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Deadline Looming for Medicare Open Enrollment
11/30/2012   Reported By: Tom Porter

Some advice now on Medicare benefits. If you're 65 or older, or close to someone who is, be aware that the open enrollment period for Medicare recipients ends next Friday, Dec. 7. For any Medicare beneficiaries who may be unsure how the system works, or what they need to do to make changes to their coverage plans, the message is: "Help is out there." Tom Porter has more.

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Raymond Hurd is regional administrator for the Centers for Medicare and Medicaid Services. He's based in Boston, but recently paid a visit to the southern Maine Agency on Aging in Scarborough, one of many locations across the state where free advice is available.

Raymond Hurd: "Open enrollment now is annual from October 15th to December 7th. Anybody that makes any changes to their Part D plans or their prescription drug plans, or if they decide to sign up for the Medicare Advantage Plan, if they do so by December 7th, then those changes take effect on January 1st."

Tom Porter: "According to a recent survey, a lot of over-60s don't know how Medicare enrollment works. What are the key things they should know?"

Raymond Hurd: "Well the key thing they should know is that there are several resources they can go to. If they Internet they can go to to get information, they can call 1-800 Medicare, or here in southern Maine they can contact their area agency on aging and talk to what we call SHIP counselors, which stands for State Health Insurance Assistance Program, and those individuals are all trained to walk people through the process of choosing what is best for them with their Medicare."

Tom Porter: "Now some of the key changes: among them, we have new screenings for things like obesity. Can you tell about those?"

Raymond Hurd: Yes, so as Medicare continues to go - it's stronger than ever and it's better costs than it's been in the past - the rates for Medicare this year are pretty much the same as they were last year. So there are screenings for obesity, screenings for diabetes, there's substance abuse screening, there's also what we call an annual wellness visit through Medicare, where you sit down and talk to your doctor - it's not a physical - you sit down and you talk to your doctor about your lifestyle and those things that may be affecting your health, so that they can help educate you."

Tom Porter: "And talking of obesity brings us nicely down to 'doughnut holes,' although they're not literally doughnut holes. This is the prescripion drug coverage gap. Tell us about the changes to that and the people who aren't covered by prescripion drug coverage?"

Raymond Hurd: "Okay, so the doughnut hole is the area where unfortunately there's a gap between where prescription drug coverage ends and catastrophic coverage begins, and that's what we call the doughnut hole. So this year, the rates have changed so the individual that hits the doughnut hole will only have to ay 48-and-a-half percent of their brand name prescription drug costs, and that's down from last year when they were paying 50 percent. That number will continue to decrease until 2020 when the doughnut hole goes away."

Raymond Hurd is regional administrator for the Centers for Medicare and Medicaid Services. He urges Medicare recipients to not to stick with the same plan every year, but to be pro-active and get the best possible deal every year.

Nancy Gordon is a volunteer at the Southern Maine Agency on Aging. Apart from dimishing so-called doughnut hole, she says there are other changes to the Part D Prescription Drug coverage plan that recipients should know about - changes which may require them to change pharmacies.

"There's a new wrinkle in the Part D prescription drug plans this year. They now have something called Network Preferred Pharmacies, and it may cost more to get your prescription filled at a non-Network Preferred Pharmacy than it does at a Network Preferred Pharmacy," she says.

And that difference, she says, could be anywhere from $200 to $1,000.

If you need some free advice on Medicare enrollment, you can call the Maine State Health Insurance Assistance Program at 1-877 353 3771. You can also find more information about enrollment on the Internet here.



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