Educate yourself during Medicare open enrollment

  • By Janet Kidd Stewart Chicago Tribune
  • Friday, October 24, 2014 11:35am
  • Business

Keeping the wallet healthy during Medicare’s open enrollment period is no small task, given the dizzying array of plans available to many seniors.

Data from 22,000 online consumers who used eHealth Medicare’s cost-comparison tool last year indicated that just 5 percent were enrolled in the prescription drug coverage plan with the lowest total out-of-pocket cost. “And these are people who are coming to the site and entering specific prescriptions,” said Ross Blair, senior vice president at eHealth Medicare, an online broker. “The (percentage) for the general population is probably even worse.”

Why the disconnect? Blair said some people entering Medicare were previously covered by employer insurance and simply aren’t used to this type of insurance shopping.“We’re just really not well-schooled when we reach retirement on how to do this,” he said.

Even if you’ve been satisfied with your health and drug coverage, you may benefit from reviewing your options. Shopping around may save you money or improve your coverage. “Their health may have changed in the last 12 months, their drugs may have changed in the last 12 months,” said Bob Moos, spokesman for the Centers for Medicare &Medicaid Services. “What may have seemed like the best choice a year ago may not be the best choice this year.”

Many plans change participating doctors each year, so if you want to keep your doctor, start there, according to the Medicare Rights Center, an advocacy organization.

The 2015 changes in premium numbers illustrate the value of shopping around, so dig out that annual change notice, which should have come in the mail in September.

Advantage plans have become popular with seniors on fixed incomes because they typically combine hospital and physician coverage with additional benefits, such as prescription drug insurance, preventive medical care, dental services and vision coverage.

However, Advantage plans have limited networks of health care providers, and doctors can drop out midyear.

Nevertheless, enrollment in the private Medicare Advantage plans is expected to grow by about a half-million to 16.1 million people in 2015 — about 30 percent of Medicare beneficiaries.

And remember that a variety of screening and wellness services are now free. Centers for Medicare and Medicaid Services officials said 18.6 million Americans took advantage of at least one such preventive service in the first seven months of this year.

Tips for plan shopping

Go online to research, or get a family member or friend to help, if you aren’t Web savvy

Narrow the field. Start by weeding out plans that don’t include your current favorite physicians.

Next look at drug plans and costs, based on your needs. To find out whether the drugs you’re taking will still be on your Medicare drug plan’s 2015 “formulary” (list of covered prescription drugs), go to www.medicare.gov and then click on “Find health and drug plans.” Answer a couple of questions and you will be able to compile a list of your drugs to see which plan covers them.

Consider all the factors in your drug costs, such as deductibles, co-payments and coinsurance.

Also consider the quality of a health or drug plan’s customer service. The medicare.gov plan finder provides star ratings for each plan.

Know the numbers. Estimate total cost, not premium alone. It may be easier to look at simple premiums than trying to estimate how much you’ll spend on the plan, a Part D prescription drug policy and a supplemental plan, for example, but the bottom line varies widely, depending on how you’ll use each policy.

Avoid scams. Don’t give out your Medicare number over the phone or in person in exchange for free equipment or services, or for “record keeping purposes.” For more information visit the government fraud website (below).

Phone numbers

Centers for Medicare and Medicaid: 800-633-4227 / TTY 877-486-2048

To see if a provider is Medicare approved: 800-MEDICARE (800-633-4227)/ TTY 877-486-2048

Medicare Right Center (has a help desk that assists seniors with choosing drug plans): 800-333-4114

Helpful websites

www.medicarerights.org

Centers for Medicare &Medicaid Services

medicare.gov/find-a-plan: Information and cost data

www.stopmedicarefraud.gov

www.stopmedicarefraud.gov/preventfraud/scams-identity-theft/index.html

Cost changes, 2015

Medicare Part D prescription drug coverage, average monthly premiums increase by $1, to $32.

Part B premiums, no increase.

Average Medicare Advantage plan premiums: increase by $2.94, to $33.90

Medicare Part B monthly premium, $104.90, and annual deductible, $147, will remain the same as the last two years. Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment and other items.

Medicare Part A monthly premiums drop $19 in 2015 to $407. Medicare Part A covers inpatient hospital, skilled nursing facility and some home health care services.

Medicare Advantage plans average monthly premiums increase by $1.29 to $32.25. Advantage plans are essentially a private version of Medicare. Instead of paying beneficiaries’ claims directly, the government pays insurance companies to oversee the health care of seniors and people with disabilities.

Average monthly premiums for basic drug plans will rise $1.32 to $32.

Sources: Pamela Yip, The Dallas Morning News; Centers for Medicare and Medicaid Services; medicare.gov; Janet Kidd Stewart, Chicago Tribune

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Business

Black Press Media operates Sound Publishing, the largest community news organization in Washington State with dailies and community news outlets in Alaska.
Black Press Media concludes transition of ownership

Black Press Media, which operates Sound Publishing, completed its sale Monday (March 25), following the formerly announced corporate restructuring.

Maygen Hetherington, executive director of the Historic Downtown Snohomish Association, laughs during an interview in her office on Thursday, Feb. 15, 2024, in Snohomish, Washington. (Ryan Berry / The Herald)
Maygen Hetherington: tireless advocate for the city of Snohomish

Historic Downtown Snohomish Association receives the Opportunity Lives Here award from Economic Alliance.

FILE - Washington Secretary of State Steve Hobbs poses in front of photos of the 15 people who previously held the office on Nov. 22, 2021, after he was sworn in at the Capitol in Olympia, Wash. Hobbs faces several challengers as he runs for election to the office he was appointed to last fall. (AP Photo/Ted S. Warren, File)
Secretary of State Steve Hobbs: ‘I wanted to serve my country’

Hobbs, a former Lake Stevens senator, is the recipient of the Henry M. Jackson Award from Economic Alliance Snohomish County.

Mark Duffy poses for a photo in his office at the Mountain Pacific Bank headquarters on Wednesday, Feb. 14, 2024 in Everett, Washington. (Annie Barker / The Herald)
Mark Duffy: Building a hometown bank; giving kids an opportunity

Mountain Pacific Bank’s founder is the recipient of the Fluke Award from Economic Alliance Snohomish County.

Barb Tolbert poses for a photo at Silver Scoop Ice Cream on Thursday, Feb. 29, 2024 in Arlington, Washington. (Annie Barker / The Herald)
Barb Tolbert: Former mayor piloted Arlington out of economic brink

Tolbert won the Elson S. Floyd Award, honoring a leader who has “created lasting opportunities” for the underserved.

Photo provided by 
Economic Alliance
Economic Alliance presented one of the Washington Rising Stem Awards to Katie Larios, a senior at Mountlake Terrace High School.
Mountlake Terrace High School senior wins state STEM award

Katie Larios was honored at an Economic Alliance gathering: “A champion for other young women of color in STEM.”

The Westwood Rainier is one of the seven ships in the Westwood line. The ships serve ports in the Pacific Northwest and Northeast Asia. (Photo provided by Swire Shipping)
Westwood Shipping Lines, an Everett mainstay, has new name

The four green-hulled Westwood vessels will keep their names, but the ships will display the Swire Shipping flag.

A Keyport ship docked at Lake Union in Seattle in June 2018. The ship spends most of the year in Alaska harvesting Golden King crab in the Bering Sea. During the summer it ties up for maintenance and repairs at Lake Union. (Keyport LLC)
In crabbers’ turbulent moment, Edmonds seafood processor ‘saved our season’

When a processing plant in Alaska closed, Edmonds-based business Keyport stepped up to solve a “no-win situation.”

Angela Harris, Executive Director of the Port of Edmonds, stands at the port’s marina on Wednesday, Jan. 24, 2024, in Edmonds, Washington. (Ryan Berry / The Herald)
Leadership, love for the Port of Edmonds got exec the job

Shoring up an aging seawall is the first order of business for Angela Harris, the first woman to lead the Edmonds port.

The Cascade Warbirds fly over Naval Station Everett. (Sue Misao / The Herald file)
Bothell High School senior awarded $2,500 to keep on flying

Cascade Warbirds scholarship helps students 16-21 continue flight training and earn a private pilot’s certificate.

Rachel Gardner, the owner of Musicology Co., a new music boutique record store on Thursday, Jan. 18, 2024 in Edmonds, Washington. Musicology Co. will open in February, selling used and new vinyl, CDs and other music-related merchandise. (Olivia Vanni / The Herald)
New Edmonds record shop intends to be a ‘destination for every musician’

Rachel Gardner opened Musicology Co. this month, filling a record store gap in Edmonds.

MyMyToyStore.com owner Tom Harrison at his brick and mortar storefront on Tuesday, Sept. 6, 2022 in Everett, Washington. (Olivia Vanni / The Herald)
Burst pipe permanently closes downtown Everett toy store

After a pipe flooded the store, MyMyToystore in downtown Everett closed. Owner Tom Harrison is already on to his next venture.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.