HomeMy WebLinkAboutattachment A 9/4/20 .9
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► Serve persons over age 60, adults over 18 with physical and or
developmental disabilities
► Long term care options counseling
► Access to long term care programs
► Community resource information
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9/4/2{ 19
AdultProtective.
► Welfare checks
Powers of attorney
► Guardianship
► Involuntary Placement
► Memory screenings
► Information and assistance to adults with memory or cognitive
concerns
► Provide information and support to family members and friends
who are caregivers
Help develop dementia-friendly communities
► Train the community on how to be dementia-capable
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9/4/2019
.Dis.a. b.ilit Ben efit.Soeci;alists
17
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Serve those age 18-59
►Assist with Medicaid and Foodshare applications
►Assist with SSI/SSDI application and appeal process
►Provide basic housing or transportation assistance information
► Provide Medicare information and counseling
No. Public outreach for available programs
Serve those age 60 and over
Assist with Medicaid, Foodshare, Senior Care applications
Provide basic housing or transportation information
► Provide Medicare information and counseling
► Provide help with Medicare annual enrollment
►Group Welcome to Medicare presentations
► Public outreach for available programs
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9/4/2019
ADReff�
...........
Provide all services at no cost to
the consumer.
► Medicare is an entitlement program for people age 65 or older
and people disabled by Social Security who have received
disability payments for 24 months
► You have your choice of doctors, hospitals or clinics as long as
they accept Medicare
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9/4/2019
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►Covers inpatient hospitalization-deductible of$1364 per
benefit period for 2019
►Skilled nursing facility
►Hospice
i
► Monthly premium of$135.50
► Part B covers 80%of cost after deductible of$185 for 2019
► Outpatient hospital services
► Doctors visits
► Durable medical equipment including oxygen
► Lab work, x-rays, MRIs
► Physical, occupational and speech therapy
► Chemotherapy and injectable drugs
► Emergency room and ambulance
► Diabetic supplies except insulin and syringes
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9/4/2019
► You have,to have Part A and Part B to get a Medigap policy
► Medigap policies are sold by licensed insurance agents
► Optional riders are sold to cover the various costs of Medicare Part
A and Part B
► Medicare pays first and then the Medigap is billed to supplement
your Medicare
► All supplements work where Medicare does
► The some benefits are available through all companies but there is
a wide range of monthly premiums
► Supplements do not include drug coverage
► Private companies that provide Part C plans are paid by
Medicare to give their members Medicare Part A and B
coverage and members follow the rules of the plan
► There are many different plans for our county with varying
monthly premiums, copays, drug costs and maximum out of
pocket amounts. Member still pays the$135.50 premium for
Medicare Part B
► Almost all services have a copay the member must pay out of
pocket
► Most Part C plans include drug coverage
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► HMO-health maintenance organization
► PPO-preferred provider organization
► For an HMO must use providers who are in the plan's network
► For a PPO you can go in or out of the plan's network but normally
pay higher copays for out of network
Medicare Part D Wisconsin Senior Care
Federal,Medicare approved drug plans Prescription drug program available
provided by private insurance only in Wisconsin. Must be 65 or older.
companies Funded by state and federal dollars.
Plans differ in coverage, formularies Senior Care coverage is based on
and copays income level.
Cost; monthly premium plus plan Cost: $30 per year plus copays and
copays and possible deductible up to possible deductible depending on
$415 in 2019 level of coverage
Prescriptions can only be filled in
Wisconsin
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9/4/20 .9
Medicare's Annual
Open Enrollment Period
WHY You Should Review Your Medicare Coverage
Each Year
Winnebago County Aging and Disability Center
Elder Benefit Specialists
1-877-886-2372
WAIMP ran PRVM W-fN Na W
What is it?
• If you have a Medicare plan,your plan will send you an"Annual
Notice of Change"(ANOC) each fall.The ANOC includes any
changes in coverage, costs, or service area that will be
effective in January.
When should I get it?
• September
Who sends it?
• Your plan
What should I do when I get this notice?
• Review any changes to decide whether the plan will continue
to meet your needs in the next year. Compare it to your other
options.
• If you don't get this important document, contact your plan.
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9/4/2019
Annual Open EnrollmentPeriod 17
October 15th - December 7th
• Medicare Advantage Plans and Medicare
Part D plans can change their plan details
each year.
• Open enrollment is your opportunity to check
your plan and make sure you will have
appropriate coverage in the new year.
Ak
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Did you
know? .
Every year insurance companies can change their
formularies,premiums,deductibles and copays? ALL
Medicare Part C and Part B plans should be reviewed
every year!
9
9/4/201.9
Medicare •
;your Reasons to Check Your Prescription Drug Plan:
1. Your plan may cost more next year due to changes in deductibles,
premiums and co-pays.
2. Your plan may no longer cover all your medications because
insurance companies change their formularies.
3. Your plan may have put restrictions on some of your medications
such as preauthorization, quantity limits and step therapy.
4. You may be taking different medications now.
0 �
Time to review your
Medicare Prescription Drug Plan!
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9/4/2019
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How Do I Choose
• Call Medicare of: 1 -800-633-1227
• Call Medigap Helpline (WI SHIP):
1-800-242-1060
• See an insurance agent
• For local assistance (ADRC): 1-877-886-2372
• Compare plans yourself on the Plan Finder at:
www.medicare.gov
Medicare.gov
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9/4/2019
The Medicare Plan Finder
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• The plan finder walks you through multiple steps to
achieve your personalized results.
• Results are based on the information you enter:
• Zip code- plans vary by county
• Your medications
• Pharmacy preference
• Eligibility for assistance- "Extra Help"
• Retail/Mail order preference
• Results will be sorted by lowest annual cost
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• Are your medical providers/pharmacy in-
network with this plan? Are you using a preferred
pharmacy for the plan?
• For Medicare Advantage plans, what services
are you most likely to use? What are the co-
pays for those services? What is the maximum
out of pocket?
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9/4/2019
Ways • Enroll
27
• Enroll online via the Medicare website or the
plan's website
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• Or call Medicare (1-500-633-4227) or the plan directly.
• Some plans will have an agent you can meet with.
What if someone needs help with
Medicare Costs?
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9/4/2019
Medicare . e• Programs
For Medicare Beneficiaries with Limited Income and Assets
• Medicare Savings Plans
• If eligible,your Medicare Part B premium will be paid for you
• Some also have co-pays and deductibles paid as well based
on income &assets
• Extra Help (Low Income Subsidy)
• Assistance with Medicare prescription drug coverage
• Reduces Part D premiums, deductibles and co-pays based on
income &assets
For more information or assistance contact:
Winnebago County ADRC
1 -877-886-2372
•
i
• Age 65 and over
• $30 Annual application fee
• NO Asset limit
• "Creditable" coverage
• Level of assistance depends on income
• May use alone or in addition to Part D
• Approved now through 2028
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9/4/2019
Don't
• If you would like assistance with a plan comparison, please
contact:
The Winnebago County Elder Benefit Specialist
1-877-866-2372
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• . The Plan Finder on.Medicare.gov is changing for 2020
• :' Before you use the Plan Finder to look at plans for next
year you need to create a MyMedicare account
16
9/4/2419
Creating a MyMed ica re
Account
state WMIN insulanca
S h esslstanae programs
h-1-044k
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LOCAL HELP FOR PEOPLE WITH MEPICARE
Go to www.MvMedicare.gov and it will open with the screenshot on the next slide.
(or you can find the login link in the upper right corner of the home page at www.medicare.eov.)
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Click "Create Account"
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Click Next when complete::
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C You're arcoss:ng data on a V.S.Governmeat
r; Information System,wbieb Is owned and operated
by tbn Cenlcm Im HndrGara k 14adl°ald Scrvl—
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-'. Myhledi"ro.tjov user3,WoulhorizO arimptoper I
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Seleat tttn'OK'bvtion to continue with lhn
rt4.tt41lon process.If you chooso not to continua
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S nuc Gt1- back to,540ALD page. ?;
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Create Username and Password
• Username must be unique
• S—30 characters long,no spaces
• Can include letters,numbers and special characters including: @ I . - _ $
• Don't use special characters as the first or last character of your username
• It must include at least 4 letters
• Can use your email address
• Cannot contain your Medicare or Social Security number
• Next create your Password
• S—16 characters long
• Must contain at least one letter and one number
• Must also contain at least one of the following special characters: @ 1 $ %
• Cannot contain your username and cannot contain your Medicare number or Social
Security number
• Select a secret question and enter your answer. This would be used if you Then Cl Ick
ever forget your username and password. rrsUbflll ,�
19
9/4/2419
A
That's`it. You Will now see a'message on the next" ;
screen indicating that your account has been created'
and"you. can now login.
You"will"need your username,`password an'd answer
to your sec ret'quest on for your account in the:future,'
sti keep it.]n a safe place where you can always find it.
You account can be used`tp compare plans foropen
enrollment and'to see"your claims"as they are'
processed by"Medicare; instead of lvaifing for;your:
Medicare notice that comes out every three months:
■ Call Medicare at 1-800-633-4227 or visit
www.medicare.go�
• Wisconsin SHIP Resources:
• Medigap Helpline: 1-800-242-1060
• Medigap Part D Helpline (forages 60+): 1-855-677-2783
• Disability Drug Benefit Helpline (underage 60):
1-800-926-4862
ADRC local assistance: 1-877-886-2372
This project was funded,in whole or in part,by the Wisconsin Department of Health a
5Il n a.<,q.i•� Services under grant number 905APG0051 from the U.S.Administration for Community
Living,Department of Health and Human Services, Washington,D.C. 20201.
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