Life After 50 Expo

Dear Marci,

A Medicare & You handbook is mailed to me every year, but I’m never quite sure what I should do with it. How should I be using my Medicare & You handbook?

-Luis (Casper, WY)

Dear Luis,

I’m glad you asked! The Medicare & You handbook can be very helpful. The Medicare & You handbook is mailed to all Medicare households each September and contains information on Medicare benefits.

Here are some helpful uses for your handbook:

Learn what’s new with Medicare. It’s important to know about updates to your Medicare benefits and coverage. Remember that Medicare Advantage Plans must cover the same benefits that Medicare does; if you see a change in Medicare coverage rules in your Medicare & You book, you should expect to have those same benefits with your Medicare Advantage Plan, although with possibly different costs or restrictions (like requiring prior authorization).

Understand how to enroll. If you are new to Medicare, the Medicare & You handbook can be helpful in explaining how to sign up for the kind of coverage you want. It explains who will be automatically enrolled, and who will need to actively sign up for Parts A and B. The handbook lists instructions for enrolling in Medicare and offers resources to contact for assistance. It also contains information about choosing Part D or Medicare Advantage Plans, as well as Medigap options in your area.

Compare private plans in your area. While there is a general version of the handbook available online, the version mailed to you or sent to you electronically will contain information specific to the area in which you live. It should contain a list of Medicare Advantage Plans, Part D plans, and supplemental Medigap plans available in your area for you to compare.

Learn more about cost assistance programs. There are a variety of programs that help people save money on their Medicare. The Medicare & You handbook contains the eligibility guidelines (which are usually a person’s monthly or yearly income, and sometimes their assets) for these different programs. Use your handbook to see if you may be eligible for Extra Help, the Medicare Savings Program, or a State Pharmaceutical Assistance Program.

Learn about your rights. If you are denied coverage for a health service or item that you believe should be covered, your Medicare & You handbook contains helpful information on filing appeals. It additionally provides tips on protecting yourself from Medicare fraud and medical identity theft.

Use as a reference guide throughout the year. It is tough (and likely impossible!) to memorize everything about how Medicare works. Instead, keep your Medicare & You handbook to use as a reference guide as you need care throughout the year. The book contains an index of topics, as well as a dedicated section for finding out if Medicare covers your test, item, or service.

As you can see, the Medicare & You handbook can be helpful to you throughout the year. I highly recommend keeping it handy!

If you don’t receive your Medicare & You handbook by the end of September, you can call 1-800-MEDICARE (633-4227) and request that a copy with information for your area be sent to you. If you would like to receive your handbook electronically, you can log into (or create) your Medicare account to sign up for electronic handbooks. You can also download a general version of the handbook at Medicare.gov.

-Marci

Dear Marci,

When speaking to my insurance company, I was told to look out for an Annual Notice of Coverage in the mail. Can you tell me more about this?

-Sara (Greenville, SC)

Dear Sara,

An Annual Notice of Coverage (ANOC) is sent out by your Medicare Advantage Plan or Part D plan, and provides information about changes to your coverage in the upcoming year. It’s usually sent out around September, since it can help you decide if you want to make changes to your coverage during Medicare’s Fall Open Enrollment period, which runs from October 15th to December 7th.

There are three kinds of changes to look for in an ANOC:

Changes to your plan’s costs like premiums, deductibles, and copays.
Changes to the plan’s network that might affect coverage for your current providers and pharmacies
Changes to the plan’s formulary that might affect coverage of your current drugs or their prices.
After you’ve read about the changes to your coverage coming up in the new year, you can decide if your plan will still meet your needs or if you’ll want to change it during Fall Open Enrollment.

If you haven’t received your notice by September 30th, contact your plan to request a copy.

I hope that helps!

-Marci

Dear Marci,

My doctor put me on a few new medications and my drug costs are becoming more difficult to afford. Is there any way to reduce my Part D costs?

– Arjun (Reno, NV)

Dear Arjun,

I’m sorry to hear that! That’s a concern for so many. There are a few programs and strategies that might help you save money on your prescriptions.

If your income is below $1,903 per month as an individual, or $2,575 if married, and you also have limited assets, you could be eligible for Extra Help. Extra help is a cost-assistance program that can help you pay for your prescription drugs and pays for a portion of your Part D premium.

There are also State Pharmaceutical Assistance Programs (SPAPs) offered by most states that can help you pay for your prescription drugs. Some SPAPS also help pay for your Part D plan’s premium, deductible, and/or copays. Check this list of State Pharmaceutical Assistance Programs to find out if your state has an SPAP, to find out if you’re eligible, and how to enroll. You can also contact your State Health Insurance Assistance Program (SHIP) to learn about possible SPAPs in your state.

If you do not qualify for these programs, check out these other options and strategies for those who are having trouble affording drug costs. For example, some of your medications may have manufacturer discounts or coupons that you can find on www.NeedyMeds.org.

Also note that beginning in 2025, your Part D our out-of-pocket costs will be limited to $2,000 in deductibles, copays, and coinsurance. Learn more about Part D changes due to the Inflation Reduction Act here.

Best of luck,

-Marci