Medicare resources for your loved ones

More than 66 million Americans care for loved ones who have a chronic illness, disability, or frailties that come naturally with old age. Nobody is in a better position than family caregivers to help loved ones manage their health and health care, like medicines, treatments, diets, and exercise. Only you know what’s most important to you and your loved ones – that’s why we want to be sure you have all the information you need to make the best decisions.

During Open Enrollment – which ends on December 7th – it’s worth your time to review and compare your loved one’s coverage choices. Only you can decide what mix of benefits and costs will work best with your loved one’s needs and budget. Now is the time to look at all of the health and drug plan options in your area. If you still need help comparing plans, call 1‑800‑MEDICARE. 

Looking for more information and support? Our caregiver resources have tip sheets, videos, and practical information for caregivers, including tips on what Medicare covers, planning for the future, and taking care of yourself. You can also sign up for our caregiver e-newsletter, so you’re always informed about Medicare issues that affect you and your loved one. We know you’re juggling a lot, so we put it all in one place to save you time.

For even more information, check out the Administration on Aging’s Eldercare Locator and the National Family Caregivers Association.

Medicare Open Enrollment: What’s your back-up plan?

By: Jonathan Blum, CMS Acting Principal Deputy Administrator and Director, Center for Medicare

We all like to plan ahead – whether it’s planning for a road trip next summer or planning a big family get-together. Despite our best planning, uncertainty is a fact of life. We always need a back-up plan. What if the car breaks down?  What if it snows on the day of the get-together?

Nobody likes to think of back-up plans when it comes to our health, but health can be as unpredictable as the weather. It’s hard to know what you’ll feel like next week, much less what health care you’ll need next year. But that’s exactly what you need to think about when you’re shopping for health coverage during Medicare Open Enrollment – which ends on December 7.

Even when future needs can be hard to forecast, taking stock of your current situation can help. Review your prescription drug needs, and look for a plan that meets those needs. Plans may vary in what drugs they cover, and some may have special rules that you must follow before they cover a drug.

You may have other health insurance from a current or past job, or through a family member. If you do, you’ll want to understand exactly how that other coverage works with Medicare. You may decide to keep what you have now – and that’s ok.

It’s worth your time to take a look and compare coverage. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1‑800‑633‑4227). TTY users should call 1-877-486-2048.

While you can’t predict everything in life, you can do your best to be prepared. Medicare will be there, stronger than ever, to help.

Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.

Medicare Open Enrollment: Be a smart shopper

By: Jonathan Blum, CMS Acting Principal Deputy Administrator and Director, Center for Medicare

In today’s world, we’re all a little more conscious of costs. Maybe we clip a few more coupons, eat out less, or compare ads to find the best price on something before we buy. Cost is an important factor in any purchase, and health care is no different. We know you want to get the best value possible from your health care coverage. Wouldn’t most of us like to get more and pay less for things that are important to us?

The good news is the health care law has gone a long way toward lowering overall costs in the Medicare program. Average premiums for prescription drug coverage and Medicare health plans will stay around the same in 2013. People who are in Medicare’s prescription drug coverage gap (“donut hole”) will continue to save money in 2013 with big discounts on brand-name prescription drugs. Since the health care law was enacted in 2010, more than 5.5 million people with Medicare have saved nearly $4.5 billion on prescription drugs in the donut hole. 

But you still need to make smart choices to get good value out of your health insurance.

There may be dozens of Medicare plans in your area, all with different costs and levels of coverage. Ask yourself:

  • How much are each plan’s premiums and deductibles?
  • How much will I pay for the benefits and services I’m likely to use?
  • Is there a limit on what I’ll have to pay out-of-pocket for the year?
  • Does the plan cover the drugs I take?
  • How much will my prescriptions cost under each plan?

Only you can determine what mix of benefits and costs will work best with your needs and budget. Shopping around can make a huge difference, and we want to help. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Whether it’s groceries, health insurance, phone plans or anything else, we all want the best value for our dollar. Make sure you have the most up-to-date information out there and be a smart shopper during Medicare Open Enrollment – which ends on December 7.

Medicare Open Enrollment: Now’s the time!

By: Marilyn Tavenner, Acting Administrator

 It’s picking season – pumpkins, apples, Halloween candy…and a Medicare health or drug plan. Today is the start of Medicare Open Enrollment!

In my work with Medicare, one of the questions people ask me often is which plan is the best one. That’s not something I can answer, because picking a plan is an important and personal decision. Each person has a unique set of priorities. How do you weigh your options? Now’s the time to think about what matters to you, and pick the Medicare plan that meets your needs.

When you sit down to review your Medicare health and drug plan choices this year, keep track of the things you may want in a plan, and pick one that’s right for you. Here are some things to keep in mind while you consider your choices:

Costs

You should look at your current health care costs to find coverage that works with your financial situation. How much are your premiums and deductibles? How much do you pay for hospital stays and doctor visits? Just like with everything else, the lowest-premium health plan option might not be the best choice for you.

Coverage

Are the services you need covered? We know future health care needs can be hard to predict, but changes happen. Maybe your doctor changed your prescriptions this year or you have different health concerns. Make sure you understand what services and benefits you’re likely to use in the coming year and find coverage that meets your needs.

Convenience

Your time is valuable. When comparing plans, make sure you check which doctors and hospitals you’ll be able to use. Where are they located and what are their hours? Check which pharmacies you can use. Can you get prescriptions by mail? Remember that even if you’re happy with your current plan, these answers might change from year to year.

Quality of care

Ask yourself whether you’re truly satisfied with your medical care. Not all health care is created equal, and the doctors, hospitals and facilities you choose can impact your health. Look for plans with a 5‑star performance rating — the right expertise and care may help speed your recovery and improve your outcomes.

 It’s worth your time to take a look and compare coverage between now and when Open Enrollment ends on December 7. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1‑800‑633‑4227).  

Only you know what’s most important to you and your family – that’s why I want to make sure you have all the information you need to make the best decision. Before you consider your Medicare plan options, think about your personal priorities so you can be sure your plan meets your unique needs.

 Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.

 

Put it on your fall checklist: Medicare Open Enrollment

By: Julie Green Bataille, Director of Communications

If you’re like me, fall is an extremely busy time of year—getting the kids ready for a new school year, making sure everyone in my family gets a flu shot, getting the house and yard ready for the winter. With everything we have going on, it’s so easy to forget another activity that should be on all our fall checklists: Helping our parents prepare for Medicare Open Enrollment.

Medicare Open Enrollment gives beneficiaries the chance to review their health and prescription drug coverage for the coming year. If they need to make any changes, they can do so between October 15 and December 7. But if they decide that they’re happy sticking with the coverage they have now, they don’t need to do anything else.

For all of us who are caregivers, or who just care about older parents and family members, we need to ensure that they have the right information to make the right choice. Sit down and have a conversation with them, and help them explore their options and find coverage that fits their needs.

If your parents want to go online and sort through the details, they can get an early start, and you can help them navigate the process if needed. We’ve already made sure that the Medicare Plan Finder is fully updated with all new 2013 cost and benefit information for health and drug plans and is ready right now. All your parents need to do is start by entering the drugs and checking on the doctors and pharmacies they want to use. A few more steps will get them a personalized list of their plan choices and help them compare.

Between now and December 7, your parents will be hearing more about the choices, benefits, and lower overall costs they’ll have when it comes to Medicare. We’ll also be adding tips and advice to this blog, to help them you and them consider and weigh choices, and to find places to go to get help if needed.

When Medicare Open Enrollment ends on December 7, we want every single person with Medicare to have health and drug coverage that meets their needs. But we need your help. We need you to help ensure that your older family members have the right health plan.  So when you’re preparing your fall checklist, don’t forget to put Medicare Open Enrollment at the top.

Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.

When was your last mammogram?

Have you had your mammogram this year?

Mammograms are breast cancer screening tests that can often detect a lump before you or your doctor can feel it. This can help detect breast cancer early, when it’s the most treatable. All women over 40 should have a screening mammogram every 12 months – and Medicare covers it at no cost if your doctor accepts assignment.

Talk to your doctor about risk factors, and to schedule your next screening. Take control of your health – better health is in your hands.

Getting outpatient therapy? Be sure you know Medicare’s limits

Are you getting physical therapy after a hip replacement? Speech-language pathology services after a stroke? Anytime you get outpatient physical therapy, occupational therapy or speech-language pathology services, be sure you know the limits for how much Medicare will pay.

Medicare helps pay for medically-necessary outpatient physical and occupational therapy, and speech-language pathology services. There are limits, called “therapy caps,” on these services when you get them from most outpatient providers.

The therapy cap amounts for 2012 are:

  • $1,880 for physical therapy (PT) and speech-language pathology (SLP) services combined
  • $1,880 for occupational therapy (OT) services

You may qualify to get an exception so that Medicare will continue to pay its share for your services after you reach the therapy cap limits. Your therapist must document your need for medically-necessary services in your medical record, and your therapist’s billing office must indicate on your claim for services above the therapy cap that your outpatient therapy services are medically necessary.

Learn more about Medicare’s limits on therapy services.