1. Using the Medicare Plan Finder Presented by the Aging and Disability Resource Center of Brown County July 2016

2. WE ARE HERE TO HELP!!!

3. OBJECTIVES FOR TODAY Part D Overview Part D Overview What is Part D, How Does it Work What is Part D, How Does it Work Part D Terminology Part D Terminology Enrollment Periods/Opportunities Enrollment Periods/Opportunities Premium Issues Premium Issues Medicare.gov plan finder demonstration Medicare.gov plan finder demonstration Medicare.gov Important contact information Important contact information

4. WHAT is Part D?? Optional coverage for prescription drugs Must have either Part A or Part B Coverage offered by private insurance Must live is the service area (usually state- wide) Stand-alone plan or part of Medicare Advantage plan (Part C) One year contracts

5. TERMS to KNOW Deductible Co-payments/Co-insurance Tiers Formularies Initial Coverage Limits Donut Hole or Coverage Gap Catastrophic Coverage

6. Enrollment Opportunities Initial 7-month window Special enrollment periods Extra Help or LIS Annual open enrollment Penalty for late enrollment

7. Open Enrollment Joining, switching or dropping your Medicare Part D prescription drug plan Joining, switching or dropping your Medicare Part D prescription drug plan Annual or Open Enrollment Period dates Annual or Open Enrollment Period dates

8. Coverage Begins January 1 Part D enrollment lasts for the rest of the calendar year unless you qualify for a special Part D enrollment lasts for the rest of the calendar year unless you qualify for a special enrollment period: enrollment period: Special Enrollment: Special Enrollment: Qualify for Extra (LIS) help from SSA Qualify for Extra (LIS) help from SSA Eligible for any Medicaid Progam Eligible for any Medicaid Progam Move out of service area Move out of service area Loss of other creditable prescription coverage Loss of other creditable prescription coverage Live in an institution (temporary or permanent) Live in an institution (temporary or permanent)

9. WISCONSIN PART D PLANS 27 Plans available for 2016 27 Plans available for 2016 7 Benchmark Plans ($0 premium if eligible for extra help) 7 Benchmark Plans ($0 premium if eligible for extra help) 12 Medicare Advantage plans include drug coverage for 2016 12 Medicare Advantage plans include drug coverage for 2016 All Special Needs Plans include drug coverage All Special Needs Plans include drug coverage

10. Part D Costs All PDP’s have monthly premiums All PDP’s have monthly premiums Premium range from $18.40-$139.40 (2016) Premium range from $18.40-$139.40 (2016) Individuals over $85K, couples over $170K have higher premiums (about 5% of universe) Individuals over $85K, couples over $170K have higher premiums (about 5% of universe) Deductibles and coverage gaps Deductibles and coverage gaps Catastrophic coverage Catastrophic coverage

11. Assistance Programs Extra Help or Low Income Subsidy (LIS) Helps reduce Part D costs Apply through Social Security Seven (7) low-cost plans See Handout “Save on Drug Costs” Medicare Savings Programs Helps pay for Medicare premiums, possibly deductibles and co- insurance Apply through Economic Support (Bay Lakes Consortium) See Handout “Medicare Savings Programs” Income and asset limits for both programs Contact ADRC and ask to speak with a Benefit Specialist for assistance

12. Other Creditable Rx Coverage  Employer/Retiree Groups Prescription coverage (need to check with Employer)  Military/TriCare/Veteran’s Prescription coverage  FEHB (Federal Employee Health Benefits)  SeniorCare (see handout in folder)  COBRA (creditable for drug coverage)  Indian Health Service 12

13. SeniorCare (Handout)  Age 65 and over  “Creditable coverage” for Part D  Cost $30 single or $60 couple per year fee  Coverage level depends upon income  No asset test  Extended through December 2018; requires federal approval 13

16. https://www.youtube.com/watch?feature=player_embedde d&v=4SCvgSZURBA#t=0

17. Plan Finder: Lesson 1 GETTING STARTED (Time 4:51) What is the Plan Finder? Information to Gather Things to Consider Using the Help Feature How to Start the Plan Finder STOP for Discussion and Questions

18. Plan Finder: Lesson 2 Entering your Prescription Drugs (Time 5:08) Entering your Drugs Saving your Drug List Retrieving Data/Information Reviewing your Drug List My Current Profile STOP for Discussion and Questions

19. Plan Finder: Lesson 3 Selecting Pharmacies (Time 1:47) Choose Up to Two (2) Pharmacies (recommended) Expanding your Pharmacy Search STOP for Discussion and Questions

20. Plan Finder: Lesson 4 Refining and Sorting your Plan Results (Time 5:19) Summary of Search Results Refining or Filtering Results Your Plan Results Quick Summary of Each Plan Comparing Up to 3 Plans Enrolling Pharmacy Status Sorting (Estimated Cost Default) STOP for Discussion and Questions

21. Plan Finder: Lesson 5 Comparing Plans (Time 6:05) Plan Overview Plan Benefits Creating Customized Reports Drug Costs Plan Ratings STOP for Discussion and Questions

22. How/Where to Enroll Complete paper application Complete paper application Call plan Call plan Enroll on the plan’s Web site Enroll on the plan’s Web site Enroll using www.medicare.gov Enroll using www.medicare.govwww.medicare.gov Call a licensed insurance agent Call a licensed insurance agent

23. Cautionary Notes Plan Finder provides only an estimate of your costs Plan Finder provides only an estimate of your costs Contact plans for actual costs before Contact plans for actual costs before you enroll you enroll Enroll directly on the Plan Finder by clicking “Enroll” Enroll directly on the Plan Finder by clicking “Enroll” Other options – contact plan, call 1-800- Medicare or contact your insurance agent Other options – contact plan, call 1-800- Medicare or contact your insurance agent

24. Changes After December 7 Medicare Advantage Disenrollment Period January 1-February 15 Medicare Advantage Disenrollment Period January 1-February 15 5-star Special Enrollment Period 5-star Special Enrollment Period Low Star Special Enrollment Period Low Star Special Enrollment Period

25. PART D One-on-One Counseling 4 th Wednesday of every month (January-September) Open enrollment season (October 15-December 7) Call the ADRC at 448-4300 to set up an appointment There is no charge for this service; although we do accept donations All plans available in Brown County will be included in the comparison 25

26. Resources Medigap Helpline 1-800-242-1060 www.longtermcare.wi.govwww.longtermcare.wi.gov Medicare 1-800-633-4227 (1-800-MEDICARE) www.medicare.gov www.medicare.gov Social Security (888) 862-4811 (Green Bay) or 1-800-772-1213 (national number) www.ssa.gov Medicaid/Badger Care Plus - Bay Lakes Consortium (Economic Support) 1-888-794-5747 www.access.wi.govwww.access.wi.gov Prescription Drug Helpline (over 60 yrs) 1-855-677-2783 Disability Drug Helpline (individuals between ages 18-59) 1-800-926-4862 26

27. Benefit Specialists Contact your ADRC’s Benefit Specialist for further assistance at: (920) 448-4300  Elder Benefit Specialist – age 60 and older  Disability Benefit Specialist – ages 18-59  www.adrcofbrowncounty.org www.adrcofbrowncounty.org  Like us on Facebook: www.facebook.com/adrcbrowncountywiwww.facebook.com/adrcbrowncountywi

28. THANK YOU Call us at (920) 448-4300