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It’s That Time of the Year‚ÄîMedicare Open Enrollment

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This week’s guest blog is provided by Charles Clarkson, Esq. This article, originally posted in issue #21 of the New Jersey Senior Medicare Patrol (SMP) newsletter¬†Advocate, will cover Medicare Open Enrollment, your options, and information about Medicare scams.

By Charles Clarkson, Esq.

Jewish Family Services of Middlesex County

Project Director, Senior Medicare Patrol of New Jersey

 

 

Every year between October 15 and December 7, a period known as “Open Enrollment,” Medicare beneficiaries can make changes in their Medicare coverage. The Senior Medicare Patrol of New Jersey (SMP), a Federally funded program of the U.S. Administration for Community Living, believes that if you know your options you can avoid being scammed and make the right choices, giving you the best coverage at the least cost.

 

Why make a change?  Whether you have Original Medicare (Part A and/or B), Part D (prescription drug plan), or a Part C (Medicare Advantage Plan,) your plan can change. Premiums, deductibles  and coverages can all change.  Even if they remain the same, your health or finances may have changed. SMP encourages all beneficiaries to re-visit their coverage and decide whether or not to change during Open Enrollment.

Beneficiaries have these choices:

  1. If you are enrolled in Original Medicare, you can change to a Medicare Advantage plan with or without drug coverage. These plans are private companies approved by Medicare and give you the services of Original Medicare. If you join a Medicare Advantage plan, you do not need (and are not permitted) to have a Medicare supplement insurance plan (also known as a Medigap policy) and if your Medicare Advantage plan has drug coverage, you will not need a Part D plan.
  2. If you are in a Medicare Advantage Plan, you can switch to another Medicare Advantage plan or drop your Medicare Advantage Plan. If you decide to drop a plan and not switch to another plan, you will be enrolled in Original Medicare. You should then consider enrolling in a Medicare supplement insurance plan to cover the costs that Original Medicare does not pay for and enroll in a Part D plan for drug coverage.
  1. If you are in Original Medicare with a Part D plan, you can stay in Original Medicare and switch your Part D plan. Medicare has a Plan Finder on Medicare.gov which allows beneficiaries to compare plans for next year. The new Part D plans should be announced in late September or early October.
  1. If you are in Original Medicare and do not have a Part D plan, you can enroll in a Part D plan. If you join a Part D plan because you did not do so when you were first eligible for Part D and you did not have other coverage that was, on average, at least as good as standard Medicare drug coverage (known as creditable coverage), your premium cost will be penalized 1% for every month that you did not enroll in Part D. You will have to pay this penalty for as long as you have a drug plan. The penalty is based on the national average of monthly premiums multiplied by the number of months you are without coverage and this amount can increase every year. If you qualify for extra help (low income subsidy), you won’t be charged a penalty.

 

Why change Part D plans?

Beneficiaries may want to change Part D prescription drug plans (PDPs) for a number of reasons: (i) the PDP has notified the beneficiary that it plans to drop one or more of their drugs from their formulary (list of available medications); (ii) the beneficiary is reaching the coverage gap (donut hole) sooner than anticipated and may want to purchase a PDP with coverage through the coverage gap, if one is available; (iii) the PDP has notified the beneficiary that it will no longer participate in the Medicare Part D program; (iv) the PDP will increase its premium or co-pays higher than the beneficiary wants to pay and a less expensive plan may be available and (v) a beneficiary is not happy with the PDP’s quality of service or the plan has received low rankings for a number of years. For 2019 beneficiaries in New Jersey can expect to choose from a number of PDPs.

 

Compare plans each year.

Beneficiaries should remember that PDPs change every year and it is recommended that beneficiaries compare plans to insure that they are in the plan that best suits their needs. When comparing plans, keep in mind to look at the “estimated annual drug costs,” i.e. what it will cost you out of pocket for the entire year, from January 1 through December 31 of each year. Plans can be compared at the Medicare web site:  www.medicare.gov. If you do not have access to a computer, call Medicare at 1-800-Medicare to assist in researching and enrolling in a new plan. Medicare can enroll a beneficiary over the telephone.  When you call, make sure you have a list of all your medications, including dosages. Another resource for Medicare beneficiaries is the State Health Insurance Assistance Program (known as SHIP), telephone 1-800-792-8820. SHIP is federally funded and can provide beneficiaries with unbiased advice.  Call SHIP to make an appointment with a counselor. You do not need to use a broker or agent who may not be looking out for your best interest. Brokers and agents are usually being paid to enroll you in certain plans. Beneficiaries can also call the Senior Medicare Patrol of New Jersey at 732-777-1940.

 

Medicare Open Enrollment can also be a time of fraudulent schemes that can cost you money. The SMP wants you to be on the alert for scams. A word of advice:

When you realize that a scammer is calling. Just hang up. Do not be polite and just hang up. Also, let your answering machine do all the work. Never answer any call unless you recognize the number. If no message is left, you know the call is probably a scam or an unwanted solicitation. For any questions about Medicare and to report any Medicare scams, call the Senior Medicare Patrol of New Jersey at 732-777-1940.

MEDICARE OPEN ENROLLMENT

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MEDICARE OPEN ENROLLMENT

ARE YOU AWARE OF YOUR CHOICES?

Charles Clarkson, Esq. Jewish Family Services of Middlesex County, Project Director/VP, Senior Medicare Patrol of New Jersey

 

Every year between October 15 and December 7, during a period known as ?¢‚Ǩ?ìOpen Enrollment,?¢‚Ǩ¬ù Medicare beneficiaries can make changes in their Medicare coverage. The Senior Medicare Patrol of New Jersey (SMP), a Federally funded program of the U.S. Administration for Aging, believes that if you know your options you can avoid being scammed and make the right choices giving you the best coverage at the least cost.

Why make a change?  Whether you have Original Medicare (Part A and/or B), Part D (prescription drug plan), or a Part C Medicare Advantage Plan, your plan can change.  Premiums, deductibles  and coverages can all change.  Even if they remain the same, your health or finances may have changed. SMP encourages all beneficiaries to re-visit their coverage and decide whether or not to change during Open Enrollment.

Beneficiaries have these choices:

  1. If you are enrolled in Original Medicare, you can change to a Medicare Advantage plan with or without drug coverage. These plans are private companies approved by Medicare and give you the services of Original Medicare. If you join a Medicare Advantage plan, you do not need (and are not permitted) to have a Medicare supplement insurance plan (also known as a Medigap policy) and if your Medicare Advantage plan has drug coverage, you will not need a Part D plan.

 

  1. If you are in a Medicare Advantage Plan, you can switch to another Medicare Advantage plan or drop your Medicare Advantage Plan.  If you decide to drop a plan and not switch to another plan, you will be enrolled in Original Medicare.  You should then consider enrolling in a Medicare supplement insurance plan to cover the costs that Original Medicare does not pay for and enroll in a Part D plan for drug coverage.

 

  1. If you are in Original Medicare with a Part D plan, you can stay in Original Medicare and switch your Part D plan.

 

  1. If you are in Original Medicare and do not have a Part D plan, you can enroll in a Part D plan.¬† If you join a Part D plan because you did not do so when you were first eligible for Part D and you did not have other coverage that was, on average, at least as good as standard Medicare drug coverage (known as creditable coverage), your premium cost will be penalized 1% for every month that you did not enroll in Part D.¬† You will have to pay this penalty for as long as you have a drug plan.¬† The penalty is based on the national average of monthly premiums multiplied by the number of months you are without coverage and this amount can increase every year.¬† If you qualify for extra help (low income subsidy), you won’t be charged a penalty.

Why change Part D plans?

Beneficiaries may want to change Part D prescription drug plans (PDPs) for a number of reasons:¬† (i) the PDP has notified the beneficiary that it plans to drop one or more of their drugs from their formulary (list of available medications); (ii) the beneficiary is reaching the coverage gap (donut hole) sooner than anticipated and may want to purchase a PDP with coverage through the coverage gap, if one is available; (iii) the PDP has notified the beneficiary that it will no longer participate in the Medicare Part D program;¬† (iv) the PDP will increase its premium or co-pays higher than the beneficiary wants to pay and a less expensive plan may be available and (v) a beneficiary is not happy with the PDP’s quality of service or the plan has received low rankings for a number of years.¬† For 2018 beneficiaries in New Jersey can expect to choose from a number of¬† PDPs. The plans are announced in late September or early October, 2017.

Compare plans each year.

Beneficiaries should remember that PDPs change every year and it is recommended that beneficiaries compare plans to insure that they are in the plan that best suits their needs.  When comparing plans, keep in mind to look at the estimated annual drug costs, i.e. what it will cost you out of pocket for the entire year, from January 1 through December 31 of each year.  Plans can be compared at the Medicare web site:  www.medicare.gov.  If you do not have access to a computer, call Medicare at 1-800-Medicare to assist in researching and enrolling in a new plan. Medicare can enroll a beneficiary over the telephone.  When you call, make sure you have a list of all your medications, including dosages.  Another resource for Medicare beneficiaries is the State Health Insurance Assistance Program (known as SHIP), telephone 1-800-792-8820.  SHIP is federally funded and can provide beneficiaries with unbiased advice.  Call SHIP to make an appointment with a counselor. You do not need to use a broker or agent who may not be looking out for your best interest. Brokers and agents are usually being paid to enroll you in certain plans.  Beneficiaries can also call the Senior Medicare Patrol of New Jersey at 732-777-1940.

Medicare Open Enrollment can also be a time of fraudulent schemes that can cost you money. The SMP wants you to be on the alert for scams involving new Medicare cards.¬† Back in the spring of 2015, Congress passed the “Doc Fix”¬ù bill which mainly dealt with the long standing problem of the Physician Fee Schedule.¬† At the same time, Congress sought to remedy the problem caused by having Social Security numbers on the red, white and blue Medicare ID cards.

 

The new cards will be rolled out starting in April of ?Ǭ†2018.?Ǭ† Since it will take a period of time to mail new Medicare cards to all Medicare beneficiaries, there will be a transition period through December 31, 2018 when beneficiaries will be able to use either card.¬† All cards should be issued by April of 2019.?Ǭ† You should start using the new Medicare card once you receive it.¬† Make sure that the Social Security Administration and Medicare have your current address to insure that you get your new card.

 

This card change is both a blessing and a curse for Medicare beneficiaries.¬† By removing Social Security numbers, the change greatly decreases the financial havoc that a stolen Medicare card can cause, but it opens the door to scammers¬† presenting a golden opportunity to take advantage of Medicare beneficiaries.¬† Remember, there is never a charge for the new Medicare card.¬† Scammers already are calling¬† and scaring seniors into paying $300 or more for a new Medicare card and asking for their checking account information to pay for the new card’s fee.

What do you do when you realize that a scammer is calling?  Just hang up.  Do not be polite and just hang up.  Also, do not open any emails about the new Medicare cards even if they appear to be coming from a legitimate source, such as Medicare.  They are most likely scams.  Any questions about the new Medicare cards, call the Senior Medicare Patrol of New Jersey at 732-777-1940.

 

 

 

 

 

 

Medicare Open Enrollment Starts Today (Oct. 15th)

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Medicare Open Enrollment Starts Today (Oct. 15th)

Open Enrollment is happening now. From October 15th to December 7th you can make changes to your Medicare coverage.

What changes can you make?

If you are enrolled in Original Medicare, you can join a Medicare Advantage plan with or without drug coverage. These plans are private companies that are approved by Medicare and give you the services of Original Medicare. If you join a Medicare Advantage plan, you do not need to have a supplement plan (also known as a Medigap policy) and if your Medicare Advantage plan has drug coverage, you will not need a Part D plan.

If you are in a Medicare Advantage Plan, you can switch to another Medicare Advantage plan or drop your Medicare Advantage Plan. If you decide to drop a plan and not switch to another plan, you will be enrolled in Original Medicare.   You should then consider enrolling in a supplement plan to cover the costs that Original Medicare does not pay for and enroll in a Part D plan for drug coverage.

If you are in Original Medicare with a Part D plan, you can stay in Original Medicare and switch your Part D plan.

If you are in Original Medicare and do not have a Part D plan, you can enroll in a Part D plan.

Why You Should Review Your Coverage

It’s important to review your coverage before making a decision. And remember just because your doctor and medications are covered in your Medicare Advantage plan, supplemental plan or drug plan this year doesn’t automatically mean they will be covered in the coming year. Research studies show that Medicare recipients can save money if they review their Part D coverage. Make sure to confirm cost, copays, coinsurance, covered providers, and prescription drugs. Here are a few things to consider:

  • Has your health changed in the last year?
  • Is your current plan still meeting all of your health needs?
  • How much have you paid out-of-pocket in the last year‚Äîand for what?
  • How is your plan changing for the coming year? How will that affect your out-of-pocket ¬†¬†¬†¬†¬†¬† costs?
  • Are there better options available to you now?

There are many ways you can get assistance with this process. You can contact Medicare directly at 1-800-MEDICARE or at www.medicare.gov

You can also contact your County SHIP (State Health Insurance Program) by calling 1-800-792-8820 or visit http://www.state.nj.us/humanservices/doas/services/ship/

NCOA (National Council on Aging) also has some useful information and tools. Like Medicare Quick Check, where you can answer some questions and you’ll get advice on choosing a new plan. Find it at https://medicarequickcheck.benefitscheckup.org/medicare-quick-check/?SID=543e7baa3cc91

In November, tune into Aging Insights to hear from the Senior Medicare Patrol of NJ, including Open Enrollment.

News-Open-enrollment-Oct-15th

Medicare Open Enrollment ends December 7th

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Medicare Open Enrollment ends December 7th

Open Enrollment is coming to a close soon. Every year Medicare gives you the opportunity to review your coverage and make changes. This year the Open Enrollment period is October 15 to December 7.

This is when people with Medicare can change their Medicare health plan and prescription drug coverage for 2014. Information on 2014 plans has been available since the beginning of October. People with Medicare can call 1-800-MEDICARE or visit www.medicare.gov for plan information. If a person is satisfied that their current plan will meet their needs for next year, they don’t need to do anything.

What can you do during Open Enrollment?

From October 15 to December 7 you can

  • Join or switch a Medicare Prescription Drug Plan
  • Join or switch a Medicare Advantage Plan

During this period you should take time to review health and drug plan choices and choose the plan that fits your needs. Coverage begins on January 1, 2014.

Each year, Medicare Advantage and Medicare Drug Plans can change costs and coverage. Plans will mail an Evidence of Coverage/Annual Notice of Change to you. This notice gives details about plan coverage, costs, etc for the next year. Some plans may choose to leave Medicare and no longer offer the plan you have, meaning you’ll have to find a new plan during Open Enrollment. If this is the case your plan would have mailed you a notice of non-renewal.

To learn more about available plans visit- Medicare Plan Finder on Medicare.gov

You can also:

  • Visit your plan‚Äôs website
  • Refer to the Medicare & You handbook
  • Call 1-800-MEDICARE (1-800-633-4227)
  • Or contact your State Health Insurance Assistance Program (SHIP)¬† at 1-800-792-8820 or http://www.state.nj.us/humanservices/doas/home/sashipsite.html

Medicare Advantage- Beware of scare tactics

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Medicare Advantage- Beware of scare tactics

What is Medicare Advantage? Medicare Advantage plans are private plans offered by insurance companies to replace your traditional Medicare benefits.

An advantage plan provides all the same benefits as traditional Medicare, such as doctor visits and hospital stays. Some plans may offer extra benefits that are not usually covered by Medicare, such as eyeglasses and hearing aids. Medicare Advantage plans come with a monthly premium that differs depending on the company and type of plan. The Federal Government pays the insurance companies to manage your care under a Medicare Advantage plan, instead of them managing it under traditional Medicare.

There have been some efforts to scare seniors into thinking that the Affordable Care Act (ACA) will change or effect their Medicare Advantage coverage. But you need to know the facts. The Affordable Care Act does not change any benefits guaranteed to Medicare recipients. This includes Medicare Advantage plans. What the ACA does change is the way the Medicare Advantage plans are paid. Starting in 2012, Medicare began reducing the extra government payments to insurance companies for Medicare Advantage plans. The reason for these plans have been made to reduce payments is because there is little evidence that better care was given to anyone on a Medicare Advantage plan. Medicare Advantage plans are eligible to receive bonuses if they provide quality care.

Enrollment in Medicare Advantage plans is low, even here in NJ, leaving some to question, what is the real advantage? Some may think having a commercial insurance company’s name on your card carries more weight than a Medicare card, but just like any commercial insurance plan, there are sometimes more hoops (referrals, prior authorizations) to jump through than there are with traditional Medicare.

What the Affordable Care Act does do for consumers who use Medicare Advantage plans is provide some protections. For example, Medicare Advantage plans are not allowed to charge more for services than traditional Medicare does. The ACA also has provisions to reduce out of pocket costs for patients using high-cost services like cancer treatment or dialysis. Under the ACA, Medicare Advantage plans have also been mandated to limit their administrative costs, as well as their profits. This measure is to ensure that the plans spend 85 % of their money on member benefits (that will start in 2014).

Rumors of Medicare Advantage consumers facing cuts to their benefits due to the ACA are rampant and intended to scare seniors. The truth is, every year the insurance companies are offered the choice to continue operating a Medicare Advantage Plan and to change the services offered under that plan (they are only required to cover what traditional Medicare covers). So, any year, not just this year, Medicare Advantage plans could chose to stop providing optional benefits such as eyeglasses.

So what does this all mean to you, the Medicare recipient? Well, if you are currently in a Medicare Advantage plan, your plan must send you a notice of any changes for 2013 by October 1, 2012. Make sure to read it carefully. Even if you are not currently in a Medicare Advantage plan, all Medicare recipients should go to www.medicare.gov to review both traditional Medicare and Medicare Advantage plans to compare and decide what is best for them. Open Enrollment is October 15 to December 7thand during that period you can decide to stay in the same Medicare Advantage plan you have now, change to a different Medicare Advantage Plan or switch to traditional Medicare. If you chose to switch to traditional Medicare, remember that if you had a Medicare Advantage plan that offered prescription drug coverage you will need to also enroll in a Medicare drug coverage plan and/or buy a Medigap supplemental policy.

 Detailed information about Medicare, Medicare Advantage, Medicare Drug coverage, Medigap plans and Open Enrollment can be found at http://www.medicare.gov/.

 For detailed information about the Affordable Care Act and seniors, visit www.ncoa.org/StraightTalk

For more information about the Affordable Care Act in general, you can visit, http://www.healthcare.gov/law/index.html

Medicare Open Enrollment Period

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Medicare Open Enrollment

Medicare Open Enrollment is October 15, 2011 – December 7, 2011

Did you know new prescription drug and health plan coverage choices are offered every year? Every fall, all people with Medicare should review their current coverage.

During the Fall Open Enrollment you can change how you receive your health coverage and add, change or drop drug coverage. You can make as many changes as you want. Changes made during the Fall Open Enrollment take effect January 1, 2012. If you don’t want to make any changes you don’t need to do anything, your current coverage will stay the same.

What you can do:

  • Change from Original Medicare to a Medicare Advantage Plan.
  • Change from a Medicare Advantage Plan back to Original Medicare.
  • Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
  • Switch from a Medicare Advantage Plan that doesn‚Äôt offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
  • Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn‚Äôt offer drug coverage.
  • Join a Medicare Prescription Drug Plan.
  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
  • Drop your Medicare prescription drug coverage completely.

Medicare Advantage Disenrollment Period 2012: January 1, 2012 – February 14, 2012

During the Medicare Advantage Disenrollment Period (MADP) you can switch from a Medicare private health plan (also known as a Medicare Advantage plan) to Original Medicare. Regardless of whether the Medicare private health plan had drug coverage, you can join a stand-alone prescription drug plan, but you are not required to. For example if you have a Medicare Advantage Plan with drug coverage you can change to Original Medicare and a prescription drug plan or Original Medicare and no drug plan.  Changes made during the MADP go into effect the first day of the following month.

What you can do:

  • If you are in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare.
  • If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.
    Note: During this period, you can’t do the following:
  • Switch from Original Medicare to a Medicare Advantage Plan.
  • Switch from one Medicare Advantage Plan to another.
  • Switch from one Medicare Prescription Drug Plan to another.
  • Join, switch, or drop a Medicare Medical Savings Account Plan.

Choosing Medicare coverage can be confusing, but understanding the different parts of Medicare and your Medicare coverage choices can help.  You can use the Medicare Plan Finder https://www.medicare.gov/find-a-plan/questions/home.aspx to help you make a decision about the best plans for you.

 If you would like assistance with this process please contact a State Health Insurance Assistance Program (SHIP). To find a SHIP program in your area visit: http://www.state.nj.us/health/senior/sashipsite.shtml