About six years ago, a credit card company debuted a TV commercial, asking about the cards you have in your wallet. It’s still around today.
I have dealt with a similar situation many times. When an acquaintance has a Medicare question, I ask, “What type of Medicare do you have?”
Blank stare.
“Do you have Original Medicare or Medicare Advantage?”
Another blank stare and then a grab for the wallet. Buried in the midst of credit cards, driver’s license, whatever, there are the cards in question. Even after finding them, they often have no idea about their coverage and how it works.
The majority of beneficiaries today have elected Medicare Advantage. These are Medicare-approved plans, sponsored by private insurance companies, that bundle Part A, hospital insurance, and Part B, medical insurance, services, and usually Part D, prescription drug coverage.
Original Medicare is sponsored by the government and consists of Part A and Part B. Many beneficiaries add a stand-alone Part D drug plan and a Medicare supplement insurance plan (Medigap policy) for comprehensive coverage.
These two types of coverage have different structures, coverage rules and costs. The type of coverage you chose has a big impact on your medical care. For instance, Original Medicare does not have provider networks, which are a staple of Advantage plans. Medicare Advantage plans can provide additional benefits, like dental and vision care, that Original Medicare cannot. Medicare Advantage plan members can face prior authorization for many services, whereas Original Medicare has considerably fewer situations requiring approval.
If you are not clear about which type of Medicare you have, pull out your cards and figure it out. Here are some tips.
The Medicare Card
After enrolling in Medicare, everyone gets a red, white and blue Medicare card. It notes:
- your Medicare number, officially a Medicare Beneficiary Identifier (MBI)
- the part(s) of Medicare you have, Part, Part B, or both, and
- the effective date(s).
Protect your Medicare card. Do not let anyone else use this card or your number.
Depending on the type you chose, you may have one or two more cards.
Medicare Advantage
This card has the words “Medicare Advantage” clearly imprinted on the front of the card, along with the type of plan, such as an HMO or PPO.
If the card has the MedicareRx logo, the plan includes prescription drug coverage (MA-PD plan). Along with the logo, there will be three numbers for the RxBIN, RxPCN and RxGRP, providing details about the specific drug coverage, important for the pharmacist.
If you have a Medicare Advantage card, you will use that for all healthcare appointments. Put your Medicare card away in a safe place.
Original Medicare
The most important card for this type of coverage is the Medicare card. Show that to any healthcare provider. Then there are two other cards that can apply.
1. Medigap Supplement Insurance (Medigap Policy)
The card must note Medicare Supplement Insurance, along with the type of plan, such as Plan G. Massachusetts, Minnesota and Wisconsin cards will note the type of plan, such as “Basic Plan” or “Supplement 1A Plan.”
The insurance company then decides what additional information to put on the card.
2. Part D Prescription Drug Plan (PDP)
This card is for those who have a stand-alone drug plan, not part of a Medicare Advantage plan. It includes the same MedicareRx logo and details to identify the member and coverage as appears on a card for a MA-PD plan.
Once enrolled in Medicare Part A and Part B, there are other options for additional coverage, such as a retiree coverage or Federal Employee Health Benefits (FEHB) plan. These beneficiaries will have specific identification cards for their type of coverage.
What’s Next
Medicare can be very confusing. Knowing what Medicare cards are in your wallet is the first step to clarity. Once your coverage is identified, it’s time to learn about how it works. Check out these resources from medicare.gov.
To paraphrase commercials, now that you know what Medicare cards are in your wallet, don’t leave home without them .
Read the full article here
