Q: Since I no longer can afford my HMO how do I stop deductions for Part D from my Social Security and only keep Part B? - M.T.
A: There are certain times during the year when Medicare beneficiaries may make changes to their health care coverage. Your next opportunity would be November 15 through December 31, 2007. Taking action before then could result in a loss of coverage, leaving you liable to potentially disastrous out-of-pocket costs should you require health care services. And should you drop your Part D coverage, and then want to enroll in another Part D plan later, you would be required to pay expensive late enrollment penalties for the rest of your life.
Because Medicare coverage choices are so complex, and the wrong choice can be so very costly, we recommend that you get one-on-one counseling from a trained, unbiased Medicare benefits counselor at your local Agency on Aging. The service is available at no charge through your State Health Insurance Assistance Program.
Before making any changes, or stopping premiums, it's important that you understand the type of coverage you already have, and what your options may be. HMOs, also known as Medicare Advantage Plans, offer more than just Part D prescription drugs. Medicare Advantage Plans also provide all of your Part A (hospital) and Part B (doctors and hospital outpatient) coverage. Usually you will have to pay a premium, co-payments or coinsurance for the services you get. However, you won't need a Medigap policy.
Understanding how your plan works may help reduce costs. For example, if you are seeing doctors or other service providers outside of your plan's network or who don't accept your plan, you may be paying higher co-payments than if you used doctors who accept your coverage.
If your income is low, you may qualify for Medicare programs that might be able to help with some of your Part B or Part D costs. A Medicare benefits counselor could help you determine if you are eligible and apply for the benefits. In addition, a counselor can help you compare and select the best health plan and most affordable drug coverage for you.
We encourage you to contact your local Agency on Aging to evaluate your needs and to determine if there are programs that can help you right now. Check the number in your local yellow pages or call the Elder Care Locator to find services near you at 1-800-677-1116.
August 2007
