Medicare’s open enrollment period began in October. The Daily Journal tackled some important questions with Ann Kinsella, Medica vice president and general manager of Medicare, who provided valuable insight for Otter Tail County residents. 

Q: What is Medicare?

A: For most people eligible for Medicare, it is a public-private partnership and among the most popular government programs. A survey last year, from Kaiser Family Foundation, found that 80% of all U.S. adults – not just those already enrolled in Medicare – had a favorable opinion of the program.

One of the reasons people like Medicare – is that it can be tailored to their needs. But it also makes it even more important that enrollees take time to understand their options and make choices that are right for them.  

Original Medicare is the federal government plan that includes Part A (hospital insurance) and Part B (medical insurance). Drug coverage is available through Medicare Part D. Medicare Part C, known more generally as Medicare Advantage, bundles Part A, Part B and, in most cases, Part D. In addition, there are stand-alone Part D drug plans.  Medicare Advantage plans are available through private insurers like Medica. They typically offer lower out-of-pocket costs than original Medicare. And they cover extra benefits that original Medicare doesn’t cover – like vision, hearing and dental. 

Medicare supplement plans, sometimes known as Medigap policies, are offered. Medigap policy only supplements original Medicare benefits. You must have original Medicare. Members pay the private insurance company a monthly premium for the Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.  If a member purchases a Medigap policy and wants prescription drug coverage, they must purchase a  stand-alone prescription Part D plan either from their Medigap company or another company offering stand-alone prescription drug plans.

Q: What is the enrollment period?

A: The Medicare annual enrollment period began on Oct. 15 and ends Dec. 7.  

Q: What is available in Otter Tail County?

A: Medica offers a new Medicare advantage plan and Medicare supplement plans in Otter Tail County. In addition to Medica, five insurers also offer Medicare advantage plans. 

Q: How/where can people enroll/get assistance?

A: There are several ways for people to enroll or get assistance. To enroll or find plan information they can visit our website at https://www.medica.com/microsites/medicare/home. The page also includes information about a number of other ways to get information including speaking to our consultants via phone number, email contact and online workshops. There also are tools to search for an independent insurance agent.

Q: Did Medica leave Otter Tail County?

A: No, Medica has always had Medicare plans available in Otter Tail County.  In 2019, Medica and other plans offering what are known as Medicare cost plans, stopped selling cost plans in Otter Tail and certain other Minnesota counties. This change was required by a federal law eliminating cost plans in certain areas.   Medica continued to offer Medicare supplement products in Otter Tail in 2019..  In addition,starting in 2021, Medica will be offering Medicare Advantage plans as well.  The Medica Medicare Advantage plans offered in the county for the 2021 coverage are full Medicare plan offerings including Parts A, B and D (medical and drug).  In fact, Medica has reduced the premium on the Medicare Advantage plans by 20% to $99/month.

Q: What benefits does Medica offer?

A: Some of the key features of the plan include a $0 copay for preventive services, copays of $15 to $25 for office, virtual and other visits, $200 per year benefit for over-the-counter medications, a $0 copay for 90-day prescriptions filled by mail for Part D drugs on Tiers 1 and 2, and an extended travel benefit for coverage while traveling.

Q: What are some red flags that residents should be mindful of? 

A: There are three very costly mistakes that many people make:

First, they don’t enroll on time.  For those turning 65, there is a seven-month window – your birthday month and three months before and three months after. You can sign up later, but you will pay a higher premium for Part B – the portion of Medicare that covers doctor visits and other nonhospital services.

Second, they assume that Medicare is Medicare and the benefits are the same. Medicare can be tailored to each person’s needs through different programs. Make sure you have the right benefits for your situation. That includes the right coverage for the prescription drugs you use; the right network of doctors and hospitals; and the added benefits that are important to you, including services like vision and dental.  In addition, seniors need to make sure they purchase prescription drug coverage (or have other qualifying coverage – through a retiree health plan, for example).  If you do not purchase prescription drug coverage (or maintain eligible coverage) at your first eligibility and decide to purchase it later, you will be assessed a late enrollment penalty for each month you are uncovered.  Medicare supplement policies do not include prescription drug coverage.

And, third, they don’t take time to study what Medicare does not cover. For example, your copays and deductibles are not included. Long-term care is not covered by Medicare. Knowing what you might have to pay for in addition to your premium is critical to making the right choice.

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