medicare coverage, our agents are happy to help! Call us at 844-431-1832 or fill out this form to get in contact with a licensed agent.
Remembering President George H.W. Bush
President George H.W. Bush was a humble and ambitious leader who died on November 30, 2018, at the age of 94. He was responsible for walking the U.S. through important milestones like the Americans with Disabilities Act, Strategic Arms Reduction Treaty, and Operation Just Cause. He will be remembered as a veteran, congressman, vice president, legacy leader, and of course, our 41st president.
President George H.W. Bush’s Top Accomplishments
1941: Joined the U.S. Navy and the fight against the attack on Pearl Harbor.
1948: Graduated from Yale University.
1966: Elected into the House of Representatives.
1971: Appointed as Ambassador to the United Nations by President Nixon.
1976: Appointed as Director of the Central Intelligence Agency (CIA).
1981: Elected as Vice President alongside President Ronald Reagan.
1988: Elected as the 41st president of the United States. Fun fact: President George H.W. Bush was the second president, after Martin van Buren, to be elected while sitting as a vice president.
1989: Sent troops to Panama for Operation Just Cause to oust the dictator of an international drug trade.
1990: Signed the Americans with Disabilities Act into law.
1990: Negotiated a budget deal to reduce the federal deficit.
1991: Signed the Strategic Arms Reduction Treaty with Soviet President Mikhail Gorbachev.
History and Impacts of Americans with Disabilities Act
The Americans with Disabilities Act (ADA) signed into law on July 26, 1990, is considered George H.W. Bush’s landmark presidential legislation. The law ensures that individuals with disabilities have the same rights and opportunities as everyone else and are not discriminated against. This equal opportunity applies to housing accommodations, employment opportunities, public transportation, government services, and telecommunications.
The ADA classifies a disabled person as “a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.”
An estimated 55 million Americans are protected by the ADA and are directly impacted by this life-changing law. Many changes brought by the ADA are seen everywhere we look, including the use of wheelchair-accessible transit, braille in public buildings, closed captioning for television and movies, and fire alarms that can be both heard and seen.
Dual-Eligibility and Special Needs Plans
If you are one of the 55 million Americans protected by the ADA, you may qualify for a Special Needs Plan. These plans are a type of Medicare Advantage plan and help cover doctor, hospital, and prescription drug costs. Plus, you may have a special enrollment period which means you can enroll during almost any time of the year! If you have questions regarding your special needs plan eligibility or plan options, a licensed agent may be able to help! Call us today at 844-431-1832 or fill out this form.
New Medicare Benefits Thanks To CHRONIC Care Act
Last month, Congress introduced the CHRONIC Care Act. The title “CHRONIC” stands for “Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care.” It is designed to help seniors and Medicare beneficiaries with chronic illnesses and disabilities and those who benefit from both Medicare and Medicaid.
New Medicare Advantage Benefits
With the CHRONIC Care Act, Medicare Advantage plans can now cover “nonmedical” benefits. Before the act passed, your Medicare Advantage plan would only cover “Durable Medical Equipment (DME).” DME includes items like blood sugar monitors, wheelchairs, hospital beds, and other items deemed medically necessary and durable (reusable for at least three years). Now, Medicare Advantage plans can cover home modifications (like wheelchair ramps, chair lifts, and bathroom handlebars) if medically necessary.
Additionally, Medicare Advantage plans can now provide more telehealth services. That means that your plan may provide coverage for virtual health services, like talking to your doctor via phone or video chat. Previously, Medicare had very strict guidelines about who was eligible to receive coverage for telehealth from Medicare. Now, the CHRONIC Care Act is expanding telemedicine.
Additional Home Care
The CHRONIC Care Act also expands your access to home care. Kidney disease patients can now access in-home dialysis treatments. This means that in the future, it may be easier for your doctor to come visit you.
Additionally, the Independence at Home program is expanding from 10,000 patients to 15,000. Independence at Home is a small program that allows doctors to visit patients on house calls and receive Medicare coverage. The program increases care quality and lowers care cost. While the program is still quite limited, this expansion means that more and more chronically ill patients are gaining access to home care.
Better Care Coordination
Lastly, the new act allows Accountable Care Organizations (doctor and hospital groups) to pay patients up to $20 when they come in for primary care services. This is an incentive to get people to visit Accountable Care Organizations. While ACOs may not be the best solution for everyone, they are beneficial because you can find all your doctors and providers located in one convenient place.
All of these updates and changes mean that it’s going to be much easier for seniors and Medicare beneficiaries with chronic conditions and illnesses to access the best possible care and coverage.
We are making every effort to help people like you enroll in the right plan with the right coverage.
Looking for help picking a plan? Give us a call at 1-844-431-1832.