On the Healthcare Front
Issue #20: October 2023
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when should you call kepro?
- If you are not ready to be discharged from the hospital.
- If your Medicare skilled services are ending too soon. Examples of skilled services include things like physical therapy and nursing services.
- If you have a concern about the quality of care you received.
- If you have a concern about your medical care that needs to be taken care of right away.
Click on the link below for the phone number for your state. These services are free for people who have Medicare.
october is health literacy month
Your personal health literacy is basically how much you are able to find, understand, and use information and services to help you to make health-related decisions.
Your healthy literacy is important because the better your health literacy is, the easier it is for you to be involved with your own health care.
Take a look at our Health Literacy Month page for more information.
Do you have the new Medicare handbook?
Download the 2024 handbook and save it to your computer.
Page 2 has information about what’s new this year to help you manage your health. Please take these changes into consideration as you think about what plan is best for you during this year’s Medicare Open Enrollment period.
Each year, the Medicare Open Enrollment Period takes place from October 15 to December 7.
This is an important time for people who have Medicare because it gives you the chance to review and make changes to your current Medicare coverage.
This article includes links and information to help you get the most out of your Medicare coverage in 2024.
why is the medicare open enrollment period important for people who have medicare?
Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. The term providers refers to things like hospitals and doctor’s offices.
how do you know if you need to change your plan?
You should always review the materials sent to you about your plan. If you have a Medicare Advantage Plan or a stand-alone Part D plan, read your plan’s Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC).
If your plan is changing, you should make sure it will still meet your needs for 2024. If you think that your current plan will meet your needs for next year and it’s still being offered, you don’t need to do anything.
Even if you’re happy with your current health and drug coverage, Medicare Open Enrollment is the time to review what you have, compare it with other options, and make sure that your current coverage still meets your needs for the coming year.
how do you know what plan is right for you?
You need to take note of what it is that YOU need. What do you need covered? What are the supplemental benefits that you need included?
With the wide range of Medicare Advantage plans that are available, make sure the plan covers what you need. The coverage that they provide is sometimes different. Will the plan cover exactly what you need? Will your prescriptions be covered? Is your doctor and hospital in that plan? What is the quality of care? And the cost doesn't include just the premium. It’s also the copays and deductibles. Can you afford the cost? Do you qualify for assistance in paying those copays and deductibles?
There are a lot of things to think about, and the whole process can be confusing. That’s why Kepro wanted to share information to help you make this important decision. Please read below for various options, including websites, phone number, and podcast episodes.
information from medicare
- Website. Learn about and compare coverage options and shop for health and drug plans. Visit www.medicare.gov.
- Telephone. Talk to someone for help comparing plans. Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
access personalized health insurance counseling for free with your local ship organization
You can contact your State Health Insurance Assistance Program (also referred to as SHIP) for any Medicare-related questions or concerns. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. Depending on your state, your SHIP may go by another name.
- Read an article on the national SHIP website about Medicare’s Open Enrollment Period at www.shiphelp.org.
- Visit www.shiphelp.org or call 1-800-MEDICARE for your local SHIP’s phone number. Many SHIPs also offer virtual counseling.
medicare savings program
If you have limited income and resources, you might qualify for Medicare Saving Programs run by your state Medicaid program. These programs could help you save money on health and prescription drug costs and/or could reduce your Part B premium.
For more information, contact your state Medicaid program (www.medicare.gov) or call 1-800-MEDICARE and ask about Medicare Savings Programs.
podcast episodes from kepro
Take a listen to Kepro's Medicare Open Enrollment series.
Episode 15: Learn about Medigap Supplement Plans. Learn about what Medigap is, the differences between Medigap and Medicare Advantage, the differences between a Medigap Plan A and Medicare Part A, how Medigap works for those with disability, and how to get a Medicare supplement guide.
Episode 16: Learn About Medicare Advantage Plans. Learn about what Medicare Advantage (or Medicare Part C) is, the differences between Medigap and Medicare Advantage, the disadvantages and advantages of Medicare Advantage plans, and the types of Medicare Advantage plans that are available.
Episode 17: Open Enrollment, Learn How to Navigate the Medicare Maze. Learn about what Medicare Open Enrollment is, how State Health Insurance Assistance Programs (also referred to as SHIPs) can help you with Open Enrollment, and some tips for Open Enrollment.
Things to Consider
- Basically, there are two ways to get your Medicare coverage — Original Medicare and Medicare Advantage (Medicare-approved plans from private companies). There are differences between the two that are important to understand when choosing your coverage.
- If you are looking at a Medicare Advantage plan, check with your healthcare providers (such as your doctor and hospital) to be sure they are in that plan’s network.
- If you are choosing a Medicare prescription drug plan, check to see if your prescription medications are included in the plan.
- A low monthly premium may not always be the best overall value to meet your specific needs.
- Review a plan’s estimated total costs to you, including deductible and other out-of-pocket costs.
If you take insulin, there is an out-of-pocket cap on a month’s supply of each insulin product when covered by a prescription drug plan or under Original Medicare. Read about insulin coverage:
Publication No. RI46810-317-10/2023. This material was prepared by Kepro, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.