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  1. Time for Medicare Enrollment – Time to Talk Turkey!
  2. Reminder – You CAN Leave the Nursing Home for the Holidays
  3. Jimmo Implementation Council Meets to Discuss the State of Skilled Maintenance Care
  4. Thank You!

Time for Medicare Enrollment – Time to Talk Turkey!

Medicare Fall Open Enrollment continues through December 7 — so you still have time to make certain changes to your coverage, including switching prescription drug plans or between traditional (sometimes called Original) Medicare and Medicare Advantage (MA).

As friends and families around the country gather for the Thanksgiving holiday, it’s the perfect time to talk turkey with loved ones and review your Medicare coverage options for 2020. Here are some tips to get you started:

Step 1: Review your current Medicare health and drug coverage

If you have traditional Medicare, take a look at the Medicare & You handbook and visit Medicare.gov to learn what your Medicare costs and benefits will be for 2020.

If you have MA or a Part D prescription drug plan (PDP), you should receive an Annual Notice of Change (ANOC) from your plan. Review this document for any changes in the plan’s costs, benefits, and/or rules for 2020. Since MA and Part D plans can make these changes every year, it’s particularly important to examine your coverage.

Step 2: Consider your options

Whether you are happy with your current coverage or not, we recommend reviewing all of your options each year. For some people with Medicare, an MA plan may be their best option, however based on your particular needs, traditional Medicare, with or without a standalone PDP or a Medigap policy may be the right choice.

If you want to evaluate your MA and/or Part D coverage choices, you can use Medicare Plan Finder to search and compare plans online, and you can also call 1-800-MEDICARE for a list of plans in your area. Be sure to contact the plan directly to confirm anything you learn online, since there have been widespread problems with the new, updated Medicare Plan Finder this year.

If you are in an MA plan, disenrolling to traditional Medicare and a standalone PDP is also an option. And depending on where you live, you may also be able to buy a Medigap policy. Before making the switch, call your State Health Insurance Assistance Program (SHIP) and ask if you have the right to purchase a Medigap during Fall Open Enrollment, what options you have, and what consumer protections your state provides.

Make sure you are getting the most out of your Medicare — know your options! Select a plan that best meets your needs and makes the most financial sense for you.

Step 3: Make changes during Fall Open Enrollment

If you find a plan that better meets your needs, the best way to enroll during Fall Open Enrollment is to call 1-800-MEDICARE. Your new coverage will take effect on January 1. Make sure you document the conversation, including the date, the representative you spoke to, and any outcomes or next steps. You may need this information later if there are problems with your enrollment.

RESOURCES

Help is Available! Call or visit the website of your State Health Insurance Assistance Program (SHIP). Your local SHIP can help you understand your Medicare coverage options and navigate any changes.

You can also call the Medicare Rights Center’s National Consumer Helpline at 800-333-4114. Counselors are available Monday through Friday to answer your Medicare questions.

The Center for Medicare Advocacy, along with the National Committee to Preserve Social Security and Medicare, relaunched the Fully Informed Project to provide objective materials about all Medicare options.

The Medicare Rights Center has several resources to help people with Medicare (1) navigate Fall Open Enrollment, including a free guide for consumers and six things to know about this important enrollment period; and (2) make coverage decisions, such as questions to ask before joining an MA plan and when comparing Part D plans, and fliers outlining the differences between Original Medicare and MA and Original Medicare and a Medigap vs. MA.

These and other resources are available on Medicare Interactive, Medicare Rights’ free and independent online reference tool designed to help older adults and people with disabilities navigate the complex world of health insurance.

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Reminder – You CAN Leave the Nursing Home for the Holidays

Late November begins a time for gatherings with family and friends – Thanksgiving, soon followed by the December holidays. Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Residents and their families and friends can put their minds at ease. While beneficiaries may be charged a “bed hold” fee by their skilled nursing facility, according to Medicare law, nursing home residents may leave their facility for family events without losing their Medicare coverage.

Happy Holidays to you and yours from the Center for Medicare Advocacy.

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Jimmo Implementation Council Meets to Discuss the State of Skilled Maintenance Care

On November 20, the Center for Medicare Advocacy, with support from the John A. Hartford Foundation, convened an online gathering of members of the Jimmo Implementation Council and other stakeholders in the effort to remove barriers to care for people with longer-term, chronic, and debilitating conditions.

The Council first met in 2015 in Washington, DC to discuss implementation of the Jimmo Settlement, which confirmed that Medicare coverage is available for skilled care to maintain a person’s condition or to slow or prevent further decline. Unfortunately, more than six years after court approval of the Settlement, improper “improvement standard” barriers continue to exist.

This online presentation included special guests Cindy Krafft, owner & Founder of Kornetti & Krafft Health Care Solutions, Dennis Knoff, Senior Vice President at United States Medical Management, and John Marmarou, Founder and Executive Director of Total Rehab & Fitness. The Center is grateful for the time these expert providers took to be with us to discuss their successful experiences providing, and billing for, maintenance therapy in home health and outpatient settings.

The Center remains committed to working with Medicare stakeholders to address ongoing barriers. It will continue to require collaboration – and persistence.

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Thank You!

This Thanksgiving we send our sincere thanks to you for the many ways in which you help us help people access Medicare and health care — giving that supports our critical work.

  • Thank you for your financial support.
  • Thank you for contacting your members of Congress.
  • Thank you for attending our webinars.
  • Thank you for amplifying our education and advocacy messages.
  • Thank you for sharing our commitment to ensuring full and fair access health care and Medicare.
  • Thank you for all the ways you give!

We hope you have a grateful and abundant Thanksgiving – We also hope you will remember the Center for Medicare Advocacy with a contribution on #GivingTuesday, December 3, 2019.

From all of us at the Center for Medicare Advocacy, THANKS for GIVING!

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