Every year between October 15th and December 7th, Medicare participants have an opportunity to change their health (Advantage Part C) and prescription drug (Part D) plans. If you switch to a new plan, coverage will begin January 1, 2015. If you decide to stay with the same plan, any changes in coverage, benefits, or costs for the new year will also go into effect January 1st. There are many details to consider when choosing Medicare coverage, and the process can easily become overwhelming for some people. The good news is that help is available.
The APPRISE program is a free health insurance counseling program designed to assist seniors. Services are provided by specially trained volunteer counselors under supervision of the staff of local area Agencies on Aging. Support and training for programs and counselors is provided by four regional coordinators, and the Pennsylvania Department of Aging employs a state coordinator to oversee all programs. Specifically, counselors can help seniors understand :
- Services covered under Medicare Parts A and B
- Part D prescription drug benefits
- The various Medicare coverage options, including traditional Medicare, Advantage plans, and Medigap policies
- Medicare eligibility requirements and the enrollment process
- Financial assistance programs which are available to help individuals pay Medicare premiums, deductibles, and co-pays, as well as the cost of prescription drugs
- The Medicare appeal process if services have been denied
Counselors may also provide assistance with the completion of application and claim forms. Information and assistance may be provided either at group events, scheduled one-on-one appointments, or via telephone. During the fall, area Agencies of Aging usually hold multiple events related to Medicare open enrollment. The events are too numerous to share in this column, but your local agency can provide a list of events in your area. Here is some general information about local APPRISE programs:
Adams County: Appointments are scheduled on Monday mornings. Call the Adams County Office of Aging at 1-800-548-3240.
Cumberland County: Medicare Mondays: informational sessions for participants new to Medicare. To register, call Cumberland County Aging and Community Services at 717-240-6110 or 888-697-0371, ext. 6110. These same telephone numbers can be utilized to schedule a personal appointment with an APPRISE counselor.
Dauphin County: Call the Dauphin County Area Agency on Aging at 717-780-6130 for information.
Franklin County: Call APPRISE volunteers directly on Tuesdays and Thursdays from 9am – 1pm at 717-262-2088.
Perry County: Call the Perry County Area Agency on Aging at 1-866-926-5118 or 717-582-5128.
For folks who are enrolled in a Medicare Advantage (Part C) plan through an insurance company, and who wish to change to traditional Medicare through the federal government, the dates to make this change are between January 1st and February 15th. If you decide to switch, you have until February 14th to also join a Medicare prescription drug plan. Coverage will begin the first day of the month following the receipt of your enrollment form.
It is important for all seniors to reconsider their Part D coverage every year. Due to changes in the types of medications you take, and the formularies (the list of covered medications) of each specific Part D plan, a plan which works well for you one year may not necessarily be the most cost effective or desirable plan for the following year. Taking advantage of the APPRISE program may help save you frustration and money related to your health care. Call today!
Karen Kaslow, RN