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Tips Offered for New Medicare Members

Have you recently made the switch from your employer’s health plan to Medicare?

Things are a little different now, and here are a couple important things you should know right from the start:

Understand Your Explanation of Benefits

You receive a Medical Explanation of Benefits each time your providers process claims for visits, labs or other services. It’s an important reference for understanding your costs, those paid for by Medicare and those picked up by your insurance company.

Each month, you also receive a Pharmacy Explanation of Benefits. Even if you didn’t fill any prescriptions during a particular month, you’ll still receive this regular reminder of your annual out‑of‑pocket drug costs to date and how close you are to Medicare’s coverage gap.

If you don’t understand either of these documents — or have questions about the coverage gap — give your plan a call.

Appoint an Authorized Representative

As a member, you have the right to name an authorized representative to make decisions regarding your Medicare benefits when you cannot do so. You can appoint one by having both you and your representative complete and sign an Authorized Representative Form, which is available on your health plan website or by calling customer service.

Upon completion, the appointment and form are considered current only for a certain amount of time — in many cases, only one year. So mark this down as an important annual to‑do.

Understanding your coverage and knowing your member rights will help you get the most out of your Medicare coverage now and in the years to come.

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