Fewer options for Medicare health coverage

Editor’s note: This story clarifies and corrects information that was published on Page 2A of Monday’s Merced Sun-Star.

Seniors insured under Medicare have until Dec. 7 to change or create their health coverage plan for next year. All changes will take effect on Jan 1.

This enrollment period, there are fewer stand-alone prescription drug plans and Medicare Advantage plans to choose from, according to Gretchen Jacobson, associate director for Kaiser Family Foundation, a nonprofit organization that focuses on national health issues.

As of March, there were about 3,600 seniors in Merced County enrolled in Medicare, Jacobson said.

When an individual chooses to go with traditional Medicare, they have to purchase a separate plan for coverage of prescription drugs, Part D, said Jack Cheevers, public information officer for the Centers for Medicare and Medicaid Services.

“It’s important to read through plans and make sure all drugs needed are on that plan,” Cheevers said.

In California, everyone on traditional Medicare can choose from 22 prescription drug plans this year, Jacobson said. Last year there were 26 options.

For those with health coverage under Medicare Advantage plans in Merced County, there are two plans this year compared to the five last year, said Jacobson. The health insurance plans available this year are through Care1st and United Health Care with AARP.

Both of the monthly premiums for Medicare Advantage plans increased from last year, Jacobson said.

“For those making new choices, it can be difficult to choose,” Jacobson said.

While looking through different health plans, Jacobson advises people to look at the costs for services, the network of doctors and extra benefits offered, such as eye and dental coverage.

The cost and terms of the doctors or hospitals an individual has access to can change, Cheevers said, and it’s important individuals make sure they have access and coverage of the physicians they need.

There isn’t one “overriding reason” for fewer health coverage options, Jacobson said, because the decisions are made by the companies.

Tricia Neuman, vice president of the Kaiser Family Foundation, said out-of-pocket expenses continue to increase across the country. Looking through the different insurance plans, she said, could be the difference between saving a significant amount of money or not having access to the right medical provider.

Individuals can go to www.medicare.gov to review or enroll in a health plan in their area, including costs and coverage on prescription drugs. For assistance or counseling on health coverage plans, individuals can contact the Health Insurance Counseling and Advocacy Program at cahealthadvocates.org/hicap or call 800-434-0222.

For round-the-clock assistance on coverage options, available in different languages, individuals can call 800-MEDICARE (800-633-4227).

This story was originally published November 16, 2016 at 5:32 PM with the headline "Fewer options for Medicare health coverage."