Tag Archives: Medicare.gov

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.

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.

October, and Its Chores, Return

Long View: It’s That Time Again

There are a lot of reminders for folks to check their smoke detector batteries when daylight saving time is over. It does make 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 things on the to-do list, like finishing up in the yard, switching out those summer clothes, or putting up the storm windows, if you’re unlucky enough to still have storm windows.

Just like these yearly chores, Medicare-eligible people need 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 thanks to the options-obsessed baby boomers. (I am including myself, so you know.)

If you’re a caregiver, a change in your loved one’s situation may show the need for different coverage. Have they started traveling more or less? Did their medication needs change because of things like new prescriptions or treatments for a chronic illness? Did their primary care provider retire or move? Did their current plan change? Does it still meet their needs? It’s time to explore your options.

We know you’re busy, so let’s look at a few resources:

Medicare.gov

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

Department on Aging

Another good resource is your state’s Department on Aging. They have independent counseling services for people who are Medicare-eligible.

Area Agency on Aging

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

HealthAllianceMedicare.org

Our website is easy to navigate and gives you a nice overview of the options we have in your county.

The Annual Enrollment Period for Medicare is once again from October 15 until December 7. Sign up then for a plan that starts on January 1, 2017. The sooner you review your needs and gather information, the better you’ll be able 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 ever going to happen.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

 

In Case of Medical Emergency

Long View: What Is a Medical Emergency?

According to Medicare.gov, a medical emergency is a situation where “[Y]ou believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.”

It seems pretty straightforward, so why are there so many questions around the decision to get treatment at your local emergency room?

An emergency room (ER) provides some of the most sophisticated diagnostic options in a hospital and the most immediate care to patients in crisis.

The list of possible emergencies is endless, so it’s important for you to recognize how serious your injury or illness is and to know the best way to get treatment for it.

Many of us have heard about folks with medical emergencies driving themselves to get treatment or catching a ride with a family member. Please don’t. Driving yourself puts you and others in jeopardy and delays the start of your treatment. Dialing 911 brings you the treatment quickly and gets you to an emergency room faster than a white-knuckle trip across town, dodging traffic lights.

Dr. Frank Friedman, one of our medical directors who specializes in emergency care, said, “A true emergency is one that can’t wait. It is something causing such severe pain or such a risk to life or limb, for oneself or a loved one, that it can’t wait hours, or a day or two, to be seen by one’s own doctor or healthcare provider.”

If it’s not an emergency but you need medical care to keep an illness or injury from getting worse, call your doctor. If your doctor can’t see you right away or the office is closed, urgent care (or convenient care) can help you get treatment quickly.

Over the years, I have heard some interesting and alarming questions from our members. This FAQ can help answer those questions.

Q. I just got one of your policies, and I’m having severe chest pain. Will you cover me for an ER visit?

A. This is one of the most unsettling questions we receive. If you’re experiencing severe chest pain, don’t call your plan, call 911. It’s as simple as that.

Q. Do I have to pay a copay when I get there?

A. No, they should be able to bill you, so there’s no reason to wave your credit card around as they wheel you through the front door. In fact, under federal law, an ER has to evaluate and stabilize you in an emergency medical situation, without regard for your ability to pay.

Q. What if I have special conditions they need to know about?

A. Keep a list of your medications with you. MedicAlert’s medical IDs or the Yellow Dot program can also help you share this information. And many smart phones have features that let you add emergency contacts and medical information. Plan ahead.

Q. What are some examples of when I should go to the ER and when I should go to my doctor or urgent care?

A. Visit the ER for emergencies like chest pain, broken bones, poisoning, shortness of breath, fainting, and seizures. For things like a constant fever, strep throat, sprains, the cold or flu, earaches, or minor infections like pink eye, call your doctor or visit urgent care.

Will you recognize a medical emergency? Probably yes, so trust your judgment, act quickly, and please be careful out there.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

Composing for Medicare Annual Enrollment Period

Long View: It’s Annual Enrollment Time

The Medicare Annual Enrollment Period starts on October 15. It’s the time of year when you can make changes to your Medicare Advantage plan. Plans can change premiums, copays, and formularies every year, so it’s important to review your coverage and see if it still suits your needs.

Medicare.gov is a great resource, as is your local senior center. You can also call Health Alliance at 1-888-382-9771 or TTY 711 (8 a.m. to 8 p.m. daily from October 1 to February 14 and weekdays the rest of the year) or go to HealthAllianceMedicare.org for insight. Because I know this subject can be a little dry, I turned it into a poem from our vantage point. I hope you enjoy!

The chaos starts in mid-October.
Medicare says, “Think it over.”
The plan choice that you made last year,
It may be time to change and steer.

You stay at home most all the year.
Your children want you safe and near.
You dislike the awful weather.
HMOs might suit you better.

Maybe you’d like a PPO.
The freedom helps the snowbirds go,
To warmer climes away from ice.
So bon voyage! (It must be nice!)

Supplements can come in handy.
If you’re mobile, they are dandy.
Great if you like to get away,
If you are active day by day.

We brace for those who wait ‘til later.
Here’s our next procrastinator,
Frantic, stricken, and full of fear.
(Showing up late year after year.)

My co-workers have lost their voices.
December 7 ends your choices.
(And why’d they pick Pearl Harbor day?
It’s odd, I know, I just can’t say.)

We’re done, all is signed and dated.
You now feel somewhat elated.
No need to worry and have no fear,
We will be back again next year.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

 

Health Alliance Medicare is an HMO and PPO plan with a Medicare contract. Enrollment in Health Alliance Medicare depends on contract renewal.

med-AEPpoem-0815 | Y0034_16_35982 | Accepted