Medicare & You 2017 is an informative, important guide

Published Dec 25, 2016 at 9:00am

For those new to Medicare, all beneficiaries receive an annual publication from the Centers of Medicare & Medicaid Services entitled Medicare & You (2017).

Everyone now has a choice of receiving it in either electronic or paper formats. Regardless of which way you choose to receive the publication, I hope everyone will take a few minutes each year to go through this guide. Because this publication contains important information, and we have many who are new to Medicare this year, I am going to again use this column to examine how to get the most benefit out of the Medicare and You 2017 guide.

If you have never read this guide I would urge that you read it once from cover to cover. After you have become familiar with the contents, you can read the publication for updates each year.

While the format and layout of most sections may change, the basic contact generally remains the same from year to year. The changes to the 2017 guide may be somewhat of an exception to that rule. This year’s edition is 28 pages shorter than the 2016 edition. In addition to using formatting changes to make the sections more readable and easy to follow, overly detailed information has also been eliminated. So, going through the various sections of the publication we can take a look at some of the major changes.

Section 1 Learn How Medicare Works. The changes to this section are a good indication of the types that have been made to later chapters. For example, the page listing important dates which had been buried on page 13 last year, now appears on page 4 where it is hard to miss. Also in Section 1, an illustration of a screen page of the Plan Finder webpage, which was almost impossible to read, has been removed. 

Section 2Signing Up for Medicare Part A & Part B. Following the brevity trend, section 2 is now four pages shorter than last year. How has this reduction been achieved? Mostly through editing, both in terms of eliminating some minor details but also in a more logical organization of information

The one change that will appear each year in this section is the Part B premium for the year. However, the manual is usually published before the final decisions on premium levels have been made by Congress. So, on page 28, it states that the standard Part B premium was $121.80 for 2016.

That amount for those new to Medicare has actually been increased to $134.00 per month for 2017. Those who paid a lower rate last year will continue to pay a lower, but slightly increased premium. If you have questions call the Oneida County HIICAP program about your 2017 premium and deductible rates. You can also go to the website for more detailed information.  

Section 3 Find Out if Medicare Covers Your Test, Service, or Item. This is a section that you should always review. Look for a particular procedure or service that you will use this year to see if there are any changes in the coverage. Beginning on page 37 all the Medicare Part-B covered services are both listed and explained.

This year the covered services that have been added include advanced care planning, chronic care management services and transitional care management services. Part B will no longer cover concierge care. It should be noted that other services not covered by Part-B are listed on page 61. These include most dental care, eye examinations related to prescribing glasses, dentures, cosmetic surgery, acupuncture and hearing aides and fitting exams.

It should be noted that several pages on suggested options for paying for the long-term care services Part B have been eliminated from this year’s edition. It is an example of the editing that has occurred in this new edition.

Section 4What’s Original Medicare? This chapter has been reduced by extensive editing.

Section 5Learn about Medicare Advantage Plans (Part C) & Other Medicare Health Plans. This section was again reduced in length through editing out extraneous material. If you are considering change from Original Medicare to a Medicare Advantage Plan, you should read this section before making a decision.

Section 6What are Medicare Supplement Insurance (Medigap) Policies. Beyond editing, there are no changes in this section.  

Section 7-Get Information about Prescription Drug Coverage. This is a good chapter for all beneficiaries to check out yearly for any new rule changes.  

Section 8Get Help Paying Your Health & Prescription Drug Costs. On page 97, it is noted that the limits on receiving extra help have been increased this year. The various extra help programs, including Medicare saving programs and state pharmacy assistance programs, are explained in detail. These programs are for those who are not eligible for either Medicaid and/or Supplemental Security Income (SSI) benefits.

Many beneficiaries are not enrolling in these programs even though they could save thousands of dollars per year. If you feel you might now qualify for extra help you should contact the Oneida County Office for the Aging/Continuing Care HIICAP Program at 798-5456.

Section 9Know Your Rights & Protect Yourself Against Fraud. Because of the increasing problems with fraud and scams, expect updates to this section every year. 

Section 10Get More Information. Remember, if you call 1-800 MEDICARE (633-4227) for information you can say “Agent” at any time and you will be directed away from the automated system to a customer service representative. 

Section 11- Definitions. No changes.

Section 12Compare Health & Prescription Drug Plans in Your Area. There are potentially important changes every year in this section. The changes are fairly easy to read and you should always find your coverage to see if there are any changes in such things as premiums, limits or co-pays for your coverage, including prescription drugs.

If there are changes you may want to call the Oneida County Office for the Aging/Continuing Care HIICAP Program at 798-5456 to seek advice about possibly making a change in your plan during the fall open enrollment period. In certain cases, you may be eligible for one of the special enrollment periods. Remember that the HIICAP program is available year-around to provide you with unbiased information about all the Medicare plans and options.

In summary, once you have read Medicare and You completely it should not be necessary to read the full document again each year. However, the guide could change dramatically next year if the new Congress makes major changes to the Medicare program. 

Dr. William Lane is the owner of William Lane Associates, a gerontological consulting firm based in Homer, NY. He is writing a monthly column on issues related to health insurance for the OFA. He does not sell insurance, work for any insurance company or recommend any insurance products.