By Kay Kaylor
I advocate for residents in extended care and assisted living residences as the regional long-term care ombudsman. I also am a Senior Medicare Patrol and State Health Insurance Assistance Program counselor, all as an employee of San Juan Basin Area Agency on Aging (SJBAAA). The many aging and care concerns will be addressed here.
For Medicare beneficiaries, in addition to the Medicare Advantage and Part D Prescription Plan Open Enrollment Period that ends Dec. 7, two special enrollment periods begin Jan. 1, 2021, including one unique so far to Colorado and 2021.
As mentioned in October, people already enrolled in a Medicare Advantage plan may change plans or go back to Original Medicare and enroll in a Part D plan from Jan. 1 to March 31 each year. For 2021, Colorado created a regulation that allows people who have a Medigap Supplement C or F to change to D or G at any insurance provider that covers Colorado without underwriting or increased prices, a classification known as Guaranteed Issue. Beneficiaries may call a Medigap company to make the switch now, effective Jan. 1; the period ends June 30.
Why switch? Plans C and F are no longer available to people eligible for Medicare Jan. 1, 2020, or later, and in price comparisons these plans have monthly rates that add up in a few months to paying more than the benefit difference between them and D and G. The only difference between C and D and F and G is that C and F cover the Part B medical deductible, paid once a year.
In 2021, the Part B deductible will be $203. The Part A deductible will be $1,484, and the Part B monthly premium will be $148.50.
The Medigap regulation also has made an exception for people losing a Rocky Mountain Health Plans cost plan if they were eligible for Medicare before Jan. 1, 2020. These beneficiaries have the option of enrolling in Plan D or G, in addition to six other Medigap plans: A, B, C, F, K and L.
Medigap beneficiaries enrolled in C or F should have received a letter in the past couple months about the Colorado Medigap period, which the Department of Regulatory Agencies finalized Nov. 20. Insurance agents should know about it, but when talking to them mention the Colorado Guaranteed Issue regulation.
Ongoing scams and new Office of the Inspector General website
A scam involving Medicare cards is the attempt to get your Medicare number by claiming Medicare cards now have data chips in them, like those on credit cards. Medicare has not changed cards since the switch from using Social Security numbers as the beneficiary number. Advocates advise not carrying the cards, either, so you will not be tempted to use them to prove you are a beneficiary in improper places, such as booths, rather than for a legitimate medical provider.
Beware of all unsolicited phone calls, some offering “help” with back or neck pain and others trying to entice you to give information or money for COVID-19 rapid tests and early vaccines. Such callers seem realistic and are taking advantage of common pain complaints and current news stories. The best advice, besides hanging up, is to initiate any contacts yourself. One clue to a scam is whether the caller will reveal a call-back phone number. Many scammers say only they can do the calling.
The federal Office of Inspector General (OIG), part of the Department of Health and Human Services, has launched a new website encouraging the public to advocate for the elder population, especially residents of long-term care facilities. Titled Operation CARE, the website, oig.hhs.gov/fraud/care, offers information about elder harm and neglect, including health insurance scams. Links from it lead to other OIG programs.
SJBAAA offers resources for people age 60 and older or on Medicare; see sjbaaa.org. For further information, please call or text 403-2165 or send an email to firstname.lastname@example.org.