Finding the Right Plan During Medicare Open Enrollment

open enrollment 2016It’s that time again for the nation’s more than 54 million people who get health coverage through Medicare to decide what they want in 2016.

Lynda Flathers just got a packet of information in the mail about changes to her Medicare Advantage plan for 2016. Although happy with her current coverage, Flathers wants to make sure that her plan is still her best option. So she’ll shop during Medicare’s open-enrollment period, which got underway Thursday and runs through Dec. 7. Still, she’s a bit reluctant.

“It can be kind of confusing, and you just never know if you’re making the right decision,” says Flathers, a 65-year-old from Chino who works in fund development.

Medicare beneficiaries can change their Medicare health plans and prescription drug coverage during Medicare’s annual open-enrollment period.

Like Flathers, many seniors find shopping for Medicare Advantage and Part D prescription drug plans overwhelming.

Experts suggest steps to finding the right plan.

Let George Help! “Most people, once they select a plan, they tend to stay with that plan,” says Ronald Bolding, president of Pomona-based Inter Valley Health Plan. And that may be fine. But the cost and benefit details of Medicare Advantage and stand-alone Part D drug plans change every year, so the plan that was the least expensive option in 2015 may not be for 2016.

“I do not remember a time when we did not make some kind of adjustment” to benefit designs, says Sherry Stanislaw, senior vice president with SCAN, a Medicare Advantage plan based in Long Beach.

Those changes can be costly. A recent survey of 49,000 people using eHealthMedicare.com to compare Medicare plans found that only 8% of those enrolled in Medicare Advantage and only 5% in a stand-alone Part D policy had the lowest-cost plan. Those who switched to a new Part D drug plan saved nearly $700 in 2015, and were 20% less likely to hit the prescription drug coverage gap.

Review all plan costs. Monthly premiums across all Medicare Advantage plans being sold in California for 2016 average $29.85. The highest premium is $221 per month, and the lowest is zero, according to an analysis by Health Pocket, a technology company that compares health plans. Nearly half of the Medicare Advantage plans available for purchase in California will have no monthly premium at all.  For prescription drugs, the average Part D premium in California is $61.78. But averages are just that.

Our big take-away is to look at not how has the market changed, but how has my plan changed with regard to the medications and services I use,” says Casey Schwarz, senior counsel for education and federal policy with the Medicare Rights Center. That means looking beyond the monthly cost of your plan to examine all possible expenses.

“A lot of people use their premium to evaluate their plans, but that’s just one cost,” says Elaine Wong Eakin, executive director of California Health Advocates, a Medicare advocacy organization.

Carefully review the deductibles, co-pays and coinsurance you’ll be required to pay when you go for care. A plan with a low monthly premium may be more expensive in the long run if doctor visits or prescriptions come with high costs throughout the year, Wong Eakin says.

Review drug lists. Drug benefits in 2016 may be less generous in many plans as insurers increase costs, including deductibles and other out-of-pocket expenses.

Confirm that the medications you need are covered by your plan, and take time to understand the various rules you’ll need to follow.

Confirm that your doctors participate in your plan. “That’s one of the things to evaluate when looking at a plan for the next year is whether your providers will be in network,” Schwarz says. Going outside your plan’s network can be costly.

Check star ratings. Medicare has a quality rating system in which plans are ranked from one to five stars, with five the highest. Experts suggest choosing a plan with at least four stars, if available. Of the 37 Medicare Advantage plans offered in Los Angeles County for 2016, 19 received a rating of four stars or higher. Just four of the 25 stand-alone Part D drug plans earned four stars; none earned the top rating of five stars.

 It’s my pleasure from year to year to help you choose and be in the right plan for you. – George

“Better, Greater” Medicare Redlands – Litchfield Insurance

Definition of Special: Better, Greater, otherwise
different from what is usual.

Growing up, I was extremely cross eyed because of a car accident when I was 2.  After four major muscle surgeries they became straight again, but not before I had endured years of ridicule and teasing. There was something “different” about me for sure. But, I also believe there’s a part of each of us that yells out “Better“, “Greater“.  We are each of these Attributes in our own Special way.

As a 14 year old in the midst of a storm I checked out Norman Vincent Peale’s book, The Power of Positive Thinking at the local library. It confirmed for me the importance of getting Better and Greater and not bitter.

We have about 2 more months to go until the next Medicare Open Enrollment (Oct.15-Dec.7). Details of Plan changes for next year won’t be released until Oct. 1st. Regardless of the outcome of elections in November, the Plans should still be strong for 2017.

I have heard that a Part C Advantage PPO plan will be available but I can’t confirm that yet. There will probably be a premium deductible and higher co-pays to go along with it.

If you are inclined to change your Plan for 2017, go ahead and call my office soon to schedule a face to face meeting for after Oct.15th. If you’re happy with your Plan we can do a review by phone after Oct. 1st or PLEASE feel free to call if you’re not sure if you should make an appointment for after Oct. 15th. My schedule will fill up fast.

I will have some details of changes in the next issue of the Gazette coming the 1st week in Oct.

Good News for those of you taking Crestor. It is going generic soon.  Also GoodRx.com can save you as much as 80% on prescriptions, for those who get into the Gap or Donut Hole, this website might especially be helpful.

I look forward to seeing many of you in the Fall.  You are very SPECIAL to Terri and I and we couldn’t ask for Better or Greater clients and friends than you!

Sincerely,
George

 

What should I consider when choosing or changing my coverage?

it is overConvenience

Where are the doctors’ offices? What are their hours? Do the

doctors use electronic health records or prescribe electronically?

Which pharmacies can you use? Is the pharmacy you use in the

plan’s network? If it’s in the network and your plan has preferred

pharmacies, is your pharmacy preferred? (You may pay more at

non-preferred pharmacies.) Can you get your prescriptions by mail?

 

Cost

How much are your premiums, deductibles, and other costs? How

much do you pay for services like hospital stays or doctor visits?

Is there a yearly limit on what you pay out-of-pocket? Your costs may

vary and may be different if you don’t follow the coverage rules.

Coverage

How well does the plan cover the services you need?

Doctor and hospital choice

Do your doctors and other health care providers accept the type

of coverage you have? Are the doctors you want to see accepting

new patients? Do you have to choose your hospital and health care

providers from a network? Do you need to get referrals?

Prescription Drugs

Do you need to join a Medicare drug plan? Are your drugs covered

under the plan’s formulary? Are there any coverage rules that

apply to your prescriptions?

Quality of Care

Are you satisfied with your medical care? The quality of care and

services offered by plans and other health care providers can vary.

Medicare has information to help you compare how well plans and

providers work to give you the best care possible.

Travel

Will you have coverage in another state or outside the U.S.?

Your other Coverage

Do you have, or are you eligible for, other types of health or

prescription drug coverage (like from a former or current employer or union)? If so, read the materials from your insurer or

plan, or call them to find out how the coverage works with, or is

affected by, Medicare. If you have coverage through a former or

current employer or union or other source, talk to your benefits

administrator, insurer, or plan before making any changes to your

coverage. If you drop your coverage, you may not be able to get it

back.

Where can I get my questions answered?

Call us at our offices at 909-792-3300. We will set up an appointment that is convenient for you and discuss your options.

 

January 1, 2015

New coverage begins if you make a change during Open Enrollment. New costs and benefit changes also begin if you keep your existing Medicare health or prescription drug coverage, and your plan makes changes.

 

National Medicare Education Week

medicareConfused about Medicare? You are not alone.

In fact, you’ve got lots of company. According to the Medicare Made Clear Index, a 2013 survey of 1,000 older adults, 1 in 5 Medicare beneficiaries described Medicare as confusing, and most could not correctly identify what Medicare Parts A, B, C and D cover.

That’s one of the main reasons UnitedHealthcare created National Medicare Education Week. We’re committed to making Medicare easier to understand for the more than 51 million people who are currently enrolled as well as those who will be enrolling in the years ahead. And there are a lot of them out there.

Every day, about 10,000 baby boomers turn 65 and become eligible for Medicare.1 That’s one every eight seconds. As the Medicare population grows, the number of people in need of clear, easy-to-understand information about the program grows as well. National Medicare Education Week is one way we’re helping to meet this need.

 

Use these tools to help guide and support your Medicare education experience.

Medicare Education Checklist

 

Learning about Medicare shouldn’t be limited to just one week of the year. Taking the time to review your coverage options and stay informed about Medicare may help you feel better prepared to enroll in Medicare for the first time or make confident health care decisions during Medicare Open Enrollment (Oct. 15-Dec. 7). Use this checklist to help you learn more about Medicare.

 

Start with the Basics: Mastering the basics of the Medicare program may help you feel prepared to find the coverage that’s right for you. Check out the Learn about Medicare page, watch the Medicare Overview video or get familiar with some terms in the Glossary.
Ask the Right Questions: Medicare isn’t one-size-fits-all. You have lots of options as you’re deciding which coverage is right for you. But those options can sometimes feel overwhelming. Make it easier by asking yourself some key questions that will help you determine your needs .
Prepare: Be ready to make decisions about your coverage options during Medicare Open Enrollment (Oct. 15-Dec. 7). Visit the Coverage Examples page to see how four Medicare beneficiaries chose their plans. Or watch the videos about Medicare Parts A, B, C and D as well as Medicare supplement insurance.
— This information is provided by Medicare Made Clear
http://LitchfieldInsurance.com – Medicare Questions?  We are here to help. Call our offices at 909-792-3300

5 Reasons to Review Your Medicare Coverage Now

Medicare - 2 days leftSaturday, December 7, 2013, is the last day of Medicare Open Enrollment for 2014 coverage. If you don’t act now, it may be next year before you can make changes to your coverage, unless you qualify for a Special Enrollment Period. Next year’s Medicare Open Enrollment is October 15 – December 7, 2014.

The materials you received from your plan before Medicare Open Enrollment began are very important. The Annual Notice of Change or Evidence of Coverage explains any changes to your current coverage, premiums or other out-of-pocket costs for 2014.

Review this information carefully so you understand how any changes may affect you. Then you can decide if you may need to make a change.

Here are five things to consider when deciding if it’s time for you to change your Medicare coverage:

1. Have you received a new diagnosis or been given a new prescription? Changes in your health may mean you require more or different health care services. Make sure you understand what your current plan will cover and how much you will have to pay.

2. Is your doctor still in your plan’s network? Plans can change their network provider lists from year to year. If your doctor is no longer in your plan network, you may want to change doctors or choose a different plan.

3. Does your plan still cover the medications you take? Plan drug formularies are reviewed annually and may change.

4. Is your pharmacy still in the plan’s network? Just like provider networks, plans can change their pharmacy networks, too.

5. Has your financial situation changed? You’ll want to make sure you are still comfortable with your plan’s cost-sharing terms.

There is no one-size-fits-all type of Medicare coverage. Everyone has different health and budget needs, and these may change over time.

Medicare Open Enrollment – Redlands CA – Yucaipa CA

Medicare Open Enrollment Is Here: 3 Must-Know Facts

medicare open enrollmentOn Oct. 1, millions of uninsured Americans got their first chance to sign up for the health insurance exchanges that the Affordable Care Act created. Yet in all the attention that the new Obamacare exchanges have received, another important event for health care coverage has largely gone unnoticed — even though it potentially affects even more of the American public.

More than 50 million Americans are eligible for Medicare according to the Department of Health & Human Services, and every year, Medicare participants get a chance to choose or make changes to their existing coverage options under the program.

With the annual open enrollment period running from Oct. 15 to Dec. 7, those eligible for Medicare — typically Americans age 65 or older — need to be prepared to make smart choices about their coverage.

Here are three things you should know in helping you make your decision.

1. Obamacare Open Enrollment Is Entirely Different From Medicare Open Enrollment.

One major source of confusion among Medicare recipients comes from the fact that the inaugural open-enrollment period for Obamacare is happening at the same time. However, if you’re eligible for Medicare, you won’t get your insurance from an Obamacare health insurance exchange, and if you visit the exchange websites, you won’t find Medicare as an option. Moreover, the insurance policies you will find on the Obamacare health insurance exchanges won’t be appropriate for Medicare recipients, as they won’t take Medicare’s provisions into account.

Instead, the Medicare website is the best place to start in signing up for Medicare or choosing a new coverage plan. There, you’ll find detailed information to help you learn more about your available options and find out about the various plans that are available to you.

2. Changing Plans During Open Enrollment Can Be Especially Smart If Your Health Has Changed.

One of the most important aspects of Medicare open enrollment is that it allows Medicare recipients to tailor their coverage to their particular needs. Although traditional Medicare Part A and B coverage doesn’t involve much decision-making, prescription drug coverage under Part D gives Medicare recipients many different choices. Some Part D plans offer comprehensive coverage of prescription drug costs but at higher monthly premiums, while other Part D plans have much lower monthly costs but don’t pay for as much of your potential prescription-drug expenses.

If your health hasn’t changed much during the past year, you might well find that your existing Part D coverage still suits your needs and therefore won’t need to make major changes. But if your health has changed markedly, requiring you to take new prescription drugs, looking at other Part D plans might save you money. Paying higher premiums might actually reduce your overall costs if a new plan covers more of the out-of-pocket costs of obtaining your prescriptions.

3. Understand the Medicare Advantage and Medigap Coverage Options.

Another source of confusion for Medicare recipients involves the difference between traditional Medicare, Medicare supplemental insurance, and Medicare Advantage plans. Traditional Medicare covers you for medical services from any provider that accepts Medicare, but it doesn’t cover all of the costs of those services. In order to cover the rest, those who have traditional Medicare can get Medicare supplemental insurance from third-party insurers, with policies designed to fit Medicare’s broad coverage.

On the other hand, Medicare Advantage plans often take the place of traditional Medicare coverage, with many plans offering both medical services and prescription-drug coverage in one package. Medicare Advantage plans often involve networks of physicians through health maintenance organizations or preferred provider organizations, so you might not have as much flexibility to choose whatever doctor you like. Assessing the cost differences can be complicated, but the right choice can nevertheless produce substantial savings.

Make the Smart Choice

It’s easy to let Medicare’s open enrollment period pass you by without a thought, especially if you’ve largely been happy with your existing coverage. But this is the only chance during the year you have to assess what you’re spending on health expenses, so taking the time to see if a new Medicare coverage option would save you money is well worth the effort.

–This article is from DailyFinance.com

Medicare’s Open Enrollment Period for 2013: What You Need to Know

medicare open enrollmentThe Medicare Open Enrollment Period for 2013 is coming up soon! For a quick rundown on what you need to know, take a look at this basic Q&A.

What is it?
Throughout the year, Medicare has different enrollment periods. The Open Enrollment Period, or OEP, is the time-frame during which Medicare beneficiaries (people with Medicare) can make changes to their Medicare plans.

What’s in a name?
In past years, you may have heard the Open Enrollment Period referred to as the “Annual Enrollment Period,” or even the “Annual Election Period.” Both of those (and the acronym that went with them, “AEP”) are older names for what officials at the Centers for Medicare & Medicaid Services are now calling Open Enrollment Period.
When is it?
OEP comes in the fall. As in 2011, this year’s OEP will take place October 15 through December 7, 2012. Any changes you make to your Medicare plan during this period go into effect on January 1, 2013.

What changes can you make?

During OEP, you can…

  • Switch from Original Medicare (Medicare Parts A and B) to a Medicare Advantage (Medicare Part C) plan.
  • Switch from a Medicare Advantage plan back to Original Medicare.
  • Switch from one Medicare Advantage plan to another. This might involve switching from a plan without Medicare Part D prescription drug coverage to one that has it, or vice-versa.
  • Make changes to your Medicare Part D prescription drug plan:
  • Join a Part D plan.
  • Switch from one Part D plan to another one.

Drop your Part D plan altogether.

Note: Medicare Supplement Insurance plans are an exception. You can join one at any time during the year, not just during OEP.

Why is OEP so im portant?
Once the Medicare Open Enrollment Period closes on December 7, you can’t make any changes to your Medicare plan until the following year. There are some exceptions, such as if you move out of the area served by your plan. But for most people on Medicare, the OEP is the only time when you can make a change.

Do you have to make a change during OEP?
Absolutely not! If the Medicare coverage you have now is working for you, and your plan(s) is offered for 2013, then you can keep your coverage as it is. However, because this time comes but once a year, it’s a good idea to evaluate your coverage during Open Enrollment Period every year. That way, you’ll know if you already have the best coverage options for you, or if you need to make some changes.

If you have more questions regarding Medicare Open Enrollment please feel free to call our offices at (909)792-3300

 

 

Applying for Medicare in the 21st Century – Medicare, Redlands, Riverside, Palm Springs

Wow have times changed! Finding information for just about anything is just a click away. Watch this video by Star Trek’s Sulu (George Takei) and with him is Patty Duke. I know most of you remember one or both of them.

Have a wonderful day! And as always if you ever have any questions I am just a phone call away!

George Litchfield
Medicare Plan Specialist
Lic#OB56846
GeorgeLitchfield.com

Call me today at 888-891-5557

 

medicare apply onlineBack in the day, the only way to apply for Medicare was to talk with a Social Security representative—in person or by phone. You can still do that, and you can complete an application with pen and paper if you choose.

Today’s technology, once the stuff of science fiction, offers another option. Social Security, Medicare and Star Trek’s Sulu (George Takei) are inviting you to “boldly go online.” Patty Duke, that former TV sprite with the look-alike cousin, has also joined the effort. Hard to imagine? Watch the video.

Note that if you are already receiving Social Security benefits, you don’t have to apply for Medicare. You will be enrolled in Medicare automatically when you become eligible.

How Does It Work?

Completing an online Medicare application takes just minutes, and you can do it from the comfort of your home or any computer. Just go to SocialSecurity.gov and select “Apply for Medicare Only.” Then follow the onscreen directions.

You’ll need to supply basic information such as birth date, etc. You’ll also answer some questions about your current health care coverage. The system will guide you through the process based on your answers.

You can start the application and save it to complete later if you need to. You’ll get an application number that you can use to access your saved information. This same number allows you to check on the status of your submitted application. The site is secure. Your privacy and personal information are protected.

You will see a receipt on the screen after submitting your application. Be sure to save it or print it out. Medicare will review your application and send you a letter with its decision.

Who Can Do It?

You can sign up for Medicare even if you’re not ready to retire. You need to meet these requirements:

  • You are within three months of turning age 65 or older.
  • You want to sign up for Medicare benefits and do not currently have any Medicare coverage.
  • You do not want to apply for monthly Social Security retirement benefits at this time.

A family member or caregiver can complete a loved one’s online Medicare application, but the beneficiary must agree to the Electronic Signature and Submission Agreement in the final step.

When is it Available?

The online application is available seven days a week during the following hours (Eastern time):

  • Monday-Friday: 5 a.m. until 1 a.m.
  • Saturday: 5 a.m. until 11 p.m.
  • Sunday: 8 a.m. until 10 p.m.
  • Holidays: 5 a.m. until 11 p.m.

 

–This information is provided by Medicare Made Clear

GeorgelitchfieldGeorgeLitchfield.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com  and we will give you a quote and help you keep money in your pocket.

 

OEP Is Over: What to Do if You Missed It

Hello!

OEP for 2013 has ended. What happens if you didn’t do anything? And what can you do now? Read below to find out more information or feel free to call me and I can answer any of your questions.

Have a great day!

George Litchfield
Medicare Plan Specialist
Lic#OB56846
GeorgeLitchfield.com

Call me today at 888-891-5557

 

The Medicare OEP, or Open Enrollment Period, runs from October 15 through December 7 each year. (It’s sometimes also referred to as the “AEP,” or “Annual Enrollment Period.”) During this time, you can take a look at changes to your current plan for the coming year, and see whether there are other choices that might better meet your coverage needs.

OEP for 2013 has ended. What happens if you didn’t do anything? And what can you do now?

If you already have Medicare coverage, then usually doing nothing means that you’ll be enrolled in the same Medicare plan or plans in 2013 that you were a member of in 2012.

Note: Though you may be enrolled in the same plan, those plan benefits may be changing in 2013. You have both print and online resources that lay out those plans for you. For more information, see the Medicare Made Clear blog post “Learning About 2013 Changes to Your Medicare Plan.”

If you want to change your Medicare coverage, there are a few other possibilities which might apply to you and your situation.

Special Enrollment Period (SEP): Under certain circumstances, you can change your Medicare coverage outside the OEP. This is called a Special Enrollment Period, or SEP. The circumstances under which you would qualify for a SEP might be a change in employer-based health insurance for you or your spouse. It might also be due to a move. The timing for each SEP is based on your specific situation.

Medicare Advantage Disenrollment Period (MADP): The MADP runs every year from January 1 through February 14. It allows you to drop your Medicare Advantage plan and return to Original Medicare, if you wish. If your Medicare Advantage plan includes drug coverage, then you can also join a standalone prescription drug plan at this time. If you already have Original Medicare, then you can’t switch your coverage at this time.

Five-Star Medicare Advantage plans: The Centers for Medicare & Medicaid Services (CMS) runs the Five-Star Quality Rating System for Medicare Advantage Plans. The purpose of the System is to help consumers learn more about their Medicare Advantage and Medicare Part D plans. The plans are rated on a variety of different criteria, including health outcomes for their members.

Starting at the end of 2011, Medicare recipients could enroll in Medicare Advantage and Medicare Part D plans which had received a five-star ranking from December 8 through November 30 of the following year—not just during OEP. (This is assuming you meet the plan’s enrollment requirements, such as living in the service area.) You could also disenroll from one five-star Medicare Part C or Part D plan and enroll in another during that time period.

Keep in mind that there are relatively few plans that have received a five-star rating for 2013. You can check the star ratings of the plans in your area by using the Medicare Plan Finder on Medicare.gov.

Medicare Supplement plans: You can apply for a Medicare Supplement plan (sometimes called a Medigap plan) at any time. However, unlike during your Medicare Supplement Insurance OEP (the six months following when you first enroll in Medicare Part B), your application can be denied. Or you may be charged a higher premium, based on your health history.

Reminder for 2013

So, there are a few opportunities to change your Medicare coverage outside of the Open Enrollment Period. However, the OEP still remains a yearly opportunity to evaluate your coverage and switch your coverage, if that’s what’s best for you.

So mark your calendars: Medicare OEP takes place October 15 – December 7 in 2013, too. And Medicare Made Clear will be here, providing you with information to help you make the right Medicare choice for you.

–This information was provided by Medicare Made Clear

www.GeorgeLitchfield.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website www.GeorgeLitchfield.com and we will give you a quote and help you keep money in your pocket.