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Dear Marci, I’m enrolled in the federal Extra Help program. Will there be changes to my benefits in 2018? How will I know about them? – Ava Huntington, WV Dear Ava, There are several changes that can happen for people with Extra Help, a federal program that helps pay Medicare prescription drug costs, before and during Fall Open Enrollment. If a change is being made to your Extra Help coverage, you will be mailed a notice sometime in September, October, or November. Look out for the colors and titles of these notices to find out if you need to take action to change or keep your Extra Help benefits. If you receive an orange notice, you do not need to take action. This is the “Change in Extra Help Copayments” Notice, and you may receive it sometime in October. This notice explains if the Extra Help copays will change in 2018. Copays usually change a small amount each year. Read this notice to learn how much you will pay for your covered drugs in 2018, and save it for your records. If you receive a blue notice, you might need to take action. There are two kinds of blue notices, and they are both called Reassignment Notices. The first kind of Reassignment Notice is sent out in October to people whose Medicare Advantage (MA) plans or Part D drug plans are leaving the Medicare program. If you receive this notice, it means that you will be reassigned to a new MA or Part D plan in 2018. If you want to choose your own plan, you will have to choose it by December 31, 2017. If you do not take action, you will be automatically enrolled in a different plan that may or may not fit your prescription drug needs. The second kind of blue Reassignment Notice is sent in October to people whose MA or Part D plan premiums have risen above the Extra Help benchmark (the maximum premium amount that Extra Help will cover). If you receive this notice, it means you will be assigned to a new plan in 2018. If you want to choose your plan, you should do so before December 31, 2017. Otherwise, you will be automatically enrolled in a new plan. If you receive a gray notice, you should be prepared to take action, because it means that you could be losing Extra Help or paying more in the coming year. The first kind of gray notice is a “Loss of Deemed Status” Notice. This notice is sent in September to people who will no longer qualify to get Extra Help in 2018. If you get this notice, but you think it is a mistake (because your income hasn’t changed and/or you’re still below the income and asset limits for Extra Help), you should reapply for Extra Help right away so you don’t lose coverage in 2018. You can apply by calling the Social Security Administration at 1-800-772-1213, visiting your local Social Security office, or applying online here. The second kind of gray notice is the “Low-Income Subsidy Choosers” Notice. You will receive this in November if you chose your current drug plan (instead of being automatically enrolled in one), and your plan premium is increasing above the Extra Help benchmark amount in the coming year. If you receive this notice, it means that you have to actively change your plan to one with a lower premium. If you do not actively switch to a plan with a premium below the Extra Help benchmark, you will pay part of the premium (the difference between the premium amount and the benchmark amount) in 2018. – Marci |
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Dear Marci,
Dear Marci,
Last year I received an Annual Notice of Change from my Medicare Advantage Plan. Will I get one this year? What should I do with it?
– Emmanuel
Springfield, MO
Dear Emmanuel,
The Annual Notice of Change (ANOC) is an important notice sent each year to people who have a Medicare Advantage (MA) Plan or aMedicare Part D Prescription Drug Plan. Plans send these notices to their members every year to notify them of cost and benefit changes that will take effect starting January 1 of the following year. If you currently have a Medicare Advantage Plan or a Part D Prescription Drug Plan, you should receive this notice by September 30 of this year. If you haven’t received it by then, you should contact your plan to ask for it.
The Annual Notice of Change is typically mailed along with the plan’s yearly Evidence of Coverage (EOC) Notice. A plan’s EOC provides a more comprehensive explanation of its costs and coverage in the following year. Remember that plans can make changes every year to costs and benefits, from changing copays to changing which providers and pharmacies are in-network or out-of-network. In reviewing the Annual Notice of Change, make sure that the providers, services, and drugs that you need are still available and covered under your Medicare Advantage or Part D plan. Also, make sure you know and understand how much you will pay out of pocket for your health care services.
If there are changes to your costs and benefits that could raise your costs or get in the way of getting the health care you need, you may want to think about making changes to your Medicare coverage duringFall Open Enrollment. Fall Open Enrollment runs from October 15 to December 7 every year. If you make changes to your Medicare coverage during Fall Open Enrollment this year, they will go into effect on January 1, 2018.
Even if you review these notices and decide that there won’t be any major changes to your Medicare coverage in 2018, it still might be helpful to look at other Medicare options and compare them to your current plan. Another plan in your area might offer health and/or drug coverage at a better price than what you currently pay. To learn more about different Medicare coverage options, call 1-800-MEDICARE or use the online Plan Finder tool at www.medicare.gov/find-a-plan.
-Marci
Dear Marci,
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Dear Marci, I turned 65 a while ago and I didn’t enroll in Medicare Part B. I instead kept my Marketplace plan. How can I enroll in Medicare? – Noah (Portland, OR) Dear Noah, In general, if you do not enroll in Medicare during your Initial Enrollment Period (IEP), you must wait for the General Enrollment Period (GEP) to sign up for Medicare. The GEP runs January 1 through March 31 of each year, and if you enroll during this period, your Medicare benefits will start on July 1. This means that you may experience gaps in coverage. You will also likely have a late enrollment penalty for not signing up for Medicare when you were first eligible. You will likely have to use the GEP to enroll in Medicare if (a) you kept your Marketplace plan and did not enroll in Medicare when you were first eligible, or (b) you enrolled in premium-free Part A and kept your Marketplace plan when you became eligible for Medicare. You will likely have to use the GEP to enroll in Medicare Part B. Currently, you may be able to request time-limited equitable relief to enroll in Part B outside of the GEP. Time-limited equitable relief is a process you can use to enroll in Part B and/or eliminate a Part B late enrollment penalty (LEP). You may be eligible to request time-limited equitable relief if you delayed Medicare Part B enrollment while you had a Marketplace plan. For example, maybe you enrolled in Medicare Part A and declined Part B when you first became eligible for Medicare because your Marketplace plan with cost assistance was cheaper than Part B. You may not have realized that you were supposed to sign up for Medicare and that you would lose your cost assistance because of your Medicare eligibility. In some instances, you may have continued to receive cost assistance even after enrolling in Part A. In other situations, you may have faced Marketplace plan coverage problems once your plan realized that Medicare should be covering costs. For example, the Marketplace plan may have stopped paying primary for your health costs. Time-limited equitable relief is a limited process that allows you to either (a) enroll in Medicare Part B without penalty, or (b) eliminate or reduce your Part B LEP if you are already enrolled in Part B but had delayed enrollment when you had a Marketplace plan. In order to qualify for time-limited equitable relief, you must be enrolled in premium-free Part A and (a) have an Initial Enrollment Period (IEP) that began April 1, 2013 or later, or (b) have been notified of retroactive premium-free Part A on October 1, 2013, or later. To request time-limited equitable relief you will need to contact the Social Security Administration or visit a local Social Security office and ask to use time-limited equitable relief to enroll in Part B and/or eliminate your Part B LEP. You should bring proof that you are enrolled in a Marketplace plan, like a recent premium bill. If you received a letter about being enrolled in Medicare and a Marketplace plan, you can also bring that letter as proof. The opportunity to request time-limited equitable relief lasts until September 30, 2017. Noah, if you think you are eligible to use time-limited equitable relief, please contact the Medicare Rights Center’s national helpline at 800-333-4114 for further assistance. – Marci |
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Dear Marci,
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Dear Marci, I am almost eligible for Medicare. I currently have coverage with a Marketplace plan– my coverage is low and I receive cost assistance. Do I have to switch coverage plans and enroll in Medicare? – Evelyn (Brainerd, MN) Dear Evelyn, Deciding what to do as your approach Medicare eligibility when you have a Marketplace plan (state or federal) depends on your unique circumstances. Let’s review what your options might be. 1. You have End-Stage Renal Disease (ESRD). If you have kidney disease that requires dialysis or transplant and are eligible for Medicare, you have the choice to enroll in a Marketplace plan with cost assistance, or keep your current Marketplace plan. If you are thinking of delaying Medicare enrollment to keep or enroll in a Marketplace plan, you should consider how the Marketplace plan coverage and costs compare to Medicare. If you have ESRD and are considering whether you should enroll in Medicare, it is best to speak with a State Health Insurance Assistance Program (SHIP) counselor about the outcomes of your decision. 2. You do not qualify for Medicare premium-free Part A. If you are eligible for Medicare but would have to pay a premium for Part A, you can keep your Marketplace plan with cost assistance as long as you do not enroll in Medicare. You should consider all consequences carefully before deciding to take a Marketplace plan instead of Medicare. If you ever decide to enroll in Medicare you will have to wait for theGeneral Enrollment Period (GEP) to sign up. The GEP runs January 1 through March 31 of each year, and your Medicare benefits start on July 1. This means that you may experience gaps in coverage. You may also likely have a late enrollment penalty for not signing up for Medicare when you were first eligible. 3. You qualify for premium-free Part A. If you are eligible for Medicare, you should not continue to use the Marketplace to get health and drug coverage (except in the two circumstances listed above). Federal law requires you to have health insurance; Medicare Part A meets the minimum essential coverage requirement, which means you will not get a tax penalty if you are enrolled in Part A. Note that Medicare Part Balone is not minimum essential coverage (MEC) and you would likely get a penalty for not having minimum essential coverage. When you first become eligible for Medicare during your Initial Enrollment Period (IEP), you should enroll. Contact the Social Security Administration at 800-772-1213 to sign up for Medicare for the first time. If you are collecting Social Security retirement benefits, you may be automatically enrolled in Medicare. When you enroll in Medicare, be sure to find out the date that your coverage will start. For example, if you enroll in Medicare during the first three months of your IEP, your Medicare benefits will start on the first day of your birthday month. You should plan to disenroll from your Marketplace plan before your Medicare benefits start. Evelyn, if you are enrolled in a plan through the federal Marketplace, contact the Marketplace at 800-318-2596 or visitwww.healthcare.gov to disenroll at least 14 days before you want your coverage to end. If you are enrolled in a plan through your state’s Marketplace, contact the state Marketplace to learn how and when to disenroll from the plan. Keep in mind that you want your Marketplace plan to cover you up until your Medicare starts. You do not want any gaps in coverage, so timing is important. |
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High heat & humidity awareness !
Every year, almost 200 Americans die of problems related to high heat and humidity, and most of these people are over 50. When the mercury climbs to above 90 degrees, older adults need to take practical steps like avoiding the sun, using air conditioning, staying hydrated, dressing appropriately, applying broad spectrum sunscreen on exposed skin, and cooling down properly after heat exposure. Click here to read Health in Aging’s list of heat-related problems, their warning signs, and what-to-do health tips.
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