What You Should Know about Medicare Open Season and the Medicare Prevention Benefits

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Recorded: August 10, 2011

Narration: Welcome to Fairfax County’s Medicare Central, the podcast that brings you the latest information on Medicare benefits. I’m your host Jim Person.

On today’s show, we will be discussing this year’s Medicare annual election period and Medicare’s new prevention benefits with Howard Houghton, manager of Fairfax County’s Virginia Insurance Counseling and Assistance Program.

Opening Music.

Segment 1: Medicare Election Period 

Jim: It’s that time of year again, when Medicare beneficiaries have the opportunity to make changes to their health and drug plans. The dates for the Medicare election period for 2011, or what most people call Open Season, have changed to October 15 through December 7. 

This is a big change that will affect over 113,000 Fairfax County residents receiving Medicare.

Jim: Howard, in previous years open season has been from November 1 to December 31. Why did the federal government change the Medicare election period dates? 

Howard: The dates were changed for two reasons: (1) to avoid people needing to make such important decisions during the end of year holiday seasons, and (2) so that the plans had additional time to process the applications so that a person’s plan ID cards can be received by January 1.

Jim: For those who are new to Medicare, briefly explain what the health and drug plan options are.

Howard: When a person becomes eligible for Medicare coverage, they need to make decisions regarding whether they should enroll in traditional Medicare or in a Medicare Advantage health.

Another decision is into which Medicare Part D drug plan they should enroll. The Part D benefit was designed to lower a person’s out of pocket drug costs.

Jim: What is your advice to people who are satisfied with their existing Medicare health and drug plans? Should they be reviewing other options?

Howard: I absolutely believe that a person needs to review their Medicare drug or health plan on an annual basis, though they may be satisfied with their current plan. Plans are supposed to notify members each year regarding any changes to coverage or costs, but it is always better to perform that research on your own whenever possible to be certain about any changes.

Jim: What steps should people take to review and choose their Medicare health and drug plan options?

Howard: They should first take a peek at their annual Medicare & You Handbook for some cursory data, but the best place to search is on www.medicare.gov.  A person can press on the button that reads Compare Health and Drug Plans to get started and then follow the prompts. If they need additional support, they can call Medicare 24/7 at 1-800-633-4227. They can also go to our Web page at www.fairfaxcounty.gov/dfs/olderadultservices, and then scroll to the Health Insurance Counseling link. They can find many good tools to assist them with finding an appropriate drug or health plan. Families need to take care of families. My program can provide limited assistance but it is much better to use the tools found on our program Web page so persons can tailor their findings as needed.

Jim: I want to remind our listeners that the dates for Medicare open election period for 2011 or what some people call open season have changed.  You have from October 15 to December 7 to make any changes to your health and drug plans. 

To make changes in your Medicare health and drug plans, visit www.medicare.gov.

In our next segment…Learn why you can take advantage of Medicare’s new prevention benefits.

Segment 2: Prevention Benefits

Jim: You know the old saying; "an ounce of prevention is cheaper than a pound of cure!" According to Medicare, "80% of all health care spending in the United States can be attributed to potentially preventable chronic illnesses such as cancer and diabetes."

Preventive services such as cardiovascular and diabetes screenings, flu shots and cancer screenings can help improve the quality of a person’s life as well as reduce the medical related cost to beneficiaries and to taxpayers. 

Jim: Howard, tell us about Medicare’s new preventive services?

Howard: Medicare has been covering many preventive services for years, but the Affordable Care Act makes many improvements to these Medicare services. The biggest change is that beginning in 2011 a person will no longer pay a deductible or the 20% coinsurance to obtain most of the preventive services offered under Medicare. There are about 18 preventive services and now all but three can now be obtained at no cost, as long as you follow the rules regarding the frequency limits on obtaining such tests.

Jim: A lot of people who are on Medicare remember the polo epidemic and how a simple vaccine saved thousands of lives. How would a person’s quality of life improve if they took advantage of preventive care services?

Howard: The simple answer is they would be a lot healthier and stay a lot healthier throughout their later years.

Medicare offers the pneumonia vaccine and flu shots. The flu and pneumonia can be fatal to older adults. Medicare estimates that 40,000 Americans die each year due to pneumococcal infections, with the highest rate among older adults. Yet, only 58% of Americans over 65 have received the vaccination.

Also, Medicare believes that early detection of chronic diseases such as diabetes and high blood pressure allows for more effective treatment. More effective treatment means you have a better chance of managing these disease and staying independent throughout your life.

Jim: How can people take advantage of preventive services?

Howard: They should consult their physician to determine which tests they may have already received and which might still be needed. If an abnormality is found then a person can obtain tests as a diagnostic tool rather than as a screening tool.

Jim: Is there anything else you would like to add about preventive services?

Howard: I will simply echo what was said earlier in the broadcast: an ounce of prevention is cheaper than a pound of cure!

Narration: Thank you Howard.

Health screenings are important because they can uncover evidence of diseases such as diabetes and high blood pressure in their early stages when they can be treated more effectively. Find out more about Medicare’s free screenings at www.medicare.gov.

Exercise is an effective way to reduce the chance of developing chronic illness and to manage existing chronic illness. Check out the Parks and Recreation Department’s fitness classes for older adults at www.fairfaxcounty.gov/parktakes. The county’s senior centers also offer exercise programs. Got to www.fairfaxcounty.gov/ncs and select Senior Services.

And finally, for information on services for older adults, including assistance with Medicare issues, go to www.fairfaxcounty.gov/dfs/olderadultservices.

I want to thank our guest, Howard Houghton, for talking to us about these important changes for Medicare and I want to thank our listeners for tuning into our show today.  This is Jim Person with Fairfax County’s Medicare Central.

Closing Music.

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