It's amazing how much the presidential election has changed our lives this year. In the case of an important annual event for elders that I report on here every year, it got postponed due to the third Clinton/Trump debate.
So here we are today, 10 days late with the information you need.
October 15 marked the start of the Medicare Open Enrollment period which lasts until 7 December. During this time, people 65 and older may, if they choose, make changes to their Advantage programs and their Part D prescription drug plans.
Oh joy. It shouldn't be this hard to keep up one's health care coverage year to year and it wouldn't be with a single-payer system like most western democracies have. But for now we're stuck with Medicare - and I'm awfully glad to we have it - so here is what you need to know.
(This is a long post. I am hoping I have created enough bold headers that you can skip to the information you care about and ignore the rest.)
If you currently have traditional Medicare, you are allowed to change to a private Advantage plan – or vice versa. Traditional Medicare does not provide drug coverage so you need a separate plan (Part D) for that.
Some Advantage plans cover drugs and others do not, so if you choose a plan without drug coverage you will need a stand-alone drug program as traditional Medicare enrollees do.
REMINDER OF SOME MEDICARE BASICS
• Part A covers inpatient hospital care, skilled nursing, hospice and home health care. It is free.
• Part B covers preventive care, outpatient services and doctor visits. The monthly premium is deducted from your Social Security benefit.
Optional • Medigap (or Supplemental) coverage pays for the “gap” between what Parts A and B cover and your out-of-pocket costs. You MAY NOT CHANGE this coverage during this 15 October-7 December open enrollment period.
• Part C is another name for Advantage plans. These take the place of original Medicare (Parts A, B and Medigap). Premiums are usually lower, they often cover drugs but physician choice is limited to the company's network and physicians are allowed to drop out of the program mid-year.
• 2017 Medicare Costs
As we discussed last week, there will be a .3 percent increase in Social Security benefits in 2017 but we do not yet know if or how much that will effect the Medicare Part B premium that is deducted from the monthly Social Security payment.
For the past two years, without a Social Security cost-of-living adjustment, the Part B premium has remained at $104.90. The new premium will be announced in November.
Certain people pay higher Part B premiums. Medicare costs in general for 2017 are not yet available. You can see last year's costs at this webpage where next year's costs will be available when they are released.
MY MEA CULPA
Medicare is a gigantic, complicated program with many permutations depending on individual circumstances. I cannot possibly pretend I understand it all and if I did, I could not account for them all here. What I can do, is provide some good links to help you through this year's ordeal to making changes (or not) you might want.
MEDICARE.GOV PLAN FINDER
The Medicare.gov website is not perfect but it gets better and easier to use each year. You can check your current enrollment, premiums, drugs list and find all sorts of general health information.
When you get there, click on the line: “Medicare Open Enrollment starts October 15 and ends December 7 Review your health and prescription drug coverage options” near the top of the home page to get into the open enrollment area with both your current coverage and options for 2017.
ONE EXAMPLE OF DRUG COVERAGE SELECTION
One of the best things about the Medicare.gov selection tool for drug coverage is that if you take the time to enter all your prescriptions and their dosages, you will get a list of plans that cover what you need and you can then compare other criteria to select the plan that works best for you.
In my case, I use no prescription drugs and since there is no way to guess what might happen to me and what kind of drugs I would need, I punt.
I choose the least expensive plan and hope (how's that for an intelligent healthcare program?) that whatever happens to me, I will be able to afford the drugs I require until next enrollment period when I can select a different plan based on my drugs.
This year, there are 27 prescription drug plans available to me. I'm lucky that my current plan has reduced the premium by 7.6 percent (whoever heard of this?). The deductible goes up by just over 11 percent but there is no increase in the in-network co-pays.
It's a no brainer for me this year; I stay with the plan I have.CAUTION
The annual open enrollment period is open season for scammers. You will likely receive many snailmail advertisements for Advantage and drug plans, and phone calls too. Be smart.
• Never give out personal information such as Medicare and Social Security numbers, account numbers, etc. to anyone who has telephoned you. Ever. Medicare representatives never call to ask this kind of information.
• If you are due a refund for any reason from a private insurer, it will be sent to you via postal mail. If anyone calls asking for personal information to receive your refund, it is probably a scam. Hang up.
• Many legitimate companies are offering a variety of health coverage plans during this period. But some are not who they say they are or will employ high pressure tactics to try to sell you coverage you don't need. Be aware.
• Many offers of “free” medical supplies or checkups via postal mail are excuses to extract personal information from you. Check them out carefully before agreeing to them.
Medicare telephone: 1-800-Medicare
Medicare and You
By now, Medicare enrollees will have received your annual Medicare and You booklet. If you have not received it, or misplaced it, there is an electronic version [pdf]. Note that only the print version has a list in the back of plans available in your state.
Here is a direct link to the Medicare Find a Plan main page.
My Medicare Matters
The National Council on Aging (NCOA) maintains a good educational website with lots of trustworthy information about Medicare and how it works.
The State Health Insurance Assistance Program (SHIP) is a national program that offers free, one-on-one counseling and assistance to people with Medicare, their families and caregivers. Find your state's SHIP here.
65 and Signing Up For the First Time
If you are new to Medicare, Kaiser Health News has a succinct one-pager to get you started with a lot of links to additional online information.
Open enrollment ends on 7 December 2016.