Question: I haven’t gotten my Prescription Drug Coverage/Insurance Company January bill yet, what should I do?

Answer: 2025 is here. This was a year of significant changes to Insurance options for many people. Some of this was due to the Inflation Reduction Act protections related to the $2000 Maximum Out of Pocket (MOOP) for all those enrolled in Medicare Part D plans. Much of the disruption was due to Medicare Advantage Plans that were discontinued.

Today’s question has been very common over the last few weeks and now in 2025. During the Annual Open Enrollment period everyone with Medicare can make a new choice for their coverage. This year a lot of people have changed their coverage. That means the insurance companies have a lot of work to do.

Everyone who changed their plans receives a series of mailings from their new insurance companies. First is a “Welcome to the Plan” letter, almost immediately and almost everyone got one of those. This letter is an important item to receive. This letter has your ID information on it and can be used as an insurance card until you get the actual card. Next plans send out new cards, and the new plan information. Eventually new bills for premiums.

If you haven’t received your Welcome letter, we have advised calling the plan and getting this information over the phone. There are times when this can be a long difficult process. Being on hold, and working through the call chain can be frustrating. Take a deep breath, sit back and wait for them to answer the call. Once you get a representative, you can talk through your concerns and get the information you require to access your prescription drug coverage.

Another way of getting your information is using the Medicare.gov website. This website has a login and password that allows you to access your personal data for many of your insurance products. If you have established that login and password you can access your current (and past) insurance coverage information. If you haven’t created this login and password, you can do so now and have access to this wealth of information available to you on the Medicare.gov website.

This website allows you to research your coverage and also print out ID card data from your new Part D insurance plan. This has allowed us to help many clients access their information using the login and password they have established on the Medicare.gov website.

You can also use the insurance company’s website to access your data. This will require you going to the company website and establishing a login and password. Unfortunately most of these sites require you to have your member ID to begin the process. But the Medicare.gov website can get your insurance member ID, which then allows you to set up a direct link with the company to access your account data. You can also pay the premiums, and access their formulary (drugs they cover) and your claim history.

If you don’t use a computer or understand how to do any of these task to get the help you need, please reach out to a family member or friend who is more computer savvy. Or you can reach out to an agency such as Office for the Aging, or the insurance broker that help you choose the plan, and they can help you through this process.

When addressing the issue of your bill, I would say be patient. The company has the month of January to issue the bill, and you have 30 days to pay. So take a deep breath and wait for the rest of your information and your bill to arrive. The important part is getting your card and being able to refill your medications and see your providers. They will cover your medications and medical appointments even if you haven’t paid your premium yet. Once you get that bill, you can catch up the payments and even set up an Electronic Funds Transfer (EFT) if you wish.

Happy New Year and wishing you all the best for 2025!

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.