Overview
The start of a new plan year brings many questions for Medicare members—and we want to ensure you’re fully equipped to support them. Below is a consolidated, easy-to-reference guide to help you know when to submit support requests and how to prepare clients as they begin using their new coverage.
Plan Materials, ID Cards, and Extra Benefit Cards
Please remember: carriers generally cannot release member-specific plan details until the plan’s effective date. Even if enrollment took place early during AEP, carriers usually do not begin mailing plan documents until mid-December or early January, with standard delivery times of 7–10 business days.
When to Reach Out to Client Services
Submit a Support Request if:
The client’s mailing address was incorrect or incomplete on the application.
The client still has not received their ID card or plan documents by January 15th.
The client has a medical appointment before January 15th and needs their Member ID number.
What to Advise Clients
Most members should expect their ID and benefit cards by mid-January.
Members are able to access their ID card information via the carrier member portal as of January 1st.
Some carriers offer combined cards—for example, UnitedHealthcare’s UCard acts as the ID card, OTC card, and access for additional plan benefits.
Part B Premium Reduction / Giveback Reminders
❗Note: With a Giveback, the client will not receive extra funds. This is a premium discount before the benefit.
Part B giveback benefits can take up to 120 days before appearing on the member’s Social Security statement.
When to Contact Client Services
If more than 120 days have passed with no reduction.
If the reduction has started but the amount seems incorrect.
Helping Clients Navigate Their New Plan
Doctor Visits & Pharmacy Pick-Ups
❗Note: Members must present their new member or ID cards at each visit. If enrolled in a Medicare Advantage plan, they should also show their Medicare Advantage plan card or Prescription Drug Plan card. Bringing the Medicare Complete red and blue card is not necessary unless the member has Medicare Complete, as it can delay billing.
Advise clients to:
Present their new plan cards at all appointments and when picking up prescriptions.
Bring their cards to their first few visits, as some provider systems take time to update.
Bring secondary insurance cards as well (TFL, Medicaid, etc.).
Medications & Prior Authorizations
When members switch plans:
They must update their insurance information with each provider.
Some medications may require new prior authorizations under the new plan.
If a prior authorization is missing, carriers may only approve a short-term supply (often 7 days) until the new authorization is completed.
Prescheduled Procedures or Surgeries
If a procedure was authorized under the member’s previous insurance:
A new authorization must be obtained for the new plan year.
Members should notify their providers as early as possible to avoid delays.
Client Services Is Here for You
If your clients need help or have questions regarding any of these areas, the Client Services team is ready to assist. Reaching out at the right time ensures faster resolutions and a smoother start to the year for your members.