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Many medicare options are available

Wednesday, October 15, 2008

The number of people on Medicare keeps growing as more people reach Medicare age. There are many options now available and they are good quality options. The annual enrollment period will be from Nov. 15 to Dec. 31, when those on Medicare may enroll in Part D prescriptions or into Medicare Advantage programs with an effective date of January 1, 2009.

The challenge is to understand the options available. With a large number of options, it is often confusing.

Most are familiar with the original Medicare fee for service, which includes Part A which is for hospitalization, and for Part B which is for medical services. These are government sponsored as well as Part D which is for prescriptions.

In recent years we have seen annual increases for the Part B premiums which are taken out of the Social Security check. For many, it seemed that the increase in premiums was more than the cost of living increases they receive for Social Security.

For 2009, there will not be any increase in the premium for Part B. This is largely due to an accounting error with the cost for Hospice being charged to Part B when it should have been for Part A. Medicare supplements have been popular to supplement the payments for Part A and Part B. Many people consider that Medicare supplements are the best choices, but others may say that other choices have a lower premium and is a better choice.

The advantage of having a Medicare supplement is that anywhere that Medicare is accepted then the supplement is also accepted. It depends on what plan a person has as to what is covered, but many have a Part F plan which covers 100 percent if it is approved by Medicare. With a supplement, there is a general understanding of what it will cost during the year. Renewal is also guaranteed.

The problem that people are having with the supplements is that the premiums keep going up, however they cannot go up unless they raise the premiums on everyone. As a result of the premium increases, many people are finding it difficult to pay the premiums and are looking to other more affordable alternatives. In Missouri, you have an open enrollment and can change companies on the anniversary of the policy by taking out the same type.

Part D may be taken as a stand alone policy with original Medicare with or without a supplement, or with a Medicare Advantage that does not include the prescription plan. There have been some who question taking out a Part D plan because they do not have enough prescriptions to make it worthwhile. This may be true, but we never know as we get older when we might have to take a large number of expensive prescriptions. By not signing up for a Plan D when first eligible, there is a 1 percent per month penalty when it is taken and will remain as additional premium.

On average those with Plan D save about 50 percent compared to not having a prescription plan. When Part D was first introduced, there was a thought that it would not be accepted by seniors and they would not like the program. Instead, about 70 percent are satisfied with it. Enrollment in Part A and/or Part B is necessary to enroll in Part D

The premiums for Part D may be different for 2009. One company which has often been the most competitive is having a 60 percent increase in premiums. When it comes to selecting the best Plan D, one size does not fit all. It depends on what medications are being taken and what the plans offers. During the annual enrollment period, people can enroll can in a plan, or change to a different plan.

With Part C of Medicare, generally referred to Medicare Advantage, private enterprises cover the medical needs. Enrollment in both Part A and Part B is necessary to be enrolled in Part C. These plans not only cover medical needs, but they also have additional benefits, including dental and vision care.

If a person is enrolled in Medicare Advantage, they show the provider only one card. The program will not recognize the original Medicare card, although it is part of the Medicare program. Some of the plans will include prescription coverage and some will not. The company contracts with the government to administer and provide the coverage. They are allowed a limited amount of profit.

Medicare Advantage include HMO's, private fee for service, PPO's special needs plans, which covers chronic health conditions and new this year MSA's. What is available depends on where you live; it also affects the premiums that you will pay.

HMO's are not offered in this area. There are some good PPO's in some locations, but the choices are more limited for Vernon County. With the PFFS plans, the provider has to agree to accept the terms of the plans. The card has to be shown to them each time for them to accept it. There are good plans available.

MSA plans have a high deductible. However, funds are placed into a savings account for the person with plan and these funds are added each month and can be used for the deductibles and other types of medical expenses. The premium is zero.

This is a partial summary of the Medicare alternatives being offered. Sound confusing? In many ways it is, still there are good, high quality choices available. Your challenge is to understand them the best you can, for yourself or to assist a parent or someone else.

Leonard Ernsbarger
Leonard At Large