As someone who is usually hesitant to try new things I’ve found that if you give something new a try, it could result in some really nice benefits and rewards. A few years ago I wrote about trying yoga classes for the first time, and as it turns out it’s something that has really helped my pain issues when they come on. I attend hot yoga classes, and I know for many with MS this style is not an option if heat sensitivity symptoms are an issue with the disease, but yoga in other formats can be beneficial too. It’s more about the movements and mindset it creates that can be valuable to all. Continue reading
Recently I went to my primary care doctor for an annual flu vaccine and physical exam to make sure everything was in check. I paid my copay when I arrived at my appointment per usual protocol, but after reviewing the Explanation of Benefits (EOB) from my insurance company that came in recently, I realized the appointment was considered preventative and I should not have had to pay my copay amount. After noticing this I called my doctor’s office and they told me that in fact there was now a credit on my account of the copay amount that I had paid. They asked me if I wanted it to stay on my account as a credit or if I wanted to be refunded the amount. This made me scratch my head in perplexity, because I realized if I hadn’t reviewed my EOB from the insurance company and contacted my doctor’s office myself, I would’ve essentially been left in the dark about this copay credit until maybe I’d gone to my primary care doctor next year and was surprised with the copay credit on my account.
I feel like this happens often to individuals who are just trying to follow up with and maintain their medical care. I think this is why it’s so vital to be your own advocate when it comes to reviewing insurance information and benefits because there are not many on the other side that will do this for you, be it insurance companies or medical offices. Now don’t get me wrong, there may be some representatives who are diligent and careful in their work and do their best to ensure accuracy, however, this may not always be the case so it’s good to check and re-check things on your own as well. Human error can occur and mistakes can happen, but if you’re not aware of your own benefits and coverage this can slip under the radar and you could be paying for things out of pocket that you didn’t have to.
Insurance benefits and coverage can be a tricky thing to try to understand, so it’s important to take one thing at a time and to make contacts when you have questions. Calling the insurance company can sometimes be challenging so set aside time you know you can dedicate to this, or maybe your doctor’s office can help you navigate and understand your benefits. Sometimes you can use online customer support services to contact your insurance or connect to patient portals through your doctor’s office too. A relative, friend, neighbor or other resources in your community may also be able to help you decipher your insurance coverage. Again, you are your own best advocate when it comes to your care so being thorough and asking questions and reviewing your benefits is an essential part of the process.
A week from now Medicare’s open enrollment insurance period will begin, running from October 15th until December 7th. This is the time when you can review your current Medicare plan and make changes if needed. You do not need to sign up for Medicare each year, but you can review your coverage and make adjustments if necessary to ensure your health insurance needs are being met.
Medicare beneficiaries who have a Medicare Advantage plan or Part D plan should receive documents such as ‘Evidence of Coverage’ or ‘Annual Notice of Change’ letters from your health plan showing coverage outlines and any changes that will occur. It’s very important to review these materials to make sure of any changes in the plan’s costs, providers, benefits, drug formularies, etc. so that if something is changing with your plan, you are aware of it and can make changes to your coverage if needed. These plans can change their benefits so it’s crucial to review your policy and any upcoming changes.
What can you do during the open enrollment period? According to Medicare’s website you can:
- Switch from Original Medicare to a Medicare Advantage Plan and vice versa.
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan or from one Part D prescription plan to another.
- Join a Medicare Prescription Drug Plan (Part D Plan) if you haven’t done so.
The Medicare website offers a Medicare Plan Finder where you can search for and compare health plans, benefits, coverage and estimated costs. You can also contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) for additional information and questions.
For additional help, you can receive individualized assistance and guidance in choosing coverage through your State Health Insurance Assistance Program (SHIP). This resource provides one-on-one insurance counseling and support, visit https://www.shiptacenter.org/ to find your local office.
MSAA’s My Health Insurance Guide is another helpful source for the MS community to find more information about insurance options and resources. This is an important time, so be sure to review your plan’s coverage and make changes if needed to make sure it’s right for you!