SUNDAY| NOV. 6, 2011
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5C 50 Cent pens young-adult novel 8C DISNEY OPENS AULANI RESORT ON OAHU
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Rapper 50 Cent’s young-adult debut novel, “Playground,” is loosely based on his personal experience. The 36-year-old rap artist has sold more than 22 million albums and earned 12 Grammy nominations, but as he notes, “not everything I’ve done in my life has been role-model material.”
On leeward Oahu, it is 85 degrees, and the trade winds are blowing. Beyond a towering volcanic outcropping, the Pacific Ocean, at a steady 70 degrees, beckons. The afternoon sun begins its lazy descent. This is Hawaii. Do you really need Disney?
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Your guide to understanding the plans and deadlines » What is changing » Decode the lingo » Fraud prevention tips, 4C » Expert FAQ, 6C
GET BUSY
MEDICARE ROADMAP
NEW DEADLINES
There are new deadlines this year to enroll in or switch Medicare plans. This year, enrollment began Oct. 15 and continues through Dec. 7. The dates were moved up to better ensure that seniors have their membership cards and can begin to receive benefits on Jan. 1. A major exception is if you want to enroll in a top-rated Medicare Advantage (Part C) plan. As a reward for high scores, those plans getting a fivestar rating can enroll new members throughout the year. Next year, between Jan. 1 and Feb. 14, you also can leave Medicare for an Advantage plan that offers prescription drug coverage.
FIND HELP
Free seminars help take confusion out of choosing Medicare coverage Patricia Anstett MCT News Service
WHERE TO GET FREE HELP
» Free one-on-one counseling is available through the Medicare/Medicaid Assistance Program, a statewide organization that works in partnership with Medicare to explain options. You can attend a seminar, or you can get an individual appointment or phone consultation with a trained counselor. The focus of these seminars is to provide helpful, impartial information. Call (800) 803-7174. » Call (800) MEDICARE (800-633-4227) for a booklet on Medicare options, including a detailed explanation of covered benefits and monthly premiums of plans. The site also gives star ratings for many of the Medicare plans. If you need individual help, you can call the Medicare hotline to talk to a counselor who will help you search for options over the phone and will mail you a summary of what you discuss. You also can go to www.medicare.gov and do the comparison yourself. Click on health plan finder, enter your ZIP code or county and the type of plan you want, such as a Medicare Advantage or Medigap policy. The site also gives star ratings, with the best plans getting a five-star rating. » Retiree groups for large workforces, such as the automakers, also may hold Medicare meetings. So do companies that specialize in advising consumers, companies and
PATRICIA BECK/ DETROIT FREE PRESS
unions on insurance benefits. These seminars, however, may focus mostly on the biggest plans that agents sell for a few companies, or they may heavily pitch Medicare Advantage products, instead of what may be cheaper Medigap policies with fewer benefits. » Talk to your pharmacist. Many offer inperson or online help. CVS pharmacies, for example, offer an online Medicare Part D calculator that gives comparisons of Part D plans at www.cvs.com/medicare. » Try other online tools. eHealthInsurance.com, an online source for health insurance, has help at www.eHealth Medicare.com. The site offers various services to compare Medicare plans, as well as a telephone counseling line at (866) 646-7654.
SAY WHAT?
Keith Gresham, a selfemployed painter who hasn’t had health insurance for nearly a decade, couldn’t wait to turn 65 this year. It meant that he finally was eligible for Medicare. “It was a godsend,” said Gresham, of Detroit, who is catching up on getting healthy after skipping yearly physicals and dental cleanings and not buying the new eyeglasses he needs. Trouble is, the federal program that insures 47.6 million Americans, including 1.6 million in Michigan, is confusing to him and millions of others. Health insurance, after all, is an industry with complicated terms, dozens of products and rules and benefits that change from year to year. The task of choosing a Medicare plan is a new one for millions of baby boomers like Gresham. He is getting free counseling about his options through a network of seminars scheduled through December through the federally funded Medicare Medicaid Assistance Program. The events allow seniors to sit with counselors for oneon-one advice about the best plans for them by comparing the price of drugs a senior uses and other benefits. The seminars also help eligible seniors
apply for financial help for Medicare programs, including programs that give deep discounts or even free medicines to low-income seniors. That help, along with a much-improved Medicare website (www.medicare.gov), are among the new or expanded offerings for this fall’s Medicare Open Enrollment season — the annual time when most seniors can make changes in their plans for benefits they will receive in 2012. This year, open enrollment began Oct. 15 and runs through Dec. 7, earlier than previous years. There are other important changes, including:
Gold-star ratings
For the first time, Medicare is giving gold stars to easily identify the best plans. Ask about a plan’s rating or look up the information on the Medicare website. The site also lets users chart their Medicare spending and medical appointments.
Expanded preventive benefits Medicare now provides nearly two dozen free prevention services, including a yearly wellness exam, a visit that covers many but not all measurements of a routine See MEDICARE, Page 3C
MEDICARE TERMINOLOGY AND WHAT IT MEANS Medicare is a federal health insurance program that provides basic coverage for medical care to seniors and people with certain disabilities. There are two basic plans, Part A and Part B.
PART A
Provides coverage for hospital care, limited nursing home stays, hospice and some home health care. Most people who have been employed get Part A coverage without having to pay a monthly premium.
PART B
Many seniors purchase this coverage for their physician visits,
outpatient services and some medical equipment. Enrollment typically is automatic once you qualify for Medicare. Recipients pay a monthly premium plus a typical 20 percent co-pay and other out-of-pocket costs.
In addition to the plans above, the following policies may be purchased from insurance companies on your own: PART C
Also known as Medicare Advantage, these plans provide more comprehensive coverage for prescription and generic drugs and
sometimes dental and vision care and contributions toward gym memberships, diet-related programs and other care. Medicare Advantage plans include all Part A and B coverage, so you don’t need the two basic plans if you have a Medicare Advantage policy.
PART D
Also known as a prescription drug plan, these policies pay for outpatient prescription and generic drug coverage. If you don’t sign up immediately for one of these plans when you reach age 65, you face penalties for joining later.
MEDIGAP
Also known as supplemental Medicare, these plans pay for additional physician and outpatient care services, but often not prescription coverage. These plans are tailored to people who don’t travel much beyond their home state and who may prefer to find drug bargains rather than paying for them monthly in a Medicare plan.
COVERAGE GAP
An interval in some Part D drug plans during which you must pay 100 percent of your prescription costs. Also know as the “doughnut hole,” the gap begins after your
costs reach an initial coverage limit and ends after you have paid enough to become eligible for catastrophic coverage.
CATASTROPHIC COVERAGE
The portion of a Part D plan that kicks in after you have paid a certain amount in a calendar year.
INITIAL COVERAGE
The seven-month period when you can first enroll in Medicare (three months before you turn 65, the month of your birthday and the three months afterward).
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