Open Enrollment 2022

Medicare news for October 2022
October 15th begins the 2022 Medicare Part D Open Enrollment standalone prescription drug program for persons enrolled in original Medicare in which 60% of Medicare beneficiaries are enrolled. Open Enrollment ends December 7th. (See next paragraph for Medicare Advantage enrollees). To fill gaps in Part A (inpatient hospital/rehab nursing homes) and gaps in Part B, (doctors, outpatient testing, ER, therapy, durable medical equipment), such as Part B’s, 20% co-insurance, those in original Medicare can add a ‘Supplement’ or ‘Medigap’ Plan such as a G or N plan, from a Medicare-licensed and regulated insurer.  See SHIP for cost/coverage of Supplement plans. During open enrollment you can change/enroll in any standalone Part D prescription drug plan from licensed Part D insurers.  Persons with low income/assets can receive a free Part D drug plan in the ‘Extra Help’ program and, depending on income, get even lower priced drugs.  Persons with even lower income/assets may qualify for a waiver program of the Part B premium (now $170.10/mo) most Medicare enrollees pay, called Medicare Savings Program (MSP).  For details on income/assets levels qualifying for ‘Extra Help’ (Part D), and MSP for waiver of the Part B premium, contact SHIP or Catholic Charities at the Senior Center.   Open Enrollment appointments, in person or on phone, with SHIP counselors at the Senior Center can be made for Tuesday and Friday mornings starting October 18th, to help you decide if you want to keep your existing prescription drug plan or switch to another.  Please bring your list of medications and your Medicare card.

Medicare Advantage (MA) (managed care HMOs/PPOs) enrollees also have an Open Enrollment running from Oct 15 to Dec 7. Their Part D (drug) coverage is included, free in their health plan (unlike those persons in original Medicare).  If you are in an MA plan or are considering enrollment in Medicare Advantage, also known as Part C, which 40% of Medicare beneficiaries have, you can join or switch plans, or revert to original Medicare, becoming effective January 1, 2023.  MA plans, heavily advertised on TV, differ from original Medicare, first in that the medical billing is sent to the private MA plan, not to Medicare.  MA plans are comprehensive managed care plans combining Part A and Part B services, and free Part D (drug) coverage, all combined into one private, Medicare-licensed and approved health and drug plan.  Some MA plans partially cover dental, vision services, and hearing aids.  Some offer health club membership.   Most MA plans are HMO or PPO type plans. They require enrollee to use only the plan’s network doctors, with some exceptions, (i.e., you can’t just pick any doctor who accepts Medicare).  In the metro Chicago area, most MA plans have no added monthly premium, even for the included prescription drug coverage (some PPOs do charge small premiums).  However, except for low-income enrollees, Medicare Advantage enrollees must pay the same monthly Part B premium ($170.10 per month) those in original Medicare pay.  In MA there are fixed copays such as $0 to $10 for a primary care doctor, $30 to $40 for a specialist, $100 for emergency room (ER) care.  You normally must go to a network primary care doctor for a referral for a specialist (who accepts your MA plan).  In MA plans your doctor or provider bills the plan, not Medicare, as would be the case with original Medicare enrollees.  You should bring your drug list and Medicare Card.

Open Enrollment appointments, in person or on phone, with the Volunteer Senior Health Insurance Assistance Program counselors at the Arlington Heights Senior Center can be made for Tuesday and Friday mornings starting October 18 to help you decide if you want to keep your existing prescription drug plan or switch to another.  Please bring your list of medications and your Medicare card. Tuesdays & Fridays beginning October 18 through December 6: Appointment timeslots:  9:00 am, 10:00 am, or 11:00 am. Contact the Arlington Heights Senior Center for your free appointment today! 847.253.5532