COLUMBUS — May is National Older American’s Month and Ohio Lieutenant Governor and Department of Insurance Director Mary Taylor is reminding Medicare beneficiaries that the Department’s Ohio Senior Health Insurance Information Program (OSHIIP) is a good resource to help answer any questions they have about Medicare.
"The Department offers a personalized approach to help beneficiaries understand the different Medicare coverage options available to them while determining if they qualify for financial assistance," Taylor said. "We want older Ohioans to know we can help them understand which Medicare plan's coverage best meets their needs."
Celebrating its 20th anniversary this year, OSHIIP is Ohio’s lead educational program for Medicare information and counseling. Beneficiaries can reach OSHIIP by calling 1-800-686-1578 for important information, including a list of OSHIIP’s outreach events, which is available in the Medicare Services section at www.insurance.ohio.gov. Currently, OSHIIP is conducting statewide Welcome to Medicare events through July 25 geared toward new and soon-to-be beneficiaries.
During Older American’s Month, OSHIIP is informing Ohioans about several important Medicare topics:
Medicare Open Enrollment Period Begins Oct. 15
The annual open enrollment period will again begin on Oct. 15 and continue through Dec. 7. These dates assist beneficiaries by having this critical coverage decision period prior to the busy holiday season. Beneficiaries will also have their new coverage cards in hand in early January.
Just as in years past, this period provides people on Medicare an opportunity to decide how they receive their coverage. Options include: Original Medicare paired with a Med-Sup plan and/or a Part D prescription drug plan, or a Medicare Advantage plan, which can include comprehensive benefits such as prescription drug coverage and dental.
Discounts Added to Medicare Prescription Drug Coverage
Some beneficiaries enrolled in Medicare Part D prescription drug plans face a gap in coverage referred to as the “doughnut hole.” This is the portion of a beneficiary’s annual drug expenditures when they may be responsible for the costs of all medications.
In 2012, beneficiaries who enter the “doughnut hole” (when drugs costs reach $2,930) will get a 50 percent discount on Medicare-covered brand name drugs and a 14 percent discount on Medicare-covered generic prescriptions. The “doughnut hole” ends when your out-of-pocket expenses and those paid by the plan total $6,657. The plan then pays 95% of your drug costs for the remainder of the calendar year. People who qualify for additional savings do not have this coverage gap.
Medicare Advantage Plans
Medicare Advantage plans cannot charge more than traditional Medicare for chemotherapy, dialysis, skilled nursing care, and other services deemed appropriate. Medicare Advantage plans must offer the benefits provided by Medicare and often offer additional benefits.
Free Preventive Services
If enrolled in Medicare, an individual qualifies for an annual wellness exam and many preventative services for free. There is no Medicare Part B deductible or co-payments for the following screenings (if certain coverage criteria apply): bone mass measurement; cervical cancer, including Pap smear tests and pelvic exams; cholesterol; cardiovascular; colorectal cancer; flu, pneumonia and hepatitis B shots; HIV; mammograms; medical nutrition therapy; and prostate cancer antigen.
Financial Assistance Programs Available
Help paying for Medicare’s Part B (medical coverage) premium, up to $99.90 per month, is available to beneficiaries who meet certain income and resources requirements. There is also a program for certain beneficiaries to help pay for costs associated with Medicare’s Part D prescription drug coverage. This program can save a qualifying beneficiary an average of $3,900 yearly on prescription drug costs. Call 1-800-SSA-1213 (1-800-772-1213) or OSHIIP (1-800-686-1578) for details and enrollment assistance.
Protect Yourself from Unscrupulous Sales Practices
Insurance agents are prohibited from soliciting door to door, giving out cash or gifts exceeding $15, utilizing high pressure sales tactics, misrepresenting a plan or giving incomplete information, and representing themselves as being from Medicare. If you feel you have been victimized, get as much information as possible and report the incident to the Ohio Department of Insurance at 1-800-686-1527.
Additional information about Medicare is available at www.medicare.gov and by calling 1-800-MEDICARE (1-800-633-4227). You can follow the Department on twitter @OHInsurance and on Facebook at www.facebook.com/OhioDepartmentofInsurance.