Information from OneExchange for our Medicare Participants Spring 2015 issue

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1 Information from OneExchange for our Medicare Participants Spring 2015 issue We've created this newsletter to keep our participants updated on what's happening with Medicare medical and prescription drug coverage this year and next. We hope you find the information useful. In this issue: After You Enroll: OneExchange Support The Continually Shrinking Donut Hole Medicare 2015 Open Enrollment Make Your Home Safer After You Enroll: OneExchange Support OneExchange will continue to be your advocate for as long as you are insured with a plan you purchased through our marketplace. If you have a question about your medical insurance, your prescription drug plan, or your funding arrangement if you have one, we are available to help. We can even have a three way call with your insurance company to help solve an issue or answer a question. This is a free service we provide to you as long as you are enrolled through OneExchange (TTY: 711) 8 a.m. 9 p.m. Eastern Visit us online OneExchange website Get answers to your questions Shop for Medicare Insurance options Twitter Some of the most common reasons people call us include questions about: Their medical provider Their insurance plans and policies How they can reinstate lapsed coverage What they need to do about insurance if they are moving

2 or have dual residences The status of their funding account Why a reimbursement request was denied or how to appeal a denied request for reimbursement Please don t hesitate to call us if you need assistance that s what we re here for. The Continually Shrinking Donut Hole If you have Medicare Part D Prescription Drug coverage, then you ve probably heard about the gap in coverage that can make it difficult to afford medications. Most people call it the donut hole. Or maybe you know about it firsthand! In 2014, more than 37 million people were enrolled in Medicare Part D Prescription Drug Plans. A small percentage of people enter the donut hole each year and have to pay a higher dollar amount for their prescriptions. After they ve paid a maximum amount, the plan begins to pay again. Before 2010, this higher donut hole amount was 100 percent of the cost of the medications. But since the Patient Protection and Affordable Care Act (ACA, also known as health care reform) passed in 2010, the donut hole has been shrinking, and will continue doing so until it s fully closed in So, instead of offering no coverage to people who enter the donut hole, Medicare and the pharmaceutical companies have been helping to foot the bill. How this affects you In 2015, if you hit the donut hole which happens after you and your plan have spent approximately $2,960 for covered prescription drugs, but before you ve paid the total out-ofpocket maximum of $4,700 you get: A 35% discount on generic drugs from Medicare A 55% discount on brand-name medicines In 2016, you ll get even more help: A 42% discount on generic drugs A 58% discount on brand name medicines

3 As of this writing, here s how the rest of 2016 is shaping up: The standard Medicare Part D prescription drug plan deductible will be increased by $40 to $360* Initial coverage limit/beginning of donut hole will increase from $2,960 in 2015 to $3,310 Out-of-pocket maximum/end of donut hole will increase from $4,700 in 2015 to $4,850. *Your plan may differ Reminder There s no need to keep track of your drug costs or spending. Your Medicare Part D plan provider follows that and sends you a monthly Explanation of Benefits (EOB). This way, you always know when you re approaching or exiting the donut hole phase of your prescription drug plan. Medicare 2015 Open Enrollment Each year, between October 15 and December 7, you have the opportunity to make changes to your Medicare Advantage or Part D Prescription Drug coverage for the following year. Medicare calls this its Open Enrollment Period. We will send you a newsletter around the start of Open Enrollment, containing information to help you evaluate whether you might want to change your coverage. But if you are satisfied with your coverage at the time of Open Enrollment, you won t need to take any action. You don t even need to contact us. Your medical and prescription drug plans will automatically renew. If you want to make a change to or enroll in a Medigap plan during Open Enrollment, we will work with you and your preferred plan to handle any preexisting conditions you may have, but we can t guarantee that they ll accept you. Make your home safer Making your home safer can help you live there longer, and prevent accidents that could lead to moving into a long-term care facility.

4 As people age, accidents in the home are a major cause of hospitalization and the need for long-term care. Making your home a safer place to live can help you stay there longer. Hazards in the home are easy to overlook, but there are many things you can do to reduce your risks. One of the most important things you can do is reduce your risk of falling. Falls are a leading cause of hospitalization and longterm care, and you are more likely to fall as you get older. According to the Center for Disease Control (CDC), every year one in three adults over 65 suffers a fall that can result in moderate to severe injuries, even death. People over 75 are four to five times more likely to spend a year or more in a longterm care facility as a result of a fall. Reducing falling hazards is important, but there are other important changes you can make. Use the checklist below to see if you re already doing the five most important things that will make your home safer: Quick start to a safer home Remove clutter: One of the quickest and easiest ways to prevent accidents in your home is to simply walk around and remove all clutter that is in or near pathways. Move furniture, decorative items, and electrical cords out of the way so there s nothing to bump into or trip over. If you have to walk around, step over, or turn sideways while walking it s hazardous and needs to be cleaned up. Clearing potential obstacles applies to pathways outside your home as well! Secure rugs: If you have any loose rugs or runners that might slip or cause you to trip over a turned up edge, either remove them or secure them to the floor with double-faced adhesive carpet tape. Brighten up your home: Good lighting is important in every room. Light switches should be easily accessible, and dim or burned out light bulbs should be replaced. Check your batteries: Make sure you have adequate smoke and carbon monoxide detectors installed; check and replace batteries as recommended by the manufacturer. Get regular exercise and check-ups: In addition to physical obstructions, falls can also be

5 caused by personal factors like poor balance, flexibility, and eyesight. Exercise regularly to improve your strength and balance, and talk with your doctor about medications that might make you dizzy or drowsy. Eyesight deteriorates as we age and can lead to accidents in the home, so get your eyes checked regularly. OneExchange 2929 Campus Drive, Suite 400 San Mateo, CA Copyright 2014 Towers Watson. All rights reserved. Contact us Privacy Medicare has neither reviewed, nor endorsed, this information. Click to view this in a browser If you no longer wish to receive these s, please reply to this message with "Unsubscribe" in the subject line or simply click on the following link: Unsubscribe Towers Watson 2929 Campus Drive San Mateo, California US