Medicare open enrollment begins this month, but Coffey Health System advises everyone to learn the facts before enrolling. Expert advice will be given at a public Lunch & Learn event on Friday, Oct. 17, at Coffey County Hospital. This free event begins at noon. Seating is limited, so register today using the form below or call (620) 364-4507.
“Medicare and Medicare Advantage plans are not the same, and they certainly carry different risks for individuals with significant health needs and those who live in rural areas like ours,” said CHS Director of Marketing Tracy Jones. “It’s crucial to learn all you can before making a decision.”
Shannan Flach will lead participants through the differences between “original Medicare” and Medicare Advantage plans. Flach is the Vice President of Health Care Finance and Reimbursement for the Kansas Hospital Association (KHA). She serves as the advocate and education coordinator for reimbursement as it relates to hospital billing and collection practices, hospital revenue cycle, and insurance payers.
Original Medicare is a health plan that consists of two parts: Part A (hospital insurance) covers inpatient hospital and skilled nursing care, and Part B (medical insurance) covers services from physicians and other healthcare providers. Original Medicare is managed by the federal government. This is the typical Medicare insurance most people are familiar with. These plans typically cost approximately $185 per month (with the cost deducted from your Social Security check) plus deductibles and copayments. Many people pay extra for Medigap to cover copays and other out-of-pocket expenses, as well as a Part D plan for drug coverage.
Medicare Advantage, also known as Part C, is a health plan offered by private insurance companies as an alternative to Original Medicare. It replaces and cancels your Original Medicare plan if you choose this option. It provides the benefits of Part A, B, and often D, usually for about the same amount, with lower copays, so there’s no need for Medigap. Some Medicare Advantage plans offer benefits not in Original Medicare, such as fitness classes or vision and dental care.
Choosing between Original Medicare and Medicare Advantage requires careful consideration of your finances and health needs. Medicare Advantage plans can carry hidden risks, particularly for individuals with significant health issues. Some people in Medicare Advantage plans may end up paying unexpectedly high costs when they become ill or find that their network lacks the providers they need.
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.
Representatives from the East Central Kansas Area Agency on Aging will also participate in the Lunch & Learn. Specially trained counselors from the Senior Health Insurance Counseling for Kansas (SHICK) program will be available to answer specific questions after the main presentation. They will also be able to schedule appointments during which they can give in-depth personal assistance.
The Lunch and Learn series is a community service of Coffey Health System.
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