Be A Smart Shopper during Open Enrollment

THE MEDICARE BLOG

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MEDICARE OPEN ENROLLMENT: BE A SMART SHOPPER

*REPOST* Brought to you by The Medicare Blog:

Whether groceries, health insurance, or anything else, everybody wants to get the best value for their money. And health care is no different—that’s why it’s a good idea to shop around for a plan. Cost is an important factor in any purchase, especially when it comes to health care, but it’s not the only thing to consider.

There may be dozens of Medicare plans in your area, all with different costs and levels of coverage. How much are each plan’s premiums and deductibles? How much will you pay for the benefits and services you’re likely to use? Is there a limit on what you’ll have to pay out-of-pocket for the year? If you’re currently in a plan, how does that plan stack up to the other plans that are available? Thinking about these things will help you make a smart choice to get good value that meets your own health care needs.

Prescription drug coverage is another part of the cost puzzle. How much will your prescriptions cost under each plan? Does the plan cover the drugs you take? Remember, thanks to the Affordable Care Act, everyone who reaches the Part D coverage gap (or “donut hole”) will benefit from a discount of 60% on covered brand-name drugs.

Only you can determine what mix of benefits and costs will work best with your needs and budget, but we can help. The Medicare Plan Finder makes it easy to compare plans so you can pick a plan that meets your needs. After you’ve narrowed your options, you can call the plans you’re interested in to get more details about their benefits and services, or check out their websites.

And lastly, protect yourself from Medicare fraud. Medicare fraud wastes a lot of money each year and results in higher health care costs and taxes for everyone. Con artists commit Medicare fraud by getting people’s Medicare number. You can help fight Medicare fraud by never giving your Medicare number to get a free offer or gift. Protect your Medicare by protecting your Medicare number.

If you believe you or someone you know is a victim of Medicare fraud, you can:

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• Report it online to the Office of the Inspector General.
• Call the Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477). TTY users should call 1-800-377-4950.

Brought to you by: Medicare

Read More @ https://blog.medicare.gov/2016/10/17/medicare-open-enrollment-smart-shopper/?linkId=31022960

Medicare 101: What is Part D?

What Is Medicare Part D and Who Qualifies?

*Repost* Brought to you by: TransAmerica: http://blog.transamerica.com/what-is-medicare-part-d#.V_QNDOUrJhE

Medicare Part A and B together make up what is known as Original Medicare and provide coverage for many things that are typically categorized as hospital insurance and medical insurance, including emergency care. But often, taking care of your daily health comes with medicines prescribed by your doctor. This is where Medicare Part D enters your healthcare picture.

What does Medicare Part D cover?

Simply put, Medicare Part D covers a patient’s prescription drugs. In the Medicare system, drugs are put intotiers based on formularies, which results in different price levels. Medicare Part D plans are generally set up to provide coverage at levels that correspond to the prescription drug tiers. In this guide, you can find a description of some common situations people face, as well as things to consider in each scenario regarding coverage options.

Who qualifies?

Medicare Part D is voluntary for everyone except those enrolled in Medicaid, or Medi-Cal for those in California. Because of that, anyone who is eligible for Medicare can sign up for a Part D coverage during the annual open enrollment period.

When should I enroll?

Enrollment follows the same initial rules as Plans A and B. You can apply three months before the month of your 65th birthday, within your 65th birthday month, and the three months following. Likewise, if you don’t select drug coverage when you first become eligible, and don’t qualify for an exception, you may encounter a late enrollment penalty that stays with you as long as you have Medicare drug coverage.

You don’t have to re-enroll each year, but you will have a chance to review your coverage and change plans if needed. In addition, certain changes in your circumstances throughout the year may prompt the need for aSpecial Enrollment Period (SEP). Rules for what you can change and when you can change it are different for each SEP.

How much does it cost?

The cost for prescription drug coverage isn’t as clear cut as with Parts A and B, since your cost will largely depend on which prescription drugs you take. Other variables include the plan you choose, if you use a pharmacy in your plan’s network, and if your prescriptions are part of the formulary of your chosen plan.

Since coverage for Part D is distributed through independent companies, you have a lot of options to choose from. We can assist you in getting started.

What about Part C?

Original Medicare is enough coverage for some people, but if you feel like you need extra benefits, that’s where Part C comes in. Part C plans are sometimes called Medicare Advantage plans. Medicare Advantage Plans are administered by private insurance providers, but are regulated by the government. They include most Part A and B benefits as well as prescription drug coverage, vision, hearing and dental services. Opting into a Part C plan means that you’ll receive benefits from Medicare Advantage instead of Original Medicare. Costs vary by plan.

For more information on Medicare, Transamerica Center for Health Studies^® has a guide that can help you compare the features of the different parts.

About Transamerica Center for Health Studies^®.
The Transamerica Center for Health Studies^® (TCHS) is a division of the Transamerica Institute^®, a nonprofit, private foundation. TI is funded by contributions from Transamerica Life Insurance Company and its affiliates and may receive funds from unaffiliated third parties. TCHS is dedicated to identifying, researching and analyzing the most relevant health care issues facing consumers and employers nationwide. For more information about TCHS, please visit www.TransamericaCenterforHealthStudies.org.

Medicare Made Clear

10 Key Medicare Facts

Your Medicare journey may be smoother when you understand the rules of the road.

Medicare is a complex subject. Watch this video to get the main ideas behind it. Then you can dig deeper into what’s most important to you

10 Key Medicare Facts Summary

1. There are two main ways to get Medicare.

   • Original Medicare (Parts A and B) which is provided by the federal government
   • A Medicare Advantage plan (Part C) offered by a private insurance company

2. With Original Medicare, you may pay a share of the cost.

   • You contributed to Medicare by paying taxes. That’s why you’re eligible for Medicare when you turn 65.
   • Original Medicare may not pay for everything. You may pay a share of the cost in monthly premiums and copays.

3. Medicare supplement insurance helps with some out-of-pocket costs.

   • Medicare supplement insurance plans help with some of the expenses Medicare Parts A and B don't pay.
   • Medicare supplement insurance plans are offered by private insurance companies

4. Prescription drug coverage may help limit drug costs.

   • Original Medicare does not include prescription drug coverage. However as a Medicare member you can get Medicare Part D prescription drug coverage.
   • Prescription drug plans, also known as PDP, and Medicare Advantage plans are offered by private insurance companies.
   • You can enroll in a stand-alone Part D plan to go with your Original Medicare coverage.
   • You can enroll in a Medicare Advantage plan that includes prescription drug coverage.

5. Coverage choices vary by plan type and state.

   • Original Medicare (Parts A and B) is the same across the United States.
   • Medicare Advantage (Part C) and prescription drug (Part D) plans are offered by private insurance companies and may be available only in certain counties, states or regions.
   • Medicare supplement plans travel with you nationwide. The plans are standardized, but the availability may vary by state.

6. Your initial enrollment in Medicare is time sensitive.

   • The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It’s the three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.
   • If you are eligible for Medicare due to disability, your IEP is based on your disability date.
   • Late enrollment penalties may be incurred for missing certain enrollment periods for Part B and prescription drug coverage.

7. Your health care needs may change over time.

   • After you choose your Medicare coverage, you can make changes once a year during Medicare Open Enrollment, October 15 through December 7.
   • You may change your coverage at certain other times if you qualify for a Special Enrollment Period.
   • Review your coverage each year to see if it still fits your needs.
   • These enrollment period restrictions do not apply to Medicare supplement insurance.

8. Special Enrollment Period (SEP).

   • In some cases you may be able to enroll in or switch plans at times besides your IEP or Medicare Open Enrollment.
   • You may qualify for an SEP if you retire and leave a health care plan sponsored by your employer or union.
   • You can usually use an SEP to change your coverage if you move out of your current plan’s service area.

9. Medicare can work with other health insurance.

   • Group or retiree health insurance sponsored by an employer or union can work with Medicare.
   • Your plan administrator can help you figure out how Medicare could work with your current coverage.
   • Medicare supplement plans work with Original Medicare, but not with Medicare Advantage plans.

10. Help is available.

    • Medicare can be complicated, but help is available.
    • You may qualify for financial help.

Medicare Made Clear: Brought to you by UnitedHealthCare

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