In an ongoing effort to maintain independent and socially active living for residents over the age of 60 in Midland County, Senior Services of Midland County, Michigan, works hand-on-hand with Medicare to offer a wide range of services and programs. These initiatives, designed to support and improve the quality of life of older adults, include everything from meals and fitness classes to educational programs, adult day services and volunteer opportunities.
Barb Zebley-Oldni of Senior Services in Midland recently shared details about one of her crucial programs: health benefit assistance. This program is intended for Medicare beneficiaries and older adults in general, offering unbiased information so that they can make informed decisions about their Medicare options.
How Does Medicare Come Into the Picture Here?
Medicare consists of several parts, each covering different aspects of health care. Part A covers hospitalization, Part B deals with doctor visits and outpatient care, Part C includes Advantage plans, and Part D focuses on prescription drugs. Unlike occupational health insurance, where you usually have a choice of 2 or 3 plans, there are up to 20 prescription drug plans and 40 Medicare Advantage plans in Midland County.
Zebley-Oldni stresses the importance of understanding the stages of enrolling in Medicare. About three months before turning 65, a person will receive information from Social Security about Medicare. It is essential to review this information and take the necessary actions. Generally, those who are not working enroll in Parts A and B, where Part A does not require premiums, but Part B does.
For those who continue to work beyond the age of 65, there is the possibility of delaying enrollment in Parts B and D if they have health insurance coverage through their employer or that of their spouse. However, it is absolutely necessary to confirm with the hiring manager if your coverage is comparable to Medicare.
Once enrolled in Parts A and B, beneficiaries can turn to Senior Services for additional assistance in choosing their Medicare options. It is crucial to review plans annually, especially during the open enrollment period, from October 15 to December 7, to ensure that the current plans continue to offer the best coverage and costs.
Using Your Medicare Advantage Plan
Medicare Advantage plans, for example, can provide additional benefits such as discounts on over-the-counter medications and dental services, Zebley-Oldni stressed. In addition, beneficiaries should be aware of changes in drug formularies and the costs of medical visits, as these may vary annually.
For those with limited income and financial resources, there are a variety of assistance programs. One of them is the prescription drug cost assistance program, which can be applied for through the Social Security Administration. With maximum incomes of $22,830 per year for individuals and $30,900 for couples, this help can significantly reduce the costs of drug premiums and copays, with costs as low as $4.10 for a generic drug.
The Medicare Savings Program, available through the State of Michigan Department of Health and Human Services, can also help cover Medicare Part A and B premiums. With specific income and asset guidelines, this program ensures that beneficiaries do not receive bills for deductibles, coinsurance or copayments.
Finally, Zebley-Oldni mentions Medicaid, a state and federal assistance program that helps cover medical costs, including home and nursing home care. Eligible older adults can benefit from both Medicare and Medicaid, ensuring more comprehensive medical coverage.
It is crucial that beneficiaries remain alert to possible scams. Zebley-Oldni cautions against handing over personal information to strangers posing as Medicare or Social Security representatives.
