Fwd: The Medicare Counselor -- November-December 2007

[Guest guest]

September - October

2007

| Volume 1, Issue

4

The Medicare Counselor is a free publication of the Medicare

Rights Center. Each issue will address timely topics that will help

yousocial workers, health care providers and other professionalskeep

up-to-date on important Medicare issues that affect the well-being of

your clients.

In this issue:

Enrolling in Medicare Without Social Security Benefits. If you

are turning 65, you need to be aware of whether you will be automatically

enrolled in Medicare or need to actively enroll yourself. Whether or not

you need to enroll in Medicare when you turn 65 depends on a number of

factors, including whether you have insurance at a current job and

how many people are employed in your company, and if you are receiving

Social Security benefits.

Read the full article. Reminder: Check Your Health and Drug Plan Benefits for Next

Year. If you are currently enrolled in a Medicare private health plan

(such as an HMO, PPO or PFFS plan) or a Medicare private drug plan (Part

D), it is very important that you review your coverage for next

year. Private plans generally change their benefits and costs every

year, and you may find one that gives you better coverage than what you

currently have.

Read the full article. How to Change Your Medicare Coverage Effectively. Switching

plans - both Medicare stand-alone prescription drug plans (PDPs) as well

as Medicare Advantage (MA) plans - continues to give people with Medicare

problems. Issues range from being enrolled or disenrolled on the wrong

date to being enrolled into the wrong type of plan. The errors occur when

someone tries to change their coverage through the plans themselves.

Information given to the private plan does not properly find its way to

Medicare's system because of a roundabout process for approving the

change in coverage. Fortunately there is a more reliable way to change

plans.

Read the full article. When Off-Label, No Coverage. Under most circumstances, your

Medicare Part D plan is required to cover the drugs on its formulary

(list of covered drugs). Sometimes, however, drugs listed on your plan's

formulary are denied coverage because your doctor prescribes them for a

use that is not approved by the U.S. Food and Drug Administration (FDA)

or listed in one of the three Medicare-approved medical encyclopedias of

drug clinical effectiveness, called compendia. If you have been denied

coverage for a drug because your prescribed use is not approved by the

FDA or in the compendia used by Part D, four tips may help you get the

drug you need.

Read the full article. Will I Have Extra Help Next Year If I Had It This Year? At the

end of each year, Social Security conducts a process called

redetermination. During the redetermination process, Social Security

looks at the income and assets of some people who have Extra Help

- a federal program that helps pay for the Medicare drug benefit - to see

if they are still eligible for assistance in the coming year. Your

continued participation in the Extra Help program depends on how you got

Extra Help in 2007 and whether your financial situation has changed.

Read the full article.

The current issue of The Medicare Counselor can always be found

online at

www.medicarerights.org/thecounselor.pdf.

Questions and comments about the topics in this issue may be addressed to

thecounselor@.... We encourage suggestions for article

topics in future issues that pertain to the well-being of your clients

with Medicare.

Thank you for your continued support.

Sincerely,

The Medicare Counselor

The Medicare Rights Center (MRC) is the largest independent source of

Medicare information and assistance in the United States. Founded in

1989, MRC helps older adults and people with disabilities get good,

affordable health care.

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