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Autumn: Time for Pumpkins, Football and…. Medicare Open Enrollment

 For most, the fall season is synonymous with football, the beauty of autumn and everything and anything pumpkin flavored or scented. However, fall now includes a new seasonal tradition- shopping for the right Medicare plan during open enrollment season running October 15 through December 7.

Medicare provides health insurance benefits to over 52 million seniors and disabled people in the US¹. And that number continues to balloon as nearly 10,000 baby boomers turn 65 every single day, thus becoming eligible for Medicare. Due to this surge, Medicare is continually changing and must evolve to remain sustainable. The health insurance landscape for seniors really began to change in 2006 with the implementation of the Medicare Part D drug program and proliferation of Medicare Advantage plans. Medicare Advantage plans were created as a more cost-effective type of Medicare health plan offered by private insurance companies that contract with and serve as a substitute for original Medicare, which then provides recipients with their Part A and Part B benefits.

The new normal

This “new normal” was meant to give Medicare recipients more choice and the capability to do cost comparisons between plans that fit individual need and budget. However, the benefit of vast choice actually creates frustration and confusion for many and may cause “decision-making paralysis.” Research has found that because of this, many Medicare recipients just go with last year’s plan because they feel it’s too much effort to switch plans. That decision could come back to haunt them. Their plan, that was perfect last year, now may have higher premiums and co-pays or may no longer really meet their specific healthcare needs.

Medicare’s labyrinth of terminology, benefit options, rules, penalties, and a myriad of forms can be staggering, especially if you’re technologically challenged due to much of the research and registration options being online. But again, annual open enrollment is said to encourage Medicare recipients to spend their money more wisely, take better care of themselves, and get better personalized health coverage. It may also be said that our health and welfare should at least be worth this effort once a year. These are all great points, but we must find a happy medium.

Medicare recipients should take more responsibility for their choice of healthcare coverage and should feel fortunate to have these choices. However, the Centers for Medicare & Medicaid Services and private insurers need to streamline the process and make it a little easier, especially for seniors. Congress needs to enact legislation to consolidate Medicare Advantage and Part D plan choices and standardize options in order to facilitate informed decision-making by Medicare plan enrollees.² Granted it is not an easy fix, but MedicareRights.com shares an interesting article,”50 Wishes for Medicare’s Future,” which details a number of ideas and solutions to fix Medicare and its delivery system.

Until then, those eligible for Medicare can find help on sites like MedicareInteractive.org, which provides a number of resources and tips such as:

  •   If enrollees want to join a stand-alone prescription drug plan (PDP), they can use the Plan Finder tool on Medicare.gov. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you go to and your drug costs. And remember coverage changes every year. The cost of your medications may look very different from the year before.

  •   If enrollees want to join a Medicare Advantage Plan, they can call 1-800-Medicare or go to Medicare.gov to find out what plans are available in their area. Once they receive the list of plans, they can check the plan websites to see which best fits their needs and budget.

  •   Call or visit the website of your State Health Insurance Assistance Program or SHIP. Your state SHIP can help you to understand all of your Medicare coverage options, and counselors are available to meet with enrollees one-on-one, in person at no cost. In Pennsylvania, the APPRISE Program offers SHIP.

Lastly, Messiah Lifeways Coaching will be hosting 2 open enrollment events on Oct. 25 and November 15. APPRISE counselors will be on hand to offer FREE 1 hour one-on-one counseling sessions. If you live in the Cumberland County area, please schedule an appointment by calling 717.240.6110. Slots are going quickly! For other counties and locations, call the State hotline at 1.800.783.7067 or call your local Area Agency on Aging. 

For additional resources on Medicare, check out the links below:

¹CMS.gov
²medicarerights.org/50wishes/streamline-enrollment

Revised form Oct. 2017

 

Understanding Medicare Coverage For Nursing Care

Episode 13 of the Coach’s Corner Podcast is entitled Understanding Medicare Coverage For Nursing Care. Grasping Medicare coverage can be tricky, especially when it comes to Part A coverage for nursing care. This episode will focus on clearing up those myths and misconceptions about Medicare Part A with special guest, Nicholle Dixon, Messiah Village Billing Coordinator. Learn more about:

  • Medicare versus Medicaid
  • how Medicare Advantage Plans differ from traditional Medicare
  • what are the qualifications for nursing coverage
  • what is considered skilled nursing care, as opposed to intermediate or custodial care
  • the myth of the 100 day benefit period and details on days 1 to 20 and 21 to 100
  • where to get help with Medicare

Medicare Resources

Statewide APPRISE Medicare Counseling Program Pennsylvania offers a free health insurance counseling program (APPRISE) designed to help older Pennsylvanians with Medicare. Counselors are specially trained staff and volunteers who can answer your questions about Medicare and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. Click [here] to visit the APPRISE website.

Official United States Government site for Mediacare www.medicare.gov/

Autumn: A Time for Football, Pumpkins and Medicare?

For most, the fall season is synonymous with football, the beauty of autumn and everything and anything pumpkin flavored or scented. However, fall now includes a new seasonal tradition- shopping for the right Medicare plan during open enrollment season, which runs each year from October 15 through December 7 .

Medicare provides health insurance benefits to over 52 million seniors and disabled people in the US¹. And that number continues to balloon as nearly 10,000 baby boomers turn 65 every single day, thus becoming eligible for Medicare. Due to this surge, Medicare is continually changing and must evolve to remain sustainable. The health insurance landscape for seniors really began to change in 2006 with the implementation of the Medicare Part D drug program and proliferation of Medicare Advantage plans. Medicare Advantage plans are a type of Medicare health plan offered by private insurance companies that contract with and serve as a substitute for original Medicare, which then provides recipients with their Part A and Part B benefits.

The New Normal

This relatively new autumn “tradition” continues to thrust its way into the lives of seniors and the disabled across the US year after year. In a matter of speaking, I’d say some may view open enrollment similarly to that of an annual health physical, “a very unpleasant, but very necessary deed.” Researching and (re)enrolling for a Medicare plan every fall is no fun, but again essential. It’s not changing anytime soon, so I guess enrollees better get used to it. Ideally, this new normal was meant to give Medicare recipients more choice and the capability to do cost comparisons between plans that fit individual need and budget. However, the benefit of vast choice actually creates frustration and confusion for many and may cause“decision-making paralysis.” Research has found that because of this, many Medicare recipients just go with last year’s plan because they feel it’s too much effort to switch plans. That decision could come back to haunt them because their plan, that was perfect last year, now may have higher premiums and co-pays or may no longer really meet their specific health care needs. Undoubtedly, this labyrinth of terminology, benefit options, rules, penalties, and a myriad of forms can be staggering, especially if you’re technologically challenged. But again, annual open enrollment is said to encourage Medicare recipients to spend their money more wisely, take better care of themselves, and get better personalized health coverage. It may also be said that our health and welfare should at least be worth this effort once a year. These are all great points, but we must find a happy medium.

We should take more responsibility for our choice of healthcare coverage and we’re fortunate to have that choice. However, the Centers for Medicare & Medicaid Services (CMS) and private insurers need to streamline the process and make it a little easier, especially for seniors. Congress needs to enact legislation to consolidate Medicare Advantage and Part D plan choices and standardize options in order to facilitate informed decision-making by Medicare plan enrollees.² Though it is not an easy fix, it’s one of a number of solutions out there. In particular, MedicareRights.com shares “50 Wishes for Medicare’s Future,” which details a number of ideas and solutions to fix Medicare and its delivery system.

In the meantime, here are some resources from MedicareInteractive.org to make this process a bit easier to understand and navigate:

  • If you want to join a stand-alone prescription drug plan (PDP), use the Plan Finder tool on Medicare.gov. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you go to and your drug costs. And remember coverage changes every year. The cost of your medications may look very different from the year before.
  • If you want to join a Medicare Advantage plan, call 1-800-Medicare or go to Medicare.gov to find out what plans are in your area. When you receive the list of plans, check the plan websites to see which best fits your needs and budget.
  • Call or visit the website of your State Health Insurance Assistance Program or SHIP. Your state SHIP can help you to understand all of your Medicare coverage options, and counselors are available to meet with enrollees one-on-one at no cost. In Pennsylvania SHIP is referred to as APPRISE, which is available in each county and holds free open enrollment events. Messiah Lifeways will be hosting several of Medicare Part D events in October and November. To get a list of those dates and locations in Cumberland County please click [here] and for a full list of events for every county, please click [here.]

For additional resources on Medicare, check out the links below:

¹CMS.gov
²medicarerights.org/50wishes/streamline-enrollment

 

It’s That Time of Year

The dog days of summer are gone, and it’s nearing that certain time of year again. Sadly, I’m not referring to football season or the beauty of autumn.  Instead I’m referring to Medicare Open Enrollment time. EXCITING! Ok, not so much. But nonetheless, it is a very important time of the year for new enrollees of Medicare along with current beneficiaries that want to make a change to their current coverage.

The Medicare open enrollment period runs from October 15 through December 7, 2013. This is the time when Medicare beneficiaries should review their current plans, compare them to the new plans available for 2014 and make changes as necessary. Information on the 2014 plans should be available by October 1.

Medicare provides health benefits to nearly 50 million seniors and disabled people¹. And that number continues to balloon as nearly 10,000 baby boomers are turning 65 every single day, thus becoming eligible for Medicare benefits. Due to this surge, Medicare is continually changing and must evolve to prolong its existence. Because of the constant evolution, this wave of consumers quickly discovers or will soon discover navigating Medicare can be confusing, especially as a new beneficiary. Additionally, the complex navigation is not isolated to just the “newbies.” Even as a “seasoned” Medicare beneficiary, you can still face challenges during the annual open enrollment periods. Choosing the right Medicare prescription plan (Part D) or weighing traditional Medicare against Medicare Advantage Plans to fit your budget and need are common quandaries that even tenured beneficiaries face. This labyrinth of terminology, benefits, rules, and the assorted options can be overwhelming. This process of “shopping around” for the right benefits is becoming the new normal.

Knowing that consumers struggle with these issues, this past July, Messiah Lifeways Coaching hosted a workshop entitled “The A, B, C, and Ds of Medicare.” We had a really great turn out and want to continue to offer outreach and education for those who need help with understanding and choosing the Medicare options that are right for them or a loved one. Therefore, Messiah Lifeways will be a host site for a FREE educational presentation entitled Get Your Ducks in a Row” on Monday, September 30 from 10-11 am in Compass Pointe Place at Messiah Village. The program will be presented by APPRISE State Health Insurance Assistance Program. APPRISE counselors will cover topics including the ever befuddling Affordable Care Act, the Marketplace, Medicare Open Enrollment and how APPRISE can help.

Additionally, on Wednesday, November 20 from 10-12 noon, Cumberland County Aging and Community Services and APPRISE will be a hosting a Medicare Annual Enrollment Event once again in Compass Pointe Place. It is geared toward people who are new to Medicare or want to learn more about the Medicare Prescription (Part D) drug benefit and how it works. Enrollees can meet one-on-one with an APPRISE counselor to explore these options by calling 717-240-6110 and scheduling an individual appointment. For a list of additional host sites for enrollment appointments, please click here.

For additional resources on Medicare, check out the links below:

>Medicare.gov

>Center for Medicare & Medicaid Services (CMS)

>Medicare Tips and Tricks from thirdage.com

>Four Medicare Misconceptions by Kristen Gerencher from the Wall Street Journal- Feb. 11, 2011

¹Henry J. Kaiser Family Foundation, Total Number of Medicare Beneficiaries Statistical Information-2012