On Friday, Nov. 24, 2017, the following letter was published in the Readers’ Views section of The Advocate:
According to the enrollment dashboard on www.cms.gov, as of September 2017, there are more than 830,000 Louisiana residents receiving Medicare benefits. With Medicare’s annual enrollment period occurring through Dec. 7, now is when beneficiaries—both current and those new to Medicare, either through age or disability—should be exploring their health plan options. Having a good understanding of the plans available and how they differ are keys to making a good choice.
There are two main ways beneficiaries can receive Medicare benefits: through Original Medicare, where the government administers benefits through the federally-funded Medicare program, or through a privately-run Medicare Advantage plan. So the first decision to make is between these options. But it’s important to understand the various parts of Medicare and how they function before making a decision. The reason being, one part may offer all the coverage a beneficiary may need, while others only address certain services.
Part A covers hospital services. When beneficiaries first become eligible for Medicare—which occurs automatically for most people at age 65—they’re entitled to this coverage. Part B covers medical services, including doctor visits, outpatient hospital and preventive services, and some home health services that Part A doesn’t cover. Most beneficiaries must enroll in Part B, and they may have to pay a premium for both parts A and B, based on income history. Part C is Medicare Advantage, and Part D is optional prescription drug coverage.
These many parts can be tricky when deciding on coverage. One thing to note is that Original Medicare doesn’t include prescription drug coverage, but beneficiaries are required to either already have “creditable” prescription drug coverage (meaning as good as Medicare coverage) or sign up for it when they first become eligible, or possibly face a Medicare-imposed penalty. Creditable coverage could be through an employer plan, for example, or through an additional stand-alone Medicare prescription drug plan.
Medicare Advantage could be the better option for those looking to have all their coverage through a single plan. With Medicare Advantage plans, beneficiaries remain in the Medicare program, but the plans administer the benefits instead of the government. These plans provide all the benefits of Original Medicare, plus extra benefits that Medicare doesn’t cover, including—with most plans—prescription drug coverage.
For Louisiana residents thinking of choosing Medicare Advantage, there are numerous options available in the area. The best place to start to find information about plan services, benefits and performance ratings is Medicare’s website, www.medicare.gov. Here, beneficiaries can explore plan costs, as well as compare plan ratings, which are an important factor to consider. Medicare establishes a rating of between 1 and 5 stars for each Medicare Advantage plan, based on the plan’s performance in areas such as quality of care and customer service. Louisiana has a few plan options rated 4 stars and above, and residents might be wise to weigh their options beginning with these.
Nick Karl
Chief Marketing Officer, Peoples Health
About Peoples Health
Established in 1994, Peoples Health is a Medicare Advantage organization serving more than 60,000 Medicare beneficiaries in Louisiana. Peoples Health Medicare health plans have been rated 4.5 out of 5 stars by Medicare for 2018, making them the highest-rated plans in the state. The physician-owned company administers and provides a unique approach to wellness, care coordination and support services for plan members. The company is a proud supporter of many social, cultural, athletic and health organizations and holds an NCQA accreditation. Visit https://www.peopleshealth.com for more information.
