This article marks the third consecutive year that I have devoted this entire space to the annual publication Medicare and You.
For those new to Medicare, prior to the open enrollment period all beneficiaries receive a publication from the Centers of Medicare & Medicaid Services entitled Medicare & You (2018). You now have a choice of receiving the publication in either electronic or paper format (I still prefer the paper booklet edition). Because this publication contains important information, I am going to again use this column to examine how to get the most benefit out of the publication.
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 this year’s edition is almost the same overall length as the 2017 edition, there are both important additions and deletions.
When you open the current edition, you will immediately find that new material has been added. Here you will find an important announcement about the distribution of the new Medicare cards. This replaces the traditional “Welcome to Medicare” letter.
According to the announcement, the new cards will be mailed to everyone between April, 2018 and April 2019. In order to ensure that you receive your card, make sure that your mailing address is up to date. If you need to change your address, contact Social Security at ssa.gov/myaccountor call 1-800-772-1213. Social Security will never call you about your new card. Never give out any personal information over the phone if you receive such a call.
A page has also been added to provide you with information on how to get the most out of your Medicare coverage. It directs you to specific pages in the booklet so you can quickly find important information. There is also a page with an infographic showing how Medicare works and another that offers you a quick guide containing things to consider when choosing between Original Medicare and a Medicare Advantage Plan. Open enrollment dates are also listed.
Section 1 – Learn How Medicare Works. There are no additions to this section. However, the material on “things to consider when choosing your plan’ has been moved to the introductory section as noted above.
Section 2 – Signing Up for Medicare Part A & Part B. Beyond formatting and some editing, there are no substantive changes in this section. They do note that the premium for those new to Medicare last year was $134 per month for Medicare Part B. However, when the premium increases took effect the majority of beneficiaries, those who were enrolled in Part B prior to 2016, continued to pay a lower premium. What will happen this year?
On page 28, the rules as they were set in 2017 are listed because they are still in effect. Sometime later this year Congress will make a determination on premiums. It was just recently announced that all Social Security recipients will receive a 2 percent increase this year. Many believe that, because of this increase, Congress may decide to increase Part B premiums for those paying the old rate. At this time no one knows, so stay tuned.
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. Be sure to check pages 37-61 for a list of the covered preventive services.
Pay special attention to those with the symbol of an apple next to them. In most cases, if these services are ordered by a physician or other qualified health care provider, they are covered in full (no-copayment).
Section 4 – What’s Original Medicare? No changes from last year.
Section 5 – Learn about Medicare Advantage Plans (Part C) & Other Medicare Health Plans. This section was again reduced in length last year and remains unchanged. If you are considering changing to an Advantage Plan, or returning to Original Medicare, be sure to read through this chapter before making your final decision.
Section 6 – What are Medicare Supplement Insurance (Medigap) Policies? Beyond editing, there are no changes in this section.
Section 7-Get Information about Prescription Drug Coverage. There are no changes in this chapter, but it is always good to review this section for any new rules.
Section 8 – Get 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 savings and state pharmacy assistance programs, are explained in detail. The eligibility limits for receiving Extra Help have again increased this year. For a single person, the income limits are now $18,090 (up from $17,820 last year).
For a married person, the limits have increased slightly from $24,030 last year to $24,360 in 2018. Many beneficiaries could save hundreds of dollars each year but they fail to apply for assistance. 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 315-798-5456.
Section 9 – Know Your Rights & Protect Yourself Against Fraud. Because of the increasing problems with fraud and scams, expect updates to this section every year.
Section 10 – Get 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 12 – Compare 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 you find that there are changes to your plan, you may want to call the Oneida County Office for the Aging/Continuing Care HIICAP Program at 315-798-5456 to seek advice about possibly making a change in your plan during the fall Open Enrollment period. Remember, the HIICAP program is available year-around to provide you with unbiased information about all the Medicare plans, options and issues.
In closing, Medicare and You is an important guide that you should review every year.
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.