Colorado Gerontological Society presents Medicare Monday, November 16

October 26, 2:33 PMDenver News ExaminerEd Duffy

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Medicare Monday is a unique opportunity for beneficiaries and their families to learn more about Medicare on November 16 from 9:30 am to 11:30 am at eight different locations throughout Colorado.   Beneficiaries will be able hear from Medicare experts, as well as do some comparison shopping on health plans and prescription drug plans that will be available in 2010.

Medicare Monday Locations

Location:                                                                                                For Reservations:

Cherry Creek Retirement Village ………………...........…… 303.693.0200

14555 E Hampden Ave, Aurora.                                               

Courtyard At Lakewood  ..………………………..….............  303.239.0740

7100 W 13th Ave, Lakewood                                                      

Northglenn Senior Center   ..……………………............…… 303.450.8801

11801 Community Center Dr, Northglenn                                   

RiverPointe  …..………………………………….............……... 303.797.0600

5225 S Prince St, Littleton                                                           

Windsor Gardens …………………………...………...........…… 303.364.9141    

595 S Clinton St, Denver

The Commons at Hilltop, Garden Room …….…...........…… 970-208-1231

625 27½ Road, Grand Junction

Wynwood of Pueblo………………………..............…..………. 719-561-1400

4723 Surfwood Lane, Pueblo

Life Care on the Campus of The Inn at Garden Plaza…...…719-630-1155

 2520 International Circle, Colorado Springs

2010 Changes To Be Discussed at Medicare Monday November 16

Denver, CO.    Are you confused about the maze of Medicare changes coming for 2010?  Health plans are changing benefits, leaving the service area and increasing out-of-pocket expenses; while prescription drug plans are changing formularies, increasing premiums and co-payments and notifying beneficiaries they will no longer be offering the plan in which they are enrolled.  Meanwhile, starting June 2010, beneficiaries who have Medicare supplements will face a host of new plans and changes in coverage as well.Each year, Colorado Medicare beneficiaries are expected to understand the new changes in Medicare itself, as well as these changes made by the plans. Medicare Monday is coming to eight locations throughout Colorado on November 16, 2009 from 9:30 am to 11:30 am to help older adults sort out all of these changes.

The most significant concern is that premiums, deductibles and co-pays for 2010 have not been announced by Medicare, but are expected to stay level for most beneficiaries who are receiving Social Security and not currently employed.

Starting October 1, 2009, beneficiaries who are receiving oxygen are subject to new rules. Durable medical equipment providers, including pharmacies must be accredited and bonded to be able to bill Medicare for services.

Medicare will begin to increase the percentage (currently 50 percent) that it will cover for mental health services as follows: 55 percent of expenses incurred in 2010 or 2011; 60 percent in 2012; 65 percent in 2013; 80 percent in 2014 or in any subsequent calendar year.  Thus, co-insurance will gradually be phased in for outpatient mental health services down to 20 percent by 2014.

More than 5000 Colorado Medicare beneficiaries will lose coverage through their health plan.  Several private fee-for-service plans and medical savings accounts are exiting the Colorado market.  These individuals have a guaranteed enrollment in a new Medicare Advantage plan in their area or a Medicare Supplement.

A number of Medicare Advantage plans offering HMO coverage will be increasing their premiums significantly, some more than $200 per month, and lowering benefits, especially such things as dental coverage.

Colorado has 48 prescription drug plans in 2010, compared to 53 in 2009. Eighteen of those plans have a zero deductible down from 29 in 2009.  Overall, monthly premiums range from $16.40 per month to $98.70 per month.  86% of beneficiaries will experience a premium increase on average of $4.29 per month.

The Part D deductible will increase to $310.  The initial coverage limit, which is the cost of prescriptions paid by the individual, including the deductible and the company, will be $2830, and the coverage gap (or doughnut hole) is $4540.  Once individuals have incurred $6440 of costs of their own funds, they will be eligible for catastrophic coverage in which the plan pays 95% of the cost and the individual pays 5%.

In addition to co-payments increasing, more drugs will be reviewed for quantity limits and prior authorizations, requiring seniors to be cautious about the frequency and dosage of the medications to ensure they will have access to the proper medications.

A major change occurring January 1, 2010 is that many more people will be eligible for the Medicare Savings Program.  Individuals who have monthly incomes of less than $903 ($1214 per month for a couple) and assets of $8100 for a single person ($ 12,910 for a couple) will be eligible for assistance with payments for Medicare Part B premiums.  Some persons may also be eligible for assistance with deductibles and co-payments.

A major consumer protection is that individuals who are eligible for the Medicare Savings Program cannot be subject to estate recovery, meaning the State of Colorado cannot place a lien on their property for using this benefit. In addition, the late enrollment penalty for enrolling in Part D is waived for those needing Extra Help.

Extra Help or assistance with paying for prescriptions may be available to those with monthly incomes of $903 ($1214 per month for a couple) and resources of less than $ 11,010 ($22,010 for a couple). Beneficiaries will no longer have to count the cash value of life insurance and income from other persons for such things as rent or utility assistance to qualify.   Co-payments will range from $1.10 for generics to $6.30 for name brands.

Persons who qualify for Extra Help will automatically be enrolled for the Medicare Savings Program; however, the county department of human services may request additional verification of income and resources, as well as identity and citizenship.

Hundreds of seniors in Colorado who have been receiving Extra Help will find themselves re-assigned to new prescription drug plans unless they actively enroll in a new plan as more than half of the companies offering plans in 2009 will not be offering coverage in2010.  Only five plans are being offered in Colorado to low income seniors without a monthly premium, down from eight in 2009, further reducing choices.

To learn about these and other changes, join us at Medicare Monday on November 16, from 9:30 am to 11:30 am at one of the following locations:  Northglenn, Denver, Englewood, Aurora, Littleton, Pueblo, Colorado Springs, or Grand Junction. Experts from Medicare will be available to share information and answer questions, as well as many of the health plans. Reservations are suggested to guarantee seating.  To reserve your seat or for more information, call 303-333-3482.

Eileen Doherty, M.S. is the Executive Director of Senior Answers and Services and the Colorado Gerontological Society.  She has more than 35 years of experience in gerontology in administration, research, training and education, and clinical practice.  She can be reached at 303-333-3482 or at doherty001@att.net.