A Recap – Medicare Open Enrollment and Survey Results

Last Thursday, November 17^th, Seniors Speak Out held a Facebook Live event with Debbie Witchey, Healthcare Leadership Council’s EVP, and me, Seniors Speak Out Spokesperson. The live event covered two subjects, information concerning Medicare open enrollment and the preliminary results of our post-election healthcare check-in survey. The live event can be found by clicking here.

Debbie introduced the program by explaining that Seniors Speak Out is part of Medicare Today a coalition run by the Healthcare Leadership Council. She explained that Seniors Speak Out is a conduit for educating seniors on issues that affect their healthcare and ways that they can advocate for changes that they feel are important and against changes that they feel would be detrimental. She then turned the time over to me.

I opened by reminding everyone that it’s open enrollment season, which started on October 15^th and ends on December 7^th, and is a time that we can review our insurance plans. These plans include traditional Medicare and Medicare Advantage (MA) which is a program where we contract with a private insurance company to administer our Medicare benefits. There is also Medicare supplemental or gap insurance which is offered by private health insurance companies separate from Medicare. I pointed out that reviewing Medicare Part D, the Medicare prescription drug program, is especially important given that it might be the Medicare program that is costing you the most. I also pointed out that, in choosing an insurance plan, your personal health requirements and financial position are the things that will point you to the best plan for you. I have found that when I moved, I found it advantageous to move from traditional (or fee for service) Medicare with supplemental insurance plan to Medicare Advantage. Changes in my situation made a Medicare Advantage plan a better fit for me. I went on to point out that a great resource that can help you make the best decision is the State Health Insurance Assistance Program (SHIP) – each state has this program. Go to the CMS website to find the contact information for your state.

Debbie pointed out that she saved a couple of hundred dollars a month by switching her insurance in the health insurance exchange, so it is very important to go through this review. Debbie’s first question was, who is eligible for Medicare?

I pointed out that everyone 65 or older, younger people with disabilities, and people with End Stage Renal Disease are eligible for Medicare. Debbie then asked what was the difference between Medicare Supplemental (or Medigap) and Medicare Advantage?

I explained that Medicare Supplemental insurance helps pay for out-of-pocket costs that were incurred under traditional Medicare whereas Medicare Advantage is a program where your Medicare benefits are administered by a private insurance company. I pointed out that the private insurance company is motivated to keep you healthy and thus often offers expanded benefits, like free exercise club memberships, some dental, eye and hearing benefits and other preventative care benefits. There are plus and minuses with each program and, again, find out which fits you best.

Debbie then asked what things are important in picking a Part D plan? I answered by detailing some important questions to ask yourself. First, does the Part D plan cover the prescription drugs you take and second, what is the cost? Those are the two most important questions. You also need to assess your own health and what indications you might have of coming health problems. Debbie interjected that your own preference for visiting a pharmacist rather than using a mail order system might be part of your decision.

Debbie then asked about possible penalties for not signing up for Medicare or trying to change plans outside of the enrollment period.  I stated that there are some situations that allow you to enroll after 65 or change plans. For example, if you had private insurance that was stopped, you have the chance to enroll in Medicare without penalty. I encouraged people who would like to make a change to not hesitate to ask if there is an option to change without penalty. Insulin users especially might find some exceptions for them.

Debbie then asked about any changes that have been made to Medicare. I detailed the increase in our cost-of-living adjustment for Social Security and the smaller Part B premium and the slightly lower average premium for Part D changes that will increase our Social Security payments. Also, there was a $35 cap put on the monthly cost for insulin, a great benefit for those who have seen their insulin costs go up and up lately. I cautioned that they haven’t had time to update the Part D plan finder for all the plans so be alert to that as you are comparing plans and disregard any insulin charge that is greater than $35 a month. Evaluate that plan using the $35 per month charge. The plan, by law, can only charge a maximum of $35. Because of this problem they have given insulin users the chance to change plans one other time during the year. I also pointed out that Congress must deal with a scheduled cut to Medicare’s payments to doctors of 4.5%. They deal with this every year, and this year especially, it could really hurt doctors who are faced with this high inflation rate which is affecting their overall costs. I encouraged all of us to talk with our members of Congress to encourage them to eliminate this harmful payment cut. Some good news is the fact that all our vaccines will be covered with no cost to us. Debbie pointed out that hospitals are also under the threat of payment cuts and we should work to make sure they don’t suffer these cuts.

We then pivoted to the post-election survey that we just completed, and I discussed the preliminary results. I first pointed out that there will be almost 100 new members of the House going to Washington in January. It is important that they know where we stand on our healthcare. In the survey seniors overwhelmingly shared with us that their biggest concerns are their out-of-pocket costs for care. When asked what actions to improve healthcare they would like to see, respondents voted for less government involvement in their healthcare decision-making and lower out-of-pocket copays and

deductibles for prescription drugs. High costs for prescription drugs were clearly weighing on seniors’ minds when they voted that their biggest concerns heading into a new congress is that their out-of-pocket costs will increase. Respondents also cited concerns with more government price controls on prescription drugs.

The bright side of this all is that when asked what’s working best for their healthcare currently, seniors cited the choices of health plans through Medicare Advantage and Medicare Part D as well as the quality of care from their area doctors and hospitals. I reiterated that the new Inflation Reduction Act did have an upside where in two years there will be a $2,000 cap on our out-of-pocket cost for prescriptions. In our survey respondents also indicated that they didn’t want to stifle innovation, and wanted to continue to have hope that new discoveries will help all of us live longer.

Debbie closed our event by reminding everyone that there is still a lot that will be happening in Congress this year, and we should still be vigilant in staying current on the issues that will affect our healthcare. You can find more information at our web site, seniorspeakout.org.

We, at Seniors Speak Out, will continue to keep you informed on the important issues that affect you and will be conduit for magnifying your voice to those who represent you in Congress.

Best, Thair