How to Call Medicare's Help Line - dummies

How to Call Medicare’s Help Line

By Patricia Barry

Copyright © 2015 AARP. All rights reserved.

Medicare’s consumer help line takes any questions on Medicare at no charge. And that includes asking a customer service representative to do a search of the online plan finder for the Part D or Medicare Advantage plans that best meet your needs and preferences — and then to mail printouts to you.

This way, you can get details of two or three plans, all ready for you to compare and pick the one you think will give you the best service and/or deal on cost.

When you call the help line — at 800-633-4227 or TTY 877-486-2048 — you don’t have to identify yourself (unless you want info mailed to you). But if you want assistance choosing a plan, the rep needs to know your zip code and some other information in order to perform an accurate search. If you don’t speak English fluently and want the help of an interpreter, tell the rep immediately. You won’t be charged any money for an interpreter’s services.

How helpful is the help line? Medicare uses contracted workers as customer representatives and gives them basic training, though their knowledge of Medicare isn’t extensive. Feedback from customers (and others who call the number to test the quality of the service) is mixed, as you may expect. Some callers get through to a rep in a jiffy; others remain on hold for ten minutes or longer. Some are satisfied with the information they receive; others aren’t.

When you talk with a rep, it helps to be as specific as possible. Use the following pointers to explain what you want:

  • Tell the rep whether you’re looking for a stand-alone Part D drug plan, a Medicare Advantage plan, or a Medigap policy.

  • If you need a plan that includes Part D prescription drug coverage, give the rep the following information:

    • The names of the drugs you’re taking, plus their dosages and how often you take them. (Keep in mind that making an accurate list of your meds is essential.)

    • Whether you qualify for Extra Help.

    • Whether you want a plan that offers mail-order services.

    • Whether you want a plan that covers prescriptions at network pharmacies anywhere in the country.

  • If you want details of a few plans that charge the least for your drugs, ask the rep to check whether each plan

    • Covers all your drugs

    • Places any restrictions on your drugs (prior authorization, quantity limits, or step therapy)

    • Has good quality ratings

    • Has in-network or preferred pharmacies that are convenient for you

  • If you’re interested in Medicare Advantage plans, ask the rep to narrow the number of plans to reflect what’s important to you — such as co-pays for doctors and hospitals or extra benefits such as vision, hearing, or dental care or gym memberships.

  • Ask the rep to mail you printouts of the three plans that best meet your needs so that you can make a final choice. If these options are Medicare Advantage plans, be sure to specify that you want printouts of the plans’ detailed health benefits information (which runs to several pages).

If the customer service rep refuses to give you all the info you request, ask to speak to her supervisor. You have a right to ask as many questions as you like. If the rep gives the impression that finding plan information for you is tedious or taking too much time, you also have the right to complain.