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Annual Medicare Open Enrollment Period: October 15th-December 7th

The Annual Election Period (AEP) is here. This is the time of year when you can change Medicare Advantage or Part D plans for the upcoming 2016 calendar year. We recommend that you take a few moments to give your Medicare Advantage Plan a check-up to ensure that your plan meets your needs. For details, we talked with THIPA’s Member Services Manager, Ana Vasquez and Insurance Consultants Vince Kelly and Rose Straub.

Healthy Living: How do you give your Medicare Advantage Plan a check-up?

Vince Kelly, Insurance Consultant:

Start with the Annual Notification of Change (ANOC) document. You’ll receive one in a packet from your current Medicare Advantage health or drug plan company. This document will contain a benefit grid that allows you to compare your 2015 plan benefits to the 2016 plan benefits. For instance, in 2015 you may have enjoyed a Silver Sneakers (gym) benefit or a transportation benefit. The grid will show you if your plan is going to offer that same or a similar

Rose Straub, Insurance Consultant: There are a few other helpful tools that you can use to determine how your current plan measures up against the other plans that are being offered.

1. Medicare & You Handbook - mailed to Medicare Beneficiaries every October. This book lists all the Medicare Advantage HMO, PPO and Rx drug plans by county with a short summary of their 2016 benefits.
2. www.Medicare.gov. This official government website can help you to see all the Medicare Advantage HMO, PPO and Rx Drug plans in your area. It can provide specific drug costs under each plan and a short summary of benefits for 2015 and 2016.
3. Local Insurance Consultants/ Agents – Vince and I work to help individuals identify ALL of their options on Medicare. We assist clients with evaluating their choices for the coming year. If you choose to use an Insurance Agent, please make sure that they are knowledgeable about all of your Medicare options, not just a few plans.

Ana Vasquez, THIPA Member Services Manager: THIPA is also conducting a Benefit Fair and two Benefit Workshops for members, their friends and family. At the Benefit Fair you’ll hear from representatives from seven Medicare Advantage Plans as they review plan benefits. The Fair is Sat., October 24, 9:30 – 11am. At the Workshops you’ll hear insurance agents compare the seven plans while you follow along on a special worksheet. The Workshops are Sat., October 31, 10am –Noon and Tues., November 10, 6:30 – 8pm. All events are being held in the Torrance Memorial Hoffman Health Conference Center, Rooms 1 & 2. Call 310-257-7239 to make a reservation.

Rose: It’s a good idea to make sure the benefits your plan provides match up with your changing medical needs. If you’re planning world travel consider your health plan’s worldwide Emergency Room and Urgent Care coverage. I also encourage members to pay close attention to their plan’s Out-Of-Pocket Maximums.

Vince: That’s great advice, Rose. It’s why I tell seniors to look at the drug formulary. It comes in the packet with your Annual Notice of Change. You need to look up all the drugs you’re taking and check their cost. For instance, in 2015 maybe your blood pressure medication was listed as a Tier 1 drug and now it’s a Tier 2 drug. Instead of paying $5 for your prescription, you’ll pay $10. For some people these little changes can add up significantly.

Ana: Another thing, if you’ve been thinking about changing your primary care physician, now is a great time. You can review the most recent provider directory online at thipa.org/ providerdirectory. You can also call THIPA’s Member Services team and we can mail you a directory. We cannot make the change of doctors here, but we can transfer you directly to your health plan so they can make the change. You can change your primary care physician at any time, not just during the Annual Election Period. Remember, THIPA offers the great benefit of Self-Referral to over 70 doctors in eight specialties.

Rose: If you do change your Primary Care Physician or your health plan, you will receive a new insurance card. When you receive your new card, please be sure to check that your Primary Care Physician and your Medical Group is listed correctly. If not, please call your health plan and ask them to correct the error for you. A corrected card will be mailed out to you within 7 to 10 working days.

Vince: Also, if you’re currently a Medi- Medi (someone who qualifies for Medicare who also qualifies for Medi- Cal, California’s assistance program for those with limited income), then you have a continuous open enrollment. You can find out if you qualify by calling Social Security and Medicare.

Vince: I also want to address the recent news stories you’ve seen about insurance company mergers. Any mergers that occur won’t change the benefits for 2016. These are set in stone for a full calendar year. Any significant changes from company mergers won’t be felt until 2017 or beyond.

Rose: There are also concerns that Medicare Part B premium costs will rise. The truth is, there’s no way anyone can know this. The only accurate information about the cost of future Medicare Part B premiums will come from Medicare and typically this is known by November 15th of each year.

Ana: It’s also important to remember that if you do nothing during the Annual Election period, your current Medicare Advantage Plan will remain the same and any benefit changes will become effective January 1, 2016.

Healthy Living: Thanks so much, Ana, Vince and Rose. If you’ve still got questions you can call THIPA’s Medicare Information Line at 310- 257-7239. Or you can reach Ana by phone 310-257- 7233 or email ana.vasquez@tmmc.com.

REMINDER...
When you have a Medicare Advantage plan, you no longer need to show your Medicare card when you visit a doctor.

Categories: Healthy Living

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