NEWS

2016 Medicare Update

Brandie Richardson
Senior Health Insurance Information Program Executive (SHIIP) Management Officer, Ron Williams, spoke at the presentation, educating attendees on Medicare advantage plans, Medicare Part A, B, C and D, programs to help people lower their drug costs, and Medicare in relations to the Affordable Care Act.

GONZALES – St. Elizabeth Hospital hosted a 2016 Medicare Update presentation on Oct. 9, providing members of the community a opportunity to learn vital information about Medicare. Attendees were also able to speak with a Medicare professional abut any questions or concerns they may have had. Senior Health Insurance Information Program Executive (SHIIP) Management Officer, Ron Williams, spoke at the presentation, educating attendees on Medicare advantage plans, Medicare Part A, B, C and D, programs to help people lower their drug costs, and Medicare in relations to the Affordable Care Act.

     What is Medicare? According to the Louisiana Department of Insurance's website, Medicare is designed to help cover a certain percentage of medical expenses. “Medicare beneficiaries also pay a portion of their medical expenses, which includes deductible, co payments, and services not covered by Medicare,” according to the LDI site.

     The federal health insurance program is not just for people over 65. There are three ways you can receive these plans.

     “If you are 65 and older, under 65 and disabled, or if you have Lou Gehrig's disease,” said says SHIIP Management Officer, Ron Williams.

There are four key parts to Medicare:

  • Part A- This covers impatient care in hospitals, as well as a skilled nursing facility following a hospital stay and some heath and hospice care.
  • Part B- Medical insurance that helps pay for doctors and, medical services, and supplies that are not covered by hospital insurance. Some examples of what this covers is clinical research, ambulance services, outpatient care, and some medical equipment, to name a few.
  • Part C- Also known was Medicare Advantage Plans. These are typically ran by private companies, such as Humana, Peoples Health, and UnitedHealthcare, to name a few. Part C features a number of different plans that includes Part A and B, but also additional benefits like vision, hearing, dental, and prescription, depending on what type of plan that is chosen.
  • Part D- This plan covers prescription drug coverage that helps pay for medications prescribed by doctors.

When do you sign up for Medicare? When you are nearing 65, you have a seven month Initial Enrollment Period to sign up for Part A and/or B. This period starts three months before your 65th birthday and ends three months after you turn 65. If for some reason you miss the seven month enrollment window, you will be penalized 10 percent for Part A, as well as an additional 10 percent for Part B.

For Part A enrollment, you are penalized for missing enrollment “when your supposed to twice a year when your late,” noted Williams. “So if your four years late, your penalized eight years, at 10 percent. Now Part B, if you didn’t sign up when your supposed to, your penalized 10 percent for the rest of your life or for as long as you have Part B.”

There are special circumstances where Special Enrollment periods are available. According to Medicare.gov, if you are covered under a group health plan from a current employment, you can sign up for Part A and/or B during the Special Enrollment Period as long as you or your spouse are working and covered by a group health plan through your employer. Additionally, there is a eight month period where you can sign up for Part A and/or B the month after employment ends or group health plan insurance ends.

More information about Medicare can be found at www.ldi.la.gov/SHIIP or (800) 259-5300.