Medicare open enrollment period ends March 31

Dezarae Willetto, a Senior Certified Pharmacy Technician at Walgreens, fills a prescription on Monday in Gallup. Those who are eligible for the Medicare Advantage Program are encouraged to apply by the end of the month to qualify for benefits. — © 2009 Gallup Independent / Brian Leddy

Copyright © 2009
Gallup Independent
By Jim Tiffin
Cibola County Bureau

GRANTS — For those who are age 65 or older and those on Social Security disability who receive Medicare parts A and B, the open enrollment period for joining a Medicare Advantage or Medicare private fee for service health plans ends on March 31.

People who are qualified may enroll, disenroll or change plans during the first three months of every year.

Thomas Burton, 51, of Grants, said he changed his plan from Humana to United Healthcare’s SecureHorizons because of changes in the Humana plan.

“The plan changed its benefits and told me I would have a monthly copay fee beginning in January,” he said. “I’m on disability and that monthly fee would have been difficult to make. It also had higher copay this year.

“So, I checked into the SecureHorizons plan, which was approved to be offered in Cibola County for the first time and it had no monthly co-pay and better benefits as an outpatient,” he said.

Both the Medicare Advantage and private fee for service plans offer the Medicare Part D drug plan, which offers prescriptions drugs, usually the generic version, and low copays for those drugs.

Many of those who qualify are not aware they may join a plan, or once in a plan — if they find it not to their liking — can change.

Maria Garcia, 68, of Laguna, said she did not know she could change her plan and that she would check into it when she went home after finishing her shopping in Grants.

Medicare private fee for service plans are the fastest growing plans in the nation with 45 percent of the growth in Medicare Advantage plans since June 2008, according to the Government Accountability Office.

The advantage to these plans is tremendous, giving more benefits than just having Medicare by itself. They offer lower copays for medication, for hospitalization, for durable medical goods and sometimes, like in the case of Secure Horizons, offer free diabetic supplies when prescribed through a pharmacy by a physician.

Plan members may choose their own doctors, as long as that doctor accepts Secure Horizons and agrees to able by the plan’s rules and billing procedures.

Most hospitals, like Cibola General, accept Secure Horizons, Humana and most, if not all, of the Medicare Advantage and private fees for service plans.

Private fee for service plans are being offered more in rural areas because residents in those areas do not have the medical options, ie: more doctors, more hospitals, etc., as in urban areas, the Government Accountability Office states.
Jose Villanueva, an independent insurance agent, is available to enroll eligible members in United Healthcare’s SecureHorizons at Walmart in Grants, from 10 a.m. to 2 p.m. Monday through Thursday through March 31. It is the plan that AARP members have.

“I advise everyone not to wait until the last week to try to enroll,” he said. “Last year, I had long, long lines and I was not able to get to everybody that wanted to enroll or change.”

Medicare also offers plans for those who have special needs but must meet certain eligibility requirements. For information on these plans contact: 1-800-MEDICARE or TTY 1-877-486-2048, 24 hours each day, every day of the year.

Special needs have been defined as low-income; those living in nursing homes or are institutionalized; and certain disease-specific conditions, such as diabetes, congestive heart failure or chronic obstructive pulmonary disease.

On the net: www.medicare.gov
To contact reporter Jim Tiffin call (505) 285-4560
or e-mail: jtiffin.independent@yahoo.com.