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Medicare Information Office2018 – Alaska Assister Summit
Jeanné Larson
Health Program Associate
Desk: (907) 269-3649
Email: [email protected]
Navigating Medicare - 2018
Our State and Federal Roles
Navigating Medicare - 2018
» The State of Alaska, Dept. of Health & Social Services, Senior & Disability Services receives three Federal grants which fund our efforts.
» Nationally we are known as the State Health Insurance Program (SHIP), Senior Medicare Patrol (SMP), and MIPPA programs.
» In Alaska, we are identified as the Medicare Information Office.
SHIP
SMP
MIPPA
Medicare Information
Office
» Medicare Information Office – manage the call center, refer customers to Medicare counselors, manage grants, write reports, provide statewide training and leadership˃ State Staff + Volunteers + UAA Internships
» Grantees˃ Anchorage Senior Activity Center (ASAC)˃ Fairbanks ACCESS Alaska
» In-kind agency volunteers – *THIS IS YOU* Senior Centers, Tribal Health Organizations, Community Health Centers, Care Coordinators, etc.
Navigating Medicare - 2018
»Health insurance for people˃65 and older
˃Under 65 with certain disabilities
˃Any age with End-Stage Renal Disease (ESRD)
Navigating Medicare - 2018
» SSDI pays monthly cash benefits if you ˃ meet the Social Security definition of disability
˃ If you’re “insured” - meaning you worked long enough and recently enough, and paid SSA taxes
» 5-month waiting period˃ From the time of disability until benefits paid
» Medicare starts on the 25th month of receiving SSDI payments
Navigating Medicare - 2018
» Federal “needs-based program”˃ No work history needed to qualify
˃ May also get Medicaid
» Generally, to be eligible for SSI, you must:˃ Be age 65 or older, blind, or disabled; and
˃ Have limited income and resources
» May have both SSI and SSDI
» If a person only gets SSI they usually don’t get Medicare until they “age in“ at 65
Navigating Medicare - 2018
» Medicare benefits are administered by˃ Centers for Medicare & Medicaid Services (CMS)
» Medicare enrollment is done by
˃ Social Security Administration (SSA)
Navigating Medicare - 2018
» Automatic for those receiving˃ Social Security benefits
˃ Railroad Retirement Board benefits
» Initial Enrollment Period Package ˃ Mailed 3 months before
+ Age 65
+ 25th month of SSDI benefits
˃ Includes your Medicare card
Navigating Medicare - 2018
Be aware! Fraudulent calls are happening regarding the new cards.
» New Medicare Cards˃ Nationally April 1, 2018 – April 30, 2019
˃ Coming in “waves” based on states
» No longer have the SSN, gender, or signature
» You can get a new Medicare number if yours is compromised
» Cards should arrive automatically
Navigating Medicare - 2018
» Is your customer’s mailing address correct with the Social Security Administration?
» Encourage customers to read their mail
» Customers can sign up for online accounts to manage personal information at:˃ My Social Security Account – www.ssa.gov/myaccount/
˃ My Medicare Account – www.mymedicare.gov/
Navigating Medicare - 2018
Part A Hospital
Insurance
Part B Medical
Insurance
Part C Medicare
Advantage Plans
Part D Medicare
Prescription Drug
Coverage
Navigating Medicare - 2018
» Enrollment is automatic˃ If you get Social Security benefits
» If enrollment is not automatic˃ You need to enroll with Social Security
+ Call 1-800-772-1213 (Monday-Friday, 7am-7pm), or
+ Online at www.socialsecurity.gov
Navigating Medicare - 2018
» Initial Enrollment Period – IEP˃ 7-months based on your Medicare eligibility date
» General Enrollment Period – GEP˃ Every Year, January 1 – March 31
˃ Part B Coverage Starts July 1
˃ Late enrollment penalty
» Special Enrollment Period – SEP˃ 8-month period based on employment/insurance ending
Navigating Medicare - 2018
» Part A – Hospital Insurance helps cover˃ Inpatient Hospital Care
˃ Skilled Nursing Facility care
˃ Home health care
˃ Hospice care
» What does Part A cost?˃ Most people get Part A premium free
+ If you or your spouse paid FICA taxes at least 10 years
˃ If you paid FICA less than 10 years
+ You can pay a premium to get Part A
+ Some will qualify under a spouse’s record
+ People with Medicaid and Medicare Savings Program get help with this cost
Navigating Medicare - 2018
» Part B – Medical Insurance helps cover˃ Doctor’s visits
˃ Outpatient medical services
˃ Clinical lab tests
˃ Durable Medical Equipment
˃ Preventive services
» What does Part B cost?˃ (It depends) The standard Part B premium amount in 2018
˃ People with Medicaid and Medicare Savings Program get help with this cost
Navigating Medicare - 2018
» Assists those with limited income & assets with Medicare Part A and/or Part B costs
» Medicare/Medicaid (dual) recipients automatically get this assistance
» Income and Assets Limits change each year
Navigating Medicare - 2018
» Available for all people with Medicare
» Provided through private insurance companies
» In 2018 there are 19 plans in AK
» Most people pay:˃ A monthly premium
˃ Deductibles and copayments
“Duals” with both Medicare/Medicaid need Part D but get help with the costs through “Extra Help”
Navigating Medicare - 2018
» During the 7-month Initial Enrollment Period
» During the yearly Open Enrollment Period˃ October 15 – December 7 each year
˃ Coverage begins January 1
» May be able to join at other times˃ Special Enrollment Period
Navigating Medicare - 2018
» Help paying Part D prescription drug costs
» Social Security or Public Assistance Office makes determination
» Some people automatically qualify if they get˃ Both Medicare and Medicaid (“Duals”)
˃ Supplemental Security Income (SSI)
˃ Help from Medicare Savings Program (Alaska “Buy-in”)
Navigating Medicare - 2018
» Encourage customers to:˃ Evaluate drug coverage during IEP (Initial Enrollment Period)
and every year (Oct 15-Dec 7)
˃ Read mail from SSA, CMS, Part D plan
+ Ask questions if you don’t understand
˃ Make sure Part D plan works
+ Covers meds
+ works with pharmacy
+ best cost
Navigating Medicare - 2018
» Medicare Part A is considered minimum essential coverage (MEC) *most people qualify for Part A premium-free*
» You may lose eligibility for any premium tax credits and/or reduced cost sharing for your Marketplace plan
» If you delay enrolling in Medicare after your Initial Enrollment Period (IEP) ends, a late enrollment penalty may apply
Navigating Medicare - 2018
» Social Security Administration˃ www.ssa.gov˃ 1-800-772-1213 (Monday – Friday, 7am-7pm in ALL time zones)
» Medicare & You Handbook – mailed or emailed to everyone on Medicare in September each year
» 1-800-MEDICARE (1-800-633-4227) 24 hours/7days˃ www.medicare.gov
» Medicare Information Office – AK SHIP/SMP˃ 1-800-478-6065 or (907) 269-3680˃ www.medicare.alaska.gov
Navigating Medicare - 2018
» The “Pathway to Certification”
» A systematic way to learn Medicare and become a certified counselor
» Helps you be a better resource for your customers
» Training is provided through:˃ Web-based learning platform shiptacenter.org
˃ Webinars
˃ In-person, telephonic, and/or webinar coaching
˃ Quizzes for accountability
Navigating Medicare - 2018
Jeanné Larson, Health Program Associate
Direct: (907) 269-3649
Medicare Information Office – AK SHIP/SMP
State of Alaska, DHSS/SDSHelpline: 1-800-478-6065 or (907) 269-3680
www.medicare.alaska.gov
Navigating Medicare - 2018