Medicare annual enrollment period opens this month BY EMILY HEDGES CONTRIBUTING WRITER This October, Medicare’s annual open enrollment period coincides with the launch of the Affordable Care Act’s state-level, health insurance marketplace, leaving many seniors unsure about how the changes will impact them. “The question I get from those who are about to go on Medicare, or are on Medicare and considering changing plans, is ‘How does Obamacare affect Medicare?’” said Darwin Klockers, a Medicare counselor with Senior Community Services (SCS) who services the Brooklyn Park and Brooklyn Center areas. “It is a very simple answer. There is no impact other than some changes in the Part D Prescription Drug Program that make the coverage more affordable, primarily by giving them a discount on their prescriptions when they go into the donut hole.” Deb Taylor, chief operating officer of Senior Community Services, believes miscommunication has made some seniors fearful of changes from Obamacare, which is more officially known as the Affordable Care Act (ACA). “There is a lot of confusion about the Affordable Healthcare Act and Medicare,” Taylor said. “Basically, there will not be enrollment changes for Medicare beneficiaries as they will continue to have their annual review time to enroll in a Part D or Medicare Advantage Plan between Oct. 15 and Dec. 7. That coverage would be effective in January 2014.” As a result of the ACA, beginning Jan. 1, 2014, all U.S. citizens and legal residents will be required to have health insurance coverage. For those who are not on Medicare or hold health insurance through work, insurance may be purchased through their state’s health insurance marketplace. For Minnesotans, that one-stop shop is MNsure.
Michele Kimball, director of AARP Minnesota, spends a good deal of time these days speaking to seniors about the ACA and MNsure. “The most common question I get from those over 65 is, ‘Do I need to worry about MNsure?’ The answer is no,” said Kimball. “Medicare beneficiaries are hearing so much about new health care exchange, and there’s a lot of misinformation.” She stresses that MNsure is not replacing Medicare. MNsure will not sell Advantage plans (also called Medigap plans), and the ACA will not be cutting
Medicare benefits to pay for coverage for the uninsured. What it will do is help seniors who have not reached Medicare age yet, or who have had trouble purchasing insurance because of preexisting conditions or cost-prohibitive premiums. “Minnesotans’ buying power will go further on MNsure. The premiums of plans on MNsure are the lowest in the country, and individuals may be eligible for financial assistance to help pay their premiums,” said Jenni BowringMcDonough, media relations coordinator for MNsure. “Individuals can only get this financial help to pay premiums
through MNsure. Some may even qualify for a no-cost plan.” The ACA plans to strengthen and improve Medicare through free preventative care that no longer requires a co-pay, along with the gradual closing of the prescription drug donut hole, which will formally close in 2020. The ACA is also projected to save the Medicare program $500 billion over 10 years. “That savings will be used to extend the life of the Medicare trust fund an additional two years beyond its current solvency,” she said. Some comprehensive advantage plan holders may see a decrease in extras, such as dental and eye coverage, because of the ACA. Kimball explained that when Congress passed the Balanced Budget Act of 1997, which originated the Part C Advantage Plans, they decided to incentivize private companies to jump into the market by enhancing reimbursements up to 115 percent for services provided to beneficiaries. This stimulus was intended to last for two years. However, companies are still receiving this benefit 16 years later, something the ACA will end. Kimball believes that much of the current health care confusion may be attributed to the slow implementation of the program. On Oct. 25, Kimball will give the Keynote Address entitled “Health Care Law and You” at the Key Community Partner Awards hosted by Senior Community Services, which recognizes the effort and impact recipients have had on seniors in their communities. Tickets for the Key Community Partner Awards may be purchased by calling 952-767-7899. For more information about SCS, or if you have questions regarding Medicare, or the ACA , go to www.seniorcommunity.org. For more information about MNsure, go to www. mnsure.org.
Page 2 Mature Lifestyles • Thursday, September 19, 2013
Part A
Late enrollment penalty
Hospital Insurance
post.mnsun.com
How do I enroll in Part D?
Can I keep my doctor?
Premiums?
Brand name drugs
Part B Medical Insurance
Coinsurance and copays
Covered vs. non-covered services
Cost and coverage comparisons
Part C
Cost and coverage comparisons
? Service areas
?
?
Combines Part A, Part B and usually, but not always, Part D
Part D
Is original Medicare enough?
Do I need a referral to see a specialist?
Coverage gap
Benefit periods
Prescription Drug Coverage
H2462_72053 Accepted 10/07/2013. HealthPartners is a Cost plan with a Medicare contract. Enrollment in HealthPartners depends on contract renewal. Š2013 HealthPartners
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Mature Lifestyles • Thursday, September 19, 2013 Page 3
1-800-333-2433 Senior LinkAge Line is a free, statewide service for seniors, baby boomers, Medicare beneficiaries, caregivers and those trying to reduce prescription drug costs
Julie Van Name is a nurse who never thought much about Medicare or prescription “donut holes.” The 55-year-old had health insurance through her work and no medical problems. All that changed suddenly when an autoimmune disease attacked her lungs, muscles and joints. She went from zero medications to 56 in the blink of an eye. “In a day I had this life-changing illness and needed all this help. I didn’t have time to prepare,” said Van Name. After going on disability, she received a notice that she was eligible for Medicare. Because she already had coverage, she declined Medicare, not realizing that she would soon be automatically dropped from her company’s policy. The result was a period of time that Van Name was uninsured. “I didn’t know what I was going to do. I couldn’t afford to pay for my oxygen,” she said. That’s when Van Name learned about the Senior LinkAge Line, Metropolitan Area Agency on Aging’s free statewide information and assistance service covering all 87 counties of Minnesota. Loudi Rivamonte, recreation supervisor for Eagan, sees firsthand how often Senior LinkAge Line helps people like Van Name deal with difficult situations. “It is a great program, and I know from touching base with many of the seniors who have participated in counseling appointments, a vital service. The counselors spend one hour of face to face time with the senior and many times their family members and caregivers to help them navigate the benefits of Medicare. Having a neutral party to offer guidance through a sometimes complicated journey through the healthcare world is quite a benefit,” she said. Michele Starkey, coordinator for the
Burnsville Senior Center, agrees. “With the variety of calls and inquiries we get on a daily basis, it’s nice to have a central contact where people can get the help they need.” For Van Name, that help came from a Senior LinkAge Line volunteer named Julie. “I learned that if you don’t sign up correctly with Medicare the first time, you can be subject to a penalty,” she said. “It can be costly. They helped me through it. That was the first step. She told me next, I’d need help with prescriptions and deductibles. She started talking about donut holes, catastrophic coverage. I was so overwhelmed.” Van Name considered herself an educated person, but felt ill-equipped to climb the mountain before her alone. Not only did Julie from Senior LinkAge Line walk her through each step of the process, she also followed up along the way even after Van Name was referred to a local Senior LinkAge Line volunteer named Sally. “Sally was an extension of Julie,” said Van Name. “She was so knowledgeable. That first day, she spent two hours with me.” Sally went over the basics of Medicare Parts A and B. She explained how supplemental plans worked, and what her options were based on the medications she needed. “They weren’t telling me what to do. They showed me the differences. It was so easy to make a mistake that might have cost me a few thousand (dollars) a year,” she said. One of the biggest problems for Van Name was a coverage gap on her prescriptions. In 2013, once a patient and their plan
LINKAGE - TO PAGE 5
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Living life with passion and a sense of rhythm Cyril Paul teaches circle drumming on Tuesdays from 6:30-8:30 p.m. at Richfield Elementary. (Photo by Mike Hanks) BY EMILY HEDGES CONTRIBUTING WRITER Bloomington senior Cyril Paul is a peace-loving man who lives to help others with the only currency he possesses – passion, drive and a pervading sense of carnival. Vibrant colors, rhythm and celebration define the 83-year-old’s memories of growing up in Trinidad. Now he uses those things to fight poverty, educate youth, and inspire change. “Poverty is something people shy away from because they don’t know what to do about it,” said Paul, who became involved in the fight against poverty during the Johnson Administration. “Johnson did a great deal and spent a lot of money, but in spite of that, poverty erodes our country.” Paul is an active member of a local organization called Isaiah, a group of congregations, clergy and people of faith working towards racial and economic equality in the state of Minnesota. “We go to legislators and speak for
the poor people in the inner city who are unable to break the threshold, unable to get in a higher level of learning,” he said. Paul knows something about poverty. Growing up in Trinidad, it was a daily reality. However, he describes his childhood as a happy one.
to make a similar impact on his community. While training to qualify for the Olympics as a sprinter, he worked as a policeman in Nassau. However, four years on the job led to disillusionment and a new calling. Paul decided to give up his Olym-
“(Drumming is) a voice, an instrument that can be used to bring people together.” – Cyril Paul “My father was a very wonderful person. He never criticized. Whenever the carnival occurred, he’d be in the middle of the fray breaking up any disagreements,” he said. His father’s example made an impression on Paul, who believed a career as a police officer would give him the chance
pic dreams and pursue a career in the church. A friend he met from Minnesota encouraged him to apply for a scholarship to Saint John’s University in Collegeville, Minn. He followed the suggestion and was accepted with a full scholarship. “I came to Saint John’s to join the
priesthood, but I didn’t like what I saw there,” recalls Paul. “I got an English major instead and started teaching.” Teaching became his true passion. After leaving a post with an inner-city school, Paul traveled around Minnesota bringing his own brand of carnival into schools. “It was a moment of excitement for the kids,” he said. “We would forget the idea of education. We wanted to teach them that life can be beautiful if we make a contribution, and make friends with lots of different people. We taught them to open their minds to new cultures and new ideas.” Paul said that as time passed, money for such educational extras dried up. Looking for a new way to challenge himself and make a positive contribution, he decided to raise money for education by riding a bicycle from Minnesota to California, where his two daughters lived. Although three friends rode part of the way with him, he was on his own DRUMMER - TO PAGE 6
Mature Lifestyles • Thursday, September 19, 2013 Page 5
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LinkAge FROM PAGE 3 have spent $2,970 on covered drugs (the combined amount plus your deductible), they end up in the coverage gap, also called the “donut hole.” “For me, the donut hole was huge, a couple of thousand dollars,” she said. The Senior LinkAge Line counselors showed Van Name drug reimbursement plans and grants that were available to help her. “By the time I left, I felt like I knew all about all different plans. I wasn’t panicked about what would happen when I hit the donut hole. She prepared me for what to do when that happened,” said Van Name. “She told me to call this clinic for this medication and that clinic for that one. I was able to do that so that the donut hole only cost me about $200.”
Van Name ended up selecting one of the cheaper Medigap plans, something she wouldn’t have had the confidence to do without the information provided by Senior LinkAge Line. “They helped make sure I was made aware of all of my choices so I could pick the best option,” she said. “We used all of the information to come up with the best possible plan so I can continue receiving care from the exact same physicians.” Van Name is eager to pay back the debt she feels she owes Senior LinkAge Line by volunteering her time to become a counselor like Julie and Sally. “I would love to make it easier for someone. They held my hand and made this process nice and smooth,” she said. “I felt like this is something I want to share. It was such a lifesaver.” The Senior LinkAge Line may be reached by calling 1-800-333-2433.
Photo illustration
“I felt like this was something I want to share. It was such a lifesaver.” – Julie Van Name
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Page 6 Mature Lifestyles • Thursday, September 19, 2013
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Drummer FROM PAGE 4 once he left Minnesota, except for the aid of his wife, who followed him in a station wagon carrying supplies. The trip took 41 days and raised approximately $18,000 through two fundraising events. One was hosted by a friend in Arizona and the other was hosted by his daughter at the end of the journey. “The main reason I did it was to do something to pay back what I’ve been given. I’m a poor person from Trinidad. All I can do is use my talents and skills to make a difference,” said Paul. These days, Paul’s message and desire to teach resonates through the drum. He leads a circle drumming class on Tuesdays at Richfield Elementary. “It’s a voice, an instrument that can be used to bring people together,” he said. He especially likes to see seniors join his group. “They think, ‘I’m old. What can I do?’ But they can come to class and learn the specific rhythm patterns that allows their own rhythm to explode.” Paul made a big impression on Bill
Jennings, an instructor with RichfieldBloomington Community Education, as Paul took one of his computer courses. “While talking with Cyril during the course breaks, I discovered that he was quite accomplished intellectually, but I was equally impressed by his vitality and sense of humor. He mentioned talents as a singer and musician, and I decided to recruit him to become involved as an instructor with Community Education,” said Jennings. Whether teaching the young or old, Paul believes helping others realize their full potential is his true calling. “I want to get into classrooms and inspire people. I see so many lives kind of wasted, like pieces of straw in a river floating to Valhalla. I want to use all the energy I have to make life a little better,” he said. In 2000, Isaiah formed through the merger of three independent congregation based community organizations: Great River Interfaith Partnership (GRIP) in the St. Cloud area; Interfaith Action in Greater Minneapolis; and St. Paul Ecumenical Alliance of Congregations (SPEAC) in Greater St. Paul. For more information, go to www. isaiahmn.org. You may contact Paul by emailing cyrilandpampaul@aol.com.
So much is changing the way we think about work and age. People are thinking differently about retirement and many want to stay in the work force or transition into part-time work. Older workers are capable, experienced and mature. Your talents are appreciated and your contribution and skills are critical to Minnesota’s economy. Call the Senior LinkAge Line® A One Stop Shop for Minnesota Seniors at 1-800-333-2433 now for help to START your journey as a mature worker.
Mature Lifestyles • Thursday, September 19, 2013 Page 7
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Page 8 Mature Lifestyles • Thursday, September 19, 2013
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YOU
NEVER LOST THAT SENSE
OF ADVENTURE, DID YOU?
WE’VE
Stay as active as you want to be. At UCare, we’ve got you covered, with a range of Medicare options designed with Boomers in mind. UCare for SeniorsSM lets you choose from plans that cover prescription drugs, travel, eyewear, dental, fitness programs like SilverSneakers® and more. There are no co-pays for primary care visits with most plans. And you’ll get to talk to a real person 24/7 when you call customer service. It’s just what you’d expect from health care that starts with you. UCare Minnesota and UCare Health, Inc. are HMO-POS health plans with Medicare contracts. Enrollment in UCare Minnesota and UCare Health, Inc. depends on contract renewal. ©2013, UCare H2459 H4270_090512 CMS Accepted (09102012)
BEEN EXPECTING YOU.
Learn more about the benefits of UCare for Seniors in our new eGuide to Medicare at ucareplans.org/eguide. Or call (toll free) 1-877-523-1518 (TTY) 1-800-688-2534, 8 a.m. to 8 p.m. daily.