Today is March 24, 2011, and in the interests of “full disclosure” (which almost never happens in the real world), be warned that I have not had a change of heart. I am going to continue to describe the view, from 30,000 feet, of the Medicare Machine.
I am doing this to us for two reasons: (1) An awful lot of people are closing in on the age of Medicare maturity and have more than a passing interest in understanding how this thing works, and (2) an awful lot of people who are already on Medicare, and had deluded themselves (as do I) into thinking that they understand it, don’t. I know this to be true because an awful lot of you have said to me, in the last week, “I didn’t know that.” Note the repetitive use of the descriptor “awful,” then we’ll move on.
Last week we were all about Part A, Part B, Part B penalties, COBRA coverage, tra la, and I have no intention of repeating all of that because I presume that you were paying attention and I like you, so I’m jumping right in to where we left off.
Unless you’ve been on Social Security Disability Insurance (SSDI) for 23 months, you qualify for Medicare when you turn 65, and if you’re still working, please go back and have a look at last week’s column; if you’re not still employed, you have a 7-month “Initial Enrollment Period” (IEP) surrounding that 65th birthday: Three months BEFORE you’re 65th birthday, the month OF that birthday and three months AFTER your 65th period.
So, if you turn 65 in May, you can enroll in Part B in February, March or April, and if you do, it will become effective on May 1st. If you enroll in May, it’ll kick-in on June 1st; in June, on August 1st; in July, on October 1st and in August, on November 1st – Because, that’s how it is.
Now, take a deep breath, because I’m going to vault over Part C and go to straight to Part D, which you can think of as standing for “drugs” – Prescription drugs – Prescription drug coverage. Part D plans are “private,” meaning that they are offered by private insurance companies, not the Federal government. Like Part B, Part D has a penalty; actually, YOU will have The Penalty if you don’t sign-up for Part D when you’re eligible, and that penalty will never go away.
Now, IF you are still employed at age 65 and have coverage through your employer, OR you get prescription drug coverage through a retiree health insurance or the VA or wherever, and IF it is “creditable” (which is an unnecessarily fancy word for “equal to or better than the Medicare Part D standard plan”), you can evade the dreaded penalty. The way that you can prove that you had “creditable coverage” is that each year (usually in the Fall) your company, plan, whomever will send you a letter saying so. Keep these letters, and put them someplace where you can actually find them.
If you don’t have said prescription drug coverage, or if it isn’t “creditable,” consider enrolling in a Part D plan, because (1) it might help you pay for prescription drugs, and (2) you will sidestep the penalty ad infinitum.
Time out: No, you don’t have to do this; in fact, you don’t have to do ANY of this! There is no law that says that you have to enroll in Medicare or any parts thereof. You can go your own way, roll the dice and take your chances – You only care about “penalties” if you change your mind down the way and decide to enroll in Medicare, then BOOM! Oops…But it’s up to you; most of us cave-in and enroll.
There are two ways to get Part D coverage; one is through a private Part D plan, as noted above, and the other is through a Medicare Advantage plan. “Advantage Plans” are another moniker for “Part C,” which I vaulted over earlier, and will come back to, later (Hey: I never told you this was easy!).
Here’s a test: Remember what “IEP” is? Go look a few paragraphs up and cheat, I did – Right! “Initial Enrollment Period!” So, the IEP for Part D works exactly the same way as the IEP for Part B! (NOTE: Re-read that last sentence. You actually understood it, didn’t you? Scary, huh? I know.)
Beginning this year (2011, in case the migraine has already started), the “AEP” (Annual Enrollment Period) for Part D will run from October 15th through December 7th – We do this every year, “this” being review our Part D plans, because formularies and premiums change – Often. We do this every year because most of us can’t afford not to. Some of us don’t do it, because we’re _____ (fill-in the blank). Whatever changes we do or don’t make to our Part D plans become effective on January 1st of the next year.
Get used to it.
I had hoped to do this all in two columns; I also thought that Rome was built in a day – There’s a fine line between optimism and delusion, so we’ll carry on next week, but here’s something else that will happen next week, seven days from this very day, March 31st:
A few of us are going to be at “Life Care Center of Port Townsend” (previously known as “Kah Tai Care Center” – 751 Kearney Street) from 2:00 to 4:00 p.m. to answer questions or engage in conversations about stuff like this, or long-term care or in-home care or Medicaid or Advance Directives or whatever-the-heck else you’d like to talk about.
We are not going to give speeches. The reason we’re not going to give speeches is because, then, we’d be talking about what we want to talk about instead of what YOU want to talk about, which doesn’t usually help you, so come on.
I presume there will be cookies; after three consecutive weeks of Medicare, there’d better be.
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