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Medicare open enrollment begins, others to follow

Watertown Daily Times (NY) - 10/20/2014

Oct. 20--Are you looking for health insurance for the first time, or thinking about changing your coverage?

During open enrollment periods, Office for the Aging representatives and health insurance marketplace navigators are ready to assist residents of Jefferson, Lewis and St. Lawrence counties in reviewing the best options for you and your wallet.

"Your first step to getting care is to be insured," said Steve Wood, community health coordinator of Community Health Advocates, a program offered through ACR Health. "That's the focus of our navigator program, to get as many people insured as possible."

Navigators are available through ACR Health, the St. Lawrence Health Initiative and the North Country Prenatal/Perinatal Council.

Mr. Wood said patient navigators can assist people in Medicaid or Children's Health Insurance Program enrollment at any time.

People who have, or may be eligible for, Medicaid and CHIP can take advantage of an always-open enrollment. Individuals are eligible for Medicaid if their income does not exceed $15,856. Both Medicaid and CHIP "provide health coverage to nearly 60 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities," according to Medicaid.gov.

Medicaid selects a physician who accepts the federal insurance program for an individual, but Mr. Wood said those people may switch physicians if desired.

Meanwhile, open enrollment for Medicare began Wednesday and ends Dec. 7. That federal insurance plan is for people 65 and older.

Matt Wiley, Jefferson County Office for the Aging health insurance information, counseling and assistance program coordinator, said it's always a good idea for Medicare recipients to make an appointment to have their plans reviewed because they may find better coverage through another plan, or lower monthly premiums. Either office staff or volunteers working through the Medicare open enrollment period will plug a person's information into Medicare.gov and log the person's needs, and the program formulates the best coverage options.

Mr. Wiley said the Office for the Aging handles about 450 to 500 appointments through the open enrollment period each year.

Changes for 2015, he said, include a couple of Medicare Part D (for prescription benefits) plans offered this year that will end Dec. 31. Medicare Advantage, according to Medicare.gov, is "a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits." Part A is hospital insurance, and Part B covers medically necessary and preventive services.

Medicare Advantage enrollment nationwide is expected to have more than 16 million beneficiaries, according to CMS.

Eligible recipients also have the option to have traditional Medicare, in which the consumer pays 20 percent of the medical bill, and a large deductible if admitted to a hospital.

Meanwhile, all other people who seek health insurance for the first time, or would like to review their plan through the health insurance marketplace, are encouraged to do so between Nov. 15 and Feb. 15. That is the open enrollment period for federally mandated health insurance.

"If you came to us last year, please come see us again," Mr. Wood said. "We'll run you through the system again."

Throughout the past year alone, navigators at ACR Health processed 8,000 applications, and about 6,000 people have coverage. According to an ACR Health news release, if people enrolled in a health insurance plan through NY State of Health in 2014, their benefits end Dec. 31, but they can renew coverage for 2015 during open enrollment.

Those who complete applications from Nov. 15 to Dec. 15 will begin coverage Jan. 1. Mr. Wood said people who decide to opt out of obtaining health insurance coverage will pay a fee of $95 per person, or 1 percent of income, whichever is greater. If uninsured for more than three months, there will be a fee of $325 per adult, or 2 percent of income. The fee for having an uninsured child is $162.50.

"There's no reason your child shouldn't be insured," Mr. Wood said.

For more information, call ACR Health at 785-8222, the North Country Prenatal/Perinatal Council at 788-8533, and the St. Lawrence Health Initiative at 261-4760.

Visit the state exchange at www.nystateofhealth.ny.gov.

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(c)2014 Watertown Daily Times (Watertown, N.Y.)

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