Healthy Living

Annual Medicare Open Enrollment Period: October 15th-December 7th

The Annual Medicare Open Enrollment Period, also known as Annual Election Period (AEP) begins October 15th and ends December 7th. This is the time when you can shop for a new Medicare Advantage or Part D plan for the 2015 calendar year. During the Annual Election Period we recommend that you give your Medicare Advantage health plan a check-up to ensure your health plan meets your needs in the coming year.

Want Help Paying for Rx Drugs?

If you have trouble paying for your prescriptions every month, there’s good news. You may qualify for extra help under a Medicare program. If eligible, Medicare could pay for 75% or more of your prescription drug costs including monthly prescription drug premiums, annual deductibles and co-insurance. For more information, contact your local Social Security office, or call Social Security at 1-800-772-1213. You can also apply for extra help online at www.socialsecurity.gov/prescriptionhelp

Confused About Medicare? Understanding these key terms can help…

Annual Notification of Change

A booklet sent by your Medicare Advantage health plan (health insurance) company that informs you of changes to your benefits for 2015. It is included in a big package of material, mailed around the first of October.

Coinsurance

The amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).

Copayment

The amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or prescription. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor’s visit or prescription.

Deductible

The amount you must pay for health care or prescriptions before Medicare, your prescription drug plan, or your other insurance begins to pay.

Drug Formulary

A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits.

Out of Pocket Maximum

The yearly out-of-pocket maximum is the highest or total amount your health insurance company requires you to pay towards the cost of your hospital and medical services. Drug costs do not contribute towards the out-of-pocket maximum.

Premium

The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage.

If You Want to Change Plans…

If you would like to switch your Medicare Advantage health plan, then you’ll need the PCAC IPA physician code for your existing primary care physician. You can get it by calling PCAC Member Services Toll-Free at 1-844-722-2472. Once you choose your health plan, you can use your PCAC IPA physician code to sign up by calling the plan at the contact number. When you sign up for a new Medicare Advantage Plan you will be automatically dis-enrolled from your old plan and your new plan will begin on January 1, 2015. If you choose a new Medicare Advantage Plan confirm that the medical group listed on your new Medical Insurance ID card is Primary Care Associates of California Medical Group (PCAC IPA). This is the only way you can continue to see your primary care physician and specialists as well as take advantage of all of the valuable programs and services PCAC offers its for its Medicare Advantage members.

Ways to Compare Medicare Health Plans

Go to www. medicare.gov and compare Medicare Advantage plans. Contact PCAC Member Services Toll-Free at 1-844-722-2472 to get expert, personalized help from health insurance agents who specialize in helping seniors select the health plan that’s best for them. If you’re satisfied with the 2015 changes in benefits and prescription drug coverage under your existing Medicare Advantage health plan and/or stand-alone Medicare drug health plan, then do nothing. You will continue with your existing health plan in 2015.