Roadmap Staff

The Roadmap for Medicare staff specialize in all topics related to Medicare Part D, choosing a Medicare plan, and making smart health decisions in retirement.

Avoiding Medicare Enrollment Road Bumps

Tips for enrolling in a Medicare Part D plan

Key Dates for Medicare Part D Annual Enrollment Period


Plan Information Available:

October 1

Enrollment Begins:

October 15

Enrollment Ends:

December 7

Note: The late enrollment penalty is 1% of the national average premium for every month you were without Part D prescription drug coverage or other creditable prescription drug coverage following your initial enrollment period, or if you had a break in creditable prescription drug coverage of 63 or more consecutive days. Creditable prescription drug coverage (for example, from an employer or union) means that it is expected to pay, on average, as much as Medicare’s standard prescription drug coverage. You will pay this late enrollment penalty for as long as you have Part D coverage.

Enrolling in a Medicare Part D prescription drug plan (PDP) is an important process that requires time and research, but it shouldn’t be a difficult one if you’re prepared well in advance for any potential bumps in the road. Unfortunately, nine in 10 people wait until the last minute to select a plan. (more…)

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Seeking Value: Looking Beyond Medicare Part D Premiums

Four simple rules for choosing the right plan for you

When choosing a Medicare Part D prescription drug plan (PDP), you might assume that a low premium (the monthly amount you pay for the plan) equals a “good deal.” While it’s easy to compare premiums, there is much more to consider. To learn more about four simple rules of the road to keep in mind as you do your research, please watch this video. (more…)

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5 Tips for Meeting with your Medicare Broker

Medicare Part A, Part B, Medigap, Medicare Advantage Plans, Medicare Part D…it can be a bit mind- boggling when researching the choices you have and trying to understand the type of Medicare coverage that makes the most sense for your healthcare needs.

Some people turn to Medicare insurance brokers to help sort through the fine print and choose the right Medicare plan. These professionals are experts at navigating through Medicare plan details and can narrow down options that suit your particular health and financial circumstances. They can also help you through the enrollment process. You will need to do some initial leg work to find the right broker and ensure you get the most out of the broker’s services, which are all free of charge.

If you choose to meet with a broker, here are five tips to help you find the right one and prepare for the meeting.

  1. Look for a specialist: Make sure you meet with a licensed broker who specializes in Medicare and has an American Health Insurance Plans (AHIP) certification. The broker should be licensed in the state where you have residency since Medicare plan options vary by state.
  2. The more information you share the better: Gather the following information that will help the broker direct you toward the best Medicare coverage for your health and financial needs.
    • Medical status and history: Your current and past health conditions.
    • Medications: Those you currently take as well as drugs you might need to take in the coming year. It’s best to have a discussion with your physician to assess what drugs you may need in the near future.
    • Finances: Be prepared to have a frank conversation about your finances so the broker can determine which plans are within your budget. It’s important to share information about your yearly income, if you’re on a fixed income, your living expenses, and the amount of money you currently spend on healthcare.
  1. The lowdown on prescription drug coverage: Each Part D plan has its own formulary, or list of covered drugs, so the broker will need to know your current prescriptions to make certain that not only the medications but the dosages you take are covered. You should ask the broker to check if the Part D plan has a preferred network of pharmacies that offers lower drug costs and if your own pharmacy or those in your area are included on that list.
  2. Know the lingo: Medicare has a lot of terminology, policies and processes that can be difficult to navigate and understand. The Medicare plan types are:
    • Original Medicare: The government-run benefit that includes Medicare Parts A and B
    • Medicare Part A: Covers inpatient care in hospitals, skilled nursing facilities, hospice care and some home healthcare. For most beneficiaries, there is no charge for Part A.
    • Medicare Part B: Covers physician services, outpatient services, laboratory tests, mental health services and other medical services not covered under Part A. Those enrolled in Part B will pay a monthly premium.
    • Medicare Part C also known as Medicare Advantage Plans: These are plans offered by private insurers as alternatives to Parts A and B. They usually provide additional benefits and may also include prescription drug coverage. The benefits and costs of these plans can vary widely.
    • Medicare Part D also known as a Prescription Drug Plan (PDP): These plans are offered by private insurers and provide prescription drug coverage which in most cases is not covered under Parts A or B. The formularies (drugs covered under the plan), clinical services and costs can vary widely.
    • Medicare supplemental insurance also known as Medigap plans: These plans are sold by private insurers and provide supplemental coverage to Original Medicare coverage. Unlike Medicare Advantage Plans, they are not meant to replace Parts A and B coverage but to provide additional benefits.

A full glossary of Medicare terminology is available at https://www.medicare.gov/glossary/a.html

  1. Make it habit to review yearly: Since your health status may change over time and plan benefits and costs often change from year to year, it’s important to review your Medicare coverage during the appropriate annual enrollment periods to ensure you have the right plan that will meet your health and budgetary needs in the coming year.

Healthcare coverage decisions can have serious consequences on your health and financial well-being, and a licensed insurance broker may be the resource that helps you find the Medicare insurance plan that is right for you at the price you can afford.

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New Medicare Cards Fight Fraud

The Centers for Medicare & Medicaid Services (CMS) is replacing the current Medicare cards with new cards. CMS is issuing the new cards in response to recommendations from the General Accountability Office, Medicare beneficiaries and advocacy groups. The new cards don’t use or display a beneficiary’s Social Security number. This protects beneficiaries who in the past have been unnecessarily exposed to fraud by the sharing of their personal information. The newly issued cards are also intended to protect taxpayer dollars because it will make it harder to bill Medicare for services that were never performed.

In place of the Social Security number, the new cards will use a Medicare Beneficiary Identifier (MBI) number that will be uniquely generated for each person. The MBI will use a random combination of numbers and capital letters. To avoid confusion between capital letters and numbers, the letters S, L, O, I, B and Z are not being used.

With more than 59 million beneficiary cards to replace, the new cards are being distributed over the course of a year.

What do beneficiaries need to do?

The new cards will be automatically sent on a rolling basis between April 2018 and April of 2019. You will not receive any calls or requests from Medicare for information. If Medicare has your current address, you don’t need to do anything. However, it’s important to call Medicare if you need to update your address so that you will receive your card promptly. You can contact Medicare at 1.800.633.4227 (TTY users, call 1.877.486.2048), 24 hours a day, 7 days a week. You can also sign up to receive an email notification about when to expect your card in the mail by visiting Medicare.gov/NewCard.

Once your new card arrives, you will need to dispose of your old one by cutting it up so that your Social Security number is destroyed. Your Medicare coverage and benefits will remain the same and there are no extra steps required by you to activate your card.

A transition period will be in effect through December 31, 2019, during which healthcare providers will accept both Medicare cards – the older plastic one, which includes your Social Security number, and the new paper version that includes your new MBI number.

Protect yourself from scammers and identity theft

A Medicare representative will never contact you by phone unless you have left a message requesting a callback. The representative will never ask you to provide personal information.

If someone calls you or sends an email asking for information or money they say is required for you to obtain your new Medicare card, you should immediately hang up and call Medicare at the numbers provided above.  You can also report it to the Federal Trade Commission (FTC) by calling 1.877.438.4338 (TTY users, call 1.866.653.4261).

At the end of the day it’s all about your protection. So be on the lookout for your new card and don’t respond to anyone asking for your information or trying to sell you what they say is the new Medicare card. Be informed. Be alert. Be protected.

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Four Rules of the Road

Four simple rules to follow when choosing a Medicare plan with Part D prescription drug coverage, including looking at your Medicare plan premium, your prescription drug costs and copays, and the pharmacy network that’s right for you.

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Understanding Medicare Part D

Watch this short video that explains the stages of Medicare Part D prescription drug coverage and how they can impact your healthcare costs.

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Pharmacy Network

Learn how using a Medicare Part D preferred pharmacy network where you live or travel can save you money on prescription drugs you take regularly.

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