Consumer beware: Deceptive Medicare advertising

Medicare Open Enrollment begins Oct. 15, 2021, through Dec. 7, 2021. For those who are currently insured under an original Medicare, and not a Medicare Advantage Plan, this means it is time for you to shop for a Medicare Part D plan (prescription drug plan) if you don't have a plan now. It also means that it is time to shop for a new/different Medicare Part D plan if you currently have this prescription drug coverage. Just because you are satisfied with the coverage you had in 2021 doesn't mean that you will be satisfied in 2022. You see, each drug plan reserves the right to change its drug coverage and the price of the monthly premium. Medicare open enrollment also applies to people who have a Medicare Advantage Plan as of Oct. 15, 2021, to Dec. 7, 2021, and there is another Medicare Advantage open enrollment period from Jan. 1, 2022, to March 31, 2022. Advertisements are being mailed to those age 65 and older, trying to get people to sign up for a Medicare Advantage Plan, which may or may not be in the consumer's best interest. The same is occurring with TV advertisements, making it appear as though older adults are missing out on getting additional cash in their Social Security checks because they have the wrong Medicare coverage. Older adults need to know that this is not true. If you are looking to "cash in," beware: This is advertising is very deceiving. The devil is in the details. Here is what is true: • There are government programs that pay for the cost of the Medicare Part B premium, which is currently $148.50/month. This is the premium, which is deducted from retirees' social security checks each month. • A Medicare consumer does not have to be on a Medicare Advantage Plan to gain the $148.50/month into your social security check. Instead, you have to have income low enough to qualify. To qualify for getting "additional cash" back into your social security check all depends on your gross monthly income and the size of your nest egg, or savings/investments. For 2021, the government will pay for a senior citizen's Part B premium without switching to a Medicare Advantage Plan by applying for a program called a Qualified Medicare Beneficiary. To qualify for a Qualified Medicare Beneficiary, your gross monthly income as a single person can be no more than $1,094, and your nest egg can be no more than $7,970. For a married couple, you qualify for a Qualified Medicare Beneficiary if your combined gross monthly income is not more than $1,472 and your nest egg is not more than $11,960. A Qualified Medicare Beneficiary also pays 20% of your bills which Medicare insurance does not pay. Generally speaking, traditional Medicare pays for 80% of the bill, and the consumer pays for the 20%. So if you are on traditional Medicare and purchasing a Medicare supplement, you should look into getting a Qualified Medicare Beneficiary. It could save you a lot of money. There are two other programs that pay for the Part B premium based on gross monthly income, but it does not pay for the 20% of your medical bills, which Medicare does not cover: One is called Specified Low Income Medicare Beneficiary, and the other is called Qualified Individual. Space prevents me from going into detail, but suffice it to say that if your gross monthly income and the size of your nest egg meet eligibility criteria described here, you can stop having the $148.50 deducted from your Social Security check. • Specified Low Income Medicare Beneficiary: A single individual's gross monthly income can be no more than $1,308/month and have a nest egg no greater than $7,970. A married couple's gross monthly income can be no more than $1,762 a month and the nest egg no greater than $11,960. • Qualified Individual: A single individual's gross monthly income can be no more than $1,469/month and have a nest egg no greater than $7,970. A married couple's gross monthly income can be no more than $1,980/month and the nest egg no greater than $11,960. Serving Our Seniors, 419-624-1856, can assist Erie County residents apply for any of these Medicare saving programs. You don't have to purchase a Medicare Advantage Plan to get this additional income. Serving Our Seniors does not charge a fee for helping you apply for one of these programs. It is part of our work to protect older adults from having their lack of Medicare knowledge exploited by private enterprises, who are Medicare spokespeople and salespeople. We can help with this any time of the year. Open enrollment has nothing to do with applying for any of these Medicare Savings Programs. For those who live outside of Erie County, call the Ohio Department of Insurance, Office of OSHIIP (Ohio Senior Health Insurance Information Program) at 800-686-1578. They, too, can assist you in signing up for a Medicare saving program. There is no fee for this service. Q&A Q: I heard that Medicare Part A is free, but I have to pay $148.50/month for Part B. Do I really need this? How is it different from Part A? A: Part B is what pays for your doctor appointments, outpatient lab tests, outpatient physical therapy, occupational therapy and speech therapy should you ever need it. Part A pays for your care if you are admitted to a hospital. You are much more likely to use health care as an outpatient. If you don't have Part B, you pay for outpatient care from your own wallet. Part B is a bargain. If you decide not to purchase Part B and decide later that you do want to buy it, you will pay a monthly penalty for enrolling late. Although there are some caveats, generally speaking, if you don't take Part B when you are first eligible, your monthly premium may go up 10% for each 12-month period you could have had Part B but didn't sign up. Q: Is Serving Our Seniors helping people enroll for Medicare Part D (prescription drug insurance) again this year? A: Yes. Erie County residents ages 60 or older should call now, 419-624-1856, and request the Medicare Part D In-Take form. Before we can help you find the drug plan that covers your medications best, at the least cost, requires us to know the name, proper spelling is required, of the drug, the dose and the quantity of pills taken each month. Don't procrastinate. Our appointments fill up fast. If you live outside of Erie County, call the Ohio Department of Insurance, Office of OSHIIP (Ohio Senior Health Insurance Information Program) at 800-686-1578. They, too, can assist you in finding a Medicare Part D insurance to meet your needs. There is no fee for this service.