YOU DON’T HAVE TO BE AFRAID… if you take action early, ask questions and plan ahead!

Hello KIRC family!

The season of fright is upon us! 🦇🧟

Halloween is just around the corner, which for many means jack-o-lanterns, spooky decorations and planning wickedly creative costumes to wear for Halloween gatherings.

But, there is something that might be even more frightening than ghosts and goblins this time of year and that is: Open Enrollment Period for Medicare (OEP).

Julia Yarbough/Keeping It REAL Caregiving – joining an early Saturday morning webinar to learn how to navigate Medicare enrollment (ignore my messy counter/workspace!)

Your correspondent spent part of this Saturday morning, joining a webinar hosted by the Georgia State State Health Insurance Program (SHIP) to help folks navigate Medicare. There are a lot of moving parts and it can be confusing! But, if we start early, read, educate ourselves and reach out to local resources, it doesn’t have to be a horror show.

Courtesy: SHIP, Georgia State

I am based in California, but I have relatives in Georgia who are eligible for Medicare. I wanted to educate myself so I could assist them.

I would encourage all of you to take the time to help an older relative to make sure they enroll and have the coverage they need.

Medicare is a federal program, so while each state may have unique offerings for additional services, Medicare itself applies to the entire country.

5 key takeaways

1. Medicare Open Enrollment period is NOW!

Open enrollment runs from October 15 – December 7.

For those who are already enrolled, this is your time window to review your current coverage options. If you need or wish to make changes, now is the time.

If you decide to change plans, be sure to research if your doctor(s), medications, any specialty services, etc. are covered under the new plan you are considering. Be sure to factor in price changes.

Visit Medicare.gov to find a plan comparison tool.

2. Part A & B: What you need to know

Only you and your family know your individual health needs and your financial resources.

Therefore, it is crucial you sign up for Medicare when you become eligible at age 65. Once you become eligible you will enroll in Part A, and Part B is optional enrollment.

But – this is where it gets complicated and truly scary.

If you fail to enroll in Part B coverage during your initial eligibility, depending on why you did not enroll, you could face financial penalties for not enrolling and those payments could last the rest of your life.

Let’s say your finances dictate you simply cannot afford the monthly premium for Part B, which according to webinar counselors, will now be $164.90/month. You could end up paying a penalty for not having Part B.

*Listen to an explanation below: Courtesy: Georgia State Heath Insurance Program Webinar

That just doesn’t seem right, but there it is. ☠👹👻

You do have the option to appeal such a penalty. But if you are denied, you could end up paying that penalty for the rest of the your life!

There are programs available for financial assistance to pay for Part B coverage, but you must determine if you qualify and then apply. (See resources in Georgia below)

It can be confusing and overwhelming. That is why you must reach out to your local Area Agency on Aging to learn about workshops regarding Medicare or call your local SHIP office to sign up for educational workshops and individual counseling.

3. Review the Medicare and You Handbook for 2023

Courtesy: Medicare.gov

There are changes to Medicare, as a result of the Inflation Reduction Act, which impacts drug coverage costs. If you have not yet done so, make sure you have the latest copy of the Medicare and You Handbook. If you didn’t already receive one in the mail, again, visit medicare.gov to request a handbook. You can also download a digital version online.

There are changes to prescription drug costs. For instance, presenters at the SHIP webinar explained that individuals who take insulin will now pay no more than $35 a month for a one-month supply of the drug.

There are additional services which are also now covered, such as cognitive assessment and care plan services. When we consider the number of individuals and families impacted by Alzheimer’s and other forms of dementia, this is a benefit you definitely want to take advantage of.

But the key thing to remember is this: Medicare does not pay for private in-home caregiving services.

Much of the literature verbiage says home health care is covered. Do not get this confused with home caregiving services.

Home health care means skilled nursing services, such as rehabilitation, occupational therapy and physical therapy. It is not the day-to-day help many caregivers may need with a loved one.

4. Review and Compare Medicare Advantage Plans

There are a host of options for having coverage through what are known as Medicare Advantage Plans, which offer Part A and Part B in a packaged set.

Many offer a wide range of supplemental services and coverage options. This is where you must review plans and determine what is the best fit for you, your family and your budget.

5. Part D = drug coverage

So you say you are now 65, eligible for Medicare but are fit and healthy? You don’t take any medication? That’s great!

But, I learned you must still show you have some kind of prescription drug coverage, whether through an employer, the V.A. or another insurance plan.

Why? Here comes the scary part. If you do not enroll for Part D drug coverage once you are eligible (age 65), and go beyond a 63-day calendar window of enrolling for prescription drug coverage, you could get a penalty!

Wow, this can be scary stuff! 🎃👻🦇

Understanding your options and choosing wisely can impact your health care for years to come.

Bottom line folks is that it doesn’t have to turn into a horror film. There are resources in every community to help walk us through what we need to know.

Take these steps before a situation leaves you shaking in fear:

Refer to your local Area Agency on Aging as a starting point.
Visit medicare.gov to create an account, and access information, resources and counseling help.
Visit SSA.GOV (Social Security Administration) to understand your income overview which impacts how much you pay for Part B Medicare and what financial assistance, if any, you may be eligible for.
Review your medications, the physicians and services in your area and make sure you enroll in the proper plan for you – before deadlines expire.
Each state has a State Health Insurance Program. Locate yours for more specialized guidance. It is a free service and not affiliated with any specific company.

Let’s not be afraid of any of this – let’s educate ourselves!

Until next time~

Julia