MEDICARE GUIDEBOOK for Marylanders

Transcription

1 MEDICARE GUIDEBOOK for Marylanders Stay connected with the right information, tips, tools and answers to your Medicare questions all from Advantage MD.

2 Welcome neighbor! Medicare Planning is starting for you Don t miss your chance to connect with a Medicare plan from a local care leader. Transitioning into Medicare is a real milestone. And it only happens once. Preparing for the change can feel overwhelming and often confusing. You ll have questions like, What is Medicare? and How does it work? Relax. We re here to help you every step of the way. We created this guide to help you understand the pros and cons of your Medicare plan options, so you can make the right choice for you, your health and your budget. Ready? Let s go!

3 Medicare In Parts A quick overview Medicare is a federal health insurance program that comes in four parts and it can be a little confusing. This should help you understand what s behind your coverage options. Original Medicare (Parts A and B) covers about 80% of the average person s costs for covered medical expenses. You are responsible to pay the rest. That s why many people look for other coverage options. Part A: Hospital Services Helps cover inpatient hospital and nursing home care, home health care, skilled nursing facility care and hospice. You must be at least age 65, a U.S. citizen or permanent resident and you or your spouse must have paid into Social Security for at least 10 years. While Part A is free for most, you will have deductibles and coinsurance costs to cover. Part B: Physician & Outpatient Services Helps cover doctor visits, lab tests, outpatient services and outpatient surgery and some medical supplies. Eligibility is the same as Part A above. Medicare charges a monthly premium for Part B, and you will have deductibles and coinsurance costs to cover. Part C: Medicare Advantage Plans Covers everything that Medicare Part A and Part B do, and often covers expenses that Part A and Part B don t. Medicare Advantage plans often include extra benefts for prescription drugs, vision, hearing, dental and ftness programs. These plans are ofered by private insurance companies contracted by Medicare. To enroll, you must have Original Medicare (Parts A and B) and live within the plan s service area. Part D: Stand-alone Prescription Drug Plans Helps cover some of your prescription drug costs. These plans are ofered by private insurance companies who are contracted by Medicare. To enroll, you must be enrolled in Original Medicare and live within the plan s service area. Medicare Advantage plans often include extra benefts.

4 3 kinds of medicare plans Only ONE is right for you! Option 2: Medicare Supplement plans cover some gaps, but still leave holes Medicare Supplements cover some out-of-pocket costs that Option 1: Original Medicare If you choose this option alone, you have to cover certain costs frst before Medicare pays for anything. Then, Medicare covers about 80% of your medical costs and you have to pay the rest. The chart shows a few examples of how you could end up paying hundreds, even thousands of dollars each year, out of your own pocket. In fact, with Medicare alone, there is no annual limit on how much you could spend. One overnight stay in the hospital would cost you at least: You ll pay this for a doctor visit or lab test frst: 20% of a common outpatient surgery could cost you: $1,340 (Part A deductible) $183 (Part B deductible) $ % of an average emergency room visit could cost you: $585 2 Medicare doesn t. But they can be expensive, and you ll also fnd a number of everyday health services that are simply not covered. In Maryland, popular Plan F premiums average $247 monthly.* Add a prescription drug plan, and the average total out-of-pocket cost reaches $7,220 a year. Carrying separate cards for Medicare, a Medicare Supplement plan plus a drug plan can be both costly and inconvenient. Original Medicare and Medicare Supplement plans generally DON T cover: X Prescription Drugs X Vision X Dental X Hearing Aids Source: HealthcareBluebook.com; Total Fair Price Estimate 1 20% coinsurance for gallbladder endoscopy with biopsy 2 20% coinsurance for the average emergency room visit * Monthly premiums for Medicare Supplement Plan F in MD range from $151 $344. Based on available 2018 monthly premium information on medicare.gov

5 Option 3: medicare Advantage plans All-in-one plans MORE coverage and an afordable cost. Johns Hopkins Advantage MD connecting expert health care and quality coverage. The goal of our Medicare Advantage plan is to ofer you comprehensive care and coverage. When Johns Hopkins created Advantage MD, we used our experience 125+ years caring for Marylanders to ensure you get features and benefts that matter most, like: All-in-one coverage, including prescription drugs, dental, vision and hearing benefts Access to 10,000+ doctors and hospitals across Maryland, including Johns Hopkins providers Low, predictable copayments Afordable monthly premiums

6 More benefits more savings Here s how Advantage MD helps you save: Low monthly premium starting at $0 a month* ($25 for non-baltimore City residents) 100% medical coverage with a $0 deductible Take your next step: Get your FREE Information Kit! Full plan details Top 100 covered prescription drugs FAQs and more 100% hospital coverage with a $0 deductible Prescription drug benefts with low copays Diagnostic dental: Cleanings, exams and X-rays Routine vision and hearing care Preventive care and more! Call (TTY: 711) 8 a.m. to 8 p.m., 7 days a week or visit HopkinsMedicare.com to request your kit. From April 1 September 30, you will need to leave a message on holidays and weekends. MEDICARE TIP: Comparing Medicare Advantage Plans? Check the network. Get access to the care you want, from routine visits to critical and emergency care and more. Advantage MD is a Maryland Medicare Advantage plan that gives you the full complement of 10,000+ Johns Hopkins doctors and hospitals, and other afliated providers, across the state. *Premium shown is for Johns Hopkins Advantage MD (HMO) plan.

7 Comparison Checklist Make sure you have the right plan for you. Access to care: Do you want coverage accepted by YES NO doctors, hospitals, and pharmacies When you re new to Medicare, it s important to think that are convenient to you? carefully before choosing a plan you want what s best Do you want access to high-quality providers, YES NO for your health needs and budget. Use this checklist to help such as the Johns Hopkins network? you compare plans. If you answer YES to a lot of these questions, then Johns Hopkins Advantage MD may be the right choice for you! Costs: Ease of use: Do you want one plan for all of your YES NO health care needs? Do you want a low monthly premium? YES NO Would you like a health plan that s easy? YES NO Could you aford the out-of-pocket costs (deductibles, coinsurance, copayments) that come with a major health issue? YES NO benefits: Be ready to compare and choose your plan. Do you want a plan that covers all YES NO Your Medicare Initial Enrollment Period your health care needs? This is the 7-month window when you should Should it cover annual checkups, YES NO enroll in Medicare for the frst time. including dental and vision exams? You can enroll... 3 months before you turn 65 Prescription Drugs: The month of your 65th birthday 3 months after you turn 65 Would you like your prescriptions covered? YES NO If you don t enroll within the 7 months, Every plan has a drug formulary where you you may have to pay a continuous penalty. can look up drugs that are covered and the Visit Medicare.gov for details. coverage amounts.

8 Are you Ready To Enroll? Here are key steps you need to take when signing up for Medicare. Some important facts about how and when to sign up. You can sign up for Medicare as early as three months before your 65th birthday Sign up for Medicare through Social Security Enroll in Advantage MD as soon as you have your Medicare ID number Remember that after your initial enrollment window (which goes three months past your birth month), late penalties may apply Check out more details in this section. We look forward to welcoming you to Advantage MD soon!

9 You re only two steps away STEP 1: Sign up for Medicare (Parts A and B) If you re already receiving Social Security benefts, you ll be automatically enrolled. If not, you ll need to sign up for Medicare yourself with the Social Security Administration: Enroll by phone or online: Call (TTY: ) Or, visit ssa.gov Enroll in person: Stop by your local Social Security ofce. You ll need an original or certifed copy of your birth certifcate, two years of W-2 forms and your Social Security number. If you want to delay Part B enrollment, you must decline it during your Initial Enrollment Period and return your Part B notice to Social Security. Depending on your situation, late enrollment penalties may apply. MEDICARE TIP: You don t have to be retired to sign up for Medicare! You can enroll in Medicare at 65, even if you re still working. (Check with your benefts department to see if you could save money on your health benefts by enrolling in Medicare.) STEP 2: Enroll in Johns Hopkins Advantage MD You can sign up for an Advantage MD plan as soon as you are enrolled in Medicare Parts A and B. If you don t enroll in Advantage MD during your Initial Enrollment Period, you will have to wait to sign up until Medicare s Annual Election Period. You ll receive your new member materials, including your Advantage MD card, as soon as your enrollment is approved by the Centers for Medicare & Medicaid Services. Enrolling in Advantage MD is easy. You choose how. In-person: We d be happy to meet you at a time and place that s convenient. By phone: Simply call (TTY: 711), 8 a.m. to 8 p.m., 7 days a week. Online: Visit HopkinsMedicare.com to enroll securely. By mail: Request your Advantage MD Information Kit by phone or online. From April 1 September 30, you will need to leave a message on holidays and weekends.

10 Q&A Questions About Medicare? We Have Answers! Q: Will I receive a notice about Medicare when I turn 65? A: If you are already receiving Social Security benefts, you will get Medicare information in the mail three months before you turn 65. If you are not receiving Social Security benefts, you must enroll in Medicare yourself by contacting Social Security directly. See the Contact section of this guide for information. Q: Will money be taken out of my Social Security check for Medicare? A: While Part A is free for most people, most pay a monthly premium for Part B. You can either write a check to Social Security or have the Part B premium automatically taken out of your Social Security check. Q: I m turning 65 this year, but won t be retiring. If I wait until retirement to enroll in Medicare Part B, will I be penalized? A: If you re still working and have employer-provided coverage, you should contact your Benefts Administrator to determine if you need to enroll in Medicare Part A or Part B. In certain circumstances, your benefts plan may require you to pay for what Original Medicare would cover if you don t enroll when you re frst eligible. MEDICARE TIP: How to get help paying your Medicare Part B premium: You may get help through a state-sponsored Medicare Savings Program (MSP). You may also be eligible for Extra Help that can help pay your Part D prescription drug costs. Call us to fnd out more.

11 Q&A Questions About Medicare? We Have Answers! Q: Are Medicare Advantage and Medicare Supplement plans the same thing? Q: Why should I look at Johns Hopkins Advantage MD plans? A: Medicare Advantage plans often include prescription drug coverage and extra benefts to help keep you healthy while also protecting you against expenses that Medicare doesn t cover. These plans typically cap your annual out-of-pocket costs and are also well-regarded for ease of use, convenience and afordability. Advantage MD is a Medicare Advantage plan accepted by Johns Hopkins doctors and hospitals. Medicare Supplement plans work to help ofset some of the expenses Medicare doesn t cover. However, Medicare Supplement plans do not cover prescription drugs you d need to purchase a separate prescription drug plan for that nor do they include the kind of extra benefts that Medicare Advantage plans do. A: Our all-in-one plans save you time and money with coverage for preventive, routine and major health care needs. Plus, Advantage MD plans give you access to Johns Hopkins doctors and hospitals, which are part of our network of over 10,000 providers across Maryland. So you can fnd top-quality care that s close to home. Q: Do I need to go to Baltimore for my health care with Johns Hopkins Advantage MD? A: No, you can choose any of our 10,000+ participating providers, located right in your community and across Maryland. Have questions? We re here to help! Call (TTY: 711) 8 a.m. to 8 p.m., seven days a week to get your questions answered or to set up an in-person meeting with one of our Medicare Experts. From April 1 September 30, you will need to leave a message on holidays and weekends.

12 Stay connected and be prepared Keep this important contact information handy as you approach your Medicare Initial Enrollment Period. Johns Hopkins Advantage MD (TTY: 711) HopkinsMedicare.com Medicare Specialists are ready to answer your questions or help you enroll, 8 a.m. to 8 p.m., seven days a week. Centers for Medicare & Medicaid Services MEDICARE ( ) (TTY: ) medicare.gov 24 hours a day, seven days a week. Social Security Administration (TTY: ) ssa.gov 24 hours a day, seven days a week. Speak directly with a representative from 7 a.m. to 7 p.m., Monday Friday. From April 1 September 30, you will need to leave a message on holidays and weekends.

13 Better care begins with Your doctor Your primary doctor is the key to coordinating your health care. It s why Advantage MD gives you access to over 10,000 providers all connected to the services you need to stay healthy. And all providing the high standard of care that Johns Hopkins has been known for. Accepted at major health care systems across Maryland including Johns Hopkins. Adventist HealthCare LifeBridge Health Anne Arundel Medical Center Mercy Medical Center Frederick Regional Health System Peninsula Regional Johns Hopkins Medicine Medical Center Other providers are available in our network. Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. Enrollment in Johns Hopkins Advantage MD HMO or PPO depends on contract renewal. This information is not a complete description of benefts. Call (TTY: 711) for more information. Advantage MD products are offered by Hopkins Health Advantage, Inc., a Maryland health insurer. To join a Johns Hopkins Advantage MD plan, you must have Medicare Part A and Part B, and live in the service area (Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester counties). Please contact the plan for more details. Out-of-network/non-contracted providers are under no obligation to treat Johns Hopkins Advantage MD members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Advantage MD products are offered by Hopkins Health Advantage, Inc., a Maryland health insurer. Notice of Nondiscrimination: Johns Hopkins Advantage MD (PPO) and Johns Hopkins Advantage MD (HMO) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. Foreign Language Assistance: Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: 711) Chinese: 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (TTY: 711) Y0124_N2MGdbk3_1018_M Accepted 9039(11/18)N2MGB