Tag: Annual Enrollment Period

  • Medicare Q&A

    Q

    I didn’t enroll in Medicare Part B back when my Part A started a few years ago. Can I enroll now?

    A

    It depends. The general enrollment period for Medicare Part B, medical insurance, begins January 1 and runs through March 31. Keep in mind that, although there is no monthly premium for Medicare Part A, there will be a premium for your Medicare Part B. And in most cases, that premium goes up each 12-month period you were eligible for it and elected not to enroll. If you are covered by a group healthcare plan based on your employment or the employment of a spouse, you may qualify for a special enrollment. For more information, please read our “Medicare” booklet, or talk to your personnel office before you decide.

    Q

    What can I do if my Medicare prescription drug plan says it won’t pay for a drug that my doctor prescribed for me?

    A

    If your Medicare prescription drug plan decides that it won’t pay for a prescription drug, it must tell you in writing why the drug isn’t covered in a letter called a “Notice of Denial of Medicare Prescription Drug Coverage.” Read the notice carefully because it will explain how to ask for an appeal. Your prescribing doctor can ask your Medicare drug plan for an expedited redetermination (first level appeal) for you, if the doctor tells the plan that waiting for a standard appeal decision may seriously harm your health.

    To find out more about Medicare, visit online at:
    www.medicare.gov  |  www.socialsecurity.gov/medicare

    For visits and appointments at your nearest SSA office,
    call from 7am–5pm, Mon–Fri:     1-800-772-1213 (toll free)
    or visit     www.socialsecurity.gov

    Medicare booklet:
    https://www.ssa.gov/pubs/EN-05-10043.pdf

    The general enrollment period for Medicare Part B, medical insurance, begins January 1 and runs through March 31. Keep in mind that, although there is no monthly premium for Medicare Part A, there will be a premium for your Medicare Part B. And in most cases, that premium goes up each 12-month period you were…

  • It’s Time: Medicare Open Enrollment

    Medicare’s Open Enrollment Period (also called the “Annual Enrollment Period”) is each year from Oct. 15th — Dec. 7th. Each year this is your opportunity to do a Medicare Checkup:

    • Will my plan still be available in 2016?
    • Is my plan still affordable (looking at premiums AND copays)?
    • Are there any new health or drug plans available in my area that my favorite doctors will work with?

    Here are some questions that we often hear from consumers:

    Do I have to change plans?

    No. If your plan works for you and provides coverage, is affordable and still available in your area then you can stay with that plan automatically. You may want to do that Medicare Check-up to look at all options.

    If a plan premium is higher than others does it mean it is a “better” plan?

    No. You should not base your decision solely on a plan premium. You should compare benefits and copays and make sure your doctor works with the plan. You might also want to check out the plan’s Medicare 5-Star Rating, which is available at www.medicare.gov after October 15th. Medicare looks at data received by the health plan and you, the customer, to rate the plans with a 1-Star (lowest) to a 5-Star (highest). Hawai‘i has been very lucky to have a 5-Star plan since Medicare started the ratings. We hope to have more than one 5-Star plan in 2016.

    What is a Medicare Supplement (Medigap) policy?

    A Medigap policy pays after Medicare and you may have little out of pocket costs. Private insurance companies sell it and the federal government in most states standardizes the benefits. What may differ is the premium and any specific state laws that apply.

    I have tried to navigate the Medicare system and I need help. Who can I call in Hawai‘i?

    You can call or email the Hawaii SHIP — State Health Insurance Assistance Program. We are a network of trained and certified volunteers who can help you walk through the system and screen to see if you qualify for any help paying for Medicare’s costs.

    Hawai‘i SHIP (State Health Insurance Assistance Program)
    1-888-875-9229 | 808-586-7299
    help@hawaiiship.org | www.hawaiiship.org
    facebook.com: Hawaii SHIP

    This SHIP project was supported, in part, by grant number 90SA0004-02-00 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C., 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.

    Medicare’s Open Enrollment Period (also called the “Annual Enrollment Period”) is each year from Oct. 15th — Dec. 7th. Each year this is your opportunity to do a Medicare Checkup: Will my plan still be available in 2016? Is my plan still affordable (looking at premiums AND copays)? Are there any new health or drug…

  • Put On Your Thinking Cap: Medicare Annual Enrollment Period

    It is that time of year (and this year it is even earlier), when you need to take a moment to think about your Medicare health coverage. Is my plan still meeting my needs? Are my prescription drugs covered? Is it affordable? Are there new plans out there that may better suite my needs? Do I have other coverage (retirement health plan, military coverage, or current employment coverage) and have they sent me creditable coverage information?

    The Annual Enrollment Period (AEP) is the time of year when individuals can review health or prescription drug plans, compare what will be available in the coming year, and choose the plan that best meets their needs. This year (and in the future) it is from October 15th – December 7th. There has never been a better time to check out Medicare coverage options. Comparing plans may help people with Medicare find a way to save money, get better coverage, or both.

    Information is available several ways and here are three easy steps:

    STEP ONE:

    Have a list of your current prescription medications available, check with your current providers (doctors office, physical therapist, etc.) to find out what plans they will work with so that you can still see them, and have your gross income and assets available (so you can be screened for the assistance available that helps pay for some or all of your medical costs).

    STEP TWO:

    In October 2011, compare plans available in Hawai‘i in 2012.

    • Visit www.medicare.gov where you can get a personalized comparison of the costs and coverage of the plans available in your area.
    • Call 1-800-MEDICARE (1-800-633-4227) 24-hours a day/7 days a week to find out more about your coverage options. TTY users call 1-877-486-2048.
    • Get one-to-one help from the Hawai‘i State Health Insurance Assistance Program (SHIP), also known as the Sage PLUS Program. A certified trained volunteer can be reached at 808-586-7299 or 1-888-875-9229. You can also pick up a Sage PLUS Medicare Prescription Health/Drug Plan Compare from most pharmacies or on-line at www.hawaiiship.org. Mail or fax the form in for a personalized comparison.

    STEP THREE:

    Enroll in a plan October 15th through December 7th so that you can enjoy the holiday season.

    From January 1, 2012 – February 14, 2012 is a one-time disenrollment opportunity if you want to change from your current Medicare Advantage (MA) Health plan and return to Original/Traditional Medicare. If your MA plan includes drug coverage, you also have the opportunity to enroll in a Medicare Prescription Drug Plan.

    There is also a new “Special Enrollment Period” that begins on December 8, 2011. At anytime during the year (2012) if you find yourself unhappy with your current choice you have one opportunity to change to a “5 Star” Plan. The stars are based on many quality indicators collected by Medicare. The 5 Stars means that the plan has done an excellent job in providing benefits, payments, limited number of complaints, drug pricing and patient safety, health plan’s responsiveness and care, managing chronic conditions and helping members stay healthy through screenings, tests and vaccines just to name a few.

    If all this feels too challenging or you would like information about the new 5 Star Special Enrollment Period, don’t hesitate to call the Sage PLUS Program for guided assistance through the Medicare Enrollment Process. OR … if you would like to help your community navigate through the Medicare system by becoming a Sage PLUS Volunteer, call us at 808-586-7299 or 1-888-875-9229 or e-mail help@hawaiiship.org

    It is that time of year (and this year it is even earlier), when you need to take a moment to think about your Medicare health coverage. Is my plan still meeting my needs? Are my prescription drugs covered? Is it affordable? Are there new plans out there that may better suite my needs? Do…