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The Sun-Times - Heber Springs, AR
  • Seniors, can we talk?

  • The national election is over and before we know it the Annual Election Period will be over, too.
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  • The national election is over and before we know it the Annual Election Period will be over, too.
    Since I've received several calls during this Annual Election Period that started October 15, I thought I'd share some of those questions. You may be having some of these same concerns or questions.
    Nickie called and said her Medicare Advantage plan is not going to be offered in 2013. What are her options? Her choices include a different Medicare Advantage plan or a Medicare Supplement plan. Even if she was not eligible for a Medicare Supplement before, she may enroll now and it is guaranteed to be issued; she cannot be denied coverage (this is because her Medicare Advantage plan is being discontinued).
    Several have called about their Medicare Supplement plan premiums increasing. Even though the Annual Election Period does not include Medicare Supplement plans, you may still apply for a new Medicare Supplement plan with lower premiums. Since you must answer medical questions, you may or may not be accepted. If you are accepted, you've saved some money. If you are not accepted, either keep what you've got or look at a Medicare Advantage plan, which is guaranteed issue. Rates for Medicare Advantage plans are much less but the benefits are very different. Make sure you look at the differences before you change plans.
    Doug called and said he has never had a Prescription Plan and wants to know if he can enroll now. Yes, until December 7. Based on when he was first eligible for a Prescription Plan, he may have a "late" penalty.
    Betty called and said "I don't like the Prescription plan I have. The premium is going up and so are my copays. I don't know which plan to change to or how to change plans."
    Since all plans are subject to change January 1 of every year (that's a nice way of saying they are going to change), this may be happening to you, too.
    How do you know if your premium and copays are going up January 1? Your Prescription Plan sent you a packet referred to as an "annual notice of change". This provides you the changes in your plan for 2013. Make sure you read your packet before December 7, just in case you want to make any changes.
    When you read your annual notice of change, make certain your plan still covers your prescriptions. Each year the list of drugs a plan covers may change. And the copays for those drugs may also change.
    If your 2012 plan had a deductible, the deductible may increase. The maximum deductible set by Medicare for 2013 is $325. If your 2012 plan did not have a deductible, it may have a deductible in 2013. (The deductible is the amount you may have to pay before you start paying copays.)
    Page 2 of 2 - There are 30 different prescription plans available in most parts of the state. To know which of those 30 plans may be the most appropriate for you is based on the prescriptions you take. If you have access to a computer, you may want to go to the Medicare.gov website. You can put in your prescriptions and this website will compare all 30 plans for you.
    Look at the details of each plan. Are there any "management tools" that apply to your prescriptions? These are guidelines set by Medicare to help keep the cost of drugs down. Management tools include quantity limits, prior authorization and step therapy. You may want to stay away from a plan that requires step therapy even though it may cost less. Step therapy means you must try several other drugs before they will fill your prescription. Some people are still taking the same drug they have been taking for years and there's a new, lower cost drug available that does the same thing. Some people need to take their specific drug because it's the only drug that works for them.
    Of course, if you have any questions or concerns, call me at 870-523-6771 and say "Caroline, can we talk?" Remember the deadline to make changes to your Prescription Plan or Medicare Advantage plan is December 7.
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