It’s that time of year again! Yes, it’s the holidays (look for our great elder gift recommendations on Pinterest!) but it’s also time to make your Medicare choices for next year. Many people we talk to don’t review their plans when they have this opportunity. We’ll share why you should and other ways you can realize Medicare savings and better value.
Medicare Savings Tips:
Review your enrollment options to determine the most cost-effective plan for 2018.
During Open Enrollment (October 15th-December 7th*) you can:
- switch from Original Medicare to Medicare Advantage, or vice versa
- switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another
- if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply
If you want to enroll in a Medicare Advantage plan, you must meet some criteria:
- be enrolled in Medicare Part A and B
- live in the plan’s service area.
- cannot have End-Stage Renal Disease (some exceptions apply)
*Also, between January 1 and February 14 each year, if you are enrolled in a Medicare Advantage plan, you can leave your plan and return to original Medicare. You will have until February 14th to enroll in a Part D plan which will be effective the 1st of the following month.
Individuals in areas affected by Harvey, Irma or Maria this year can access a special enrollment period to have until December 31st. Contact 1-800-MEDICARE to request this opportunity to enroll, disenroll or switch plans through the end of the year.
Tips: Use the same pharmacy for your medications. This provides better continuity of care to avoid medication problems. Make sure to bring all your medication information to doctor appointments. Moreover, ask for a periodic review to make sure you aren’t taking unnecessary meds. In addition to being a Medicare savings tip, this is good for your health.
How to determine what the best value plan is for you:
Visit www.Medicare.gov. The Medicare Plan Finder guides you through the process of selecting your coverage for 2018. Take some time to prepare beforehand and have available:
- your Social Security number;
- adjusted gross income (from your tax return);
- other insurance coverage;
- current medications and pharmacy (including name, strength and amount prescribed per day);
- routine medical treatments and physicians.
Get advice from healthcare experts; find out how Medicare (all its parts) works with VA benefits, Medicaid, and other insurance. Get a complete Medicare analysis or help planning for retirement health coverage.
What if I like my current plan?
If you’re already enrolled in a Medicare Part D or a Medicare Advantage Plan and you don’t want to make changes to your coverage, you don’t need to do anything during open enrollment. You should have received a non-renewal notice if your plan is being discontinued and isn’t eligible for renewal. If you don’t, it means you can keep your plan without doing anything.
However, be aware that your benefits and premium could be changing. So even if you think that you want to keep your current coverage for the coming year, it’s important to make sure you understand any changes. Drug formularies frequently change. Take a few moments to make sure it’s still the best option for you in the coming year. You could be missing out on important Medicare savings by being stuck in the wrong plan.
Know what’s changing in 2018.
The Donut Hole
Medicare recipients reaching the donut hole will benefit from Medicare savings with increased prescription drug discounts. The gap in prescription drug coverage (i.e. donut hole) starts when someone reaches the initial coverage limit ($3,750 in 2018), and ends when they have spent $5,000. These thresholds are $50 higher than they were in 2017.
Prior to 2011, Part D enrollees paid the full cost of their medications while in the donut hole. But the ACA has been steadily closing the donut hole, which will be fully closed by 2020. For 2018, while in the donut hole, enrollees will pay 35 percent of the cost of brand-name drugs and 44 percent of the cost of generic drugs. These are down from 40% and 51% respectively in 2017, meaning more Medicare savings for many.
Medicare Premiums and Deductibles
Click Here to get our Medicare Fact Sheet 2018 for all the Medicare premiums and deductibles for the coming year.
This isn’t going to provide Medicare savings per se, but could help you avoid identity theft. Medicare beneficiaries will begin receiving new Medicare ID cards that don’t have Social Security numbers on them. The new cards will be mailed out starting in April 2018 and everyone will have them by April 2019. You can continue to use your current card until your new one arrives. Once it does, you’ll want to destroy and securely dispose of your old one.
Take advantage of free preventative care benefits.
You could be leaving free benefits on the table if you don’t use your preventative care benefits. And, you can realize Medicare savings by spotting problems early and avoiding others altogether. Most importantly, you could be saving your life.
As a new Medicare beneficiary, you are entitled to a free “Welcome to Medicare” preventive visit within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health, plus education and counseling about preventive services. You get a written plan letting you know which screenings, shots, and other preventive services you need. Each year you are eligible for a free Wellness visit to develop or update your personalized prevention plan.
Register at MyMedicare.gov to get access to your preventative health information. You can track your preventive services, get a two-year calendar of the Medicare-covered tests and screenings you’re eligible for, track your personal medical conditions/diagnosis, medications and pharmacy information, and print a personalized “on-the-go” report to take to your next doctor’s appointment.
Take advantage of screenings, shots and other preventative services such as the advance care planning consultation. Only 12% of people have used this benefit. You could be realizing big Medicare savings by reducing unnecessary crises.
Don’t fall prey to scams or sign up for unnecessary expenses.
Beware of these Six Common Medicare Scams. Warn your loved ones. Here are more tips and resources. You may run into someone attempting to sell you something you don’t need, charging illegal fees, or promoting a plan that’s wrong for you. Read more on the rules and what to watch for on Medicare’s site.
Know your rights and use an advocate.
Hospitalization and rehabilitation can result in major medical costs, so it’s vital to know your rights and coverage. The hospital must provide you with a Medicare Outpatient Observation Notice (MOON) so you know if you’re being covered by Part A or B. This can make a big difference in costs for both the hospital stay and rehabilitation following. If you don’t understand this or need help, contact us anytime. Our care managers have expertise in navigating this system and making sure you get appropriate treatment and coverage.
One positive change for Medicare enrollees came out of a February 16, 2017 Jimmo v. Sebelius case: “The Medicare program covers skilled nursing and skilled therapy services under Medicare’s SNF, HH, and outpatient therapy when a beneficiary needs skilled care in order to maintain or to prevent or slow decline or deterioration. Lack of restoration potential cannot serve as basis for denying coverage.” In the past, this was a common reason for denying continued therapy. Now, the maintenance standard is recognized as a valid goal for rehabilitation.
Get help from an Aging Wisely advocate. Call us anytime at 727-447-5845.