For the growing number of Millennial and Sandwich generation caregivers, this topic can't wait. Why? Well, if you had a chance to listen to my previous podcast with attorney Virginia Samson, as we discuss Caregiver Compliance, you know your loved one will need a designated person to speak on their behalf to help them establish or maintain their Medicare coverage. In that respect, you will need to know more about Medicare sooner than you probably planned on.
We are now in Open Enrollment between October 15th through December 7th. At this time, more than 63 million people with Medicare in the U.S. can review their health care coverage to find new plans or change existing plans. Now is the time to discover extra benefits and save money. Medicare Advantage enrolled 26.9 million during 2021 and is expecting to enroll up to 29.5 million during this 2022 open enrollment. According to The Centers for Medicare & Medicaid Services (CMS), you can expect a reduction in the average premium to be down by 10% or $2.22 for the average premium with a slight increase to the Part D coverage of 4.8% or $1.53 per month.
2020 and part of 2021 was a scary period for everyone around the globe, but those dependent on healthcare services and prescription drugs like insulin, know this fear. Seniors living on a fixed income were challenged even more. So in response to such a challenging year, the percentage of plans offering special supplemental benefits for chronically ill individuals will increase from 19% to 25%. More plans will be added to the Medicare Advantage dual-eligible special needs plans, covering both Medicare and Medicaid services for those dually eligible. 2021 had 256 plans to choose from, which has increased to 295 plans for 2022.
I asked Monique and Joe Barajas, co-owners of Barajas Insurance Group, to come back on the show with me to share Medicare changes for enrollees of the 2022 plan year. Both are licensed agents who live and breathe the ins and outs of Medicare plus train new agents to do the same.
If you will be new to a plan this year, then this information should be helpful for you to know. Millennial Caregivers with loved ones now eligible for Medicare also need to know this information.
>What is Medicare?
This government program began back in 1966 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services. It is a comprehensive program of health insurance designed to assist the nation's elderly in meeting hospital (emergencies and surgeries), medical (doctors and treatments), and other health costs (services and medicines). Medicare is available to most individuals 65 years of age and older, along with younger people with disabilities.
>What is the difference between Medicare and Medicaid?
Part A is considered "hospital insurance." Part A also covers skilled nursing facilities and home health care. Most Americans who worked in the U.S. already paid for it through their payroll taxes over 40 quarters or ten years, so you do not have to pay for Part A premium. If you never worked, you may still qualify for premium-free Medicare Part A, if married, through your spouse's work history or based on certain medical conditions.
Part B, also referred to as the "medical insurance," is paid for through monthly premiums. Part B covers the medically necessary services to treat illnesses, including doctor office visits, lab work, x-rays, and outpatient surgeries. It also covers preventative services such as cancer screenings or flu shots.
>What is a Medicare Advantage Plan?
Medicare Advantage is also referred to as Medicare Part C. It is an alternative to Medicare and not a replacement of Medicare. The Medicare Advantage plan is the "all-in-one" plan that bundles Medicare Part A, Part B, and commonly Part D (prescription drugs). The cost and plan will vary because Medicare advantage plans are offered by private companies that have been Medicare-approved. These plans also offer dental, hearing, and vision benefits that Original Medicare does not cover.
Having Medicare does not mean everything is covered, though. Supplemental coverage helps with the cost of dental care, eye exams, hearing aids, acupuncture, and select cosmetic surgeries. Medicare does not cover long-term care expenses, which many find out when they need it most. Some of the confusion comes in because many pass on purchasing Long-term Insurance with a false understanding they don't need it if they have Medicare or can qualify for Medicaid, but that is not true.
Suppose you care for a loved one with a disability or meet the age requirements and struggle financially. In that case, it is beneficial to spend time with an agent like Monique and Joe Barajas to find out what you may qualify for or update the current coverage you have if need be. When Mom needed additional help through Home Health services for occupational therapy, it was such a relief to know her appointments would be covered through her chosen coverage rather than having one more out-of-pocket expense.
>Will Medicare or Medicare Advantage cover Respite Care needs?
Although Long-term care is not covered through Medicare, it covers Respite care through a hospice benefit for your loved one under Part A. Respite care allows the caregiver to rest while their loved one temporarily stays in a hospital or other facility under the hospice benefit. Medicare's hospice benefit offers end-of-life palliative treatment, including support for your physical, emotional, and other needs. Hospice is to help your loved one live comfortably, not cure them, while providing you with a break. Your loved one must be enrolled in Medicare Part A.
The details are vast, and approaching them in crisis mode can be overwhelming. It is better to know what it is, what it is not, and how it can help you proactively plan for your loved one. You don't have to wait until they are 64 before you begin to figure out the system. As an adult child taking care of an aging parent, you might have to get into the details long before they are of age to help them decide on the type of insurance and coverages needed year after year.
New changes to expect for 2022 include Innovation Center's Medicare Advantage Value-Based Insurance Design (VBID). These benefits are designed to customize benefits to manage disease(s) better and meet a range of social needs such as food insecurity or social isolation. Medicare Advantage plans in portions of 22 states and U.S. territories provide enrollees with increased access to palliative and integrated hospice care. Over 500 new Medicare Advantage and Part D prescription drug plans and two new pharmaceutical manufacturers of insulin are joining the model this year. The goal is to provide even more opportunities for eligible seniors to reduce their out-of-pocket spending on insulin.
>Beware of Medicare and Social Security Scans.
It is extremely upsetting to know there are so many people in the world ready and able to take advantage of you or your loved one to gain confidential information. It is more upsetting knowing seniors are targeted for their much-needed social security benefits. It is yet another reason to be proactive to become more aware of options before finding yourself in crisis mode.
As you begin to make phone calls and solicit your own inquiries on behalf of your loved one, then keep in mind the Social Security Administration does not cold call to solicit information or sell services. CMS offers social services paid for by federal and state funding, so there is no marketing for profit. Never give out your information over the phone to random callers or click on links in emails or text messages. Be aware of questions asked phishing for answers to potential security questions. Stay vigilant! With many areas of advancement in technology, a culprit is waiting to use it against our vulnerable loved ones and us.
If you are not sure what to look for or how to compare your existing plan to others, than visit Medicare.gov for an easy-to-use Medicare Plan Finder for your personalized options. You may also contact your State Health Insurance Programs at https://www.shiphelp.org/ for one-on-one assistance.
These are federal and state-run programs so that you can find the most current information under websites such as www.Medicare.gov or www.SSA.gov. All other websites with .com are designed for sales even if the word Medicare is included.
Be sure to listen in to the Caregiver Updates for Medicare 2022 podcast episode to hear additional information.
Thank you for joining in and listening with us today. I hope this gave you more food for thought and until next time, BE PROACTIVE. Take care everybody.
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