Medicare Coverage – Tips and Advice

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Today, most purchases are made through a customer-service app; you can check your order status and pay in advance, too. But some things — like medical insurance — are best-received face-to-face. That’s because insurers and other healthcare providers may not be able to answer your questions over the phone or email. Many people who need healthcare don’t have e-commerce websites at all.
Make sure you’re getting the right coverage for your needs:
One of the most important things you can do when shopping for Medicare coverage is to make sure you’re getting the right coverage for your needs. And, if you’re unsure whether a given option covers what you need, contact your healthcare provider. For example, some people with disabilities will need specially designed wheelchairs to get around. Other people with chronic pain may need medication that’s specific to the condition. And still, others may require support to help them manage daily activities, like walking or climbing stairs. These are all areas where Medicare has different coverage requirements and benefits. So, make sure you know what you need to meet and keep it in mind when applying.
Hire a healthcare advocate to help guide you through the application process:
Many insurance companies now offer assistance through “anchor” programs. These are dedicated call centers where you can speak with customer service representatives about your health plan and apply for coverage. We like CareFirst Blue, which offers more than 100 different plans and is available through over one hundred different insurers. Its “anchor” program is especially helpful for people who have difficulty making phone or online calls, have limited English proficiency, or need constant assistance during the application process.
Find out if there’s a waiting period for applications or appeals:
Waiting periods are periods during which you cannot start the process of applying for a benefit. In the case of Medicare, these are usually between two weeks and six months after you’ve qualified for benefits. Depending on how long it has been since you last applied, your waiting period may be shorter or longer. It’s important to note that if you don’t apply during your waiting period, you won’t be able to start the process until after your waiting period has passed. In some cases, you may be able to appeal your waiting period length if you think it’s too long. But, keep in mind, most insurers will always rule in line with what you’ve already heard from your doctor or other healthcare providers.
Don’t sign up for coverage you don’t need until it becomes available:
Some providers may only cover a limited number of specified services or charge higher rates for certain types of coverage. If you don’t have to pick a plan until the next open enrollment period, check to see if there is an open-enrollment period. Most providers will offer some type of coverage opening up again in October. But, you should only sign up for coverage that’s available during that open enrollment period. That way, if you want to change providers, you can easily do so without having to start the process over again.
Shop around to find the most competitive rates and plans:
If possible, try to shop around to find the most competitive rates and plans. But, keep in mind that many insurance companies only sell specific plans at specific companies. You may find a plan at your local independent doctor’s office that you like better than the one you were originally applying to. Some providers only offer specific insurance plans at specific companies; check to see if this is the case with yours.
Ask about eligibility requirements, like prior covered conditions and income levels:
Once you sign up for a plan, check to see if all of the coverage requirements you needed to meet when you first applied are still valid. This includes income requirements, required surgeries, and other critical details. Many providers will only cover you if you meet certain income levels or have a specific condition. So, make sure you understand if you’re required to have certain levels of income or meet specific conditions to qualify for certain coverage.
Get advice from an elder care professional or expert before making large life changes — like moving to a new state or losing your job.
Elderly people often face unique challenges when it comes to shopping for Medicare coverage. For example, someone moving to a new state may be required to show a government-issued photo ID, like a driver’s license, to ride on public transportation or get a food stamp card. People who are near retirement age may also have unique financial issues. For example, some people who are near retirement age may have a difficult time saving for long-term care because they have a family or other dependents to support.
Shop around to find the most competitive rates and plans. Ensure the coverage requirements you needed when you first applied are still valid. And always get advice from an elder care professional or expert before making large life changes — like moving to a new state or losing your job.