URBAN CALL — HEALTHY LIVING EVERY DAY!
Taking the mystery out of Medicare This quiz will help you learn the ABC’s
MEDICARE & YOU
Are you turning 65 this year? Are you disabled or caring for a child? Are you a caregiver for a senior citizen? Then you might want to take this Medicare IQ test to make sure you are up on the ABC’s of Medicare. The answers are on page 2. 1) Medicare Part A (Hospital Insurance) helps cover: A) Inpatient care in hospitals B) Skilled nursing facility care C) Hospice care D) Home health care E) All of the above
2019
2) Medicare Part B (Medical Insurance) Get acquainted with the four helps cover: parts of Medicare in this A) Services from doctors and other federal handbook that has health care providers answers to many detailed B) Outpatient care questions about your C) Home health care benefits. D) Durable medical equipment E) Preventative services F) All of the above Have questions about Medicare?
Get Medicare ready!
2 Humana can help
3
Diet and Exercise
We offer a variety of plan options and the experience to help you find the Humana plan that’s right for you Halle Berry
Humana provides all-in-one Medicare Advantage plans and stand-alone prescription drug plans to more than 8 million* people across the country. Our Medicare Advantage plans cover doctor office visits, hospital stays, preventive services and prescription drugs—helping to ensure your healthcare costs are predictable and easy to budget. SHIIP
Neil Steffens
Medicare Assistance
4) Medicare Part D (Medicare prescription drug coverage): A) Helps cover the cost of prescription drugs. B) It may help lower your prescription drug costs and helps protect against higher costs in the future C) It is run by Medicare-approved private insurance companies. D) All of the above
Important Dates to Remember ......... 2
Michelle Obama
Inside... • What are my options? • Which plan is right for me? • How do I choose?
3) Medicare Part C (Medicare Advantage): A) Includes all benefits and services covered under Part A and Part B. B) It usually includes Medicare prescription drug coverage (Part D) as part of the plan. C) It may include extra benefits and services for an extra cost. D) It is run by Medicare-approved private insurance companies E) All of the Above
4 Get Ready
THE OFFICIAL U.S. GOVERNMENT MEDICARE HANDBOOK
Medicare
Sandra Miller Jones
Segmented Marketing Services, Inc. Founder & CEO
Lafayette Jones
Publisher, Urban Call; SMSi-Urban Call Marketing, Inc. President & CEO
Knowledge is power
Welcome to another special edition of Urban Call. This publication will help you to find out more about your Medicare options and key resources to assist in your enrollment. We are delighted that our SMSi Community Ambassadors and Community Advocate Partners will be providing education to you on the ABC’s of Medicare. If you have limited income and resources, you may qualify for some help, or a subsidy, to reduce the costs of some health care benefits, prescription drugs, deductibles and other costs. The more you understand Medicare the greater your benefits will be.
For more information on your Medicare options Call: (366) 759-7477 Text: (336) 414-0905 E-mail: SMSiPartners@smsi-net.com For a digital copy of Urban Call visit: http://Issuu.com/SmsiUrbanCallMarketing.com
PAGE 2 URBAN CALL — HEALTHY LIVING EVERY DAY!
What you need to know this Medicare Enrollment Season By Neil Steffens VP, MEDICARE REGIONAL PRESIDENT, SENIOR MARKETS HUMANA
It’s that time of year when people with Medicare review their health insurance choices and enroll in a Medicare Advantage or Prescription Drug plan for the coming year. People typically have a lot of questions as they research their Medicare options, which primarily include Original Medicare, Medicare Advantage and Medicare Supplement plans, before finding the plan that best fits their needs. Here are some of the most commonly asked questions Humana licensed health insurance agents get from consumers during the Medicare Annual Election Period:
automatically be re-enrolled in your same medical or prescription plan for 2019.
When is the annual enrollment period to choose a Medicare plan for 2019?
The Medicare Advantage and Prescription Drug Plan Annual Election Period takes place from Oct. 15 through Dec. 7, 2018, for coverage that takes effect Jan. 1, 2019.
Does Medicare include coverage for my prescription drugs?
Original Medicare does not cover most prescription drugs. Many Medicare Advantage Do I have to re-enroll in plans include prescription drug Neil Steffens Medicare every year? coverage, or you can sign up for You don’t need to sign up for Original a Part D Prescription Drug Plan separately. Medicare each year. However, you A licensed agent can look up your should review your Medicare Advantage medications and tell you what the cost of or Prescription Drug Plan coverage each drug would be on a plan. annually, since Medicare plans and personal circumstances can change every How are health insurers like Humana able to offer Medicare Advantage year. If you take no action during the plans with no monthly premium? annual enrollment period, you’ll typically
Private insurers keep premiums low through programs like disease and chronic care management, which help people better manage health conditions and, in turn, reduce health care costs. Keep in mind that you still need to pay your Medicare Part B premium, which covers medical services and preventive care. You might want to use the additional premium dollars you save for out-of-pocket medical costs, such as co-pays. How do I find out if my doctors, hospitals and specialists are in my Medicare Advantage provider network?
Most Medicare Advantage plans offer easy-to-use online tools to help you find doctors and hospitals that are in the plan’s
see ENROLLMENT, page 3
Seniors’ Health Insurance Information Program (SHIIP) has answers
The SMSi Companies Corporate Offices 51 E. Fourth St., Suite 810 Winston Salem, N.C. 27101 Office: (336) 759-7477 Fax: (336) 941-3547
SMSi & Urban Call Community Outreach Office Goler CDC Center 899 North Liberty Street Winston Salem, NC 27101 Office: (336) 759-7477
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SMSi-Urban Call Marketing, Inc. President and CEO; Urban Call Publisher: Lafayette Jones Executive Editor: Alan Cronk Editorial Director: Rose M. Walsh Production Manager: Jodi S. Sarver Financial Services: Wanda Courts Project Manager: Gerry Patton Archivist: Avis Patterson
National Sales Manager Donevan K. Cherry Warehouse and Shipping: Donevan K. Cherry Agent Ambassadors: Alvin Borders, Sharon Lyles, Talaya Loyd, Olivia J. Allen Yvette Canty and John Wall
Segmented Marketing Services, Inc. SMSi Founding Chair and CEO: Sandra Miller Jones National Project Manager: Constance Harris National Public Relations Manager: Tonya Monteiro
National Logistics Manager: Camille Allen Director, Operations: Tahnya Bowser Director, Financial Services: Roslyn Hickman
SMSi Community of Networks
Seniors’ Health Insurance Information Program (SHIIP) is a consumer information division of the North Carolina Department of Insurance that assists people with Medicare and long-term care insurance questions. The organization also helps people recognize and prevent Medicare billing fraud and abuse.
SHIIP provides education and assistance in three ways: 1. Operating a toll-free consumer information phone line. 2. Training volunteers, including senior citizens to counsel Medicare beneficiaries about all the parts of Medicare. 3. Creating educational materials for consumer use including the Medicare Supplement Comparison
Answers to the Medicare IQ quiz 1. E — All of the above is the answer. Medicare Part A covers inpatient care in hospitals, skilled nursing facility care, hospice care and home health care. 2. F — All of the above is the answer. Some preventative services are included in Medicare Part B. It also covers services from doctors and other health care providers, outpatient care, home health care and durable medical equipment. 3. E — All of the above is the answer. Medicare Part C (Medicare Advantage) is run by Medicare-approved
private insurance companies. It includes all benefits and services covered under Part A and Part B. It usually includes Medicare prescription drug coverage (Part D) as part of the plan. It may include extra benefits and services for an extra cost. 4. D — All of the above is the answer. Medicare Part D (Medicare prescription drug coverage) is run by Medicareapproved private insurance companies. It helps cover the cost of prescription drugs. It may help lower your prescription drug costs and helps protect against higher costs in the future.
Guide and the Medicare Supplement Comparison database on the web. Trained SHIIP volunteers are in existing human services agencies such as the Council on Aging or Cooperative Extension offices. Nationwide toll-free number (800) 443-9354 North Carolina toll-free number: (855) 408-1212 www.ncshiip.com ncshiip@ncdoi.gov
Important Dates Oct. 15 to Dec. 7, 2018: Known as the annual enrollment period, anyone with Medicare can select a new Medicare health and/or prescription drug plan for 2019. This is also the time that anyone with Medicare can make changes to their current coverage. January 1 through March 31, 2019: During this Open Enrollment Period, you may change to a different Medicare Advantage Plan, a different combination Medicare Advantage — Prescription Drug plan, or a different stand alone Prescription Drug plan. You may also return to Original Medicare.
SUBSIDIES ARE THE EXCEPTION
If you have limited income and resources, you may qualify for some help, or a subsidy to reduce your cost. Those who are eligible can enroll or change their plan once per quarter.
PAGE 3
URBAN CALL — HEALTHY LIVING EVERY DAY!
Health Association Directory
Halle Berry
Michelle Obama Former First Lady Michelle Obama and film star Halle Berry encourage Americans to eat nutritious foods and get adequate exercise. Obama made the “Let’s Move” outreach program to combat childhood obesity, a signature of her stay in the White House. Berry, who deals with Type I diabetes, is a spokeswoman for organizations battling the disease.
Aging Life Care Association (520) 881-8008 AgingLifeCare.org
American Diabetes Assoc. (800) 342-2383 Diabetes.org
Alzheimer’s Assoc. (800) 272-3900 (866) 403-3073 TDD Alz.org
American Geriatrics Society (212) 308-1414 Americangeriatrics.org
Alzheimer’s Foundation of America (866) 232-8484 Alzfdn.org
American Heart Assoc. (800) 242-8721 Americanheart.org
American Academy of Home Care Medicine (AAHCM) (847) 375-4719 Aahcm.org American Cancer Society (800) 227-2345 (866) 228-4327 TTY Cancer.org
Arthritis Foundation (800) 568-4045 Arthritis.org Assoc. of Black Cardiologists (800) 753-9222 Abcardio.org
International Society on Hypertension in Blacks (703) 351-5023 Ishib.org Leukemia & Lymphoma Society (914) 949-5213 Lls.org Lupus Foundation of America, Inc. (202) 349-1155 Lupus.org National Alliance for Caregiving (301) 718-8444 Caregiving.org National Council on Aging (202) 479-1200 Ncoa.org
Center for Disease Control and Prevention (800) 232-4636 Cdc.gov
National Institute on Aging (301) 496-1752 Nia.nih.gov National Kidney Foundation (800) 622-9010 Kidney.org National Medical Assoc. (202) 347-1895 Nmanet.org National Pharmaceutical Assoc. (877) 215-2091 nationalpharmaceutical association.org U.S. Department of Health and Human Services (800) 444-6472 Omhrc.gov
Medicare & You CMS (Centers for Medicare & Medicaid Services) publishes the official U.S. government handbook, “Medicare & You.” It answers many detailed questions. To get a printed copy visit your nearest Social Security office. You can view the handbook online at (medicare.gov/sites/default/files/2018-09/10050medicare-and-you.pdf). Medicare’s toll free telephone number is (800) 633-4227.
ENROLLMENT, from page 2 network. A licensed agent can also help you look up hospitals and doctors to see if they’re accepting a plan and taking new patients. If I select a Medicare plan for the coming year, and then find I don’t like it, can I drop it and choose another plan?
The plan you select by Dec. 7 will be your Medicare plan for all of 2019, with few exceptions, so it’s wise to research your options carefully. If you sign up for a Medicare Advantage plan for 2019, and then find it’s not the right fit, between Jan. 1 and March 31, there will be an Open Enrollment Period during which you can switch from a Medicare Advantage or a Medicare Advantage-Prescription Drug Plan
to another Medicare Advantage plan with or without prescription drug coverage, or choose Original Medicare with or without a stand-alone Prescription Drug Plan. Full information on 2019 Medicare health and prescription drug plans is available on www. medicare.gov, and for Humana plans at www. humana.com/Medicare. You can also call 1-800-MEDICARE (1-800-633-4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week, or call Humana at 1-877-8770714 (TTY use 711) 8 a.m. to 8 p.m. local time seven days a week. Humana is a Medicare Advantage HMO, PPO, and PFFS organization, and stand-alone prescription drug plan, with a Medicare contract. Enrollment in any Humana plan depends on plan renewal.
LIS program provides subsidies If you have limited income and resources, you may qualify for help to pay for some health care and prescription drug costs. Extra Help, also called low-income subsidy (LIS), is a Medicare program to help people with limited income and resources pay a portion of Medicare costs. Section 7—Get Help Paying Your Health & Prescription Drug Costs, Medicare & You
Licensed Medicare Agent Team Sandra Miller Jones SMSi Health Insurance Solutions (336) 414-0905 smjones@smsi-net.com Sharon Lyles SMSi Lead Agent Ambassador (336) 451-1328 SharonKayLyles@gmail.com Alvin Borders SMSi Health Insurance Solutions (336) 987-1256 bordersalvin@yahoo.com Yvette Canty SMSi Health Insurance Solutions (336) 491-4552 ycanty62@gmail.com Talaya Loyd SMSi Health Insurance Solutions (336) 734-9196 taloyd5@gmail.com John Wall SMSi Health Insurance Solutions (704) 905-4451 jfwall50@hotmail.com Constance Baker Harris Authorized Agent (336) 965-4140 constanceharris@live.com Debra Shore Authorized Agent (336) 813-2049 shoreweb@bellsouth.net Natalie Nicholson Authorized Agent (336) 624-3183 natnic25@gmail.com Sandra McCauley Authorized Agent (336) 988-1506 sandramccauleyinsurance@gmail.com
Get Medicare ready! Have questions about Medicare? • What are my options? • Which plan is right for me? • How do I choose?
Humana can help We offer a variety of plan options and the experience to help you find the Humana plan that’s right for you Humana provides all-in-one Medicare Advantage plans and stand-alone prescription drug plans to more than 8 million* people across the country. Our Medicare Advantage plans cover doctor office visits, hospital stays, preventive services and prescription drugs—helping to ensure your healthcare costs are predictable and easy to budget.
Call a licensed sales agent Humana Cary Office
919-465-1367 (TTY: 711)
Humana Charlotte Office
704-643-1009 (TTY: 711)
Humana Greensboro Office
Monday – Friday, 8 a.m. – 5 p.m.
Monday – Friday, 8 a.m. – 5 p.m.
Monday – Friday, 8 a.m. – 5 p.m.
336-547-2701 (TTY: 711)
*Humana Inc. First Quarter 2017 Earnings Release May 3, 2017 Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premium and/or member cost share may change on January 1 of each year. You must continue to pay your Medicare Part B premium. For accommodations of persons with special needs at meetings call 1-800-457-4708 (TTY: 711), 8 a.m. – 8 p.m., seven days a week. Discrimination is against the law. Humana Inc. and its subsidiaries (“Humana”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. See our website for more information. English: ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-457-4708 (TTY: 711). Español (Spanish): habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (Chinese): 1-800-457-4708 1-800-457-4708 (TTY: 711). (TTY: 711). For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov GHHJEW7EN19 1018