Area Agency on Aging for Southwest Florida HELPLINE: 866-413-5337
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Medicare Minute: Common Fall Open Enrollment Notices

In the month or two leading up to Medicare’s Open Enrollment that runs from October 15 to December 7, expect some important letters about your Medicare! These notices will tell you how your coverage and costs are changing next year. During this Medicare Minute, you’ll learn what to look out for in these notices so that you can evaluate how well your coverage will meet your needs in 2025. For details and a quick reference guide, a handout by the State Health Insurance Assistance Program (SHIP) is available for download.

Common Open Enrollment Notices include:

  • Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) – sent to people who have a Medicare Advantage Plan or Part D plan, look for any changes to the plan’s provider network, costs, and formulary (list of drugs)
  • Medicare & You Handbook – sent to everyone enrolled in Medicare, it includes information about Medicare-covered services and lists Medicare Advantage Plans and Part D plans in your area
    • If you did not receive a Medicare & You handbook, you can call 1-800-MEDICARE to request that your region’s copy be sent to you.
  • Plan Non-Renewal Notice – you will receive this notice in October if you are enrolled in a plan that is leaving the Medicare program in the coming year
  • Consistent Poor Performance Notice – you will receive this notice in late October if you are enrolled in a plan that has received a low rating for three or more years in a row and is sent to encourage you to look at other plan options in your area

Reminder to Read Your Medicare Statements

It is important to read your Medicare statements especially during Open Enrollment as you may be switching plans.

You should receive Medicare Summary Notices (MSNs) if you have Original Medicare (You can also review your MSNs on your online Medicare.gov account).

You should receive Explanation of Benefits (EOBs) if you have a Medicare Advantage Plan or Part D plan.

MSNs and EOBs provide a summary of the services and items you have received and how much you may be billed for them. Remember that MSNs and EOBs are not bills. If you need help reviewing your Medicare statements, you can contact your local SHIP or Senior Medicare Patrol (SMP). 

Reading your MSNs and EOBs is an important strategy for detecting potential Medicare fraud, errors, or abuse. Keep the following tips in mind:

  • Review yours or your loved one’s Medicare statements as soon as they arrive.
  • Keep notes of your medical appointments and compare these to your statements to ensure that your MSN or EOB is accurate.
  • Confirm that everything listed on the statement is accurate—in other words, that you actually received all listed services or items.
  • Contact your health care provider or plan if you have any questions or notice any mistakes on your MSNs or EOBs.
  • Contact the SMP for a My Health Care Tracker (helps you keep track of your appointments) or to receive assistance on how to read your Medicare statements.

For more help, contact your local SHIP, also known as SHINE in Florida (Serving Health Insurance Needs of Elders). Call 866-413-5337 or email shineinfo@aaaswfl.org.

Contact your local SMP if you receive any notices or Medicare statement charges that seem suspicious. SMP representative can teach you how to spot and protect yourself from potential Medicare fraud, errors or abuse. Your local SMP can be reached at 66-413-5337 or by emailing shineinfo@aaaswfl.org.

The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document was supported, in part, by grant numbers 90SATC0002 and 90MPRC0002 from the Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. [July 2024]

Area Agency on Aging Hosts 2nd Annual Community Resource Fair

In an effort to connect older adults and adults with disabilities in Southwest Florida to important resources and services, the Area Agency on Aging for Southwest Florida (AAASWFL) is hosting their second annual Community Resource Fair at its offices in Fort Myers. The event is scheduled for Friday, September 13, 2024, from 10:00 a.m. to 12:00 p.m. at 2830 Winkler Avenue, Suite 112, Fort Myers, FL 33916.

Anticipated exhibitors that community members can engage with include Lee Health – providing free health screenings, Florida Power & Light (FPL) – sharing information about lowering utility costs, and Sam’s Club – providing membership opportunities.

Door prizes will be raffled during the event and community members can connect with essential resources for living safely and independently. The Pacos Tacos food truck will be on-site and open for purchasing snacks.

If you plan on attending AAASWFL’s 2024 Community Resource Fair, complete this brief form: Event Registration.

Exhibitor opportunities are still available, contact Sarah Gualco, Director of Programs and Planning at sarah.gualco@aaaswfl.org if your organization is interested in partnering with the Area Agency on Aging for SWFL for this event.

The Area Agency on Aging for Southwest Florida is a 501(c)3 organization serving Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota Counties. AAASWFL has been operating for 45+ years to provide information and referrals, screening and assessment for Long-Term Care programs, and Medicare counseling. More information is available by visiting the AAASWFL website (www.aaaswfl.org) or by calling the Helpline: (866) 413-5337.

Helping Seniors Stay Connected with Free Tablets!

To help combat social isolation and promote digital literacy, the Area Agency on Aging for SWFL recently offered free tablets along with technology training in three of the seven counties we serve. We partnered with several local organizations to host and assist with training.

Thank you to the following organizations for your support in engaging members of your community:

Collier County Public Library, Everglades City 
Dr. Piper Center for Social Services
Lee County Library System
Neighbors Network of Lee County 
Senior Friendship Centers of DeSoto County 
Unity of Fort Myers

The training sessions also served as an opportunity for the Area Agency on Aging for Southwest Florida to share valuable resources with participants, including navigating our website to find upcoming events, connecting to SHINE Medicare counseling, and signing up for health and wellness classes.

It was a great experience for everyone involved.

We appreciate The Community Foundation for the generous grant that made this opportunity possible!

Make a Difference by Helping Others Navigate Medicare!

Navigating Medicare can be complicated but SHIP counselors can help by answering questions and providing personalized guidance to those who need it.

Make a difference by helping others navigate Medicare, join our team! In Florida, your local SHIP program is SHINE (Serving Health Insurance Needs of Elders). Learn more about volunteering with SHINE. We currently need volunteers in DeSoto, Glades, Hendry and Sarasota counties.

SHINE provides unbiased support to Medicare beneficiaries and their families so they can make informed decisions about their care and benefits.

Medicare Minute: Cost Saving Programs

From premiums to copays and deductibles, it can feel so difficult to afford health insurance—especially with rising costs all around us. In this Medicare Minute, we’ll tell you about programs that can help you save on your Medicare costs. Expect to hear about programs like the Medicare Savings Program, Extra Help, and more. You can also attend our “SHINE Medicare Financial Assistance” webinar held by our SHINE Medicare experts at the beginning of every month. Visit our event calendar for dates.

What is the Medicare Savings Programs?

Medicare Savings Programs (MSPs) are state programs that help cover your Medicare costs. To qualify for a MSP, you must meet your state’s income and asset limits. Below are the baseline federal income and asset limits for each MSP. Most states use these limits, but some states have different guidelines, such as different income limits or not imposing asset limits. You should consider applying for the MSP even if you are over the limits, because some income and assets are not counted toward the limits. There are three main programs, each with different benefits and eligibility requirements:

MSP

Benefits

Monthly income limit

Asset limit

Qualified Medicare Beneficiary (QMB)

– Pays Part A and B premiums

– Eliminates cost-sharing for Medicare-covered services

Individual: $1,275

Couple: $1,724

Individual: $9,430

Couple: $14,130

Specified Low-income Medicare Beneficiary (SLMB)

– Pays Part B premium

Individual: $1,526

Couple: $2,064

Individual: $9,430

Couple: $14,130

Qualifying Individual (QI)

– Pays Part B premium

Individual: $1,715

Couple: $2,320

Individual: $9,430

Couple: $14,130

What is Extra Help?

Extra Help is a federal program that helps pay for most of the out-of-pocket costs of Medicare prescription drug coverage. If you have Medicaid, and MSP or receive Supplemental Security Income, you will be automatically enrolled in Extra Help. If you are not enrolled in these programs, you must apply directly and meet the eligibility requirements below:

Income limit

Asset limit

Benefits

Individual: $1,903 /month

 

Couples: $2,575 /month

Individual: $17,220

 

Couples: $34,360

$4.50 generic copay

$11.20 brand-name copay

$0 deductible and premium (for a basic Part D plan with a premium at or below your state benchmark)

Medicare Cost Assistance Programs

Below is information on programs that can help you save on your Medicare costs. To learn more about these programs and receive help with applications, contact your local State Health Insurance Assistance Program (SHIP), known as SHINE (Serving Health Insurance Needs of Elders) in Southwest Florida, at 866-413-5337 or email shineinfo@aaaswfl.org.


What other programs can help me save money on my care?

State Pharmaceutical Assistance Programs (SPAPs)

• Many states offer SPAPs to help residents pay for prescription drugs.
• Each program works differently and has different requirements for eligibility.
• To learn if your state has an SPAP and find out if you qualify, call your SHIP.

Facilities that may offer care at a reduced cost

  • Human Resources and Services Administration (HRSA) facilities
    • HRSA facilities may also be called Federally Qualified Health Centers (FQHCs).
    • Hundreds of these government-funded health centers around the country provide medical care regardless of your ability to pay.
    • For more information, contact your SHIP.
  • The Hill-Burton Program
    • The Hill-Burton Program offers free or reduced cost care at Hill-Burton facilities.
    • Most states have the Hill-Burton program.
    • Services that are fully covered by other types of insurance (like Medicare or Medicaid) are not eligible for Hill-Burton coverage.
    • Eligibility for the Hill-Burton program is based on your income and family size.
    • To apply, call the Admission, Business, or Patient Accounts office at a Hill-Burton facility.

Medicaid

  • People can be eligible for both Medicare and Medicaid.
  • Medicaid can cover services that Medicare does not, like long-term care.
  • It can also pay secondary to Medicare, picking up Medicare’s out-of-pocket costs, like copayments or coinsurances.
  • Generally, your income and assets must be below a certain amount to qualify, but this amount varies from state to state and from program to program.
  • Call your local Medicaid office to learn about Medicaid programs in your state.

What other benefits, rights, and protections come with MSP? Download the full handout on Medicare Savings Programs this post is an excerpt from for more. 

Call your local SHIP and SMP at 866-413-5337 or email shineinfo@aaaswfl.org for assistance.

The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document was supported, in part, by grant numbers 90SATC0002 and 90MPRC0002 from the Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. [July 2024]

Donut Hole? Medicare Drug Plan Coverage Gaps

Most Medicare drug plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. You enter the coverage gap when your total drug costs—including what you and your plan have paid for your drugs—reaches a certain limit.

In 2024, that limit is $5,030. While in the coverage gap, you are responsible for 25% of the cost of your drugs.

A SHIP (SHINE) counselor can answer your Medicare questions and help you understand coverage and options!

To reach SHINE, call the Helpline at 866-413-5337.

Medicare Minute: New to Medicare

If you or a loved one will soon be eligible for Medicare, join us for this Medicare Minute! We’ll go over all the basics you should know—from enrollment periods to coverage choices and beyond.

Some people are automatically enrolled in Medicare. For example, if you are already receiving retirement benefits from Social Security when you become Medicare-eligible, or if you’ve been collecting Social Security Disability Insurance for two years. If you are automatically enrolled, you should receive a package in the mail with your Medicare insurance card telling you so. Otherwise, there are three times to enroll in Parts A and B:

Initial Enrollment Period (IEP): The three months before, the month of, and the three months after your 65th birthday.

Special Enrollment Period (SEP): Allows you to delay Medicare enrollment without owing a late enrollment penalty. You may qualify for an SEP if:

  • You or your spouse (or sometimes another family member) are still working, and you are covered by the employer health insurance. Note that you shouldn’t delay Medicare enrollment if this employer coverage pays secondary to Medicare.
  • You have experienced other exceptional circumstances, like losing Medicaid coverage, being released from incarceration, being misinformed by an employer, or being impacted by an emergency or disaster.

General Enrollment Period (GEP): Every year from January 1 through March 31. You may owe a late enrollment penalty and face gaps in coverage if you use the GEP.

Download the full “New to Medicare” handout by the State Health Insurance Assistance Program (SHIP). 

The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document was supported, in part, by grant numbers 90SATC0002 and 90MPRC0002 from the Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. [April 2024]

Spot the Signs of Elder Abuse

Abuse can happen to any older person. Learn about the different types of abuse, how to recognize the signs, and where to get help.

Source: NIIH.org

There are different types of abuse: 

  • physical
  • emotional
  • neglect
  • sexual
  • financial
  • abandonment

Be alert to the following signs:

Depressed, confused or withdrawn

Isolated from friends and family

Unexplained bruises, burns or scars

Appear dirty, underfed, dehydrated, over or under medicated

Bed sores

Changes in banking or spending patterns

Medicare Minute: Preparing for Future Health Care Needs

Many people assume that their family members would automatically be able to make decisions about medical treatments if they were to become incapacitated. However, rules vary greatly from state to state:

  • Your family may have to go through a costly and time-consuming court process to get the legal right to make medical decisions for you.
  • Your family members may disagree on who should make medical decisions on your behalf, which could lead to legal disputes.
  • Someone unfamiliar with your preferences may be placed in charge of your treatment choices.

It’s important to have a plan ahead of time to avoid disagreements around treatment issues and to ensure your wishes are honored if you are incapacitated. Advance directives, living wills, health care proxies, and powers of attorney can help ensure that decisions made on your behalf meet your needs and preferences.

Important documents to have include:

  • Health care proxy – Names someone you trust as your proxy, or your  agent, to express your wishes and make health care decisions for you if you’re unable to speak for yourself.
  • Living will – A written record of the type of medical care you would want in specified situations.
  • Advance directive – Often refers to a combination including both a living will and health care proxy documents.
  • Power of attorney – Names someone you trust as your agent to make property, financial, and other legal decisions on your behalf.

For detailed tips on preparing these documents download the “Preparing for Future Health Care Needs” handout by the Medicare Rights Center. 

To understand how Medicare covers hospice and for answers to other Medicare coverage questions, contact your State Health Insurance Assistance Program (SHIP). You can visit www.shiphelp.org or call your local SHINE Medicare Counselors at 1-866-413-5337.