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Diagnosing best Medicare options

Staff writer

Medicare enrollment for seniors, people with end-stage renal disease, and those with disabilities is open through Dec. 7.

The Centers for Medicare and Medicaid Services expect prices for Medicare Advantage plans, which provide Medicare Part A and Part B, to decrease nearly 8% and the number of plan choices to increase.

Medicare Part D plans that cover prescriptions are expected to decrease as well, and benefits are expected to increase. Part D plans now have a $35 cap on out-of-pocket cost of a month’s supply of insulin and include recommended vaccines at no additional cost.

Kansas’ 561,254 people enrolled in Medicare have 90 Medicare Advantage plans available for 2023. Of those, 20 offer additional options including incentive programs for healthy behaviors and customized benefits for people who qualify for low-income subsidies.

People considering a Medicare Advantage plan should be cautious, St. Luke Hospital spokesman Michael Perigo said.

Advantage plans typically are good for people who generally are healthy and don’t often need to see a physician or visit a hospital, he said.

“The real issue is whether the Advantage plan includes local physicians,” Perigo said. “The likelihood is, it does not. The same applies to local hospitals. We have so many patients who come in our door and have a Medicare Advantage plan. They can’t get treated here.”

Perigo said people considering a specific plan should call their local hospital and see whether it is included in the plan network.

The county department on aging works with people considering enrolling in Medicare Advantage plans.

“With Medicare Advantage they can come in and I can look up what plans are available for our county and what they cover and then they can enroll in it,” director Gayla Ratzlaff said. “The thing I tell them is they need to call their local hospital or local provider and see if they are covered.”

People also can compare Advantage plan policies by calling 800- 633-4227 or Senior Health Insurance Counseling for Kansas at (800) 860-5260.

Prescription coverage

This year, Kansans have choices among 23 Part D prescription plans. Prices of all plans are expected to decrease.

Local pharmacies offer assistance in choosing the most effective Part D program.

The department on aging also is taking appointments to review Part D options. Appointments may be made by calling (620) 382-3580.

“We ask people to bring us their information and I look it up and then get back to them,” Ratzlaff said.

Pharmacies also provide help comparing Part D policies.

Lanning, Hillsboro Hometown, and CK pharmacies are making lists of people who want a comparison and will run comparisons and report back to patients in November.

Cost assistance

Low income seniors might qualify for Medicare financial assistance through KanCare. More information is available at https://www.kancare.ks.gov/contact-us.

Last modified Oct. 20, 2022

 

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