Tag Archives: Annual Enrollment Period

Making Sense of Medicare Advantage and Medicare Supplement

Vantage Point: Medicare Supplement or Medicare Advantage? What’s the Difference?

Have you ever had a conversation with a friend or family member where you were both thinking that you’re talking about the same thing, but then you realize (usually after much confusion and the conversation has drifted a bit), that you’re in fact not talking about the same thing?

The conversation comes to the point where you find that you’re talking about two different things, an “apples and oranges” conversation.

I think that there are a lot of “apples and oranges” conversations when it comes to what Medicare Supplement and  Medicare Advantage plans are. We’re talking about insurance with both, but they are different things.

Medicare Supplement plans, also known as Medigap plans, work with Original Medicare, which is Part A (hospital) and Part B (medical) coverage. They help pay for all or part of the 20% that Original Medicare doesn’t pay for, depending on what plan you choose. Medicare Supplement plans do not include prescription drug coverage, so if you want that, you’ll have to pick up a prescription drug plan separately.

Medicare Advantage, also known as Part C, are plans where a private insurance company replaces Original Medicare. Medicare Advantage plans have the same Part A hospital coverage and Part B medical coverage that you’d get with Original Medicare. (Remember, you’d still pay your Part B premium if you get a Medicare Advantage plan.) Plus, Part D prescription drug coverage is included in many Medicare Advantage plans. That means you’d have hospital, medical, and drug coverage together in one plan. Medicare Advantage plans may come with extras as well.

Now that the Annual Enrollment Period is here, you’ll be better equipped to have the “apples and oranges” conversations if they come up. If you still want more direction when it comes to your options, there’s a great local service available called SHIBA (Statewide Health Insurance Benefits Advisors). SHIBA is a free service of the Washington State Office of the Insurance Commissioner, Consumer Protection Division and can be reached at 509-902-1114 or 1-800-562-6900  It has great volunteers who can help you.

You can also come into our local office in Creekside Business Park, and we can go over anything you’re confused about in person, bit by bit.

We at Health Alliance Northwest in Yakima are here to help our community learn what the various parts of Medicare are to help each person make informed decisions that are the best for them. (The best choice might not be us, and we’re okay with that!)    

Breck Obermeyer is a community liaison with Health Alliance Northwest, serving Yakima County. She is a small-town girl from Naches and has a great husband who can fix anything and 2 kids who are her world.

Changing with the Seasons for AEP

Covered Bridge: It’s That Time Again: AEP

There is a lot of publicity to remind folks to check their smoke detector batteries when daylight saving time is over. It makes sense to tie that chore to something that occurs on a regular basis (why not Valentine’s Day?), but I almost always forget to do it.

It seems there are always other more pressing duties on the to-do list, like finishing up in the yard, switching out those summer clothes, or putting up the storm windows (if you are unlucky enough to still have storm windows).

Another reminder comes along this time of year. Medicare-eligible individuals’ mailboxes are bombarded with mail for the Annual Enrollment Period (AEP). While it can be annoying and overwhelming, it’s incredibly important for them to review their healthcare coverage every year to see if their current plan still meets their needs. The days of one-size-fits-all are over.

If you are a caregiver, a change in your loved one’s situation may indicate the need for different coverage. Have they started traveling more? Less? Have their medication needs changed, like new prescriptions or treatments for a chronic illness? Did their primary care provider retire or relocate? Did their current plan change, and does it still suit their needs? It’s time to explore their options.

We know you are busy, so let’s look at a few resources.

A great one is Medicare.gov. This site is easy to navigate and packed with information. You can check the plan’s Star Rating while you’re at it.

Another great resource is your state’s Department on Aging. It offers impartial counseling services for people who are Medicare-eligible.

Your local Area Agency on Aging is a gold mine. Find one near you at n4a.org.

HealthAllianceMedicare.org is also easy to navigate and gives a nice overview of the options we offer in your county.  

The AEP for 2019 is October 15 through December 7. The sooner you review your needs and gather information, the better equipped you will be to make an informed choice. When you’re done, you can move onto something really important, like cleaning out the junk drawer in the kitchen (like that’s going to happen).

Morgan Gunder is a community and broker liaison for Reid Health Alliance. Born in the South and raised in the Midwest, she is a wife and mother with a passion for traveling, learning, and technology.

Change in the Air

Vantage Point: Change Is Near

As our days get shorter, our nights get longer, the temperature drops, and the cool crisp air hits our faces, we know winter is approaching. It’s also a reminder that the year is about to end, and a busy time is coming.

Our grocery lists start to get longer as we start preparing for Thanksgiving. We begin our research for recipes to outdo our dessert from last year. Then, we gather with our family and friends, share what we’re all thankful for, and of course, enjoy a delicious meal.

I personally start to reflect on the year I’ve had. Was this a good year? What would I do differently? Did my health change? Do I need to look at my coverage?

As you all know, we’re in the Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year. This is the time for you to reassess what type of coverage you might need for the upcoming year.

In September and October, Medicare beneficiaries’ mailboxes were full of marketing materials from many different insurance companies. So much information is provided that it can be hard to keep track of everything that’s coming in. Each company has different prices, networks, copays, and perks.

It’s hard to handle all of this alone. Your family might be able to try to help sort everything out, but even then, it is a hard task to take on without any background knowledge. You want to make sure you’re making the right decision for the year ahead and that you’re not missing out on the perfect plan for yourself. Who should you turn to?

Luckily, Health Alliance Northwest has a local office in Wenatchee with a staff ready to assist current or future members. Our local office is a great asset to our community. We know insurance is already hard, and getting help over the phone can be an added barrier. We’re able to sit down with you and your family to answer and explain any questions you might have.

Our Wenatchee office is open Monday through Friday, 8 a.m. to 5 p.m., and no appointment is needed to sit down with our representatives. We want to help educate you, put you at ease before the holidays begin, and make sure you’re ready for a new year.

Jessica Arroyo, born and raised in Wenatchee Valley, is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. During her time off, she enjoys spending time with her husband and infant son.

Time for Change

Long View: Is It Time for a Change?

“Everyone appreciates the long, light evenings. Everyone laments their shortage as Autumn approaches; and nearly everyone has given utterance to regret that the clear, bright light of an early morning during Spring and Summer months is so seldom seen or used.”

This was written by a London builder named William Willett, who proposed daylight saving time from an idea conceived by Benjamin Franklin.

“Spring forward. Fall back,” was how I learned it! I remember daylight saving time when I was a child was a big deal. The Saturday night before the official time change would take place, my entire family worked together to make sure that all the clocks and watches in our household were set, not to mention the clocks in my parents’ cars. It never failed. There was always that tiny clock on the top of our stove that we would miss. My mom always caught it when she went to set the oven timer!

Then, once the clocks were all set, my sister and I pondered whether we lost or gained an hour of sleep. We always had to sit there for a minute or 2 and do the math before coming up with the answer.

For most of us today, time changes are not nearly as complicated as they used to be. Our world is much more hurried, and automation is everywhere. It’s accepted that almost every clock, watch, appliance, iPhone, and computer is programmed for daylight saving time. We really don’t have to worry about making sure all of our timepieces make the change. With our schedules so full, we don’t even realize we’ve gained an hour or lost an hour of sleep.

Just like the time change happens each November, Medicare’s Annual Enrollment Period (AEP) happens each October. Medicare beneficiaries can review their current plan and make any changes they feel are needed from October 15 through December 7.

Every year, the AEP is a good time to check your drugs and review upcoming services with your doctor, then make sure the plan you’re on is still the best fit. You might even want to get your family together to make sure you didn’t miss anything.

Some resources available to help you this AEP include Medicare.gov, which is easy to navigate and packed with information, and Illinois’ very own Senior Health Insurance Program (SHIP). The Illinois Department of Insurance offers this free, impartial counseling service for people who are Medicare-eligible. Visit Insurance.Illinois.gov or call them at 1-800-548-9034. You can also find the nearest SHIP office in this directory, or, in Iowa.

And don’t forget to check out your current insurance info at HealthAllianceMedicare.org. If you need to research plan options, you can “fall back” on us! We’re ready to help with any questions you may have for the upcoming plan year.

Mervet Adams is a community liaison with Health Alliance. She loves her grandson, family, nature, and fashion.

Answers to Your Health Insurance Questions

Vantage Point: Time to Answer Important Health Insurance Questions

It’s that time of year again. My husband comes home with a huge packet of healthcare information. Yep, it’s open enrollment for his employer health plan. It’s time for us to look at the options and choices that best suit our family in the coming year.

Every year, Medicare beneficiaries get this kind of event too. It’s called the Annual Enrollment Period (AEP). Each year from October 15 to December 7, they have the opportunity to look at the options available in their service area and choose which plan is the best for them and their health.

This is an important time for everyone. As we age, our health may change too. Understanding and knowing what coverage is best for you can be a daunting task, so you should ask yourself some very important questions each and every year.

Am I happy with my current plan? What’s changing for the new year? Is the premium going up on the plan I currently have? Do I need more coverage?

I understand that as Medicare members, you’re sent an enormous amount of marketing material during this time of year. All the Medicare Advantage, Medicare Supplement, and prescription drug plan companies are trying to get your attention and your business.

How do you weed through all the material? And even more important questions come up for you each year. Do I know the difference between Medicare Advantage and Medicare Supplement? Is the prescription drug plan I’m currently on the best value for the prescription drugs I’m taking? Finding the answers can be confusing and frustrating.

The answers you seek can be found quickly and easily. Visit our website or call us directly for answers to your health insurance questions. There are also independent brokers available to you, like GHB Insurance located right in Olympia, to help you with all the plan information you receive. In the Thurston County area, there are also SHIBA (Statewide Health Insurance Benefit Advisors) representatives who volunteer their time to help you understand Medicare and all the parts associated with it. They can be found at both the Lacey and Olympia senior centers.

So never fear, your Medicare questions can be answered here. Or at least, we can assist you in getting the answers you need. Remember, you have resources available to you. All you have to do is use them.

Joy Stanford is a community liaison with Health Alliance, serving Thurston County. She’s been involved with Medicare for 20+ years and truly enjoys it. She enjoys gospel, R&B, and country music, and she owns over 100 pairs of shoes.

Making a Difference on Every Call

Vantage Point: Making a Difference

As our Annual Enrollment Period (AEP) came to an end, I sat back and thought of all of the work our team had done. Each year, prospective members call in to get information to determine if Health Alliance is the right fit for their needs.

Of course we go over the basics, like monthly premiums, copays, and out-of-pocket maximums, but that is all very black and white, and not every situation is the same or so simple.

At Health Alliance, the expectation is to go the extra mile for our members and prospects. Our potential members rely on our expertise to guide them in the right direction.

This past AEP, I had someone call in asking if our plan covers a certain medication that’s given at the doctor’s office. My immediate response to the caller was, “I don’t know, but let me research that for you.”

I wanted to make sure they were making the right choice by switching to our plan. After doing some research and calling our pharmacy department, I called them back and shared the details I’d gathered.

Later, I got the chance to meet the potential member to go over our plans in person. They could not thank me enough for gathering the information and told me my phone call back was a nice surprise. We gained credibility and their trust by taking the extra step to respond to their particular situation.

I was actually surprised because I didn’t feel like I had done that much, but after thinking about it for a while, I realized it really is the little things that count the most to our members. This is a perfect example of why our role as liaisons is so important for our community and what sets Health Alliance apart.

As liaisons, we go out of our way to give our members the most accurate information we can and to take away the pressure of those difficult and complex questions. Our job is to simplify and educate. We’re making a difference every day, no matter how big or small.

Jessica Arroyo, born and raised in Wenatchee Valley, is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. During her time off, she enjoys spending time with her husband and infant son.

HappyHappy, Healthy, Medicare New Year!

Long View & Vantage Point: Steps to a Happy Medicare New Year

Winter preparations are all done, and winter festivals and end-of-the-year holiday celebrations have ended. Just when you think you can sit back and relax, there is still one last item you may need to consider.

If you made any changes to your Medicare plan during the Annual Enrollment Period, here are some actions you can take to help you have a happy Medicare New Year:

  1. Make sure you’ve received your new plan’s member ID card.

If you joined a Medicare prescription drug plan (PDP) that works with Original Medicare, you’ll get a separate card to use when you fill your prescriptions, but you’ll still use your Medicare card for hospital and doctor services.

If you joined a Medicare Advantage plan, like a Health Alliance plan, you’ll get a new card to use when filling your prescriptions and for hospital and doctor visits.

If you need medical care or need to fill a prescription before you receive your ID card and your new coverage has already started, you may be able to use other documents as proof of coverage, like the welcome letter you got from the plan, or even your enrollment confirmation number and the plan’s name and phone number.

  1. Show your new member ID card to your doctor’s office and pharmacist on your first visit of the new year.

If you have stayed with the same insurance company, be sure to replace last year’s card with your new card. If you changed companies, be sure you’re always using your new card.

  1. If you chose to have your plan premium withheld from your Social Security check, don’t be alarmed if you don’t see it deducted right away. It can take up to 3 months from when you made this request to start seeing it withheld from your Social Security payment.
  1. Remember that your deductibles start over at the beginning of the year, so normal copayments won’t start until all applicable deductibles have been met for the year.
  1. Take advantage of your annual wellness visit. This free preventive benefit is designed to help you take charge of your health, learn about preventive services you might need in the future, and establish a baseline for personalized care.
  1. Take advantage of any gym membership benefits from your plan. Many plans offer gym memberships or access to fitness activities, at no cost to you. Our Be Fit benefit helps pay you back for your gym membership or fitness classes, so you can get fit at the gym of your choice.

Wishing you all a happy and healthy 2017!

Sherry Gordon-Harris is a community liaison at Health Alliance. She is a wife and mother of 2 boys and enjoys traveling, collecting dolls, and hosting princess parties and princess pageants.

Breck Obermeyer is a community liaison with Health Alliance, serving Yakima County. She is a homegrown girl from Naches and has a great husband who can fix anything and 2 kids who are her world. When not attending community events or providing Medicare education throughout the Valley, she can be found indulging in her hobbies of homesteading, pioneer cooking, and learning new survival techniques. She also has a strong love for all things Halloween.