Medicare Plan Differences & Deadlines

HEALTH

Honolulu (KHON2) – Living808 went to the experts for a guide to choosing Medicare plans before the looming December 7th deadline.

Jose Cabrera, Director of Humana for the Hawaii and Northern California Markets, described the Medicare Advantage and prescription drug plans,  Parts of Medicare, and the annual enrollment period.

The Medicare Advantage and Prescription Drug Plan Annual Election Period (AEP) runs from October 15 through December 7.  

There are two main ways to get Medicare: Original Medicare, which includes Medicare Part A (hospital insurance), and Part B (medical insurance), or Medicare Advantage, also known as Part C, which is an “all in one” alternative to Original Medicare. These bundled plans include Parts A, B and usually, Part D (prescription coverage).  

With Medicare Advantage, you’re receiving your Medicare coverage through a private insurer, like Humana, whose resources are there to help you.  

Medicare Advantage plans (Medicare Part C) include all of the benefits covered by Original Medicare (Parts A and B)  

Medicare Advantage plans from Humana may also include:  

  • Predictable copayments and lower or no plan deductibles  
  • Part D prescription drug coverage (Medicare Advantage plans without Part D prescription coverage are also available)  
  • Maximum out-of-pocket protection  
  • Programs designed to improve health and help manage chronic conditions  
  • Dental, hearing and vision coverage 
  • Fitness center membership  
  • Allowance for over-the-counter personal care items like toothbrushes and toothpaste, pill boxes, aspirin, cough and cold medicines, eye drops, vitamins, heating pads, compression stockings and other supplies for diabetics, plastic bandages and other first aid items

Some key differences between Original Medicare and Medicare Advantage, according to Cabrera:

  •  Medicare Advantage plans cover everything Original Medicare covers and may include extra benefits, services and often prescription drug coverage through a private insurer like Humana.
  •  Many Medicare Advantage plans offer extra coverage and services, like vision, hearing and dental benefits, and health and wellness programs, at no additional cost. Most also include Medicare prescription drug coverage.
  •  Medicare Advantage plans generally cover a broader array of health-related services and benefits that may help people with Medicare improve their health.
  • Health and wellness benefits often include fitness programs and gym memberships, and transportation to medical appointments and fitness centers. Some Humana Medicare Advantage plans also include home support and resources for caregivers.
  • All Humana Medicare Advantage plans will feature a primary care virtual visit benefit. Members who may not have a primary care physician, or who may need additional support between doctor visits, can connect with a U.S. board-certified doctor using a phone, tablet or laptop anywhere at any time. Humana will offer this expanded virtual capability next year for behavioral health, urgent and primary care.
  •  For a second year, a Medicare Advantage plan called Humana Honor, will be available in select markets in 46 states, up from 27 and while available to all beneficiaries in the areas available, is designed with U.S. military veterans in mind.

Due to COVID-19, this year’s Annual Enrollment Period will offer fewer face-to-face agent interactions. However beneficiaries can expect simple and secure education and enrollment both online and over the phone with Humana.

  • Humana conducted a market assessment to consider how consumers will enroll and shop as a result of COVID-19.
  • From that assessment and to meet consumers where they feel comfortable, Humana has expanded its capabilities to meet them virtually (by phone or through their digital devices)
  • Humana is offering online workshops to review 2021 Medicare Advantage plan options and eligibles can set up a virtual one-on-one meeting with an agent.

Beneficiaries can also go to Medicare Plan Finder on Medicare.gov to compare plans, benefits and costs.

“It is critical that patients have good relationships with their primary care physicians,” says Dr. Kevin Lum. “The patient needs to be an empowered participant in the decision making processes for care.  Having ancillary support staff (like care coordinators/navigators) helps to augment the physician’s reach to engage with the patients. Being able to address the non-clinical social determinants of health (such as barriers to transportation) is just as important as the physical care delivered by health providers.”

From a physician’s perspective, Dr. Lum cites these important things that people should know about Medicare Advantage:

  • Medicare advantage plans provide insurance coverage for our kupuna – those persons over the age of 65.
  • Each year, Oct. 15 through Dec. 7 is the Medicare Annual Election Period (AEP). During AEP, you will have the opportunity to explore and choose your Medicare coverage for 2021. You will have many choices, which includes selecting a Medicare Advantage plan or staying with your current option.
  • Even if you are satisfied with your current option, it is important to review your Medicare plan during AEP for a few reasons:     
  • Your plan may change     
  • The cost and coverage of your Medicare plan may change each year. Make sure that your plan meets your needs. Medicare recommends reviewing your health plan’s “Annual Notice of Change.”     
  • The physician network, specialists, and hospitals may change.
  • To avoid having to find a new doctor or paying for higher costs, it’s a good idea to make sure your doctor is participating in your Medicare Advantage plan physician network. Medicare Advantage physician networks vary greatly in size and composition. This may have important implications. For example, if you are enrolled in an HMO plan, you have limited access to the number of doctors or hospitals. Please check and make sure your primary care physician, specialists, and hospitals you trust and prefer are participating in your 2021 Medicare plan option.
  • A new plan may be offered — or additional benefits may be available.
  • Certain plans offer additional benefits not provided by Original Medicare. Medicare Advantage Plans, for example, offer additional benefits, such as dental, prescription drug, vision or gym membership, possibly at no additional cost.
  • Your healthcare needs may change.
  • You may find that you want more coverage than you currently have. By planning, you can ensure that you have the coverage that is right for your anticipated healthcare needs.
  •  Your prescription needs may change.
  •  You may require different prescription medications if your healthcare needs continue to change.
  •  Remember, the Medicare annual enrollment period runs from Oct. 15 through Dec. 7, 2020.

Website: Medicare Plan Finder: https://www.medicare.gov/plan-compare/#/?lang=en on Medicare.gov to compare plans, benefits and costs.

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