How Medicare Part B pays for a colonoscopy under Preventative Services.

Medicare Myth: “ I can enroll any time I want to”

The Annual Enrollment Period (AEP) is just around the corner. AEP happens annual, October 15 th to December 7 th , and is approximately a six week time frame when you can change your Medicare plan. The new plan selected during AEP will take effect January 1 st of the following year.

There are other opportunities to enroll in Medicare, for example, when you are new to Medicare at age 65 or due to a disability or certain illnesses. Another opportunity to enroll in Medicare is when you leave your employers group health insurance plan (at age 65 or older). There are qualifying opportunities to change your Medicare plan outside the Annual or Open Enrollment Period (AEP) and SOME of the opportunities are if you have EPIC, Extra Help, Medicaid. List is NOT an all inclusive list.

WARNING: This is NOT an all inclusive summary of your Medicare options and enrollment periods. This is a brief description to start a conversation and awareness of the upcoming AEP/Open enrollment period. Call for more information and questions that pertain directly to your specific situation.

Did you know that Medicare Part A and Part B, known as Original Medicare, does not cover everything?

Here is a list of what Medicare does not cover:

Alternative Medicine, Cosmetic Surgery, Long-term Care, Personal Care, Dental and Vision Care, Routine Hearing Exams, Foot Care, Non-Emergency Services, Overseas Coverage.

For more information on what Medicare does and does not cover, you can visit:

           http://medicare.gov/pubs/pdf/10050.pdf    

This booklet  is called the “Medicare and You” booklet for 2015.  On Page 62, it will further explain what is not covered by Medicare.

However, some of these services may be covered under a Medicare Advantage plan, like:  dental and vision care, foot care, and hearing.

On August 20, 2013, an announcement was made that the NY Health Benefit Exchange, the state’s health insurance exchange under the federal health-care reform law, is now called “NY State of Health.”   Website: www.NYStateofHealth.ny.gov

What is the NY State of Health?  It is an insurance marketplace for New Yorkers to purchase affordable and comprehensive insurance coverage for themselves, their family, or for their small business employees.

The health-care reform law known as Patient Protection and Affordable Care Act of 2010 requires individuals to have health insurance coverage effective January 1^st, 2014, or pay a penalty.

The Exchange Open Enrollment period becomes available to purchase insurance starting October 1^st, 2013.

Exchange plans can be purchased online, by phone (call center), or through an agent/broker.  Once online a person can shop, compare, and enroll in a health plan.

Licensed, local, certified agents and brokers can be found on:  www.dfs.ny.gov starting October 1^st.

Federally subsidized premium tax credits will be available for New Yorkers who purchase coverage for themselves, based on income level, to help further reduce their costs.  Individuals can determine if they qualify for the tax credits through the application process.

Employers with up to 50 employees can also obtain health coverage for their employees through the Small Business Health Options Program (S.H.O.P).  Employers have an October 1^st deadline to provide all employees with a written notice about the upcoming health insurance marketplace.  Call me for details.

As of October 1^st, 2013, I will be certified to educate, consult, and enroll individuals and small businesses into the “NY State of Health” insurance plans. Please call me to schedule an appointment to discuss your options, enrollment, and premium tax credits.

I can be reached at 315-676-4933 or email: tcangemi@twcny.rr.com.