Medicare: A Recipe For Success

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Select Health Idaho

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Posted on

Jan 04, 2024

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Idaho - Boise and the Treasure Valley

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Medicare: A Recipe For Success

Medicare can be confusing.  With the right information, you’ll be ready to shop for a plan and choose the right one for you and your needs. As you compare plans, benefits, and prices, it’s important to keep a few key things in mind.

1. Many people take one or more medications on a regular basis. Review the drug formulary to make sure the medication(s) you take are covered by the plan.

Make sure to check:

  • Drug brand names and generics
  • Prior authorization requirements
  • Prescription tiers and the associated costs

2. What may have been a great plan may not suit your needs anymore. Remember to review your plan and coverage every year.  Always keep your eyes out for:

  • Provider and facility network: In-network versus out-of-network. Are your doctors and facilities covered on your current plan?
  • Monthly premiums: This is the monthly bill you pay for your coverage.
  • Out-of-pocket (OOP) maximums: This is the total amount you may pay for services covered each year.
  • Copays and coinsurance: You may have copayments or coinsurances to pay for services. Copays are fixed amounts, and coinsurance is usually a percentage of the cost you pay.
  • Bonus perks: What options, tools, and services are included on your plan? Find out about gym memberships, OTC items, vision and dental, and other extras. Some perks may cost more.

3. Wading through the hundreds of insurance companies can be downright exhausting. For starters, there are several categories to consider:

  • Not-for-profit vs. for-profit: Who is the priority—you or shareholders? For-profit companies must return profits to investors while not-for-profits must reinvest their profits back into the plan to benefit members.
  • Customer service you deserve: This is a big deal! Can you talk to a local person on the phone? When you need answers, you need a real person to make things happen for you.

4. The Centers for Medicare and Medicaid Services (CMS) use a five-star quality rating system. The Star Rating can tell you about a company’s customer service, member satisfaction, benefits, and overall quality. Companies receive an updated rating annually, making it easy to weed out less than the best.

This article was submitted by Darin Vickery, Idaho-based Medicare Sales Executive for SelectHealth. darin.vickery@selecthealth.org or 208-338-2019

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Identifying Medicare Scams

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The fraudster will inform you that in order to issue a new card, they will need your social security number and/or your Medicare card number.Truth: Medicare will not call you if there is an issue with your card. They will send a letter to arrange a phone interview.Your Medicare plan is about to be canceledThe caller will claim that in order to prevent your Medicare from being canceled, you will need to verify your current Medicare number, full name, address, banking information, birthdate, and social security number. This is also a common Social Security scam.Truth: Medicare representatives have your Medicare number on file- they will never ask for it. Additionally, Medicare representatives never ask for details such as your social security number to verity your identity.You are eligible for early access to vaccinationsThe COVID-19 pandemic spawned many pandemic-related scams such as being sent at-home testing kits or special access to vaccinations. 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They use this offer to get your Medicare number and other personal information as well as your credit card number so that you can pay for shipping. Your information will be used to over-bill Medicare.Truth: Medicare is not likely to call you to offer free medical supplies/medications. They will never ask for you to pay for shipping or provide financial information. Never pay for anything without seeing an invoice that can be confirmed with Medicare.You overpaid and are due a refundOne of the most common scams fraudsters use is to contact you via a phone call or text offering a refund on overpayment.Truth: Medicare will not call you to verify your personal financial information before issuing a refund. If you are due for a refund, a paper check will be sent out or it will be sent to the bank account on file.Youve been pre-approved for a cheaper/better planSome scammers will try to convince you that you are eligible for a cheaper/better plan than you are currently on. 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6 Questions to Get Your Medicare Right

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Its All In The Stars: Rating System For Medicare Plans Explained

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Select Health

Medicare Advantage Plans 3330 East Louise Drive, Meridian, Idaho, 83642

We offer plans to serve all members of our community, from individuals and families to employers. And everything we do is aimed at helping you manage your healthcare.We're constantly striving to improve the communities we serve. Our active volunteer services and programs like SelectHealth Awards, B3, and GREENbike help us do just that.  Our integration with Intermountain Healthcare and our partnership with St. Luke's Health System allow us to offer the best possible care.