Dec. 07 Marci Medicare Answers

Dear Marci, I have a Medicare drug plan, and it worked very well for me this year. Can I just keep it next year? Frances Dear Frances, Most Medicare private drug plans ("Part D") change their costs and benefits every year, so don't assume that your plan will work the same way in 2008. It's important to review your drug plan options now, because after January 1, most people will be locked into the plan they chose until 2009. Before deciding on a drug plan, review all of your options for 2008 by visiting Medicare's "Prescription Drug Plan Finder" at www.medicare.gov or by calling 800-MEDICARE. It's also important to call the plan and confirm all details. People with low incomes and few assets may be eligible for Extra Help, a federal program that helps pay for some or most of the costs of Medicare prescription drug coverage. You can apply for Extra Help through the Social Security Administration, using either the agency's print or online application (available at www.ssa.gov). Marci Dear Marci, I recently went to see a psychiatrist to be treated for depression. Medicare covered the usual 80 percent of the cost of my first visit, but after that, they covered only 50 percent. Why? Albert Dear Albert, Original Medicare covers mental health services differently than other types of doctor services. Medicare will pay 80 percent for your initial mental health visit so that your doctor can determine your diagnosis. However, Medicare will pay only 50 percent of its approved amount for future visits. The same payment rate applies to other mental health providers, such as psychologists and social workers. If you have supplemental insurance, such as a Medigap plan, it will cover your coinsurance as it does with your other medical services. People who get their health care coverage through a Medicare private health plan, such as an HMO or PPO, should check the coverage rules and costs of their plan. Marci Dear Marci, I will be eligible for Medicare soon, and was thinking of trying a Medicare HMO. A friend told me that some plans have expensive copays for inpatient hospital care. Is that true? Paula Dear Paula, Medicare HMOs are run by private insurance companies, and vary widely in their costs and benefits. But your friend is right to warn you that some private health plans charge high copays for inpatient hospital care. The best place to get up-to-date information on Medicare private health plans is from the plans themselves. Confirm the details before signing up, because you will have limited opportunities to switch plans. Also, keep in mind that you could get your benefits from Original Medicare the traditional fee-for-service program run by the federal government. Original Medicare will often cover a shorter hospital stay or the first part of a long hospital stay for free after you've met your deductible. If you have Original Medicare you may want to get a supplemental insurance plan (Medigap) to help with your out-of-pocket costs. Marci Marci's Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation's largest independent source of information and assistance for people with Medicare. To subscribe to "Dear Marci," MRC's free educational e-newsletter, simply e-mail dearmarci@medicarerights.org.