URBAN CALL — HEALTHY LIVING EVERY DAY!
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However, you should review your Medicare health and prescription drug coverage and make changes if it no longer meets your needs or if you could lower your out-of-pocket expenses. Mark your calendar with these important dates! This may be the only chance you have each year to make changes to your coverage. October 1, 2019: Start comparing your current coverage with other options. You may be able to save money. Visit Medicare.gov/ plan-compare October 15 to December 7, 2019: Change your Medicare health or prescription drug coverage for 2020, if you decide to. This includes returning to Original Medicare or joining a Medicare Advantage Plan.
Silver Sneakers
Medicare Assistance
SHIIP
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stions about ? Humana is
CMS (Centers for Medicare & Medicaid Services) publishes the official U.S. government handbook, “Medicare & You.”
Sandra Miller Jones
Segmented Marketing Services, Inc. Founder & CEO
Lafayette Jones
Publisher, Urban Call; SMSi-Urban Call Marketing, Inc. President & CEO
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/201809/10050-medicare-andyou.pdf). Medicare’s toll free telephone number is (800) 633-4227.
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January 1, 2020: New coverage begins if you made a change. If you kept your existing coverage and your plan’s costs or benefits changed, those changes will also start on this date. January 1 to March 31, 2020: If you’re in a Medicare Advantage Plan, you can make a change to a different Medicare Advantage Plan or switch back to Original Medicare (and join a standalone Medicare Prescription Drug Plan) once during this time. Any changes you make will be effective the first of the month after the plan gets your request.
Neil Steffens
Inside...
Premium Care
If you’re new to Medicare: Learn about your Medicare choices. There are 2 main ways to get your Medicare coverage—Original Medicare and Medicare Advantage. See the next few pages to learn more. Find out how and when you can sign up. If you don’t have Medicare Part A or Part B, see Section 1, which starts on page 15. If you don’t have Medicare prescription drug coverage (Part D), see Section 6, which starts on page 73. There may be penalties if you don’t sign up when you’re first eligible. If you have other health insurance, see pages 20–21 to find out how it works with Medicare. If you already have Medicare: You don’t need to sign up for Medicare each year.
It’s time to review your Medicare options
Medicare
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!
Licensed Medicare Agent Team
SilverSneakers health tip: Plan a monthly date with accountability buddies
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 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
This image is the sole property of Humana, Inc. and is made available for editorial use only.
“For the past few years, a group of friends and I have chosen a fun activity like going for a walk, seeing a movie, or attending a yoga class together to do first, and then we each make a promise to the group that we will work on one behavior for the four weeks that follow,” says Katie A. Rickel, Ph.D., a clinical psychologist based in Durham, North Carolina. It’s important that everyone selects a behavior over which they have complete control (“I will walk for 10 minutes at least three times each week,” for example) rather thanan
outcome (“I will lose 10 pounds”), she says. “Before we part ways, we make a plan to repeat the same activity exactly four weeks from now and promise to share our experience,” Rickel says. “It’s a given that we’ll all encounter obstacles and struggles, so we always return to the follow-up confident that we will be embraced, accepted, and encouraged regardless of our success in meeting our stated goals.” Reprinted with permission from SilverSneakers and Tivity Health
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. Who qualifies for LIS? Annual income • > $18,210 (Individual)/$24,690 (Married) • May still qualify if annual income is higher in special cases Assets/Resources • > $14,100 (Individual)/$28,150 (Married Couple Living Together) • Includes: checking/savings accounts, stocks, bonds • Does not include: primary residence, one car, any life insurance policy, up to $1,500 savings toward burial expenses, burial plot, furniture/household/personal items Must have original Medicare Parts A and B and reside in one of the 50 states or District of Columbia.
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
Website and Blogger Services Director: Jimmy Davies, Every.Black Collation and Shipping Manager: Terrance Hairston Photographer/Videographer: Donevan K. Cherry, CherVeli Media
Seniors’ Health Insurance Information Program has answers
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. 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
Segmented Marketing Services, Inc. SMSi Founding Chair and CEO: Sandra Miller Jones National Project Manager: Constance Baker Harris National Logistics Manager: Camille Allen
Director, Financial Services: Roslyn Hickman Agent Ambassadors: Sharon Lyles, Talaya Loyd, John Wall, Constance Baker Harris, Debra Shore, Natalie Nicholson, Sandra McCauley
SMSi Community of Networks
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URBAN CALL — HEALTHY LIVING EVERY DAY!
Born before 1955 or living with a disability? By Neil Steffens Regional Medicare President, Humana
If you’re one of 56 million Americans eligible for Medicare, it’s important to understand coverage options when selecting your health plan for 2020. Research can take time, and many people find working with a licensed health insurance agent helpful when deciding between Original Medicare, Medicare Advantage plans, Prescription Drug Plans and Medicare Supplement plans. Answering these five questions can help you make an informed choice during the Medicare Annual Election Neil Steffens Period, October 15 to December 7: Regional Medicare
President, Humana
Are my doctors, hospitals and specialists in network? Most Medicare Advantage plans offer online tools to help you find doctors and hospitals that are in a plan’s network. A licensed agent can also help you look up hospitals and doctors to see if they’re in a plan’s network and taking new patients and confirm what’s in network if you’re a seasonal resident. Which plans will cover my prescription drugs? Original Medicare does not cover most prescription drugs. Many Medicare Advantage plans include prescription
If you are within three months of turning 65, you are eligible for the Medicare Initial Enrollment Period (IEP) and can enroll in a Medicare plan to complement your veterans benefits.
drug coverage, or you can sign up for a Part D Prescription Drug Plan separately. A licensed agent can look up the medications you would like covered and help you estimate what the cost of each drug would be on a plan. Are there new, innovative benefits I should consider? Beyond vision, hearing and dental coverage, if you aim to become healthier, look for fitness program benefits as many Medicare Advantage plans offer a gym membership. If you travel or appreciate technology, virtual doctors are helpful services when you can’t see a doctor right away. Most Medicare Advantage plans now offer transportation to doctor appointments and the gym. Will a zero monthly premium plan save me money? Private insurers help keep premiums down through programs like disease and chronic care management, which help people better manage health conditions and, in turn, reduce medical costs. You’ll 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. Do I need to sign up for Medicare Parts A and B if I’m still working? If you or your spouse have health insurance from an employer, you can delay enrolling in Medicare until the employment or the coverage stops. At that point, you’re entitled to a special enrollment period of up to eight
Here are 5 questions to help you choose a Medicare plan
months to sign up for Medicare without incurring any late penalties. Resources are available to help you in this process, including licensed sales agents, local seminars, and websites such as medicare.gov and 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 1-800-2135286 (TTY: 711) 8 a.m. to 8 p.m. local time seven days a week. As with any major decision, proper research will go a long way toward making the best plan choice for your personal health care needs. 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. Y0040_GCHKLWKEN_C
The importance of a primary care physician What is the purpose of a primary care physician? A primary care physician (PCP) is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions. A PCP may also refer you to a specialist when appropriate. What does a primary care physician do? General practice doctors treat illnesses and help educate patients. Their specialties include: preventive medicine, adolescent medicine, family practice and public health. Geriatric medicine
doctors provide care for aging adults. Their specialties include: internal medicine and family practice. Why going to the doctor is important? Primary care Regular health exams and physician tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure
are better. By getting the right health services, screenings, and treatments, you are taking steps that help your chances for living a longer, healthier life. Why is it important for patients to have a strong relationship with a primary care physician? This helps maximize your treatment. Primary care physicians are vital to a person’s overall healthcare. They can provide a medical home of sorts—a place where all care is managed from one trusted source. Make sure you select a doctor you feel the most comfortable with.
Have questions about Medicare? Humana is here to help! • Which plans fit my lifestyle? • Are prescriptions covered? • What about wellness programs? Humana can help you sort through the options— so you can focus on your health! Humana provides all-in-one Medicare Advantage plans and stand-alone prescription drug plans to more than 7.8 million people across the country.* Our Medicare Advantage plans cover doctor office visits, hospital stays, preventive services and prescription drugs—so you have the freedom to enjoy life without the worry of unexpected healthcare costs.
Call a licensed sales agent Asheville Neighborhood Location 828-772-3090 (TTY: 711) 1863 Hendersonville Rd, Suite 122 Charlotte Office 704-643-1009 (TTY: 711) Greensboro Neighborhood Location 336-547-2701 (TTY: 711) 1420 Westover Terrace, Suite C Cary Office 919-465-1367 (TTY: 711)
*Humana Inc. First Quarter 2019 Earnings Release May 1 2019 This advertisement was sent by an independent agent licensed to sell Medicare plans. If you do not want to receive future mailings from this agent, please contact the agent to be removed from their mailing list. 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. Applicable to Humana Gold Plus® (HMO) H1036-233, -263, -275 and H6622-025, -060, -061. At Humana, it is important you are treated fairly. Humana Inc. and its subsidiaries 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. English: ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call 1-877-320-1235 (TTY: 711). Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición (Chinese): servicios gratuitos de asistencia lingüística. Llame al 1-877-320-1235 (TTY: 711). 1-877-320-1235 (TTY :711) Y0040_GHHJEW7EN20_M