If you have a Medicare Advantage Plan (Medicare Part C)...
1. Assess changes to your current plan. Your Medicare Advantage Plan will
soon send a big packet of information to your home. Pay close attention
to the “Annual Notice of Change” (ANOC) letter that outlines
how some of your benefits will change. This package will contain a benefit
grid that allows you to compare your 2016 plan benefits to the 2017 plan
benefits. The ANOC gives you details about what the plan covers, how much
you pay and more. You may find an increase in co-pays or a change in benefits.
For example, a plan might drop a vision benefit or an exercise benefit
(Silver Sneakers). You’ll also receive a drug formulary for the
plan. It’s a good idea to look up all of the medications you’re
taking and check for any increases in cost.
2. Compare your current plan to other plans. There are three helpful tools
that you can use to determine how your current plan measures up against
other plans offered.
Medicare & You handbook is mailed to Medicare Beneficiaries every October. This book lists
all the Medicare health plans including Medicare Advantage HMO, PPO and
Prescription drug plans by county with a short summary of their 2017 benefits.
www.medicare.gov This official government website can help you compare Medicare health
plans for your area. It also provides estimated costs for specific prescription
drugs and a short summary of benefits for 2016 and 2017.
Local Independent Insurance Consultants/Agents assist you with evaluating ALL your choices under Medicare for the coming
year. Consultation is free. If you choose to use an insurance agent please
make sure they are knowledgeable about all your Medicare options, not
just a few plans. For more information call the Medicare information line
3. Decide to change plans or keep your current Medicare health plan. If
you want to change your current plan, call the new plan at the contact
number available in the information you receive. Double check that your
primary care physician (PCP) name and medical group name is correct. Also
check to see if your PCP is affiliated with your medical group. When you
sign up for a new plan, you will automatically be disenrolled from your
old plan and your new plan will begin on January 1, 2017. It’s important
to remember that if you do nothing during the Open Enrollment period,
your current Medicare Plan will remain the same and any benefit changes
will become effective January 1, 2017. :
If you have other Medicare Plans…
If you’re on Medicare and receive low-income subsidy (LIS) benefits
or have a group health plan through your current employer or as a retiree,
you might receive greater health benefits at a lower cost through a Medicare
Advantage plan. There are multiple ways to receive your Medicare benefits.
You may receive benefits through Original Medicare (Parts A & B),
by signing over your Medicare benefits to a private insurance company
and enrolling in a Medicare Advantage Plan (Part C), or enrolling in supplemental plans.
Under Original Medicare you pay premiums, deductibles and co-payments to
doctors and hospitals directly, as well as buy a Part D drug plan. You
may buy Medicare Supplemental insurance (also known as Medi-gap) to cover
costs not paid by Original Medicare. Under Medicare Advantage, physician,
hospital and pharmacy services are wrapped into one private plan—and
with benefits such as routine vision or discounted dental coverage—that
are provided by a medical group or physician network. This means you must
pick a medical group and a primary care physician with a Medicare Advantage plan.
If you need more information about how Medicare works, HMOs, Medigap Insurance,
or Medicare Prescription Drug Coverage (Part D), contact The Center for
Health Care Rights (CHCR). It’s a non-profit organization that provides
free information and help with Medicare. CHCR does not sell insurance.
To schedule a one-hour individual Medicare Insurance Consultation through
Torrance Memorial, call 310-517-4666. :
You can also find detailed comparisons of insurance options at the Medicare
Rights Center, www.Medicarerights.org.
Choosing the right Medicare Plan should be based on your individual medical
needs and personal preferences. Here are some important things to compare:
Expenses: How much are your premiums, deductibles or co-pays for doctor visits?
What about hospital stays?
Your Doctors and Hospital: Can you see your current Torrance Memorial Medical Center doctors and
specialists, as well as use hospital services under your new plan?
Your Treatments: What are your routine medical treatments? Are they covered?
Prescription Drug Costs: Does the plan cover prescription drugs? What will your prescription drugs
cost under the plan?
Travel Coverage: All Medicare Advantage HMO plans cover you for emergency treatment out
of the area. However, some have dollar limits when traveling out of the USA.
Dental, Routine Vision and Hearing Care Coverage: These services are not covered under Original Medicare. However, many
Medicare Advantage plans offer some or all of these services.
“Maximum Out-Of-Pocket” limit: All Medicare Advantage Plans must include a yearly “Maximum Out-of-Pocket”
limit or MOOP. This is the maximum amount you would pay for medical costs
in the calendar year. This includes all your copayments and coinsurance
for medical costs. BUT NOT prescription drug costs. What is your MOOP? :
For more information about the Medicare plans available to you, or to schedule
a free consultation with an independent insurance agent, call 310-257-7239.