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Aging Wisely November 2016 - Aging Wisely

What Everyone Ought To Know About Medicare Open Enrollment


Medicare open enrollment and health insurance choices

Medicare open enrollment is October 15 – December 7 every year. This is your opportunity to review your current plan, coverages and costs. You need to determine whether to stay with your current plan or if you want to change to a new plan.

As much as you may want to rely on an insurance salesperson to direct you, many of the choices and decisions you need to make to determine the best policy are very personal choices – and most likely only decisions you can make. It is startling to me to be shopping at the Dollar Tree (one of my favorites) and walk out and see a card table set up with someone trying to sell me a health insurance policy. REALLY!!!!

Before you get started, below are the items you should have ready:

  • Name & DOB
  • Medicare Number and effective dates for Part A and Part B
  • List of prescriptions and pharmacy address(es)

If you need any help completing the steps below or have any questions, call your Aging Wisely expert.

8 steps to completing your Medicare Open Enrollment:

#1 You start by going to the website

#2 Click on Review your health and prescription drug coverage options.

Medicare open enrollment page review choices

#3 Next step is completing the Personalized Search.

personalized choice in Medicare open enrollment

#4 Your home zip code, your Medicare number if you are already enrolled, your last name, and your effective dates for Medicare Part A and Part B.

#5 What plan you currently have? For example, Medicare, a Medicare Plan (aka as an Advantage Plan), you don’t have a plan yet, or if you don’t know you have the option of stating I don’t know what plan I have.

#6 The next question asks you to list all of your medications and dosages. The easiest place to find this information is directly from the container your medication comes in from the pharmacy. If you do not have the container(s) you will need to call the pharmacy and ask them for a list or better yet, stop by the pharmacy and ask them to print you a list.

Bonus Tip: If you use more than one pharmacy, one of your New Year’s resolutions needs to be to commit to one pharmacy. Managing your prescriptions appropriately as well as one pharmacist reviewing your medications is an invaluable resource. When you have a primary care physician as well as specialists prescribing your medications it is typically the pharmacist that can review the medications and look for concerns or issues you need to know and address with your healthcare providers.

#7 Once you have entered in each of your medications and dosages, the next question asks for the name and address of your pharmacy. You can find the name and address of the pharmacy on the medication container.

#8 Upon entering all of the above information the next screen allows you to apply a variety of filters, for example, limit plan premium, select star ratings, etc.… if you want to reduce the number of the choices. Otherwise, you may go directly to review the following:

making decisions about MedicareA. Prescription Plans (Part D) with Regular Medicare
B. Medicare Health Plans (Medicare Advantage Plans) with Drug Coverage
C. Medicare Health Plans without Drug Coverage

The options are listed and you can make a decision from the list. My list came up with over 40 choices – so my work to make a decision is still not done.

How do I decide which plan is best for me?

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How Do You Choose the Best Medicare Plan?


confused choosing a Medicare plan

If you are on regular Medicare Part A and Part B, you will want to review your supplemental policy (if you have one). While the monthly premium you have to pay for a Supplemental Health Plan is typically more expensive than you would pay for a Medicare Advantage Plan it often provides you more choices in healthcare providers and greater coverage towards payments, and covers co-pays, etc. You usually get to select your healthcare providers and change healthcare providers whenever you want. You can choose whether to use community physicians or the specialized university medical system. You can choose the rehabilitation center you want or the mental health treatment center you want. The gamble is whether you get sick or not. If you get sick your premium will feel reasonable when you see what your care would have cost if you did not have the insurance coverage. If you do not get sick, it feels like you wasted a year’s worth of premium payments that could have been used for something fun.

This is where the personal part comes in. We all have to decide what our priorities are and how we want to spend our money. The Medicare Advantage Plans often are less expensive on a monthly basis and include expanded coverage for items Medicare A and B do not cover. Many Medicare Advantage plans have contracts with healthcare providers, limiting their plan coverage to those providers. The contract may limit which hospital, rehabilitation center, mental health provider, physician, just about any type of healthcare provider you may use. It is up to you to decide if you are going to be content with the limitations. You will be “stuck” with the plan you have chosen until the next open enrollment period.

Confused? Call an Aging Wisely Expert for help!

The Medicare Advantage plans may change their healthcare provider contracts at any time. It is your responsibility to review their website and keep up to date on any changes. Sometimes your healthcare provider will contact you and state “After next month I am no longer part of your insurance plan.” When this happens you have to decide whether to pay for out of network coverage or change to a healthcare provider covered by the plan.

Some people can live with the changes, go with the flow, and are able to change healthcare providers without being upset. They do not feel limited by only having certain healthcare providers to select from.

Most healthcare providers in Florida accept Medicare assignment. This means the healthcare provider agrees to accept the payment determined by Medicare. This does not eliminate your need to meet a deductible or pay a co-pay. We are fortunate in Florida. In many states there are plenty of private insurers and patients covered by insurance provided by employers. The reimbursement to healthcare providers is more significant than the reimbursement Medicare pays. So, many healthcare providers in other states choose to not accept Medicare.

If your healthcare provider only participates with certain insurance plans it is not an indicator that they are good or bad. You should not feel like you have poor choices if you are limited to certain healthcare providers by your Medicare Advantage Plan. Each insurance company is allowed to negotiate contracts with whatever healthcare provider they choose. It is often determined by costs and reimbursement rates, truly nothing to do with the patient. In recent years we have seen many small healthcare providers join together to become much larger offices. This allows for economies, with technology being one of the primary expenses. The more cost effective the healthcare provider is, the better contract they can negotiate with the insurance company.

Good luck with reviewing your options and determining what plan works for you. At the end of the day, remember you are in charge of your own health, responsible for how you take care of your body, and need to determine what works best for you.

Bonus Tip: Ask yourself these questions before choosing a plan.

  • Do I want to be on a Medicare Advantage Plan and/or pay for a supplemental policy?
  • Are my physicians, hospital, rehabilitation center, etc. contracted to take my Medicare Plan?
  • Will my physician, hospital stay, rehab visit, etc be 100% covered by my Medicare Plan?

Need help navigating this complex system? Please call 727-447-5845 to speak with one of our Aging Wisely experts. They can assist you with determining your Medicare options through the Medicare website, help you understand what you need to consider when making your selection, and helping you look ahead to plan for your future.

You might also want to check out our Medicare Fact Sheet 2017, which explains the parts of Medicare and their associated costs for 2017 as well as key dates and FAQs.

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Medicare Costs 2017


Medicare 2017 Costs

Medicare just announced the Medicare 2017 costs and we’ve provided a simple overview and comparison to what you paid in 2016. Be sure to check out our Medicare Fact Sheet 2017 for all of the Medicare 2017 costs and a concise overview of the various parts of Medicare. You’ll also find a more detailed breakdown of key Medicare information on page 2.

Medicare 2017 Costs

Medicare A Premium: 

$0 if you or spouse has 40+ quarters of Medicare-covered employment

If you do not have enough eligible quarters of employment, you’ll pay up to $413 (was $411 in 2016).

Medicare B Premium:    

Standard premium $134 (higher for individuals with incomes above $85,000 or $170,000 if filing jointly)

Average premium for those receiving Social Security benefits $109 (was $104.90 in 2016)

Medicare B Deductible: 

$183/year (was $166 in 2016)

Medicare D premium:    

Varies by plan (higher income individuals will pay additional adjustment)

Medicare A Hospital Coinsurance:   

$1316 deductible for each benefit period ($1288 in 2016)

$0 coinsurance for days 1-60

$329/day for days 61-90 ($322 in 2016)

$658/day for up to 60 additional “lifetime reserve” days after 90 days ($644 in 2016)

All costs beyond lifetime reserve days

Medicare A Skilled Nursing Care: 

Pays 100% up to 20 days

$164.50/day co-pay for days 21-100 ($161 for 2016)

Medicare A Mental Health Inpatient Care:

$1,316 deductible for each benefit period ($1,288 in 2016)

$0 coinsurance for days 1-60Days 61–90: $329 coinsurance per day of each benefit period ($322 in 2016)

$329 coinsurance per day of each benefit period ($322 in 2016) days 61-90$644 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime) ($658 in 2017)

$658 coinsurance per “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime) ($644 in 2016)Beyond lifetime reserve days: all costs.

Beyond lifetime reserve days: all costs20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you’re a hospital inpatient.

20% of the Medicare-approved amount for mental health services you get from doctors/providers while you’re a hospital inpatient

Contact us today for a personalized Medicare analysis and help with all types of benefits. Save money and get the best options for your situation!


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National Family Caregivers Month


national family caregivers month

Each November, we celebrate National Family Caregivers Month along with Alzheimer’s Awareness Month. This is an important reminder of the invaluable contributions of family caregivers. There are some 34 million family caregivers in the U.S., providing $470 million worth of unpaid care (2013 data) for adults aged 50+. Over 15 million adult family caregivers care for loved ones with Alzheimer’s disease/dementia. (National Alliance for Caregiving and AARP, 2015)

National Family Caregivers Month Theme

This year’s National Family Caregivers Month theme is “take care to give care”. Only by taking care of themselves first can caregivers be strong enough for the duties of caregiving. As organizations and as a society, we must also focus on how we can take care of caregivers so they are able to provide care to the best of their abilities. Here are a few tips on this theme to help you “take care to give care”. Dedicate this National Family Caregivers Month to making one small change, doing one important thing for your health, seeking a new resource, or taking some respite time. Then, try to slowly incorporate more changes throughout the next several months.

National Family Caregivers Month Action Tips

Caregiving is stressful. It is important to have some release from that stress. Find out what works for you. Perhaps you need to plan time to chat with friends each week (or even a professional, who can help you work through your emotions). Or, take one afternoon/week for rest or an outing. Make sure you have easy activities you can do at home that help you reduce stress. Maybe it is short meditation (there are great apps for that!) or a hobby like knitting. How about listening to favorite music or watching some comedy on YouTube? For a quick laugh, we recommend this Seinfeld episode where he volunteers to help an older man…you just might relate!

It is vital to guard your own health. Caregiving can take a toll on your health. The stress and physical strain of caregiving can weaken your immune system. And, you may be exposed to germs if you are in and out of doctor’s offices, hospitals, etc. Take a moment this month to schedule any exams, immunizations or follow-up appointments you’ve been putting off (you don’t have to do them all immediately, but get them scheduled!).

One important thing you can do to boost your health is to improve your nutrition. This is a simple (but not always easy!) way to strengthen your body. Start with small changes. Add more variety to your diet with a couple extra servings of fruits and veggies. This is great for you and your care recipient! Try out a new healthy recipe this month. There are lots of quick, simple healthy recipes and meal ideas online. Or, hire a caregiver to come in and prepare some meals in advance or use a meal service like Peach Dish. We have reviewed some meal services such as Mom’s Meals in the past and hope to bring you more first-hand reviews in the future. Sign up for our newsletter for updates!

Another vital step is to get some exercise. Strengthening and balance exercises are particularly important to help you stay safe as you assist with physical needs or household tasks. If you can’t find much time, there are many programs you can do at home. Check out YouTube for videos like these or consider hiring our recommended in-home personal trainers (who can also work with your aging loved one!).

Remember this mantra shared by the Caregivers Action Network: rest, recharge, respite! To learn more about respite care, see Respite Care 101 from EasyLiving.

Want to take the first step for your own health and well-being as a caregiver? Call us at 727-447-5845!

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