Yes. If your prescription needs have changed since you enrolled in your 2013 Medicare Part
D plan, you can check to see if your new medications are covered by your Part D plan. If your
new prescription is not listed, show the list of covered medicines to your doctor. Ask if there are
alternative drugs from this list that he/she can prescribe.
ALWAYS review your plan during every year (October 15th through December 7th) to see what changes are
expected in your drug coverage. Serving Our Seniors can help you with that!
The following is the information I received from the news release:
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Serving Our Seniors is someone to call when you need help.
419-624-1856 800-564-1856
What’s New with Medicare Part D in 2014
By Tina Elmlinger, RN, Trainer/Instructor for “How to Be Your Own Health Care Advocate”, Serving Our Seniors
Two men, Mr. Adams and Mr. Bates, went into the
emergency room for an acute bronchial infection. They
both ended up staying in the hospital for four days. Mr.
Adams was admitted within 24 hours and Mr. Bates
was under observation for 48 hours before he was
offcially admitted. They both were sent to a Skilled
Nursing Facility for aftercare. Medicare paid its portion
of Mr. Adams’ aftercare, but not Mr. Bates. What is the
reason for this?
While both men were at the hospital for the same
amount of time, only Mr. Adams was “admitted” to the
hospital for three days. Mr. Bates was not “admitted”
for three days. He was staying at the hospital, but he
was in “observation” for two days. Observation is not
the same as being a “admitted”. Once he was offcially
“admitted”, Mr. Bates was an “in-patient” for two days.
What is a qualifying hospital stay?
Three
consecutive days as an “in-patient”
in a 30 day period before a skilled
nursing facility is ordered by your
doctor.
What is skilled nursing care?
Skilled nursing care
includes: Intravenous injections, tube-feedings,
catheter changes, changing of sterile dressings,
training the Medicare patient and caregivers to perform
required tasks; observation and assessments of
conditions involving complications or worsening of
health; management and evaluation of the plan of care.
The hospital doesn’t have to tell you if you are “in
observation” or if you have been “admitted” as an “in-
patient” -- unless you ask. Be proactive by asking the
status of your admission. If you don’t, you could fnd
out the hard way that Medicare doesn’t cover the cost
of your care.
Observation or Admittance?
Why it is important to know before you are discharged from the hospital
By Wendy Boyer, Senior Advocate Assistant, Serving Our Seniors
Call NOW (419-624-1856 or 800-564-1856) and ask for an appointment
to help you with your Medicare Part D for 2014.
Q: Last October, I chose my 2013 Medicare Part D drug plan
based on my 2012 prescription needs. Is there anything I can do
now that my prescription drug needs are changing?
1. The 2014 standard Initial Deductible will decrease
from $325.00 to $310.
What does this mean to you?
Next fall, if you enroll
in a 2014 Medicare prescription drug plan with a
standard Initial Deductible, you will pay less for your
prescription drugs before your Medicare Part D plan
begins to pay a portion of the medication costs –
and that is good news.
2. The Initial Coverage Limit (or Donut Hole entry
point) will decrease $120 from the current value of
$2,970 to $2,850 in 2014.
What does this mean to you?
In 2014 Medicare
prescription drug plan will provide $120.00 less
coverage before you enter the 2014 Coverage Gap
or Donut Hole – which is not really good news.
-Tina Elmlinger
-Wendy Boyer