Medicare Counseling

Navigating Medicare

Here's a step-by-step guide to setting up a Medicare account to help you compare plans.  

Follow this schedule to prepare for Open Enrollment:

Medicare Annual Enrollment Review

Medicare beneficiaries should review their coverage every year to determine if they should change plans for the next year. The Annual Election Period (AEP) or Open Season is to change plans is from October 15th thru December 7th.

Medicare Advantage plans and Medicare drug plans make changes to their coverage and costs each year. They raise premiums, raise deductibles or raise copays. They remove certain drugs from their plan formulary or move drugs from one tier to another tier, costing you more money.

 

Early October - Prepare and Compare:

Watch for your Medicare & You Handbook for information about plans in your area.  Your current plan will mail information to you if they plan to make any changes. If you note changes you do not like then you need to consider another plan. You can review which plans are available at www.medicare.gov . You can also call Medicare at 1-800-633-4227. You should start your research now to be ready to enroll soon.

 

October 15 – Open Enrollment Begins:

This is the first day you can change plans with an effective date of January 1st. You should not only compare the cost, but also the coverage and the pharmacy network. Make your choice by early December so that new plan ID cards will reach you by January 1st.

 

December 7 – Open Enrollment Ends:

This is the last day to enroll in a new plan. If you are staying with your current plan you usually do not need to do anything.

 

Do You Need Help Paying Your Plan Costs?

You may qualify for Social Security’s Low Income Subsidy (LIS) Program. If eligible, it can lower the cost of obtaining your medications. Call Social Security at 1-800-772-1213 for more details or go to www.ssa.gov/prescriptionhelp .  You may qualify for Medicaid, which also helps pay these costs, so contact your Medicaid office. 

If you are unable to secure assistance from the above offices contact the Virginia Insurance Counseling & Assistance Program (VICAP). In Harrisonburg and Rockingham County call 540-615-5341. If you live in Staunton, Augusta County or Waynesboro please call 540-949-7141.

 

Need additional assistance?  Certified counselors are available to help individuals and their caregivers make sense of Medicare and compare other health insurance benefits to find the best plans available.

The Virginia Insurance Counseling and Assistance Program (VICAP) is part of a nationwide network of health insurance assistance programs. VICAP is offered at various locations throughout the VPAS service area (see sidebar) and throughout the communities VPAS serves.  Trained and certified counselors assist older adults, persons with disabilities and their caregivers understand and compare Medicare and other health insurance benefits.

VICAP counselors are not associated with any insurance company and do not sell insurance products. Counseling is non-biased, confidential and free and is offered by appointment.  Home visits can be arranged for homebound older adults.

VICAP Counselors provide information on:

  •     Medicare Basics for persons newly enrolling to Medicare.
  •     Medicare Prescription Drug Plans (Part D).
  •     Applying for Extra Help in paying for Part D premiums and drug costs.
  •     Applying for Medicare Savings Programs for help with Medicare premiums, deductibles and co-payments.
  •     Medicare Advantage Health Plans.
  •     Medicare Supplemental Insurance (Medigap).
  •     Medicaid
  •     Long Term Care Insurance
  •     Understanding medical and insurance statements.
  •     Filing claims and appeals.
  •     Medicare and Medicaid fraud and abuse.

 New to Medicare? If you are preparing to turn 65 years old and need help understanding Medicare, we can help. VPAS' certified staff are trained and available to provide you with information to help you better understand Medicare coverage. There is no formal charge for services, however donations are requested.