With National Caregivers Month quickly approaching, let’s remember former First Lady Rosalynn Carter, who said it best in 2012—“There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”
As a caregiver, what questions should I ask to help me assess the best Medicare Advantage (health plan) possible?
n Is the plan comprehensive? Does it include prescription drug coverage? Does it have those extra benefits that are important for the person I am caring for? Hearing aid coverage? Prescription glasses? A gym membership?
∗ Are there social workers to help me navigate the system to ensure that the person I am caring for receives the care and services they need? Is there a cost for those services to understand and navigate the systems?
∗ Is the plan an integrated health program? Can my physician see the notes from other physicians? Are they able to see when I last filled a prescription for my loved one? If I need a new prescription, can the pharmacy notify the physician directly and in a timely manner so there isn’t a delay in medication coverage? Can the physician email an order for an X-ray, so that it’s waiting for me when I arrive for services?
∗ What is the Medicare Star Rating? The Centers for Medicare & Medicaid Services (CMS) uses a Five-Star Quality Rating System to track every health and drug plan very closely each year. Measures include various health plan screenings, care for older adults, member satisfaction and complaints, medication adherence and more. In mid-October each year, CMS reports the Star Ratings to the Medicare Health and Drug plans for the next calendar year.
› If a plan receives one or two stars, it means, on average, the plan’s scores declined (got worse).
› If a plan receives three stars, it means, on average, the plan’s scores stayed about the same.
› If a plan receives four or five stars, it means, on average, the plan’s scores improved.
These are just some of the questions to consider asking your current health plan provider or if you are researching other options in preparation for the Medicare Advantage Annual Enrollment Period this fall, which spans Oct. 15 to Dec. 7 in 2019.