Tag Archives: percent

The Holiday Season

Long View: Did You Thrive or Survive this Holiday Season?

Here at Health Alliance, we’ve made it through another holiday season. Most years I’m stressed from Thanksgiving through New Year’s Day. Add in Medicare and Individual enrollment seasons, and it’s easy to wish the holidays away. Here are some ways I managed to thrive, not just survive, during the holidays.

I need to say no sometimes.

I didn’t attend every activity I was invited to, and I am a better person for it. Most years, I cause a lot of my own stress by trying to fit too many things on the calendar. Setting aside some time to relax and reflect became an important part of this round of celebrations. Try it. You might enjoy the things you agreed to do a little more.

I need to get over myself.

I don’t have to be involved in every decision. All the adults in my life are capable of selecting a turkey or picking up family from the airport. My involvement is not only unnecessary, but sometimes unwelcome. That realization took stress off me and my family!

I will not whine.

The grocery stores seemed to be crowded every time I needed to shop. Long lines, people rushing around, tempting candy displays—you know the scene. Every time I was close to whining, I remembered almost 20 percent of the population in Champaign County doesn’t know where their next meal is coming from. We can all stand in line without complaining. This gave me a much better attitude throughout the holidays.

I will not mention how cold it is outside.

I need to hunker down and stop focusing on the weather. We live in Illinois, not Hawaii. The weather is no surprise. I’m trying to focus on the warmth of the holidays, not the cold outside.

These little steps helped me have a more enjoyable holiday season. We’re also using them to get through our Health Alliance busy season with great results. Give them a try and you can thrive during the holidays, too.

Medicare Advantage Mythbusting

Long View: Medicare Advantage Truths Might Just Change Your Mind

As I travel around the Illinois countryside, I hear the same misinformation about Medicare Advantage over and over. To tackle some of that, here’s a Q and A.

Question: When I join a Medicare Advantage plan do I lose my Medicare coverage?

Answer: No. If you have a Medicare Advantage HMO or PPO plan, a private health insurance company that has a contract with Medicare, like Health Alliance Medicare, provides the services instead of Original Medicare. People who disenroll from Medicare Advantage plans revert to Original Medicare. In either case, no one loses Medicare coverage.

 

Question: Will I be able to stay with my current doctors?

Answer: Probably, especially with Health Alliance Medicare. That’s why it’s important to check any plan’s provider directory to confirm your doctors work with the plan. People who select a Preferred Provider Organization (PPO) plan can use out-of-network providers, but they typically pay more when they receive services.

 

Question: We travel and might need to use the emergency room. Will Medicare Advantage plans only cover me for emergency care when I’m close to home?

Answer: No. Medicare Advantage plans cover out-of-area emergency and urgently needed care.

 

Question: If something serious happens and we need lots of services, could we predict how much we would pay for care?

Answer: Yes. Medicare Advantage plans have an annual Out-of-Pocket Maximum (OOPM), also called a Yearly Limit. When a Medicare Advantage member reaches that limit, the health plan pays 100 percent for Medicare-approved services. This amount doesn’t include the premium and other limited expenses. You can estimate what your expenses would have been last year on the Medicare Advantage plan you are considering.

 

Question: Medicare Advantage sounds good for me, but wouldn’t the premium be too costly for my 88-year-old mom?

Answer: Not at all. One of the best things about Medicare Advantage plans is the premium is the same no matter the member’s age. You and your mom would pay the same monthly premium if you had the same plan, unless either of you could get extra help paying for coverage based on your income.

 

Question: Would I have to deal with all the paperwork I get when I receive services from Original Medicare plus a Medicare Supplement plan?

Answer: No. You would have much less paperwork with a Medicare Advantage plan. In fact, that’s one reason Medicare Advantage plans exist, and I’m all for less paperwork.

 

Remember, the Medicare Annual Enrollment Period, or AEP, runs from October 15 to December 7. That’s the only time most people can change their coverage for the following year.

If you are thinking about a change for yourself or a loved one, you will have to do a bit of research. Trusted resources like Area Agencies on Aging and your local senior center can help.

Please consider Health Alliance Medicare a resource, too.

We all want to make well-informed choices that don’t depend on myths and misinformation.

AEP Autumn

Vantage Point: It’s That Time of Year

Days are warm and evenings crisp. Orchards bustle during the pear and apple harvest. It is my favorite time of year, but for seniors it can be stressful because of Medicare’s Annual Enrollment Period (AEP), which runs from October 15 through December 7. This is the time of year when most Medicare beneficiaries can choose or change their Medicare coverage.

Better-than-ever health care coupled with healthier lifestyles means people are living longer. With that, living on a fixed income means many seniors worry about having affordable health care for years to come.

One of the most common questions we hear in our Wenatchee office is, “What is the difference between a Medicare Supplement and Medicare Advantage plan (also known as Part C)?” Learning about each product can help people understand what best fits their lifestyles, pocket books, and health care needs.

Whether choosing a Supplement or Advantage plan, you must continue to pay your part B premium.

Medicare Supplements work much like a secondary insurance. They pick up their share of the covered health care cost after Medicare pays, depending on what plan you purchase. For example, it may pick up 10 percent of the 20 percent coinsurance (meaning you would still pay 10 percent). Supplements will not cover any cost Medicare denies, and some Supplements require medical underwriting to gauge the health of the individual. Premiums, or the cost you pay for the coverage each month, are generally more expensive. Like with Original Medicare, you can see any doctor who accepts Medicare.

Medicare Advantage plans replace Original Medicare, which means hospital and doctor visits are paid directly by the plan. Many Advantage plans also include prescription coverage making for one tidy package. To be clear, you still keep all your Medicare benefits. There is no medical underwriting, and premiums are generally lower. Advantage plans also cover extras that Medicare does not, like dental and fitness programs. They also work closely with provider offices to help coordinate care. This helps many members stay healthier. Advantage plans have contracts with provider offices so a member normally must chose a doctor within the plan’s network.

Health Alliance takes Medicare seriously, and our Wenatchee office and helpful customer service representatives are a resource you can count on to help make a great decision for you during AEP and beyond.

Visit us at 316 S. Fifth St. in Wenatchee from 8 a.m. to 5 p.m., weekdays. Or call 1-877-561-1463, TTY 711, from 8 a.m. to 8 p.m. daily. That looks like a toll-free number, but our local representatives are on the other end waiting to help.

Fighting Hunger Through Food

Long View: Solving Hunger One Bite at a Time

It seems I might be a little fixated on food. A number of friends and family members seem to think I live mealtime to mealtime, which may explain my recent weight gain. As many of us enjoy Central Illinois’ bounty, it’s important to remember many of our neighbors are not so lucky.

In Illinois, we are fortunate to have access to food banks across the state. Julie Melton is the director of Marketing and Development at the Eastern Illinois Foodbank (EIF). They distribute millions of pounds of food to over 100,000 individuals across their network of more than 220 sites. She told me, “Based on our Hunger in America Study, a full third of the seniors in the Eastern Illinois Foodbank’s service area experience food insecurity rates of 15 percent to 41 percent. In some areas, more than 42 percent of seniors are food insecure, which is among the highest rates of senior hunger in Illinois.”

You can help fight food insecurity, which means someone doesn’t have reliable access to nutritious, affordable food.

“Every $1 donation can buy $10 worth of food or provide 6 meals for neighbors in our community,” Melton said.

Jim Hires, executive director at the EIF, said, “Older American food insecurity is a growing problem. Addressing senior hunger has become an increasingly major concern and focus across the nation, and especially in our 14-county region. The Eastern Illinois Foodbank and our agency partners are committing more of our resources to this issue in the coming months and long term.”

Donating and volunteering at your local food pantry or soup kitchen are better ways to give. Your nearest food bank will be thankful for any support you offer. Search for one nearby at FeedingIllinois.org.

Solving hunger won’t happen overnight. But we can all help one small bite at a time. There are people in all of our communities who don’t have enough to eat. After seeing these statistics, I am more thankful for my food. I bet you will be, too.