Care Connection Aging & Disability Resource Center

Medicare Improvements for Patients and Providers Act

Medicare health and prescription plans offers changes to plans each year during October 15th through December 7th. Changes can be seen in cost, coverage, and changes to providers and pharmacies listed within Medicare’s networks. This gives Medicare recipients an opportunity to change their Medicare health plans and prescription drug coverage plans to better assess their needs.

To stay abreast of the time to change always review materials sent by your plans, i.e. Evidence of Coverage (EOC) and your Annual Notice of Change (ANOC). Review carefully the changes to your health plan, to ensure the changes still meet your needs for the following year. If you are satisfied with the current plan and that plan will continue to be offered, you don’t have to do anything.

To become familiar with changes to next year’s plan changes, you may call 1-800-MEDICARE or visit www.Medicare.gov. Centers for Medicare and Medicaid Services partners can find information to help people with open enrollment using outreach and media materials for English-speaking and other audiences by visiting www.cms.gov.

To determine if you need or want to switch plans, talk about plan options or get help on identifying the best plan for you, please call 855-937-2372.

 

The “Extra Help” Program 
 
 
Medicare beneficiaries who have limited income and resources may qualify for extra help to pay for prescription drugs costs. This Extra Help program from Medicare provides financial assistance for beneficiaries who have limited income and resources. Those who are eligible for this program will get help paying for monthly premiums, yearly deductibles, prescription coinsurance and copayments and will have no gap in coverage.
 
Image of an older couple sitting in a chair together
Some people are automatically eligible for the Extra Help program.  Those include people who are: full benefit dual eligibles (Receive Medicare and Medicaid); Social Security Insurance recipients with Medicare and Medicare Savings Programs participants.
 
Some people must apply through the Social Security Administration. This includes Medicare beneficiaries with income below 150% FPL who meets an asset test—i.e.—beneficiaries who have a yearly income (in 2009) below $16,245 ($21,855 for a married person living with a spouse and no other dependents) and resources (in 2009) less than $12,510 ($25,010 for a married person living with a spouse and no other dependents).
 
Generally, dual eligibles and others deemed eligible for the Extra Help Program pay no Part D plan premiums or deductibles, but pay $1.10 or $2.40 for generic drugs and $3.20 or $6.00 for brand-name drugs, depending on their income.
 
Please note that the dollar amounts are subject to change. Please call 1-855-YES-ADRC (1-855-937-2372) for more information. The content above was adapted from the Centers for Medicare and Medicaid website: http://www.cms.gov
 
 
Medicare Savings Programs
 
Medicare Savings Programs are state programs created to help people with low income who qualify to enroll in Medicare to pay for the costs of its coverage. These programs help pay for Medicare premiums. Some programs also help pay for Medicare Part A and Part B deductibles, copayments and coinsurance. These programs are very helpful since many people who qualify to receive Medicare benefits have limited income. Many older adults who are no longer working and disabled individuals incapable of working can benefit from these programs. For more information on these programs, see http://www.mymedicarematters.org