medicare

 

Each fall, Medicare seniors can sign up for, change or disenroll from a health plan for the following year. Yet, despite having more options than ever, research shows that most people choose the wrong health plan, often paying more than they need to.

Calyx Health, a doctor’s office exclusively for Medicare seniors in Alameda, analyzed its patients’ secondary insurances (Medigap, Medicare Advantage, Prescription Drug Plans) and found some alarming results:

 

This past holiday season, I found myself in line at the airport counter, waiting to check a bag prior to a flight to visit family and friends. The gentlemen in front of me got frustrated when he found out he had to pay more to check a bag because he hadn’t paid for it online beforehand. After talking to a manager and reviewing the terms of the ticket purchase, the man paid the extra fee.

 

Not long ago, I had dinner with a group of friends from college. One of the big topics of conversation was Medicare, for which we’ll all be eligible in the next several years. (Farewell, callow youth!) And one of the biggest questions about Medicare was, “How much is it going to cost me?”

Like private health insurance, Medicare has premiums, deductible, and co-pays. These costs can — and often do — change from year to year. What you actually pay depends on your work history, income and inflation.

 

Did you know that Medicare helps pay for prescription medications? Even if you don’t take many prescriptions now, you should consider joining a Medicare drug plan. There are two ways to get Medicare prescription drug coverage:

1. Medicare standalone drug plans, also known as Part D plans, add drug coverage to Original Medicare, as well as to some Medicare Cost Plans and Medicare Private Fee-for-Service plans. You must have Medicare Part A or Part B to join a standalone Part D plan.

The biggest news in Medicare for 2016 is the Part B premium. I’m happy to report that for most people with Medicare, the premium will stay the same as it was in 2015: $104.90 per month.

In fact, Part B premiums — which pay for doctor services, outpatient care, and preventive health benefits, among other things — haven’t changed for the last three years (2013, 2014 and 2015).

That’s because of slow growth in medical costs and inflation.

Part B is medical insurance. It covers professional fees for doctors and other health-care providers, outpatient treatment, durable medical equipment, home health services, and preventive care like flu shots and screenings for cancer and heart disease.

Part B requires a monthly premium, which is $121.80 for most Americans in 2016. You’re not required to pay the premium if you don’t want Part B coverage. But is it to your advantage to pay?

The answer depends on your current and future health insurance coverage and needs.

When you get health care services, record the dates on a calendar and save the receipts and statements you get from providers to check for mistakes. Compare the dates and services on your calendar with the statements you get from Medicare to make sure you got each service listed and that all the details are correct. These include the "Medicare Summary Notice" (MSN) if you have Original Medicare, or similar statements that list the services you got or prescriptions you filled.

It’s an unfortunate truth, but health care fraud drives up costs for everyone in the health care system. Fraud schemes often depend on identity thieves getting hold of people’s Medicare numbers. So guard your Medicare number. Treat it as you would a credit card. 
What can you do to protect yourself from health care fraud? 
n Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email, or by approaching you in person. Medicare will never contact you and ask for your Medicare number or other personal information. 

Did you know that you may be able to get help from your state paying your Medicare premiums? State-based Medicare Savings Programs also may pay Medicare Part A (hospital insurance) and Part B (medical insurance) deductibles, coinsurance, and copayments.

If you have income from working, you may qualify for these programs even if your income is higher than the income limits listed below.

There are four kinds of Medicare Savings Programs: 

As a person with Medicare, do you have any rights and protections? You certainly do!

You have rights whether you’re enrolled in Original Medicare — in which you can choose any doctor or hospital that accepts Medicare — or Medicare Advantage, in which you get care within a network of health care providers.

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