Medicare in Minnesota 2012 Your Medicare: Making the Best Possible Decisions October 2011 Presented by Stephanie Minor Senior LinkAge Line® Program Consultant.

Medicare in Minnesota 2012Your Medicare: Making the Best Possible Decisions

October 2011

Presented by Stephanie MinorSenior LinkAge Line® Program Consultant

Minnesota Board on Aging

Overview

• Open Enrollment Period Changes• 2012 Medicare Changes• Assistance with Medicare Out-of-Pocket Costs• Reminder of 2011 Medicare Changes• Resources

– Health Care Choices– Senior LinkAge Line® – Online Resources

Open Enrollment Period Change

• Open Enrollment Period – October 15, 2011- December 7, 2011 (54 days)

– Will need to make plan changes during this time period• Medicare Part D and Medicare Advantage• No changes from December 8 – December 31, 2011

– Plan effective date will be January 1, 2012• Not seeing huge increase in premiums

Medicare in Minnesota 2012• Medicare Advantage Options

– 4 Local HMO Plans– 9 Preferred Provider Organization Plans– 1 Private Fee-for-Services Plan– 3 Special Need Plans for Chronic Conditions– 8 Special Need Plans for Duals 65+– 3 Special Need Plans for Duals under age 65

• Other Medicare Plans– 21 Cost Plans

• Stand Alone Prescription Drug Plans– 33 Options

Reduced Medicare Prescription Drug Benefit (Part D) Donut Hole Beneficiary Costs

• 2011– 50% discount on brand

name drugs purchased while the beneficiary is in the donut hole

– 7% discount on co-insurance for generic drugs purchased while the beneficiary is in the donut hole. Beneficiary pays 93%

• 2012– 50% discount on brand

name drugs purchased while the beneficiary is in the donut hole

– 14% discount on co-insurance for generic drugs purchased while the beneficiary is in the donut hole. Beneficiary pays 86%

5%95% Catastrophic Benefit

100% with discounts

75%25%

$320 Deductible

Monthly Premium

$2,930.01 - $6,657.50

$320.01 - $2,930

$.01 - $320

Over $6,657.50 (copays of $2.60/$6.50 or 5%)

Drug Costs

Beneficiary CostsPart D Plan

2012Part D Standard Benefit

No Extra Help (LIS)

Donut Hole50% discount on Brand Name drugs

14% discount on co-insurance for generic drugs

Medicare Prescription Drug Benefit Changes

• Beginning 1/1/12– Full duals receiving home and community based services

• Those on Elderly Waiver, as well as CAC, CADI, BI or DD Waivers

• Part D cost sharing will be the same as it is for beneficiaries in a SNF or ICF/MR

– $0 cost sharing for full duals

» Waiver clients

Reminder: Medicare Advantage Disenrollment Period

• January 1, 2012 – February 14, 2012• During this Medicare Advantage Disenrollment period,

– Beneficiaries can dis-enroll from a Medicare Advantage plan and switch to Original Medicare

– Beneficiaries can enroll in a Stand Alone PDP plan for Part D coverage

– Beneficiaries enrolled in a Medicare Advantage plan cannot switch to another Medicare Advantage plan

– Beneficiaries in Original Medicare cannot enroll in a Medicare Advantage plan

Medicare Advantage Updates

• 5-Star Rating System: – Beginning January 2012, plans may receive higher

payment if demonstrate providing high-quality care to enrollees (must receive 5 stars)

– Plans receiving 5-star rating may enroll beneficiaries year round

• Minnesota has no 5-star plans in 2012

Extra Help with Prescription Drugs• Extra Help (Low-income Subsidy)

– Administered by the Social Security Administration– Helps lower the cost of the Medicare Part D premium, deductible and out-of-pocket drug

costs– Paper application or apply online at www.ssa.gov – Income and Asset Guidelines for 2011:

• Income: – Single: $1,225.13 - $1,361.25/mo. – Couple: $1,654.88 - $1,838.75/mo.

• Assets: – Single: $12,640– Couple: $25,260

Medicare Savings Programs (MSP)• Helps individuals under 135% of Federal Poverty Guidelines pay for medical and

prescription drug expenses

• Apply through county of residence

• Three types of MSPs– QMB: Covers Medicare Part A premium (if any), Part B premium, Parts A and B out-of-

pocket costs

– SLMB and QI: Covers Medicare Part B premium

– All MSPs reduce Medicare Part D prescription drug costs: • No deductible• No premium (if on a benchmark)• Lower copays

Medicare Reminders from 2011

• Annual Wellness Visit – Receive personalized prevention plan services (PPPS)

• Establish a screening schedule for the next 5 to 10 years

• Provide personal health advice and coordinate appropriate referrals and health education

• Preventive services– Eliminates cost-sharing for most Medicare-covered preventive

services

– This includes the flu shot – don’t forget to get yours!

Health Care Choices 2012• Available online at www.mnaging.org and www.MinnesotaHelp.info

– Mid-October (scheduled)

• Print copies provided to the Senior LinkAge Line® for local community distribution

• Call 1-800-333-2433 to request a copy by leaving your name, address and phone number

• Includes all Minnesota plan options

• Also includes information on:– Long-term Care– Medicare Supplements– Help paying for Medicare costs

The SHIP in MN (MNSHIP) = Senior LinkAge Line®• State Health Insurance Assistance Program• 300+ certified volunteers in Minnesota• Medicare and long-term care option experts located in your community• Unbiased, Comprehensive, Neutral source• State based program that provides

– One to one counseling and assistance to people with Medicare and their families

– Free service provided through phone, in person, online chat, community events and media activities

– Grants provided by CMS– MN Board on Aging is the grantee

• Senior LinkAge Line® 1-800-333-2433• Available in all 87 counties of Minnesota through the Area Agencies on Aging

Senior LinkAge Line®: Your Link to An Expert

• Senior LinkAge Line® 1-800-333-2433 – Statewide– Objective– Comprehensive– Individualized assistance by phone, by online chat, in

your community and in your home– There is no fee for assistance provided– Does not sell, endorse or promote any insurance, long-

term care or health care product

MinnesotaHelp Network™ is here to help you

• Senior LinkAge Line® 1-800-333-2433• Disability Linkage Line® 1-866-333-2466• Veterans Linkage Line™ 1-888-LinkVet• www.MinnesotaHelp.info® (including Live Chat)• http://longtermcarechoices.minnesotahelp.info/• Local community based sites throughout Minnesota• 2012 edition of Health Care Choices available October 2011

Questions?

Thank you!

Stephanie Minor

[email protected]

651-431-2602