Sign-ups for Obamacare have gotten a lot of attention recently, but another health insurance enrollment for people age 65 and older is also underway.
And this year, there's a one-time chance for some people who bypassed it before to buy supplemental health insurance.
The option is available to more than 5,700 people in Douglas and Sarpy Counties because their Medicare Advantage plan won't be offered next year. They must find another plan to help pay any physician, hospital and/or pharmaceutical bills they may incur.
“We've been getting a lot of calls on it,” said Sue Fredricks, executive director of Volunteers Assisting Seniors, a nonprofit group that helps older people understand benefits and programs.
The rest of the Medicare beneficiaries are, as usual, being asked to choose a Part D, or prescription drug, plan.
The volunteer group encourages everyone enrolling in any kind of plan to comparison shop, because the best plan for this year might not be the best one for next year.
This year, for example, Omahan Vicki Morgan paid $179 less for her Medicare Part D prescription drug plan than she paid last year. And the plan she chose cost her $2,142 less than the one her provider was going to put her in.
Many people might assume they should stick with the plan that had saved them money. But Morgan, 68, had Volunteers Assisting Seniors review her options for 2014. The group found that if she had stayed with the same plan, her monthly premium would have risen from $27.10 to $39.90. Instead, they found her a plan that provided the same deal on her medications for $23 per month.
“You'd better be checking on it, because it may not be to your advantage to stay with it,” Morgan said.
To help senior citizens find the best Part D plan available, Fredricks said, her group has public sessions scheduled through early December.
The volunteers also need to help some people find a health plan, she said, because of the decision by United Healthcare to discontinue one of its popular Medicare Advantage, or Part C, plans.
Medicare Advantage plans are offered by private insurance companies and approved by Medicare. Medicare Advantage plans offer some benefits that aren't covered under original Medicare. They also establish a network of health-care providers that plan members can use. If people go outside the network, the services may not be covered or they may cost more.
Fredricks said many Omaha-area residents liked the features offered by the expiring plan, United Healthcare's AARP Medicare Complete Plus Plan 1 (HMO-POS).
“When people are relatively healthy and they don't go to the doctor a lot, these Advantage plans work well, because they're not paying (an additional) monthly premium,” she said. “Maybe they're going to the doctor once or twice a year. Maybe they have a $45 copay. For them, it's kind of a sweet deal.”
When people start to get sick and go to the doctor more often, she said, costs can add up quickly under an Advantage plan, although the plans cap members' annual out-of-pocket expenses.
A statement from United Healthcare notes that changes to its plan offerings were caused by many factors, “including the increasing cost of health care services and changes in Medicare rules and U.S. government funding for Medicare Advantage.” The changes resulted from rate reductions and an insurance premium tax under the Affordable Care Act (Obamacare) and sequestration cuts, according to the statement.
Nebraskans still can access other Advantage plans through United Healthcare.
“While making these changes,” the United statement said, “our priorities were to minimize disruption to our members and their access to health care, make our plans as affordable as possible, and ensure we can continue to offer our plans in the years ahead.”
People can go to the website medicare.gov to review their plan options and sign up. Many who were in Advantage plans this year can switch to another Advantage plan, Fredricks said, although people who live in 29 Nebraska counties won't have access to such a plan next year.
Fredricks said Medicare beneficiaries losing their coverage get a special two-month enrollment period after their coverage ends Jan. 1 to consider buying supplemental health insurance, or Medigap coverage, without being denied because of pre-existing conditions. Usually, she said, people can buy supplemental coverage under such conditions only when they first sign up for Medicare, at age 65.
“From the point of view of an entity trying to educate people on their options,” Fredricks said, “it scares me they're missing an opportunity with the supplement coverage that they're not going to get again.”
Supplemental coverage, while it covers expenses that Medicare Parts A and B don't cover, does come with a monthly premium, Fredricks noted, and people will have to sign up for prescription drug coverage separately.
“For the most comprehensive supplement plan, they would pay anywhere from $98.50 per month to $357 a month,” Fredricks said. “Why somebody would go with the higher premium, I don't know, but people do.”
Tom Gilsdorf with Blue Cross Blue Shield of Nebraska said people should consider the stability of a supplemental insurance provider, its history of plan changes and rate increases and its customer service record. What a company did in the past is no guarantee of what it will do, he said, but it's good information to know. Independent insurance agents can help people sort out their options, he said.
“We would encourage people, before making a decision, to shop through an agent that offers multiple plans,” Gilsdorf said.
People who want assistance from Fredricks' group can call 402-444-6617. Nebraskans outside the Omaha area can call 800-234-7119 for assistance. Iowans can call 800-351-4664. People also can call 800-MEDICARE for help.
Need help signing up for Medicare?
Volunteers Assisting Seniors is offering help in the Omaha area during Medicare open enrollment, which runs through Dec. 7. Counseling is by appointment only at all locations:
╗ Today, 1 p.m. to 5 p.m., North Bend Library, Heritage Room, 402-727-2775
╗ Tuesday, 10 a.m. to 3 p.m., Metro Community College Fremont Area Center, Room 210, Fremont, 402-444-6617
╗ Friday, 9 a.m. to 3 p.m., MCC Sarpy Center, Room 222, 9110 Giles Road, La Vista, 402-444-6617
╗ Saturday, 9 a.m. to 1áp.m., Volunteers Assisting Seniors office, 1941 S. 42nd St., Room 502, Omaha, 402-444-6617
╗ Nov. 5, 9 a.m. to 3 p.m., VAS office, 402-444-6617
╗ Nov. 7-8, 9 a.m. to 3 p.m., Dodge County Extension Office, 1206 W. 23rd St., Fremont, 402-727-2775
╗ Nov. 8, 9 a.m. to 3 p.m., Goodwill Headquarters, 4805 N. 72nd St., Omaha, 402-444-6617
╗ Nov. 12, 9 a.m. to 3 p.m., VAS office, 402-444-6617
╗ Nov. 14, 9 a.m. to 3 p.m., VAS office, 402-444-6617
╗ Nov. 15, 9 a.m. to 3 p.m., MCC Elkhorn Valley Campus, N. 204th Street and West Dodge Road, Room 131, 402-444-6617
╗ Nov. 20, 10 a.m. to 3 p.m., Sump Memorial Library, 222 N. Jefferson St., Papillion, 402-444-6617
╗ Nov. 22, 9 a.m. to 3áp.m., Goodwill Headquarters, Omaha, 402-444-6617
╗ Nov. 26, 9 a.m. to 3 p.m., VAS office, 402-444-6617
╗ Dec. 2, 9 a.m. to 3 p.m., VAS office, 402-444-6617
╗ Dec. 4, 9 a.m. to 3 p.m., Immanuel AgeWell, 6801 N. 67th Plaza, Suite 100, Omaha, 402-444-6617
╗ Dec. 6, 9 a.m. to 3 p.m., Goodwill Headquarters, Omaha, 402-444-6617
╗ Seminars for people losing their Medicare Advantage plan also will be held at Goodwill Headquarters, 4805 N. 72 St., at 10 a.m. and 1 p.m. on both Nov. 8 and 22. To make a reservation, call 402-444-6617.