Original Medicare has new ID cards!
Still waiting for your new card?
Your new Medicare card should have arrived in the mail by now. If you didn’t get it, here’s what to do next: • Look around the house for any old or unopened mail. Your new Medicare card will come in a plain white envelope from the Department of Health and Human Services. • If you still can’t find it, call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. They may not have your correct address on file. Their call center representatives can help you check your address and fix it if needed. • In the meantime, use your current Medicare card to get health care services.
11 things to know about the new Medicare card:
The new card won’t change your coverage or benefits.
Once you get your new Medicare card, destroy your old Medicare card and use your new card right away.
Guard your card: Only give your new Medicare Number to doctors, pharmacists, your insurer, or people you trust.
This new Medicare Beneficiary Identifier (MBI) number is unique to you.
The MBI has 11 characters and those in the positions 2, 5, 8, and 9 will always be alphabetic. All letters are UPPERCASE. The letters S, L, O, I, B and Z will never be used because they are frequently mistaken for certain numbers.
Your new card is paper. It is easier to copy. You can print your own replacement card if you need one.
Carry your new card with you and show it to your health care providers when you need care.
Your doctor knows it's coming: Doctors, other health care facilities and providers will ask for your new Medicare card.
If you forget your new card, you, your doctor or other health care provider may be able to look up your number online.
Keep your Medicare Advantage Card: If you're in a Medicare Advantage Plan (like an HMO or PPO), your Medicare Advantage Plan ID card is your main card for Medicare - you should still keep and use it whenever you need care. However, you may be asked to show your new Medicare card, so you should carry this card too.
Help is available: If you don't get your new Medicare card by April 2019, call 1-800-MEDICARE.
Here are how the numbers play out for 2019:
For 2019, the standard benefit requires the beneficiary to pay (depending on the specific Part D prescription drug plan):
$0 - $415 deductible (depending on the specific Part D prescription drug plan).
Initial Coverage Stage (between the annual deductible and $3,820)
25% of prescription drug costs in the Initial Coverage Stage. The amount of $3820 is reached after total spending on drugs by the beneficiary, by certain subsidy programs, and by the Part D prescription drug plan.
Coverage Gap Stage (between $3,820 and $5,100)
37% of generic drug costs and 25% of brand name drug non-discounted costs. Once beneficiary expenditures (including drug manufacturer discounts) reach a total of $5,100, the beneficiary is through the Coverage Gap Stage and reaches the Catastrophic Coverage Stage. As of 2020, your cost sharing for generic drugs will also be 25%.
Catastrophic Coverage Stage
On any future prescriptions the beneficiary pays either a co-pay of $3.40 for generic drugs or $8.50 for brand name drugs or a coinsurance of 5%, whichever is greater.
Caps on physical, speech and occupational therapy eliminated!
Millions of Medicare beneficiaries will be able to afford the physical, speech or occupational therapy they need because the payment caps on those services - $2,010 for physical and speech language therapy and $2,010 for occupational therapy - were permanently repealed in February, 2018
Medicare has a NEW Open Enrollment Period
for Medicare Advantage Plans starting in 2019!
The Medicare Annual Enrollment Period which runs from October 15th – December 7th will continue. During that time, Medicare Advantage Plan members are allowed to switch Medicare Advantage and Prescription Drug Plans, as well as return to Original Medicare and purchase a Medicare Supplement (Medigap) Plan.
The Medicare Advantage Open Enrollment Period runs January 1st – March 31st and allows Medicare Advantage Plan members to disenroll from their current plan and switch to a different Medicare Advantage plan one time only within the period. They will also be able to return to Original Medicare and purchase a Medicare Supplement Plan if they choose, but this is not "Guaranteed Issue" business, meaning their application may have to be medically approved. Members can only enroll into a new Part D plan if they have disenrolled from a Medicare Advantage Plan which includes prescription drug coverage (MA-PD).
Changes to Medicare Supplement Plans C and F in 2020
The new MACRA legislation, which goes into effect on January 1, 2020, affects your ability to enroll in Plans C and F.
If you are eligible for Medicare Part A before January 1, 2020, you can enroll in Plans C and F even after January 1, 2020, and keep your plan as long as you choose.
If you are newly eligible for Medicare Part A on or after January 1, 2020, you will not be able to purchase Medicare Supplement Insurance Plans C or F.
If you are already enrolled in Plan C or F, you do not need to take any action and you can keep the plan you have if you choose.
Medicare’s Wellness Visit Isn’t The Same As An Annual Physical
When you call your primary care doctor's office to schedule an annual visit, please use the magic words "annual wellness visit" instead of asking for an "annual checkup" or "routine physical" or some such phrase, otherwise you might be on the hook for a few hundred dollars for a physical exam and tests not covered by Medicare.
Original Medicare Does Not Cover An Annual Physical
However, some Medicare Advantage Plans cover annual physicals for their members without charge.
An annual physical typically involves an exam by a doctor along with blood work or other tests. The annual wellness visit generally doesn’t include a physical exam, except to check routine measurements such as height, weight and blood pressure.
It's important not to get tripped up by Medicare’s confusing coverage rules. Federal law prohibits the health care program from paying for annual physicals, and patients who get them may be out of pocket for the entire amount. But beneficiaries pay nothing for an “annual wellness visit,” which the program covers in full as a preventive service.
The focus of the Medicare wellness visit is on preventing disease and disability by coming up with a “personalized prevention plan” for future medical issues based on the beneficiary’s health and risk factors. At their first wellness visit, patients will often fill out a risk-assessment questionnaire and review their family and personal medical history with their doctor, a nurse practitioner or physician assistant. The clinician will typically create a schedule for the next decade of mammograms, colonoscopies and other screenings and evaluate people for cognitive problems and depression as well as their risk of falls and other safety issues. Medicare beneficiaries can also receive other covered preventive services such as flu shots at those visits without charge.