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Monmouth, IL 61462

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Serving Fulton, Hancock, Henderson, Henry, Knox, McDonough, Mercer, Schuyler, Rock Island, and Warren Counties.

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How to Deal with a Loved One That Refuses Needed Support There Really Is No Place like Home Home Care 101 Risks of Hiring a Private Caregiver HOME

Open enrollment for Medicare is going on now through December 7th, 2014. This is an important time of year for Medicare beneficiaries. It is the time of year that you have the chance to make changes to your plans. Plans change each year so it is important to have your information checked with a Senior Health Insurance Program Volunteer (SHIP worker) to ensure you are enrolled in the best plan for you and your health care needs.  

Medicare A benefits are your hospital benefits. This is the insurance for when you are in the hospital, skilled nursing facility, or are receiving home health or hospice care.

Medicare B benefits are your medical benefits. This is the insurance that covers your doctor visits, lab tests, surgeries, medical supplies, outpatient services, and more.  

Medicare D is your prescription drug coverage. Medicare D is offered by private insurance companies that contract with the government to provide coverage. Medicare D plans are mandatory, unless you have a letter from your employer-based insurance or private insurance stating the benefits you currently have are as good or better than the Medicare plans. If you do not take any medications, you still need to choose a plan when eligible for Medicare to avoid a penalty when you do enroll.    

Medicare C is a Medicare replacement plan. These plans are also through a private insurance company and replace regular Medicare benefits and lump all of the Medicare benefits into one plan such as HMO or PPO’s. They also usually include your prescription drug plan. There are additional premiums for these plans, but unlike other plans, this is optional. It is important for people in our rural area to really look at these plans and make sure your preferred doctor, hospital, home health agency, and other providers are in network. If they are not, you will have to choose new providers. Remember, Medicare C is optional, and you do have a choice to stay on regular Medicare.

If you have both Medicare and Medicaid benefits, due to a new Managed Care Model that Illinois is implementing, you will now have an option for a Managed Care Organization provide all of your benefits. These are private insurance companies that contract with the state to provide all Medicare/Medicaid benefits. You will hear the term dual eligible referenced, and it means that you have both Medicare and Medicaid benefits. Your Medicaid benefits are your state of Illinois benefits and you must meet financial criteria to qualify for these. If you fail to opt out of this program, the state will automatically enroll you in a plan. At this time, Knox County is the only county in the immediate area participating in this new model, but at some point the entire state may move into this model.

If you or someone you know is reviewing their plan please remember or remind them to check their preferred home care agency to be sure it is in network with their plan choice. Western Illinois Home Health Care is a full service provider in your area. Please call 1-800-228-5993 if you or someone you know is in need of home services.

Amanda Powell, BSW is a Senior Care Manager for Western Illinois Home Health Care.  

Getting to Know Your Medicare Benefits

October 2014

by Amanda Powell

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