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December 26, 2007

Seniors may still qualify for Extra Help

By Mary Phillips The Tribune Star Wed Dec 26, 2007, 07:47 PM EST

TERRE HAUTE — Q: I received a letter stating that I will no longer receive Extra Help next year. I am on limited income; is there anything I can do?

A: Letters were sent to Medicare beneficiaries, who no longer automatically qualify for Extra Help. A person has been automatically qualified for extra help if they fell into specific categories. These criteria include: if they have both Medicare and Medicaid (dual-eligible); they are part of the Medicare Savings Program (they get help paying for their Medicare premiums and/or co-pays from Medicaid); or they have Medicare and receive Supplemental Security Income (SSI)

Those beneficiaries who are no longer in one of these categories will not automatically qualify for Extra Help in 2008.

For assistance, call your local SHIP site to make an appointment or call the state office at 1-800-452-4800 to obtain a list of local SHIP sites.

You may still qualify for Extra Help, even if you do not qualify automatically. You will just need to complete an application for Extra Help. Applications were included in the letters informing beneficiaries they no longer automatically qualify.

To speed up the determination process, you can apply online at the Social Security Web site, www.ssa.gov.

Q: What are the enrollment periods for Medicare Advantage Plans?

A: There are four types of enrollment periods for Medicare Advantage Plans (MA): Initial Enrollment, Annual Enrollment, Open Enrollment, and Special Enrollment.

The Initial Enrollment Period is determined by when your Medicare coverage begins. There is a 7-month period for Initial Enrollment. This period includes the 3 months before an individual becomes eligible, the month the person becomes eligible, and the 3 months after the month of eligibility.

The Annual Enrollment Period begins Nov. 15 and ends Dec. 31. Every year during this period, Medicare beneficiaries will be able to enroll into a plan, switch plans or disenroll from a plan and return to Original Medicare.

The Open Enrollment Period runs between Jan. 1 and March 31 each year. You may join or switch plans at this time; however, your choice of plans will be limited based on your prescription drug coverage. Between Jan. 1 and March 31, you will not be able to add or drop drug coverage.

If you have an MA Plan with drug coverage (MAPD), you can join another MAPD plan, Original Medicare with a Prescription Drug Plan (PDP) or a Private-Fee-For-Service (PFFS) advantage plan with a PDP.

If you have an MA Plan with no drug coverage (MA-only), you can join another MA-only or Original Medicare only.

If you have Original Medicare and a PDP, you can join MAPD, or a PFFS with the same PDP.

If you have Original Medicare, you can join an MA-only plan.

Special Enrollment Periods are available when specific conditions occur, such as when you move out of the service area.

For more information on Medicare Advantage Plans and the enrollment periods, call SHIP at 1-800-452-4800, 1-800 MEDICARE (1-800-633-4227), or go to the Medicare Web site www.medicare.gov.

Address your questions to: Ask SHIP, 714 W. 53rd St., Anderson, IN 46013; go to www.Medicare.in.gov; or call 1-800-452-4800.

SHIP is a free, unbiased counseling program provided by the Indiana State Department of Insurance. For assistance, call your local SHIP site to make an appointment or call the state office at 1-800-452-4800 to obtain a list of local SHIP sites.

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