Medicare Information Office Alaska Assister Summit Assister Summit...Navigating Medicare - 2018. Our...

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


» 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.


»Health insurance for people˃65 and older

˃Under 65 with certain disabilities

˃Any age with End-Stage Renal Disease (ESRD)


» 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


» 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


» Medicare benefits are administered by˃ Centers for Medicare & Medicaid Services (CMS)

» Medicare enrollment is done by

˃ Social Security Administration (SSA)


» 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


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


» 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/


Part A Hospital

Insurance

Part B Medical

Insurance

Part C Medicare

Advantage Plans

Part D Medicare

Prescription Drug

Coverage


» 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


» 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


» 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


» 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


» 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


» 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”


» 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


» 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”)


» 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


» 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


» 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


» 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


Jeanné Larson, Health Program Associate

Direct: (907) 269-3649

[email protected]

Medicare Information Office – AK SHIP/SMP

State of Alaska, DHSS/SDSHelpline: 1-800-478-6065 or (907) 269-3680

[email protected]

www.medicare.alaska.gov


Medicare Information Office Alaska Assister Summit Assister Summit...Navigating Medicare - 2018. Our...

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