Medicare Enrollment: What You Need to Know

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1 Medicare Enrollment: What You Need to Know September 18, 2014 Brandy Bauer National Council on Aging 1

2 National Council on Aging (NCOA) Who We Are: NCOA is the nation s leading nonprofit service and advocacy organization representing older adults and the community organizations that serve them. Our Mission: To improve the lives of millions of older adults, especially those who are vulnerable and disadvantaged. 2

3 What we ll cover today Quick review: The parts of Medicare Medicare enrollment periods: Which one is for you? The importance of the Annual Open Enrollment Period & what you can do Ways to assess your Medicare coverage Medicare and the Health Insurance Marketplaces 3

4 Quick review: Parts of Medicare 4

5 Quick review: The parts of Medicare Part A: Hospital insurance Covers inpatient stays, some costs of skilled nursing facilities, and hospice care Part B: Outpatient coverage Covers physicians visits, preventive care, medical equipment, and ambulance services Together, Parts A & B are referred to as Original Medicare 5

6 Quick review: The parts of Medicare (cont.) Part C: Medicare Advantage Medicare offered via private health plans Many MA plans also cover prescription drugs and may offer services above and beyond Original Medicare Part D: Prescription drug coverage Private plans that cover prescription medications (different formularies mean different coverage rules/rates by plan) Medigap (Medicare Supplemental Insurance) Purchased through private companies Pays for cost-sharing for Parts A & B and other services not covered by Original Medicare 6

7 Enrollment periods 7

8 Enrollment periods: Resources Understanding Medicare Enrollment Periods (official Medicare publication): Download NCOA s calendar of enrollment periods: 8

9 Knowing when to enroll is important! If you don t enroll on time, you could face steep penalties Part B penalty: Part B premium increases 10% for every 12-month period you could have had Part B but did not enroll Part D penalty: 1% of the average Part D premium ($32.42 in 2014, or 32 cents), times the number of months late enrolling, rounded to the nearest 10 cents Example: You missed enrolling in Part D by 12 months in 2014; your premiums would cost an added $3.80 every month These penalties last as long as you have Medicare! 9

10 Who gets automatically enrolled into Medicare? Some people are automatically enrolled into Medicare (Parts A & B): People receiving Social Security Disability Insurance (SSDI) benefits will get Medicare after 24 months of receiving SSDI People with ALS (Lou Gehrig s disease) get Medicare as soon as they start to receive SSDI People with End Stage Renal Disease don t get Medicare automatically, but can apply after 3 months of dialysis People turning 65 who already receive Social Security or Railroad Retirement Board benefits will be automatically enrolled around their birthday 10

11 Enrollment periods: Initial Enrollment Period Everyone gets an Initial Enrollment Period (IEP) during 7- month window around their 65 th birthday Can apply up to 3 months before and 3 months following birthday month Coverage start date depends on enrollment, but no sooner than birthday month During IEP, you can enroll in Parts A, B, & D Can choose Medicare Advantage plan after you ve enrolled in A & B If you don t enroll during your IEP and don t qualify for Special Enrollment Periods, you may pay a penalty for joining Medicare later 11

12 Enrollment periods: Medigap Open Enrollment Period People turning 65 and enrolled in Parts A & B have a 6- month window to enroll in a Medigap plan Enrollment period starts during the 1 st month you are age 65 and enrolled in Part B For those who still have coverage through active employment at 65, you get a 63-day period to enroll when that coverage ends Not subject to medical underwriting (companies must sell the policy regardless of medical history) People under 65 with Medicare may be able to buy a Medigap policy, depending on your state May be subject to medical underwriting and pay more based on your condition 12

13 Enrollment periods: Special Enrollment Periods Some people get special windows to enroll/change coverage without penalty: Lose active employee/spousal coverage (not COBRA) Move out of a plan s active coverage area (for Parts C & D) Enter or leave an institution Qualify for Part D Low Income Subsidy (for Part D only) If you/spouse is actively working and covered under employer coverage, you may have an option to delay initial enrollment into Medicare Have an 8-month window when current coverage ends to enroll in Part B Have 2-month window to join Parts C/D after current coverage ends Have a 63-day window to pick up Medigap plan 13

14 Enrollment periods: General Enrollment Period For people who did not sign up for Parts A & B when first eligible, and who do not qualify for Special Enrollment Periods Runs Jan. 1 March 31 each year Coverage starts July 1 May be subject to penalty for late enrollment 14

15 Enrollment periods: MA Disenrollment Period For people who have Medicare Advantage (MA) and want to leave their plan and return to Original Medicare Runs Jan. 1 Feb. 14 each year Can also pick up a Part D plan if you don t have one already Cannot switch between MA plans, Part D plans, or move from Original Medicare to MA 15

16 Enrollment periods: Open Enrollment Period Runs Oct. 15 Dec. 7 each year Anyone with Parts A & B (including those who already are in Medicare Advantage and/or Part D plans) can: Change from Original Medicare* to Medicare Advantage Leave Medicare Advantage and go back to Original Medicare Join, drop, or change Part D plan Switch Medicare Advantage plans New coverage starts on Jan. 1 *People with Original Medicare and Medigap plans should weigh the decision to take MA carefully; they may not be able to get Medigap again 16

17 Getting ready for open enrollment 17

18 Open enrollment matters! Plans change, and so do you! Annual guaranteed opportunity to assess and make changes in coverage Potentially save on out-of-pocket costs Yet the majority don t take advantage of it: 2010 survey from Kaiser Family Foundation found that only 13% of beneficiaries switched plans during open enrollment Of those who didn t change plans, most saw an increase in premiums the following year 18

19 Consider the 4 Cs Cost What is the annual cost of the plan (premiums, deductible, coinsurance, copayments)? What tiers do your medications fall into, and how does this affect what you pay for them? Did you enter the prescription drug coverage gap ( donut hole ) last year? Coverage Review coverage of strength, dosage, and route of administration and any formulary limitations in your plan How does the coverage/plan rank under Medicare s star quality rating system? 19

20 Consider the 4 Cs (cont.) Convenience Can you get your prescriptions at your preferred pharmacy or by mail at the preferred price? Does the plan restrict access to medications (prior authorization, step therapy, quantity limits)? Can you get medication while travelling/living part of the year elsewhere? Customer Service How responsive is the plan to your problems/questions? Again, what is the overall quality rating for the plan? 20

21 Also consider other potential savings Good opportunity to see if you qualify for the Part D Low Income Subsidy (Extra Help) Helps pay Part D premiums and reduces copayments for those who qualify Also check to see if you may get help from other programs State Pharmaceutical Assistance Program Drug manufacturer rebate programs Use our online screening tool at: 21

22 Ways to assess your Medicare coverage 22

23 Medicare.gov Official Medicare website Plan Finder: allows you to compare plans and coverage in your area Find out if your test/service is covered at: Can create a personal account at MyMedicare.gov to track claims and coverage Call MEDICARE ( ) with questions 23

24 State Health Insurance Assistance Programs (SHIPs) Federally funded to provide objective assistance to people with Medicare and their families Called different things in different states (e.g., SHINE, HICAP, CLAIM) Search at or 24

25 My Medicare Matters Educational service from NCOA that walks you through Medicare enrollment, coverage, costs, and more Prescription drug savings calculator Take the Medicare QuickCheck Get personalized recommendations for your situation Identifies whether you may be able to save on costs through subsidies/benefit programs Connections to get assistance in enrollment and choosing a plan 25

26 My Medicare Matters ( 26

27 Medicare & the Marketplaces 27

28 The Health Insurance Marketplaces Available at Established under Affordable Care Act Individuals and small businesses can buy affordable coverage for themselves/their employees People with incomes between 100% and 400% of poverty get subsidies/tax credits to help pay for coverage Also can enroll in Medicaid and Children s Health Insurance Program (CHIP) Marketplace open enrollment for 2015 runs Nov. 15, 2014 Feb. 15,

29 Do the Marketplaces affect Medicare? The Marketplaces do not affect Medicare coverage Medigap policies, Medicare Advantage plans, and stand-alone Part D drug coverage will not be sold through the Marketplaces People with Medicare should not use the Marketplaces to change their coverage It is illegal for a Marketplace representative to sell a plan to someone they know has Medicare Once a person becomes eligible for Medicare, they will lose those Marketplace subsidies/tax credits 29

30 Learn more Center for Benefits Access at NCOA: Fact sheets on Medicare, enrollment periods, and Affordable Care Act Free monthly webinars on topics related to Medicare and benefits Medicare Rights Center Medicare Interactive: More info on Marketplaces and people transitioning to Medicare 30

31 Get involved with NCOA Visit ncoa.org and sign up to receive news, resources, and opportunities to learn and act. Donate to support NCOA s work: ncoa.org/donate. Share NCOA s free, trusted tools with older adults. BenefitsCheckUp.org EconomicCheckUp.org MyMedicareMatters.org RestartLiving.org 31

32 Questions? Brandy Bauer: 32

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