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  • Tom Cianflone

Getting the Most Out of Your Medicare Coverage


So, you’re on Medicare, or you’ve changed to a new Medicare plan. Now what? Here are my tips for getting the most out of your Medicare coverage.


Know Your Customer Service Phone Number

When you get your member ID card, locate the customer service phone number on the card and enter it into your phone contacts if you’re a smartphone user or into your personal phone directory. This will make it easy to contact your plan when necessary.


Create a Login Account at your Member Portal

All plans have web portals these days. If you know your way around a computer or tablet, find the member portal for your plan and create an online account. Once you’re logged in, it’s usually pretty easy to find out what providers are in-network for you (Advantage plans), the cost of prescription drugs, etc. It’s also the fastest way to file an appeal in the event there is a coverage decision you don’t agree with, or to file a grievance if you think you are getting substandard care from one of your providers.


Know Which Cards to Present for Medical Care or Prescription Drug Coverage

If you are on a Medicare Advantage plan, you will present your plan member ID card for all care including medical care and prescription drug coverage. You will not need to present your original Medicare card (the red, white and blue government issued card). Be sure to update your prescription drug coverage at your pharmacy the first time you visit to pick up prescriptions. If you are on original Medicare with a supplement and a separate prescription drug plan (PDP), you will need to carry three cards with you: your original Medicare card, your supplement member ID card and your PDP member ID card. Present both your original Medicare card (your primary insurance) and your supplement member ID card (your secondary insurance) for medical care. Present your PDP member ID card for prescription drug coverage.


Learn How to Use Your Over-the-Counter (OTC) Benefit

Why spend your own money at the drug store for OTC products when you probably have a quarterly OTC benefit in your Advantage plan? Don’t leave any of your OTC benefit on the table; use it! Most carriers have a few different ways to order covered OTC products: in participating stores, online, over the phone. Call your plan customer service number to find out the most convenient way for you to use your OTC benefit.


Learn How to Minimize Prescription Drug Costs

Submit prescription to your pharmacy first. When it’s ready for pick-up, you will know exactly what your cost is through your insurance. If that cost is unacceptable, look at alternatives (goodrx.com, etc.) Buy the prescription at whatever the lowest price is, no matter if it’s through your plan or not. If you’re a smartphone user, install the goodrx.com app on your phone. No smartphone? You can use goodrx.com from a computer or tablet and print the coupon to your printer. Or, you can have a family member or friend print the coupon for you. For more about saving money on prescription drugs, check my blog post here.


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