SMOKINCHOICES (and other musings)

October 22, 2012

Do Medicare homework

(Our window is small this year for those of us among the Social Security crowd who use Medicare, to do some fairly quick but deep ‘homework’.  We must try to decipher whatever changes are going to be in the plan we now have and consider if a change would be advantageous.  I was mailed a notice from my insurance provider telling me that my  plan was being discontinued.  Stressful.  Wasn’t anticipating having to go through all that again this year.  If one can afford it, using Medicare (the original plan) and separate purchase of a supplemental plan is the most satisfactory which allows full choice.  (see any doctor you choose)  For detail oriented – better get cracking.  Jan )


Do your Medicare homework, seniors told


For the first time, the number of Ohioans enrolled in Medicare is about to top 2 million. And many of them stand to gain if they switch to a new health or prescription drug plan.

The open enrollment period runs  from October 15 through Dec. 7.

During the next eight weeks, government officials urge Medicare enrollees to research not only a plan’s premium costs, but also co-pays and the drugs that are part of its formulary.

“Even if the premiums stayed the same, everyone really should check out their options just in case their own personal drug needs may have changed,” said John Hammarlund, Centers for Medicare & Medicaid Services administrator for Region 5, which includes Ohio.

“There still is an emphasis for people to really do some homework to compare plans.”

When people turn 65 years old, they can sign up for traditional Medicare coverage or opt for expanded coverage plans that might better suit their individual health-care needs.

Premiums for Medicare Part D stand-alone prescription-drug plans are expected to rise by an average of 7 percent next year following a slight overall decline this year, according to a new report from the nonprofit Kaiser Family Foundation.

Meanwhile, monthly premiums for Medicare Advantage plans are expected to increase by 4.7 percent, or $1.47, if enrollees remain in their current plan, Hammarlund said. If they switch to lower-cost plans at the same pace with which they have in the recent past, the monthly increase would average 1.8 percent, or 57 cents per month.

Premium hikes are especially steep for some of the more popular plans. For example, Humana is raising the monthly premium for its Walmart-Preferred Rx Plan by 23 percent to $18.50 next year, according to Kaiser.

  • Medicare Advantage plans tend to have lower monthly premiums. But more traditional Medicare plans with supplemental coverage, while more expensive, can provide seniors with some peace of mind, said Andy Haggard, the Medicare outreach program director at the Central Ohio Area Agency on Aging. They also can provide greater choice of medical providers.

About 34 percent of Ohio’s Medicare enrollees are on Medicare Advantage plans, private insurance plans that cover hospital, medical and often prescription-drug expenses. Most residents are on traditional Medicare plans.

In Ohio, as well as nationally, enrollment in Advantage plans has been rising.

Enrollment in Medicare Advantage plans grew by 11 percent in Ohio from 2011 to 2012, reaching 706,425, according to Kaiser. In Ohio, the top three Medicare Advantage firms last year in terms of market share were Humana (27 percent); Well-Point Inc. (26 percent); and Aetna Inc. (15 percent), according to the foundation.

That growth has been driven in part by decisions over the years by the state’s large retirement systems to enroll retirees in Medicare Advantage plans, said Christina Reeg, interim director of the Ohio Senior Health Insurance Information Program.

During open enrollment, the federal government will nudge some Medicare recipients to enroll in higher-ranked plans.

Those who want to enroll in a plan with fewer than three stars (out of five) will not be able to do so through   and will have to call the plan directly. Those now enrolled in one of 26 plans that have received 2.5 or fewer stars in the past three years will receive letters encouraging them to move to a higher-ranked plan. Those letters likely will be sent in late October or early November.

“We simply want to alert them about the status of their plan and make it easier for them to enroll in a five-star plan, if possible,” Hammarlund said.

In Ohio, one plan, which serves the Cleveland and Akron areas, has received a five-star rating for 2013. There were no five-star plans in Ohio this year.

A small percentage of Medicare enrollees nationwide — 12 percent of Medicare Advantage enrollees, 28 percent of prescription-drug plan enrollees — are in plans that received fewer than three stars this year.

The ratings are based on patients’ health outcomes and satisfaction with the plan.

A study by PlanPrescriber, part of eHealth Inc., found that the average person could save more than $600 a year if he or she picked a prescription-drug plan with the lowest out-of-pocket costs. The study found that 5 percent of people were on the lowest-cost prescription-drug plan available, while 24 percent were in the Medicare Advantage plan with the lowest total out-of-pocket drug costs.

Medicare checkup sessions will be offered again across Ohio this year.

In Franklin County, on-site counseling will be offered from 10 a.m. to 2 p.m. at Veteran’s Memorial, 300 W. Broad St. Last year’s sessions were attended by nearly 7,500 people statewide.


Medicare Resources

Centers for Medicare & Medicaid Services

• 1-800-633-4227 (24 hours)

Ohio Senior Health Insurance Information Program  , click on “Medicare Services

• 1-800-686-1578

Ohio Department of Aging

• 1-800-266-4346 Central Ohio Area Agency on Aging

• 1-800-589-7277 ” Franklin County Office on Aging

• 614-525-6200


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