Health officials are stressing one point to Medicare recipients this fall: There’s no need to make changes to their current health coverage because of the Affordable Care Act.
The fall enrollment period begins Tuesday, allowing seniors to enroll in Medicare for the first time, obtain prescription drug coverage or review their health plans. Enrollment decisions need to be completed by Dec. 7 for benefits that take effect Jan. 1.
Medicare is the national health program for people age 65 and older and for certain disabled adults.
In Stanislaus County, Humana received federal approval to enter the local marketplace for Medicare Advantage plans. Seven Advantage plans are available in the county, offering coverage for hospital services, doctor visits, lab tests and X-rays, prescription drugs and other services.
Besides Humana, the insurers are AARP-Secure Horizons, Care 1st, Care More, Citizen’s Choice, HealthNet and Kaiser Permanente Senior Advantage.
The federal government subsidizes Medicare Advantage plans, which provide benefits in addition to basic Medicare coverage.
County residents have been able to choose plans with no monthly premium or coverage costing as much as $135 a month. The zero-premium plans may be an option for people with tight budgets. Plans with higher monthly costs have more benefits and may cover additional rehabilitative care after surgery.
Medicare recipients can compare the plan benefits and costs, and learn about other changes for 2014, at workshops scheduled this month by the Health Insurance Counseling and Advocacy Program. The workshops are set for:
• Wednesday from 9 a.m. to 11 a.m. at Hammon Senior Center in Patterson, 1033 W. Las Palmas Ave.
• Thursday from 9 a.m. to 11 a.m. at Modesto Senior Center, 211 Bodem St.
• Oct. 24 from 9 a.m. to 11 a.m. at Turlock Senior Center, 1191 Cahill Ave.
• Oct. 29 from 1 p.m. to 3 p.m. at Gladys Lemmons Center in Oakdale, 450 E. A St.
The Medicare Advantage plans available in the county may be reviewed at www.medicare.gov.
The Affordable Care Act will gradually close the doughnut hole, or coverage gap, for Medicare prescription drug plans. In 2014, coverage stops when a person’s retail costs for drugs total $2,850 for the year. At that point, he or she is responsible for paying 47.5 percent of costs for brand-name drugs, and 72 percent for generics, until the costs hit $4,550.
The federal law will close the coverage gap by 2020. For now, the drug coverage in Medicare Advantage plans or stand-alone drug plans may offer discounts in the coverage gap.
Officials are warning seniors about an identity-theft scam timed with the first-ever enrollment for Affordable Care Act coverage. Callers are telling seniors the government needs to send them a new Medicare card because of the federal health law and are asking for their Social Security numbers.
Sandy Ranzo-Howell, a counselor for HICAP in Modesto, said Medicare is not issuing new cards and does not call to verify Social Security numbers. Anyone receiving these calls should hang up, she said.
Bee staff writer Ken Carlson can be reached at email@example.com or (209) 578-2321.