COLUMBUS— Ohio Lieutenant Governor and Department of Insurance Director Mary Taylor is recognizing May as National Older American’s Month and is asking seniors to contact her office’s Ohio Senior Health Insurance Information Program (OSHIIP) with any questions they may have about Medicare and their health insurance.
This year’s theme for National Older American’s Month, “Connecting the Community,” fits well with the ongoing efforts of the Department of Insurance’s OSHIIP program, as Department staff and OSHIIP volunteers work within communities to share information about Medicare.
“The Ohio Senior Health Insurance Information Program is a great resource to help seniors understand their Medicare benefits,” Taylor said. “As more Ohioans reach the Medicare eligibility age of 65, this program allows them to get answers to questions about the program that may initially appear daunting.”
OSHIIP has been the state’s lead educational program for Medicare information and counseling since 1991. You can contact the Medicare experts at the Department of Insurance at 1-800-686-1578, and also learn about OSHIIP’s many statewide outreach events at www.insurance.ohio.gov.
During Older American’s Month, OSHIIP is making an effort to inform seniors about Medicare changes in 2011.
New Medicare Open Enrollment Period
The annual open enrollment period starts earlier this year. In 2011, Medicare’s open enrollment period begins on Oct. 15 and continues through Dec. 7. The new permanent dates remove beneficiaries from making critical decisions about their coverage during the heart of the busy holiday season. Beneficiaries also are provided an extra week and a half to make their decisions and will 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 or 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 2011, beneficiaries who enter the “doughnut hole” (when drugs costs reach $2,840) will get a 50 percent discount on Medicare-covered brand name drugs and a seven percent discount on Medicare-covered generic prescriptions. The “doughnut hole” ends when your out-of-pocket expenses and those paid by the plan total $4,550. The plan then pays 95% of your drug costs for the rest of the year. The gap will be reduced in phases and eventually closed in 2020.
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 a new 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 $115.40 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.
Additional information about Medicare is available at www.medicare.gov and by calling 1-800-MEDICARE (1-800-633-4227).