Actions to Take After Medicare AEP

The Medicare Annual Election Period (AEP) is one of the most important times of the year for anyone enrolled in Medicare. It’s an opportunity to assess your current plan, explore alternatives, and choose the coverage that best suits your needs for the upcoming year.

Once you’ve dealt with the difficult task of completing AEP, you may feel a sense of accomplishment, but there are still a few steps to take to ensure you’re ready to make the most of your Medicare benefits. By following the right actions after AEP, you can set yourself up for a smooth and worry-free year. Let’s talk about some of the actions you should take after AEP.

1. Notify Providers and Pharmacies of Your New Insurance Information

One of the most important tasks after the Medicare Annual Election Period is updating your healthcare providers and pharmacies with your new insurance details. This step is particularly critical if you’ve switched plans, as outdated insurance information could lead to billing errors or delays in receiving the care you need.

Medicare Advantage and Part D plans often have specific provider networks or preferred pharmacy arrangements. Ensuring your healthcare providers and pharmacies have your updated information can help prevent confusion or claim denials when accessing services or filling prescriptions.

Contact your primary care doctor, specialists, pharmacy, and any other healthcare providers you visit regularly. Share your updated insurance ID card with them and confirm that they are still in-network under your new plan. Since provider networks can change each year, it’s always a good idea to double-check this information.

Helpful Tip: Keep your old Medicare card or previous insurance ID on hand for a short time. This can be helpful if billing questions or issues arise as you transition to your new plan.

2. Review and Understand Your Coverage

Once your new Medicare plan becomes active, familiarize yourself with the details of your benefits. Understanding your plan thoroughly will help you avoid unexpected costs and make the most of your coverage throughout the year.

Each Medicare plan has its own set of rules regarding coverage, deductibles, copayments, and provider networks. Take some time to carefully review these details. For Medicare Advantage plans, confirm which services are covered in-network versus out-of-network. If you have a Part D prescription drug plan, review your plan’s formulary to ensure your medications are covered and check for any applicable restrictions.

Some key areas to focus on include:

• Preventive care services (e.g., screenings and vaccinations).

• Specialist coverage and referral requirements.

• Cost-sharing amounts, such as copayments and coinsurance, for services you’re likely to use.

Refer to your plan’s Summary of Benefits or Evidence of Coverage documents, which provide a comprehensive overview of your plan’s features. Additionally, many insurers offer online member portals where you can access tools and resources to better understand and manage your coverage.

3. Make the Most of Extra Benefits

Many Medicare Advantage plans go beyond standard medical coverage by offering additional benefits that can enhance your healthcare experience and save you money. These perks are designed to support your overall well-being, so it’s important to take full advantage of them. Some common extra benefits include:

• Dental, Vision, and Hearing: Coverage for routine cleanings, eye exams, hearing tests, and hearing aids.

• Fitness Programs: Options like SilverSneakers, which provide free access to gyms, fitness classes, and wellness activities.

• Over-the-Counter Allowances: A quarterly allowance to purchase items like vitamins, first-aid supplies, and other health essentials.

To maximize these benefits, schedule routine dental, vision, and hearing appointments early in the year to ensure you get the care you need. You should also use your fitness benefits to stay active, maintain strength, and boost overall health. Finally, take advantage of over-the-counter allowances by stocking up on health items offered through your plan.

Some plans may offer additional perks such as transportation to medical appointments or home-delivered meals after a hospital stay. To ensure you’re fully utilizing your plan, contact your insurer’s customer service team to learn about all the benefits available to you.

4. Keep Track of Your Prescriptions and Manage Costs

Prescription medications can represent a significant portion of healthcare expenses, so it’s important to ensure your drugs are covered and to explore cost-saving strategies. Start by reviewing your plan’s formulary to confirm that your medications are included. Be aware of any restrictions, such as step therapy, quantity limits, or prior authorization requirements, which may impact your ability to fill prescriptions.

To help reduce costs:

• Opt for generic medications whenever possible, but always consult your doctor before making any changes to your prescriptions.

• Use a preferred pharmacy instead of a standard pharmacy, as preferred pharmacies typically offer lower out-of-pocket costs.

• Check if your plan offers a mail-order pharmacy option, which can provide additional savings and convenience for ongoing prescriptions.

If a medication isn’t covered or is too costly, contact your plan to discuss alternatives. In some cases, you may be able to file an exception request or switch to a different medication that is covered under your plan.

5. Prepare for Future Healthcare Needs

Taking a proactive approach to your healthcare can make a significant difference in managing both routine needs and unexpected health challenges. Planning ahead ensures you’re ready to make the most of your Medicare coverage throughout the year.

Start by prioritizing preventive services such as annual wellness visits, cancer screenings, and vaccinations. These services are often covered at no extra cost, so scheduling them early in the year is a great way to maintain your health and catch potential issues early.

For those managing chronic conditions, confirm that you have access to the right specialists, medications, and resources to support your care plan. If you anticipate needing surgery or other major healthcare services, review your coverage details in advance to avoid surprises and ensure a smooth process.

Also, stay informed about other important Medicare enrollment periods, such as the Open Enrollment Period (OEP) from January 1 to March 31. During this time, certain beneficiaries can make changes to their plan if needed, giving you an additional opportunity to adjust your coverage.

Take Control of Your Coverage with Local Medicare Specialists

Now that the Medicare Annual Election Period has ended, following these steps will help you avoid potential complications and maximize your benefits in the new year. At Local Medicare Specialists, we understand that Medicare can feel overwhelming, but you don’t have to navigate it alone. We’re here to support you every step of the way.

Whether you have questions about your plan, need help accessing your benefits, or want to explore your options for the future, our team of Medicare experts is ready to assist. We’re committed to helping you understand your coverage and ensuring you get the most out of your Medicare plan.

Contact us today to schedule a consultation or to learn more about how we can help you make the most of your Medicare coverage.