Did you know that Medicare open enrollment runs from Oct. 15 to Dec. 7? This is the time when seniors can switch coverage between Original Medicare and Medicare Advantage, or change a prescription drug plan.
Osborne County Memorial Hospital wants to help take the uncertainty out of open enrollment and invites members from the county to participate in a Medicare education session on Tuesday, Oct. 15. Two sessions are scheduled at 1 p.m. and 5 p.m. at Sims Event Center. The events will be facilitated by Erin Petersilie, director of health plans for Kansas Farm Bureau.
OCMH is offering education sessions to help with frequently asked questions from patients and to help provide education so seniors feel confident that their healthcare choices are benefiting them.
"We often get questions from patients about the differences between Original Medicare and Medicare Advantage," said Doris Brown, CEO at OCMH. "The information can be confusing, and patients often don't know that Medicare Advantage is not the same as Original Medicare."
Original Medicare is a health plan that has two parts: Part A (hospital insurance) covers inpatient hospital and skilled nursing care, and Part B (medical insurance) covers physician services. Original Medicare is managed by the federal government. This is the typical Medicare insurance most people are familiar with. These plans typically cost about $165 a month (with the cost deducted from your social security check). Many people pay extra for Medigap to cover copays and other out-of-pocket costs, as well as a Part D plan for drugs.
Medicare Advantage is a health plan called Part C and is offered by private insurance companies as an alternative to Original Medicare. It replaces and cancels your Original Medicare plan if you choose this option.
Choosing between Original Medicare and Medicare Advantage requires careful consideration of your finances and health needs. With Original Medicare, individuals can see any provider who accepts Medicare, which is most. However, Medicare Advantage plans typically require that you get care from a more limited network of providers, and in most cases, you will need a pre-authorization from the insurance payer to see specialists, receive Part B drugs, get skilled nursing facility stays or inpatient hospital stays, receive mental health services or receive diagnostic services such as procedures, labs, tests, therapy, dialysis, hearing, eye exams, dental care and many other services.
Kansans should be aware that the only way to learn about a Medicare Advantage plans' approval and authorization practices is to ask your physician and hospital provider. Contact your local healthcare providers. They can connect you with individuals who can help you navigate the differences between Original Medicare and Medicare Advantage.
"We hope these education sessions are well attended and provide information to help patients decide the best health plan for their financial and medical needs," Brown said. "Erin Petersilie is well-versed in the options and gives a great presentation that makes the process easier to understand."
Petersilie and Kansas Farm Bureau provide educational programming to counties as part of KFB's mission to strengthen agriculture and the lives of Kansans through advocacy, education and service.
Before coming to KFB, Petersilie served as a Kansas State Research and Extension agent for the Walnut Creek District and a Family and Consumer Sciences teacher at Deerfield High School. She is originally from Downs. Kan.
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