Are you getting the best Medicare coverage you can? If you’re like most seniors, you’re spending a considerable amount of attention to the changes made to Medicare and its HMOs this time of year. Many people are satisfied with their current plan and they probably won’t change, but if you’re not completely satisfied, pay attention.
There is a lot to learn about Medicare enrollment and unfortunately, not a lot of time to learn it in. To help, Family Physicians Group is periodically blogging important key information you need to know before the enrollment deadline.
Enrollment Period Dates
The annual fall enrollment period is from October 15th through December 7th; however, there are special enrollment periods that you should know of. If you lose coverage through no fault of your own – say your plan loses its coverage or you lose your employer-provided coverage – you will be allowed to enroll in a new plan.
Another enrollment opportunity is all about your 65th birthday. From 3 months before the month of your birth until 3 months after (7 total months), Medicare allows you to enroll for the first time.
Prescription Drug Coverage Gap (Donut Hole)
If you require medication, your Medicare drug plan will pay some percentage of the cost of your prescription based on the terms of your plan. But there is a limit to how much Medicare will pay. This limit varies from year to year and in 2015 the limit was raised to $2,960. When you enter the coverage gap, you will be responsible for a greater percentage of your drug costs, but you will receive a 65% discount on generics and a 45% discount on brand name medications.
You will stay in the gap until you cross another predetermined spending threshold of $4,700 in 2015. At this point you will be eligible for catastrophic coverage and most of your prescription expenses will be covered.
Medicare Star Rating
The Centers for Medicare & Medicaid Services implemented a star rating system in an effort to assist consumers by scoring the quality of all Medicare HMO plans. Plans may earn up to 5 stars based on the following categories:
- By providing an adequate number of screenings, vaccines, check-ups and other preventive medicine techniques to help patients stay healthy
- By providing an adequate number of tests and treatments to help members maintain manage their chronic condition should they have one
- By receiving positive scores in member satisfaction
- By avoiding multiple complaints b appropriately handling and reducing the number of complaints received byy members and Medicare
- By improving performance over time
- By positively and effectively responding to member appeals
We recommend that you consider each plan’s star rating when choosing a plan.
Attend a Free Health Insurance Benefits Seminar
Want to find out more? We want to make sure you have the best plan for your needs and stay with your own FPG doctor. Join us for this Health Insurance Benefits Seminar for guidance at one of our Seniors Clubs near you!
For more information call 1.866.999.3741 or schedule your appointment with FPG, today. We encourage your feedback please comment below, or you can chat with us on Facebook and Twitter.