CDIS Blog
Medicare offers a variety of preventive care and screening services that are included as part of your benefits package. Preventive services are designed to prevent you from getting sick or ill. Typically, they include exams, lab tests, shots, and screenings that help detect problems early on when treatment is most successful. In addition, preventive care includes counseling that can help seniors make more informed decisions about lifestyle choices as they age. If you’re looking to learn what preventive and screening services Medicare covers, the following information can help.
Preventive Services
For seniors enrolled in Medicare, a key benefit is preventive services, or those exams, tests, and screenings that provide a snapshot into the state of your health and well-being. Staying current with all of the required exams and screenings is the most effective way to ensure you stay healthy and strong. In addition to a “Welcome to Medicare” visit, seniors can expect to receive an annual wellness visit along with routine glaucoma tests, bone density tests, flu shots, and even tests for identifying sexually transmitted diseases.
Covered Preventive Services
One-time “Welcome to Medicare” preventive visit
Glaucoma tests
Bone mass measurements
Sexually transmitted infection testing
Yearly wellness visit
Flu, Hepatitis B, and Pneumococcal shots
Cancer, diabetes, and cardiovascular disease affect thousands of seniors each year, and Medicare offers regular screenings as part of preventive care benefits. Treatment is most successful when illness is detected early, which is why screening services are prioritized as an important preventive benefit.
Covered Screening Services
Multiple cancers
Hepatitis C
Diabetes
Depression
Obesity
Alcohol
Cardiovascular
HIV
Finally, Medicare recognizes that seniors often struggle with making healthy lifestyle choices. Original Medicare provides a variety of counseling services designed to help interested seniors learn about important lifestyle choices. Important information on alcohol use, smoking, and even tips on how to prepare nutritious meals are provided as part of Medicare preventive counseling services. By giving seniors the tools and resources they need to make more informed decisions, Medicare encourages health and wellness for well-deserving seniors.
Covered Counseling Services
Alcohol
Obesity
Sexually transmitted infections
Tobacco use cessation
Nutrition therapy
References:
https://www.medicare.gov/coverage/preventive-and-screening-services.html
MUC17-2016-BCBS
CDIS Blog
Most people have enrolled automatically in Medicare (Part A and Part B) as they approach the age of 65 with coverage start dates based on birthday month. For those who need to enroll manually, effective coverage dates could be earlier or later, depending on the situation. Knowing exactly when your coverage starts can help you make the right decisions about your medical care.
Coverage Starts Near Your 65th Birthday
Here’s the good news: most people have enrolled in Original Medicare automatically, and receive a red, white, and blue Medicare card by mail approximately 3 months before turning 65. In this case, Medicare benefits begin on the first day of your birthday month. For example, if you were born on July 24, July 18, or even July 31, your benefits begin on July 1. There is one exception. For those born on the 1st of the month, benefits begin on the 1st day of the month before the birthday month. For example, if you were born on December 1, your benefits begin on November 1.
If You Sign Up Manually During Your Initial Enrollment
In the event you have not enrolled automatically and choose to enroll in Medicare yourself, effective coverage dates vary based on the month you sign up. If you sign up during your Initial Enrollment Period (the 7 months beginning 3 months before your 65th birthday and ending 3 months after your 65th birthday) effective start dates are shown below.
If you sign up for Medicare:
The same month you turn 65, coverage begins 1 month after you sign up.
1 month after you turn 65, coverage begins 2 months after you sign up.
2 months after you turn 65, coverage begins 3 months after you sign up.
3 months after you turn 65, coverage begins 3 months after you sign up.
If You Sign Up Manually After Your Initial Enrollment Period
You may enroll in premium-free Part A (most people are eligible) anytime during or after your Initial Enrollment Period starts with coverage start dates based on when you sign up. However, if you do not qualify for free Part A, and need to buy it or need to sign up for Part B, and miss your Initial Enrollment Period, you may have to wait until General Enrollment Period, Jan 1-Mar 31, with coverage starting on July 1.
References:
https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-coverage-starts/when-coverage-starts.html
https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html#collapse-5769
https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-html
https://www.medicare.gov/your-medicare-costs/part-a-costs/part-a-costs.html
MUC64-2017-BCBS
CDIS Blog
Sometimes, even when you think you’ve made the right choice in a Medicare Advantage plan (Part C), you need to make changes. Whether it’s because you’re moving out of your plan’s service area, or you simply want to change plans or return to Original Medicare, there are rules for when and how you can adjust your Part C coverage. While Annual Enrollment in the fall is typically the time when most seniors make changes, there are other times throughout the year when you can change your Medicare Advantage plan.
2024 Annual Enrollment
Annual Enrollment extends from October 15 to December 7 each year and is the best time to make changes to an existing Medicare Advantage plan. During this time, you can add, drop, or switch Medicare Part C plans without any penalty or restrictions. You can also join or drop a Medicare Prescription Drug Plan, or switch from one Medicare drug plan to another during Annual Enrollment. All changes you make during Annual Enrollment will become effective on January 1. The Annual Enrollment period isn’t just for Medicare Advantage or Part D recipients. All Medicare beneficiaries are allowed to make changes to their coverage during this time. Some people join Medicare Advantage or enroll in a prescription drug plan for the first time. Even if you are satisfied with your Medicare Advantage plan, Annual Enrollment is the time to look at other options in your area to make sure all of your needs will continue to be met the following year. Comparison shopping is smart and may help you find better coverage at a more affordable price.
Note: if you are currently enrolled in a Medicare Supplement plan, you can make changes to Medigap anytime throughout the year, and you are not restricted to the Annual Enrollment period. However, underwriting may apply.
Medicare Advantage Disenrollment
If you’re interested in dropping your current Medicare Advantage plan to return to Original Medicare, a specific period has been created for you to do so. The Medicare Advantage Disenrollment period extends from January 1 through February 14. This is the time for you to drop Medicare Advantage and return to Original Medicare.
Note: You cannot join a new Medicare Advantage plan or switch prescription drug plans during this time. The Medicare Advantage Disenrollment Period is for dropping Part C only. However, if you have prescription drug coverage with your Part C plan, and will lose it when you disenroll, you have until February 14 to join a new Medicare Prescription Drug Plan. All changes made during the Medicare Advantage Disenrollment Period will be effective on the first day of the following month. For example, if you drop your Part C plan on January 22, your new coverage will begin on February 1. Note: Coverage for a new prescription drug plan will begin the first day of the month after the plan gets your enrollment form.
Other Reasons to Change
What happens if you need to make changes to your Medicare Advantage plan outside of the Annual Enrollment or the Medicare Advantage Disenrollment Period? Special Enrollment periods were created for people who need to make changes to Part C at other times throughout the year. For example, if you move out of your current plan’s service area or your plan leaves your area, you can switch to another Part C plan or return to Original Medicare at any time during the year. New coverage typically begins the first day of the month after you disenroll from a previous Medicare Advantage plan. Another qualifying reason to use the Special Enrollment period is if you want to join a 5-star Medicare Advantage plan. You may switch from your current Part C plan and join a new plan at any time during the year if the new plan has an overall performance rating of 5 stars. Note: you may only use this Special Enrollment option once during the year.
Resources:
Switching from Medicare Advantage to Original Medicare https://www.medicareinteractive.org/get-answers/overview-of-medicare-health-coverage-options/changing-medicare-health-coverage/switching-from-a-medicare-advantage-plan-to-original-medicare
Medicare Advantage Disenrollment https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html#collapse-3192
5-star enrollment period https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/five-star-enrollment/5-star-enrollment-period.html
MUC60-2017-BCBS
CDIS Blog
Understanding the ins and outs of Medicare Supplement insurance can be challenging. So, we decided to put together a list of the top ten most asked questions about Medigap coverage. If you need a quick refresher, or you’re simply looking for an answer, you may find it here.
Q: Do I have to buy Medicare Supplement insurance to keep my Original Medicare?
A: No. Medicare Supplement insurance is optional insurance designed to help pay for some of the out-of-pocket expenses associated with Medicare, like deductibles, coinsurance, and copays.
Q: Can I Combine Medicare Supplement with a Medicare Advantage Plan?
A: Unfortunately, no. It would be nice to combine the extra benefits of an MA plan with the cost-saving benefits of Medigap. However, it is not allowed. It is against the law for private insurers to sell you a Medigap plan if they know you have Medicare Advantage.
Q: If I have Part A, but choose to delay Part B, can I still purchase Medicare Supplement insurance?
A: No. You must have both Part A and Part B coverage (Original Medicare) to be eligible for Medigap.
Q: Does Medigap cover both my spouse and me?
A: No. Medigap covers one individual at a time. If both you and your spouse wish to have Medicare Supplement coverage, you each need to have your plan.
Q: Can my Medigap policy be canceled if my health deteriorates?
A: No. Standardized Medigap policies are “guaranteed renewable”. That means that even if your health deteriorates, as long as your premiums are paid on time, you cannot be forced out of your policy.
Q: Do any Medicare Supplement plans include prescription drug benefits?
A: No. In the past, some Medigap policies included drug coverage. However, policies sold after Jan 2006 do not.
Q: When should I enroll in Medicare Supplement?
A: The best time to buy a Medigap policy is when you are first eligible, during your Open Enrollment period. This is a 6-month period of time that begins the month you turn 65 and enroll in Part B. If you wait until after your enrollment period, you may not be able to buy a policy, or it could end up costing you more.
Q: Medigap policies are “standardized”. What does that mean?
A: All Medigap policies must follow federal laws. Standardized plans, named for letters of the alphabet, must offer the same basic benefits, regardless of who sells them. For example, a Plan “F” at one company must include the same basic benefits as a Plan “F” at another company.
Q: How much does Medicare supplement insurance cost?
A: Cost varies significantly, and insurance companies often charge different premiums for the same policy. The key to getting a good rate is to compare the same policies at a few different companies. Premiums differ between plans, but some states offer the Medicare SELECT option as a way to save money—you agree to use doctors and hospitals in the network in exchange for a reduced premium.
Q: What if I travel outside of the country? Does my Medicare Supplement insurance travel with me?
A: Plans C, D, F, G, M, and N include foreign travel emergency benefits. Medigap pays 80 percent of medically necessary emergency care outside the U.S. after you pay a $250 deductible. If you purchased Plan E, H, I, or J before June 1, 2010, you also have coverage.
Resources:
https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html
https://www.medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/when-can-i-buy-medigap.html
https://www.medicare.gov/supplement-other-insurance/medigap/costs/medigap-plan-costs.html
https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html
MUC55-2017-BCBS
CDIS Blog
There’s no question, that navigating the world of Medicare can be complicated, time-consuming, and frustrating. With many different options, varied plans, enrollment rules, and more, it’s easy to make mistakes. Errors can be costly, which is why it’s so important to understand common pitfalls. Here are the top ten Medicare mistakes, and how to avoid them.
1. Failing to Sign Up When You Are First Eligible
With more people working beyond the age of 65, it’s not uncommon to delay signing up for Medicare—and that’s okay. As long as you have health coverage after age 65 through an employer or a spouse, you can delay enrolling in Medicare without paying a penalty. However, if you do not have group coverage, the right time to sign up is during your Initial Enrollment Period. This is the seven-month period of time that begins three months before your 65th birthday and ends three months after. There are also Special Enrollment Periods for those with unique circumstances, such as losing their job. The important thing to remember is that if you fail to sign up for Medicare when you are first eligible and delay Part B enrollment without proof of other health coverage, you could end up having a lifetime late enrollment penalty added to your premium.
2. Not Taking Advantage of Annual Enrollment
Medicare Annual Enrollment takes place each year between October 15 and December 7. This is the time for everyone to evaluate their current Medicare plan to see if changing plans makes sense. Cost and coverage can vary from year to year, and taking the time during Annual Enrollment to review your plan is smart. During Annual Enrollment, you can switch from your Original Medicare to a Medicare Advantage Plan, switch from one Medicare Advantage Plan to another, or return to your Original Medicare. You can also join a prescription drug plan, change plans, or drop one that no longer meets your needs. Not taking advantage of this opportunity means you could end up paying more for your plan or keeping a plan that doesn’t fit your changing needs.
3. Thinking You Don’t Need Prescription Drug Coverage Because You Don’t Take Medicine
One of the biggest mistakes people make concerning Medicare is failing to think ahead. If you are healthy and do not take prescription medication, great! However, if you wait to sign up for Part D benefits until you urgently need them, you risk paying a late penalty if you cannot provide proof of creditable coverage for the time you went without.
4. Choosing a Prescription Drug Plan Based on Cost Alone
Cost is a primary consideration when choosing the right Medicare plan. However, with drug coverage, it is often as important to ensure the drugs you use are on the formulary. If you choose a plan based on cost alone and your medication is not listed, you may end up paying much more for what you need.
5. Thinking You Have More Time to Enroll in Part B With COBRA Benefits
After you turn 65, Medicare becomes your primary coverage, unless you have coverage through an employer. However, the coverage must be current, and COBRA benefits or retiree benefits are not coming from a job you still work, and are not considered primary coverage. COBRA benefits extend an employer’s health care benefits for eighteen months. However, you only have eight months, not eighteen months after your group coverage ends to sign up. If you do not sign up for Medicare during this time, you will have gaps in your coverage and may be responsible for paying a late enrollment penalty.
6. Choosing the Same Plan as Your Spouse
It’s important to realize that you and your spouse likely have very different healthcare needs. When choosing a Medicare plan, whether it’s for prescription drug benefits or Original Medicare, be sure to think about your unique needs and how the plan you’re considering can help you with your medical needs.
7. Waiting Too Long to Enroll in Medicare Supplement Insurance
The good news is, that you have a full six months after enrolling in Part B to join a Medigap plan with full protections in place. All recipients who join Medigap during this period are entitled to “guaranteed issue rights”. This means that no company can refuse to sell you a plan or charge you more for a plan because you have a pre-existing condition. Once these six months end, these protections are no longer in place and you may not be able to get a Medigap plan.
8. Forgetting to Review Your Annual Notice of Change
The Annual Notice of Change that comes by mail each year is filled with critical information on any changes you will see in your Medicare coverage for the upcoming year. Changes in cost, network providers, and even formularies (list of covered drugs) must be noted in this documentation. Read it fully to avoid being surprised by higher out-of-pocket expenses or limited access to health care providers.
9. Not Taking Advantage of Extra Help
Medicare has safeguards in place to help those with limited income afford prescription drug coverage. Unfortunately, many Medicare recipients are not aware that they qualify, and could save money on the same plans they pay for each month. Be sure to read about extra help and make notes on whether or not you are entitled.
10. Going Out-of-Network with a Medicare Advantage Plan
Medicare Advantage makes it easy for seniors to receive all of their Part A and Part B benefits as well as a few extras like prescription drug benefits and in some cases, vision and dental care. However, most plans have very strict requirements regarding network providers. Going to a doctor or hospital outside the plan’s network of providers could end up costing you a lot more out-of-pocket.
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References:
Delaying Part B
https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#collapse-3156
Special enrollment periods
https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html
Open Enrollment
https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html#collapse-3190
Part D Late Enrollment
https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html
Medicare and other insurance
https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/how-medicare-works-with-other-insurance.html
When to buy Medigap
https://www.medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/when-can-i-buy-medigap.html
MUC68-2017-SSI:CDIS
