Transcript Medicare in Minnesota 2012

Medicare in Minnesota 2012
Your Medicare: Making the Best Possible Decisions
October 2011
Presented by Stephanie Minor
Senior LinkAge Line® Program Consultant
Minnesota Board on Aging
Overview
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Open Enrollment Period Changes
2012 Medicare Changes
Assistance with Medicare Out-of-Pocket Costs
Reminder of 2011 Medicare Changes
Resources
– Health Care Choices
– Senior LinkAge Line®
– Online Resources
Open Enrollment Period Change
• Open Enrollment Period
– October 15, 2011- December 7, 2011 (54 days)
– Will need to make plan changes during this time period
• Medicare Part D and Medicare Advantage
• No changes from December 8 – December 31, 2011
– Plan effective date will be January 1, 2012
• Not seeing huge increase in premiums
Medicare in Minnesota 2012
• Medicare Advantage Options
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4 Local HMO Plans
9 Preferred Provider Organization Plans
1 Private Fee-for-Services Plan
3 Special Need Plans for Chronic Conditions
8 Special Need Plans for Duals 65+
3 Special Need Plans for Duals under age 65
• Other Medicare Plans
– 21 Cost Plans
• Stand Alone Prescription Drug Plans
– 33 Options
Reduced Medicare Prescription Drug Benefit
(Part D) Donut Hole Beneficiary Costs
• 2011
– 50% discount on brand
name drugs purchased
while the beneficiary is in
the donut hole
– 7% discount on coinsurance for generic
drugs purchased while
the beneficiary is in the
donut hole. Beneficiary
pays 93%
• 2012
– 50% discount on brand
name drugs purchased
while the beneficiary is in
the donut hole
– 14% discount on coinsurance for generic
drugs purchased while
the beneficiary is in the
donut hole. Beneficiary
pays 86%
2012
Part D Standard Benefit
No Extra Help (LIS)
Beneficiary Costs
Part D Plan
95% Catastrophic
Benefit
5%
Donut Hole
50% discount on
Brand Name drugs
14% discount on
co-insurance for
generic drugs
100% with discounts
25%
75%
$320 Deductible
Monthly Premium
Drug Costs
Over $6,657.50
(copays of $2.60/$6.50 or 5%)
$2,930.01 - $6,657.50
$320.01 - $2,930
$.01 - $320
Medicare Prescription Drug Benefit Changes
• Beginning 1/1/12
– Full duals receiving home and community based services
• Those on Elderly Waiver, as well as CAC, CADI, BI or DD
Waivers
• Part D cost sharing will be the same as it is for beneficiaries in
a SNF or ICF/MR
– $0 cost sharing for full duals
» Waiver clients
Reminder: Medicare Advantage Disenrollment
Period
• January 1, 2012 – February 14, 2012
• During this Medicare Advantage Disenrollment period,
– Beneficiaries can dis-enroll from a Medicare Advantage plan and
switch to Original Medicare
– Beneficiaries can enroll in a Stand Alone PDP plan for Part D
coverage
– Beneficiaries enrolled in a Medicare Advantage plan cannot switch
to another Medicare Advantage plan
– Beneficiaries in Original Medicare cannot enroll in a Medicare
Advantage plan
Medicare Advantage Updates
• 5-Star Rating System:
– Beginning January 2012, plans may receive higher
payment if demonstrate providing high-quality care to
enrollees (must receive 5 stars)
– Plans receiving 5-star rating may enroll beneficiaries
year round
• Minnesota has no 5-star plans in 2012
Extra Help with Prescription Drugs
• Extra Help (Low-income Subsidy)
– Administered by the Social Security Administration
– Helps lower the cost of the Medicare Part D premium,
deductible and out-of-pocket drug costs
– Paper application or apply online at www.ssa.gov
– Income and Asset Guidelines for 2011:
• Income:
– Single: $1,225.13 - $1,361.25/mo.
– Couple: $1,654.88 - $1,838.75/mo.
• Assets:
– Single: $12,640
– Couple: $25,260
Medicare Savings Programs (MSP)
• Helps individuals under 135% of Federal Poverty Guidelines pay
for medical and prescription drug expenses
• Apply through county of residence
• Three types of MSPs
– QMB: Covers Medicare Part A premium (if any), Part B premium,
Parts A and B out-of-pocket costs
– SLMB and QI: Covers Medicare Part B premium
– All MSPs reduce Medicare Part D prescription drug costs:
• No deductible
• No premium (if on a benchmark)
• Lower copays
Medicare Reminders from 2011
• Annual Wellness Visit
– Receive personalized prevention plan services (PPPS)
• Establish a screening schedule for the next 5 to 10 years
• Provide personal health advice and coordinate appropriate
referrals and health education
• Preventive services
– Eliminates cost-sharing for most Medicare-covered preventive
services
– This includes the flu shot – don’t forget to get yours!
Health Care Choices 2012
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Available online at www.mnaging.org and www.MinnesotaHelp.info
– Mid-October (scheduled)
Print copies provided to the Senior LinkAge Line® for local community
distribution
Call 1-800-333-2433 to request a copy by leaving your name, address
and phone number
Includes all Minnesota plan options
Also includes information on:
– Long-term Care
– Medicare Supplements
– Help paying for Medicare costs
The SHIP in MN (MNSHIP) = Senior LinkAge Line®
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State Health Insurance Assistance Program
300+ certified volunteers in Minnesota
Medicare and long-term care option experts located in your community
Unbiased, Comprehensive, Neutral source
State based program that provides
– One to one counseling and assistance to
people with Medicare and their families
– Free service provided through phone, in person,
online chat, community events and media activities
– Grants provided by CMS
– MN Board on Aging is the grantee
• Senior LinkAge Line® 1-800-333-2433
• Available in all 87 counties of Minnesota through the Area
Agencies on Aging
Senior LinkAge Line®: Your Link to An Expert
• Senior LinkAge Line® 1-800-333-2433
– Statewide
– Objective
– Comprehensive
– Individualized assistance by phone, by online
chat, in your community and in your home
– There is no fee for assistance provided
– Does not sell, endorse or promote any insurance,
long-term care or health care product
MinnesotaHelp Network™ is here to help you
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Senior LinkAge Line® 1-800-333-2433
Disability Linkage Line® 1-866-333-2466
Veterans Linkage Line™ 1-888-LinkVet
www.MinnesotaHelp.info® (including Live Chat)
http://longtermcarechoices.minnesotahelp.info/
Local community based sites throughout Minnesota
2012 edition of Health Care Choices available October 2011
Questions?
Thank you!
Stephanie Minor
[email protected]
651-431-2602