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October 2, 2012 > Medicare Open Enrollment - Is Your Plan Right For You?

Medicare Open Enrollment - Is Your Plan Right For You?

Washington Hospital Seminars Focus on Medicare Part D and Changes to Medicare in 2013

If you are a Medicare recipient and want to review your plan or are enrolled in a Part D prescription drug plan and are concerned that you may not have all the coverage you need, you may want to attend two upcoming seminars at Washington Hospital.

Washington Hospital will present "Medicare Part D Prescription Plan Update for Open Enrollment" on Tuesday, October 9, and Thursday, October 11, from 10 a.m. to 12 p.m. "Medicare Changes for 2013" will be offered Wednesday, October 10, from 10 a.m. to 12 p.m. and Thursday, October 11, from 6:30 to 8:30 p.m. The free seminars will be held at the Conrad E. Anderson, M.D. Auditorium, located at 2500 Mowry Avenue (Washington West) in Fremont. Register online at or call (800) 963-7070 for more information.

"It is important to understand what the different plans offer," said Kristi Caracappa, health insurance information service coordinator at Washington Hospital. "For example, there are more than 30 Medicare Part D plans available with different premiums, co-pays, and benefits. It is recommended that you review your plan every year."

At the seminar focused on Medicare changes for 2013, Caracappa will update participants on any new changes to Medicare, Medicare Part D, and Medicare Advantage Plans. At the Medicare Part D seminar, Caracappa will explain how the prescription drug plan works and what you need to consider when evaluating the different plans, such as what your annual out-of-pocket expenses will be with each plan. While these plans are provided to anyone who qualifies for Medicare, they are offered through private insurance companies that are approved by Medicare.

You can sign up for the Medicare program when you turn 65 (or younger if you have a disability). At the time of enrollment, you can choose a medical plan that best suits your needs. If you are already enrolled in Medicare, you have an opportunity to review your Part D prescription drug plan each year during open enrollment. This year open enrollment runs from October 15 through December 7.

"Open enrollment is the time to evaluate your Medicare Part D plan and determine if it is still the best plan for you," Caracappa said. "This is also the time to evaluate your Medicare Advantage Plan. Sometimes plans change and medications that were covered before are not covered anymore. Also, new plans become available, so there may be a better option for you than the plan you currently have."

Medicare and Healthcare Reform

Caracappa will also explain how the Affordable Care Act is helping to close the coverage gap that is often referred to as the "donut hole" - a gap in coverage that requires beneficiaries to pay the full cost of their prescription drugs until the total out-of-pocket maximum is reached.

"The extra help in the coverage gap is part of health care reform" she said. "Instead of paying the full cost of brand name prescription drugs during the gap period, beneficiaries only pay 50 percent. That percentage will continue to go down until 2020, when it is 25 percent."

Medicare Advantage Plans can also affect coverage under Medicare Part D. They are Medicare health plans offered by private insurance companies. Most Medicare Advantage Plans, or Medicare Part C, provide health coverage and drug coverage under one plan, Caracappa explained.

In Alameda County, Medicare Advantage Plans can include health maintenance organizations (HMO) or preferred provider organizations (PPO). Most Medicare Advantage Plans offer prescription drug coverage.

"There is a lot to consider when choosing the plan that is right for you," she said. "We can walk you through the whole process so you get the plan that best suits your needs."

At the end of each seminar, Caracappa will set up appointments for anyone who wants help selecting their Medicare Part D plan as well as other Medicare options through the Washington Hospital Health Insurance Information Service. The free, confidential, and unbiased service can help you get all the information you need to make informed decisions about your health insurance, including Medicare.

For more information about Washington Hospital's Health Insurance Information Service, visit or call (800) 770-9447. To learn about other classes and seminars offered at Washington Hospital, visit

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