November 2006 Vol. 25. No. 11

Published by the Humboldt Senior Resource Center in Eureka, California. HSRC is a non-profit community-based organization offering services for senior citizens, multi-generational families and caregivers.

Alzheimer's Month: Walking the long road together
What are the new private fee-for-service Medicare plans all about?
Senior employment: Experience Works replaces AARP
Light a candle for Alzheimer's
Memory screenings set Nov. 14
Honoring veterans: Take a sentimental journey with us Nov. 11

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In addition to any choices you have through Dec. 30 about changing or joining a Medicare prescription drug plan, you will also have opportunities through March 31 to completely change the way you receive your Medicare benefit.

During 2006, if you have Medicare you have had the option of new private Medicare Advantage plans. In 2007, in addition to the Blue Cross PPO plans called Freedom Blue, a number of companies will be offering 18 new private fee-for-service Medicare plans.

These plans will be sold by salespeople, and just like buying a car, you will want to look carefully at all information before you agree to change your coverage.

These plans are private Medicare plans offered by private companies, usually sold by private insurance agents. You must have both Medicare part A and part B in order to get a plan. Some plans include drug coverage, some do not. Some include an extra monthly premium cost in addition to your regular part B premium.

Medicare fee-for-service plans are not Medicare supplement plans. They have co-pays just like original Medicare. You cannot use a Medicare supplement or Medi-Cal to supplement the Medicare fee-for-service plans that will be available locally. If you get a fee-for-service plan you will have to drop any supplement coverage you have, and you may not be able to get the supplement coverage back if you change your mind about your coverage at a later date.

Medicare fee-for-service plans may be less costly than original Medicare if you are in excellent health and more costly than original Medicare if you are in poor health. Many fee-for-service plans have an annual out-of-pocket cap on Medicare approved expenses.

Unlike original Medicare and the PPO plans, fee-for-service plans do not have a directory of providers. You are responsible for verifying that your doctor or other provider is willing to bill the fee-for-service plan. If your doctor is not willing to bill the plan you will be responsible for the charges. Any charges that are not billed to the fee-for-service plan do not count towards your out-of-pocket cap.

In considering fee-for-service plans you will want to know
• Will my doctor agree to bill the plan?
• Do I get other medical services; how does the plan cover these services; and will the providers bill the plan?
• If I go into the hospital, will I be able to afford the co-pay with the plan?
• How does the plan compare to insurance I currently have; and if I find I do not like the plan, will I be able to get my former insurance back?

The enrollment for Medicare Advantage fee-for-service plans begins Nov. 15. You can enroll though March 31, 2007.

Changing Medicare coverage is a big decision. It is a good idea to carefully consider your options. You may want to talk with friends and family or call HICAP for help. Call 444-3000 in Humboldt 464-7876 in Del Norte.

HICAP will give a free presentation on Medicare Drug Plans and Medicare Advantage plans Thursday, Nov. 9, at 1:30 p.m. at the Humboldt Senior Resource Center.