Planning for Medicare in 2018

Oct. 02--This year, the government will spend $609 billion to cover 58 million Medicare beneficiaries.

Those numbers lump everybody together into one monolithic group, but that's not the case when Oct. 15 arrives. That date opens a 54-day window where each individual covered by the program gets to make changes to how they receive the Medicare benefit they paid for through regular payroll deductions during their working years.

And there are plenty of choices. In San Diego County alone, 24 different prescription drug plans are available with another 23 Medicare Advantage plans offered by third-party providers.

Many who are already enrolled in a plan they like simply let Medicare's open enrollment window close without taking any action. David Weil, director of San Diego's Health Insurance Counseling & Advocacy Program, said that is a mistake. Everyone should at least take a look at the options available to them every year, he said, especially if they are taking prescription drugs.

"For most people, this is the one time during the year when they can make changes. But you don't want to make those changes without doing your homework first," Weil said.

There are also a few changes that are coming your way whether or not you decide to take a look around during Medicare's open enrollment window.

Today, most Medicare beneficiaries are paying a $109 monthly Part B premium, while those who enrolled in 2017 pay $134 per month. Medicare was able to charge more to new enrollees but was unable to spread overall cost increases to the already enrolled due to "hold harmless" provisions in the federal laws that underpin the government's largest health care benefit. However, those same laws allow a broad-based premium adjustment anytime the government grants a cost-of-living increase to Social Security benefits, and Weil said it looks like it will happen in 2018.

"It's likely that, across the board, people who are paying $109 per month now will see an increase, and those who are paying $134 will see a little bit of a drop. We won't know for sure until November," Weil said.

That's when Medicare is expected to announce basic Part B premiums for 2018.

There is also a bit of intrigue around another significant change in how everyone will use Medicare next year. In April, the U.S. Centers for Medicare & Medicaid Services will mail new Medicare cards to every one of the nearly 60 million Americans receiving benefits. These new cards will feature 11 randomly selected numbers and letters called a Medicare "Beneficiary Identifier" that will replace your existing health insurance claim number.

Why are they doing this? Well, your old number is based on your Social Security number and because it appears on all Medicare-related paperwork, it was often used to defraud seniors. The new number, because it's randomly selected, carries no such risk of inadvertently providing your Social Security number to thieves.

However, in an ironic twist, those same thieves are using this change for one last burst of malfeasance. In San Diego and across the nation, reports are surfacing of Medicare beneficiaries receiving calls from scammers who demand their personal information and, in some cases outright payment, to get their new card.

"In some cases we have reports of people calling up and telling them they can get their number embossed on a nice metal plate if they provide information over the phone," Weil said.

There are other variations of these scams which have callers impersonating Social Security or insurance company employees. In all cases, experts advise hanging up and not providing any information even if the caller already has certain information about you such as your date of birth or Social Security number.

Medicare does not call and request this type of identifying information from its beneficiaries. Once the new ID number is in place, beneficiaries will have a 21-month grace period during which they can use either their old number or the new one.

The one site you must know

Visit www.medicare.gov/find-a-plan to enter your information and see what's available in your specific ZIP code. There is even a place for you to enter up to 25 different prescription drugs and have the website show you only those plans which include everything you're taking.

If you're not an Internet person, that's OK too. Anyone living in San Diego County can call the Health Insurance Counseling & Advocacy Program at (858) 565-8772 for help. Imperial County residents have their own line at (760) 353-0223.

Health insurance brokers are also available to help, and because they are paid through commissions on the plans they sell, they offer assistance at no cost to you. You can find an agent at www.nahu.org.

Medicare's makeup

Here is a refresher on Medicare's four essential parts. It pays to remind yourself what these mean before starting your research:

* Part A: Hospital insurance. Everyone gets it if they or their spouse has worked in the United States for at least a decade. There is no premium.

* Part B: Health insurance. This covers doctor visits, medical equipment and a vast range of other outpatient services. The government charges a monthly fee, and they deduct it from your Social Security check if you receive one.

* Part C: This is not a separate benefit but rather a special section which allows private companies to administer a person's Medicare benefit through Medicare Advantage plans. In San Diego County there are usually dozens of options, many offered by familiar names such as Sharp, Scripps, Kaiser and SecureHorizons.

* Part D: This part of Medicare pays for prescription drugs and has its own monthly premium on top of what you pay for Part B.

There is another key to understanding Medicare: There are two different flavors, Original and Advantage. Our "Turning 65" article describes the differences between the two.

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Twitter: @paulsisson

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