With the market getting very competitive in the Medicare space, there seem to be more cards showing up in the mail once you have selected and enrolled in your plan or plans. The good news is that this is because plans are adding more and more benefits, such as flex spending cards, over-the-counter cards, etc. However, be cautioned about what card or cards you show a provider or front office person. No offense to any administrative staff, but they often do not understand the difference in those cards any more than you do as a beneficiary. If they bill or charge incorrectly, getting everything corrected can be a nightmare. The following tidbits are going to hopefully make your experience smooth!
The Cards In Your Hand
Not everyone will have all the following cards. These are examples of the various cards you may receive. How and when to present each card is in the next section.
The first and most obvious card is your Original Medicare card. Every Medicare Beneficiary will have this card. It is red, white and blue and states, ‘Medicare A (hospital)’ and ‘Medicare B (medical)’ on the card
Supplement or Medigap card – this card will have an insurance company’s name on it and will have a letter title such as ‘Plan G’ or ‘Plan N’
Prescription Drug Card – this card will also have an insurance company’s name on it but not always the same company as your Supplement card. This card is for prescription drugs only
Advantage Plan Card – this card has an insurance company’s name on it and will usually say HMO or PPO at the top (this card takes the place of your Medicare, Supplement and Prescription Drug cards)
Flex Spending Card – this will be a Visa or Mastercard and work just like a credit card, however, there are usually limitations on what you can use it for
OTC Card – you may have a separate card for Over The Counter items, but this is only available on some plans, not all plans
Healthy Rewards Card – this will also be a Visa or Mastercard and only available on some plans. This is usually money earned by getting preventive care and wellness visits. This money can be used on anything you want
Take Control of Your Billing Fate
When you are at a doctor’s office, lab or hospital, we recommend you resist the urge to just give the front office person all your cards and let them figure out what and where to bill. Let’s inform you so you can take control and be sure the hassles don’t follow you later. Here is what to present and when….
Original Medicare Card -- you will only carry and present this card if you have a Supplement or Medigap plan and a stand-alone drug plan. Otherwise, leave it at home and locked up. If you give this to a front office or registration person when you have an Advantage Plan HMO or PPO also, they will likely bill incorrectly
Supplement Card and Prescription Drug Card – these are secondary to your Original Medicare if you have this combination of coverage. The Supplement Card goes with your Medicare Card for medical visits and procedures. The Drug Card is for the pharmacist when you pick up a prescription
Advantage Plan Card – this type of coverage is a ‘one stop shop’. You present this card only (which usually says HMO or PPO on it) to any and all providers. This includes medical, pharmacy, dental, vision, hearing, etc. DO NOT show providers your Original Medicare Card in this case
Flex Spending, OTC and Health Rewards Cards – these are extras that you can use just like a credit card in most cases. Always select ‘credit’ when checking out even if the card says ‘debit card’. There are some limitations to what you can spend it on so check with your insurance agent!
What Else Can You Do
We also recommend you never pay a copay or coinsurance at the time of service. Most front office or registration people do not realize there are nearly 45 different types of Advantage Plans and over 60 different types of Supplement Plans in a given market or area. All those plans have different copay amounts for each service. The best way to minimize paying too much or the wrong amount is to tell them to bill your insurance first. Whatever amount you may owe will then be billed to you by the provider after they have received confirmation from the plan on what you actually owe. So do NOT give the person ‘at the window’ any money.
When You Change Plans
If you keep the same plan or plans, the cards will be good year over year. However, if you change plans at any point in time, you will get new cards, and you’ll get the pleasure of figuring it out all over again. However, we know of a great service that will help you navigate for free! Wink, wink……
Want to Know More?
Not to worry, friend. CDI is here to help you through this entire maze. We can help from the very beginning even if it takes multiple meetings, in person or virtual. Reach out to us if you would like more information. We get excited to take some hassle and worry away from our clients’ daily lives! Email me at carrie@cdi-cares.com or check out www.cdi-cares.com for a contact page and other helpful blogs.
QUOTE OF THE DAY:
“I can accept failure, everyone fails at something. But I can’t accept not trying.”Michael Jordan