Medicare in Minnesota 2012 Your Medicare: Making the Best Possible Decisions October 2011 Presented by Stephanie Minor Senior LinkAge Line® Program Consultant Minnesota Board on Aging

Overview Open Enrollment Period Changes 2012 Medicare Changes Assistance with Medicare Out-of-Pocket Costs Reminder of 2011 Medicare Changes Resources –Health Care Choices –Senior LinkAge Line® –Online Resources

Open Enrollment Period Change Open Enrollment Period –October 15, December 7, 2011 (54 days) –Will need to make plan changes during this time period Medicare Part D and Medicare Advantage No changes from December 8 – December 31, 2011 –Plan effective date will be January 1, 2012 Not seeing huge increase in premiums

Medicare in Minnesota 2012 Medicare Advantage Options –4 Local HMO Plans –9 Preferred Provider Organization Plans –1 Private Fee-for-Services Plan –3 Special Need Plans for Chronic Conditions –8 Special Need Plans for Duals 65+ –3 Special Need Plans for Duals under age 65 Other Medicare Plans –21 Cost Plans Stand Alone Prescription Drug Plans –33 Options

Reduced Medicare Prescription Drug Benefit (Part D) Donut Hole Beneficiary Costs 2011 –50% discount on brand name drugs purchased while the beneficiary is in the donut hole –7% discount on co- insurance for generic drugs purchased while the beneficiary is in the donut hole. Beneficiary pays 93% 2012 –50% discount on brand name drugs purchased while the beneficiary is in the donut hole –14% discount on co- insurance for generic drugs purchased while the beneficiary is in the donut hole. Beneficiary pays 86%

5% 95% Catastrophic Benefit 100% with discounts 75%25% $320 Deductible Monthly Premium $2, $6, $ $2,930 $.01 - $320 Over $6, (copays of $2.60/$6.50 or 5%) Drug Costs Beneficiary Costs Part D Plan 2012 Part D Standard Benefit No Extra Help (LIS) Donut Hole 50% discount on Brand Name drugs 14% discount on co-insurance for generic drugs

Medicare Prescription Drug Benefit Changes Beginning 1/1/12 –Full duals receiving home and community based services Those on Elderly Waiver, as well as CAC, CADI, BI or DD Waivers Part D cost sharing will be the same as it is for beneficiaries in a SNF or ICF/MR –$0 cost sharing for full duals »Waiver clients

Reminder: Medicare Advantage Disenrollment Period January 1, 2012 – February 14, 2012 During this Medicare Advantage Disenrollment period, –Beneficiaries can dis-enroll from a Medicare Advantage plan and switch to Original Medicare –Beneficiaries can enroll in a Stand Alone PDP plan for Part D coverage –Beneficiaries enrolled in a Medicare Advantage plan cannot switch to another Medicare Advantage plan –Beneficiaries in Original Medicare cannot enroll in a Medicare Advantage plan

Medicare Advantage Updates 5-Star Rating System: –Beginning January 2012, plans may receive higher payment if demonstrate providing high-quality care to enrollees (must receive 5 stars) –Plans receiving 5-star rating may enroll beneficiaries year round Minnesota has no 5-star plans in 2012

Extra Help with Prescription Drugs Extra Help (Low-income Subsidy) –Administered by the Social Security Administration –Helps lower the cost of the Medicare Part D premium, deductible and out-of-pocket drug costs –Paper application or apply online at –Income and Asset Guidelines for 2011: Income: –Single: $1, $1,361.25/mo. –Couple: $1, $1,838.75/mo. Assets: –Single: $12,640 –Couple: $25,260

Medicare Savings Programs (MSP) Helps individuals under 135% of Federal Poverty Guidelines pay for medical and prescription drug expenses Apply through county of residence Three types of MSPs –QMB: Covers Medicare Part A premium (if any), Part B premium, Parts A and B out-of-pocket costs –SLMB and QI: Covers Medicare Part B premium –All MSPs reduce Medicare Part D prescription drug costs: No deductible No premium (if on a benchmark) Lower copays

Medicare Reminders from 2011 Annual Wellness Visit –Receive personalized prevention plan services (PPPS) Establish a screening schedule for the next 5 to 10 years Provide personal health advice and coordinate appropriate referrals and health education Preventive services –Eliminates cost-sharing for most Medicare-covered preventive services –This includes the flu shot – don’t forget to get yours!

Health Care Choices 2012 Available online at and –Mid-October (scheduled) Print copies provided to the Senior LinkAge Line® for local community distribution Call to request a copy by leaving your name, address and phone number Includes all Minnesota plan options Also includes information on: –Long-term Care –Medicare Supplements –Help paying for Medicare costs

The SHIP in MN (MNSHIP) = Senior LinkAge Line® State Health Insurance Assistance Program 300+ certified volunteers in Minnesota Medicare and long-term care option experts located in your community Unbiased, Comprehensive, Neutral source State based program that provides –One to one counseling and assistance to people with Medicare and their families –Free service provided through phone, in person, online chat, community events and media activities –Grants provided by CMS –MN Board on Aging is the grantee Senior LinkAge Line® Available in all 87 counties of Minnesota through the Area Agencies on Aging

Senior LinkAge Line®: Your Link to An Expert Senior LinkAge Line® –Statewide –Objective –Comprehensive –Individualized assistance by phone, by online chat, in your community and in your home –There is no fee for assistance provided –Does not sell, endorse or promote any insurance, long-term care or health care product

MinnesotaHelp Network™ is here to help you Senior LinkAge Line® Disability Linkage Line® Veterans Linkage Line™ LinkVet (including Live Chat) Local community based sites throughout Minnesota 2012 edition of Health Care Choices available October 2011

Questions? Thank you! Stephanie Minor