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Case Study: The Value of SHIP and Medicare Open Enrollment Plan Comparisons
 Written by Jan Neal, Jan Neal Law Firm, LLC (M4A’s Legal Service Provider)
 
How important is the State Health Insurance Assistance Program (SHIP) to Medicare beneficiaries?  Extremely important and here is just one example!  A gentleman we will call Mr. A came to a SHIP Open Enrollment Event.  He drove 20 miles to check out his coverage because he was unsure of whether he needed to keep or change his Medicare Part D prescription drug plan (PDP) for 2017.  He opted to do the safe thing and check it out. Thank goodness he did.
 
Mr. A’s prescription drug plan for 2016 had a zero premium and covered his 10 medications prescribed by his doctor.  That all worked out well, and during 2016 Mr. A’s total out of pocket expenses related to his prescription drug plan totaled $542.00.  This was a manageable arrangement for him.
 
When a comparison of plans was run, Mr. A was shocked to learn that his 2016 prescription drug plan would have a premium of $26.80, a deductible of $400.00, and his 10 medications had been reconfigured on the plan formulary resulting in 2 of his medications no longer being covered and 3 of his medications reclassified as Tier 3 medications, meaning that his copayments would be higher. In all, Mr. A would have had to pay $3276.00 in out of pocket expenses related to his prescription drug plan during 2017 if he made no changes in coverage.
 
The comparison provided Mr. A with several options, and he selected a plan that would result in $360.00 in total out of pocket expenses for 2017, saving him $2916.00 over what he would have had to pay if he had not had a comparison run.
 
While Medicare enrollees can run their own comparisons, they will need to use the online plan finder provided by Medicare.  Comparisons are performed free and counseling provided through M4A’s SHIP Program.  To learn more, contact M4A directly.

 
THE MEDICARE OPEN ENROLLMENT PERIOD ENDS ON DECEMBER 7TH! Please enrcourage people with Medicare to have a free plan comparison completed by a M4A Certified Medicare counselor. Contact M4A today!

So What Is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
The different parts of Medicare help cover specific services:


Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance) 
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Medicare Part C (Medicare Advantage Plans)
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.
*The description used in this section was taken directly from the www.Medicare.gov website.  Go to www.medicare.gov to access more information.
When making decisions about their Medicare Advantage and/or Part D plan coverage, Medicare beneficiaries are vulnerable to fraudsters and dishonest brokers, particularly during Open Enrollment (October 15 – December 7). This short video from the Centers for Medicare & Medicaid Services (CMS) explains some common enrollment fraud schemes and how beneficiaries can protect themselves.

Please see the video below for more information. 
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                                                  P.O. Drawer 618
                                             Saginaw, Alabama 35137


                                             
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                                                 209 Cloverdale Circle
                                            Alabaster, Alabama  35007
                                           
                               

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                     Contact M4A at: (866) 570-2998 or (205) 670-5770






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Middle Alabama Area Agency on Aging · 209 Cloverdale Circle · Alabaster, AL 35007 · USA

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