ALTON — Learn what changes are anticipated for Medicare in 2016 during a free program from 10 to 11:30 a.m. Tuesday, Oct. 6, in the Alton Memorial Hospital cafeteria meeting rooms. Call (800) 392-0936 to register.
OASIS Medicare counselors will provide a synopsis of the SHIP (Illinois) insurance counseling program, information on how to access their services, plus information on Part D (Prescription Drug Coverage).
Medicare is a federal program that provides health insurance for those 65 and older, and some people younger than 65 with certain disabilities. It is the largest U.S. health insurance program. Once people become eligible for Medicare, they can sign up regardless of what month it is. Enrollment continues year-round for people newly eligible for Medicare.
However, each year, enrollees have a chance to make changes to their Medicare Advantage (Part C) or Medicare prescription drug coverage (Part D) for the following year. This is called Medicare Open Enrollment, which starts Oct. 15 and ends Dec. 7. The changes people make to their Medicare during this enrollment period will take effect Jan. 1.
During this period, people can switch from original Medicare to Medicare Advantage, or vice versa. They also can switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another, or drop their Medicare Part D coverage altogether.
To help sort out which Medicare Advantage plans might save money while providing the best benefits, the Medicare Rights Center has developed a list of questions people should ask before enrolling in a plan. Here are some of the key items from that list:
- Will I be able to use my doctors? Are they in the plan’s network and are they taking new patients who have this plan?
- Which specialists, hospitals, home health agencies and skilled nursing facilities are in the plan’s network?
- How much is my monthly premium?
- How much will it cost to see my primary care physician? A specialist?
- Are my prescription drugs on the plan’s formulary (list of covered drugs)?
- Does the plan require that I get “prior authorization” before my prescription will be covered, or impose other restrictions (like limiting the quantity or requiring that I try a cheaper medication before it will cover a more expensive one)?
- How much will I have to pay out of pocket before coverage starts (what is the deductible)?
- How much will I pay for brand-name drugs? How much for generic drugs?
- What service area does the plan cover?
- What kind of coverage do I get if I travel outside of the service area?
Alton Memorial Hospital and OASIS sponsor the Senior Health Insurance Program Medicare counseling office at Alton Memorial Hospital. This free and confidential service is available to any senior or person with disabilities who has questions or problems with Medicare or health insurance. Call (800) 392-0936 to schedule a one-on-one appointment with a SHIP certified counselor.