Personalizing your Medicare options: What’s right for you?

(BPT) – Finding the right Medicare plan can be a little confusing – there are so many plans and coverage options to choose from.

Health and wellness company Humana is helping to simplify the selection process and educate Medicare shoppers as they decide on 2015 coverage during the annual Medicare enrollment period, from Oct. 15 to Dec. 7. Getting back to the basics can help people choose a plan that will fit their budget and help them stay healthy in the year ahead.

For people eligible for Medicare, one challenge can be understanding the differences between Original Medicare and Medicare Advantage. While both Original Medicare and Medicare Advantage offer coverage for check-ups, hospitalizations, and emergency care, Medicare Advantage provides a more comprehensive array of features to help people maintain and improve their health.

“With Medicare Advantage, you get all the benefits of Original Medicare … and much more,” says George Renaudin, one of the leaders of Humana’s Medicare business. “Increasingly, Medicare Advantage plans are focused not only on getting people the medical services they need, but also on helping members get and stay healthy.”

Accountable actions: Medicare Advantage is evolving with the U.S. health care system. Enrollees in many Medicare Advantage plans benefit from an “Accountable Care” model of health care. This means that everyone involved in a person’s health – doctor, pharmacist, insurer, caregiver, patient – teams up to ensure that the patient is receiving the best, most effective and personalized care. With everyone working together, more appointments are kept and personalized regimens are more likely to be followed. In addition, the doctors’ payments are tied to how well their medical care impacts their patients’ health. Original Medicare coverage operates in a “fee-for-service” environment, in which doctors’ compensation rests on the volume of patients they see and procedures they perform, not on their patients’ health outcomes.

Supportive partnerships: With Medicare Advantage, personalized care continues past the doors of an enrollee’s doctor or hospital. By partnering with a private insurer, Medicare Advantage members can benefit from a variety of resources to help them successfully continue on their wellness journey. For example, Humana At Home, a nationwide chronic care management program, offers eligible Humana Medicare Advantage members tools and resources to help them maintain a personalized path to wellness and stay in their homes. Another service made available is Humana’s SmartSummary statements. These serve as the health care equivalent of a bank statement. The Humana SmartSummary statements detail members’ medical and prescription drug activity to help them stay on track and know the costs they are incurring. Most Medicare Advantage members also have access to free gym memberships and can participate in fitness classes specially designed to meet their health needs.

Many Medicare Advantage (MA) plans also include:

* Coverage for Medicare Parts A & B, with predictable copayments and no deductibles

Part D prescription coverage

* Maximum out-of-pocket protection (on all MA plans)

* Programs to improve health and manage chronic conditions

* Access to Active Outlook, a health and wellness magazine designed especially for Humana Medicare members

* Benefits for services that Medicare doesn’t cover, such as routine eye exams, preventive dental care and over-the-counter medications

* Emergency coverage when you travel – even outside the U.S.

* Full coverage for most annual screenings and preventive care at no charge

* Reward programs to encourage and incentivize healthy activities and choices

Today, more than 15 million Americans have Medicare Advantage plans and 90 percent report high satisfaction with the quality of personalized care they receive, according to a survey conducted by America’s Health Insurance Plans. In addition, studies show people with Medicare Advantage plans have hospital readmission rates up to 20 percent lower than those who have Original Medicare, according to the American Journal of Managed Care.

“It’s important for people with Medicare to know their options,” Renaudin advises. “Remember, whatever plan you choose in the fall of 2014 will likely be yours for all of 2015. At Humana, we want to help you feel confident about your choice. We partner with you to simplify the information and help you make the decision that’s right for you.”

Medicare’s Annual Election Period started Oct. 15, and continues through Dec. 7, 2014, with people signing up for coverage that begins Jan. 1, 2015.

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