It's that time of year again.
No, I don't mean it's time for seniors to change options for Parts C Medicare Advantage or Part D prescription drug plans (but that is also true). Or even to change plans.
No, what I mean is it's time for the press to put out reams of bad information about Medicare, seriously misleading senior citizens. The October 14, 2012 Detroit Free Press had one of the worst examples (no link provided for the obsious reason) of misleading information for seniors that I have ever seen, something like 15 errors in 500 words. That is pretty hard to do.
The Press begin:
“The annual eight-week window allows newly minted seniors -- Michigan's baby boomers who turned 65 this past year -- to sign up for policies.”
“Newly minted seniors” can sign up anytime plus or minus three months of their 65th birthday. Their timing choices have nothing to do with the annual Part C or Part C open-enrollment period. Even a senior signing up for the first time in October 2012 can choose a different plan to begin January 1, 2013.
“But this much is clear: Nothing -- nothing -- has been changed to substantially change Medicare yet. As it stands now, the heart of Medicare -- the idea of offering health insurance to Americans 65 and older and those with certain disabilities -- remains strong…”
The Patient Protection and Affordable Care Act of 2010 has made substantial changes to Medicare. People disagree on whether they are positive or negative but no one can say they are not substantial. Conversely no one is proposing to change the “idea of offering health insurance” to older Americans.
It also said:
“Many seniors purchase (Part B) 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% co-pay and costs.”
A. This gets too complex for a newspaper article but almost all seniors purchase Part B. The only good easy reason not to purchase B is if you are still working and getting insurance from your employer and your employer employs more than 50 people (or you’re covered by a spouse’s plan employed similarly). Seniors on VA might also want to skip B but only if they are close to a VA medical center. Some union members and retirees getting insurance from a former employer might not need Part B but usually the union or former employer retiree plan requires it. In general most – a lot more than “many” – take Part B
B. Enrollment is “typically automatic” if you are on Social Security, NOT “once you qualify for Medicare.” In fact, if you are already on Seocial Security when you turn 65 you will automatically receive a Medicare card that shows you already enrolled in Parts A and B. You have to proactively turn Part B down if you meet one of the reasons in 3A (or one of the rare other reasons not to sign up for B).
C. Conversely, if you are not on Social Security already once you qualify for Medicare (i.e., turn 65), NOTHING is automatic. The senior has to proactively sign up from Medicare and decide if he or she wants Part B.
D. Part B also covers in-patient hospital stays where the patient is not admitted but is only observed. This admitted vs. observed status has many other implications that seniors need to understand
E. Not sure what the newspaper even means by “plus a typical 20% co-pay and costs.” There is a deductible after which the co-pay is the cost?
And the Press reporter said
“Also known as Medicare Advantage, these plans are purchased through insurance companies and provide more comprehensive coverage. Options might include coverage for prescription and generic drugs, dental and vision care, 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.”
A. This varies in every state but not all Part C Medicare Advantage plans provide what most seniors would consider “more comprehensive coverage.” Many provide basically the same coverage as Medicare Parts A and B but effectively cost a lot less than Medigap plans and even rebate the seniors’ Part B premiums. (That being said, all Part C Medicare Advantage plans have to include catastrophic coverage, which is not included in Medicare Parts A and B)
B. You DO need the two basic plans – Parts A and B – first in order to sign up for C. And you have to keep paying the B premium.
And the Detroit newspaper conclded
“(Part D 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 penalities (sic) for joining later.”
A. It is not correct to make a distinction between “outpatient prescription and generic” drug coverage. I am not sure what point the reporter is trying to make but a prescription is always required: it could be for a specific brand of drug or for a generic drug
B. Seniors do not necessarily face a penalty if they don’t get Part D when they turn 65 if they get what is known as "minimum creditable coverage" through an employer (many people over 65 still work since SS retirement age is now north of 66), a spouse’s employer, a former employer’s or union retiree plan, the VA or other minimum creditable sources.
-- Dennis Byron
(In addition, but this is pretty wonky, the Press said:
(“Medicare discounts continue to deepen on drugs in the donut hole... When beneficiaries reach that gap in 2013, they will pay 47.5% of the cost for brand name drugs and 79% for generic drugs next year.”
(Actually most of the discounts until 2013 came from the drug manufacturers, not Medicare.)