MEDICARE FACTS YOU NEED TO KNOW.

Do you understand your options regarding Medicare? No, well join the crowd! Ask questions until you get answers you understand. The Medicare Assistance Program , Oklahoma Insurance Department (OID ), wants to help you make the right choice. As a state agency, they do not sell anything. Their only agenda is to help you make the right choice for your situation.

Reputable insurance professionals share the same concerns regarding the calls, texts, emails, and standard mail contacts from “insurance providers.” No one should give any personal information over the telephone or the internet to someone they don’t know... fraudsters aren’t going to tell you they’re committing fraud! Do not respond to television advertisements, calls, texts and junk mail! Contact your broker or agent or the Medicare Assistance Program at OID.

Medicare will have 2024 plan information available by October 1, 2023. It is important to learn to use Medicare.gov. This is a great tool for comparison of the available drug plans and Medicare Advantage and Medicare Supplemental plans in Oklahoma. Circumstances change; premiums and co-pays change, and covered medications or treatments can change, all leading to changing insurance coverage. By doing the comparison you might save hundreds if not thousands of dollars.

MIPPA: Medicare Improvements for Patients & Providers Act

Do you have limited resources or income? Do you have to choose between your monthly prescriptions and other expenses? There are programs available that can assist low-income seniors and persons with disabilities with the costs related to their Medicare expenses. The Medicare Assistance Program and Oklahoma Human Services can educate people about these programs and assist with the application process.

Low-Income Subsidy (LIS) or “Extra Help”

If you are on Medicare and have trouble paying for your prescription medications you might qualify for this program. Eligibility varies depending on marital status, income, and resources. Everyone is encouraged to inquire.

Medicare Savings Program

Depending on your particular situation you might qualify to have your Part A and/or Part B premiums reduced or eliminated Diabetes supplies & services.

Home and Community-Based Services Waivers for persons with physical disabilities

(a) ADvantage Waiver. The ADvantage Waiver Program is a Medicaid Home and Community Based Services (HCBS) Waiver used to finance non-institutional long-term care services through Oklahoma’s SoonerCare program for elderly and disabled individuals in specific waiver areas. To receive ADvantage Program services, individuals must meet the nursing facility level of care criteria, be age 65 years or older, or age 21 or older if disabled. ADvantage Program members must be SoonerCare eligible and reside in the designated service area. The number of members in the ADvantage Waiver is limited.

(b) Medically Fragile Waiver. The Medically Fragile Waiver Program is a Medicaid Home and Community Based Services (HCBS) Waiver used to finance non-institutional long-term care services through Oklahoma’s SoonerCare program for medically fragile individuals. To receive Medically Fragile Program services, individuals must be at least 19 years of age, be SoonerCare eligible, and meet the OHCA skilled nursing facility (SNF) or hospital level of care (LOC) criteria. Eligibility does not guarantee placement in the program as Waiver membership is limited.

Go to MIPPA (Oklahoma gov); access the MIPPA map and contact your coordinator.

Ultimately, it is your decision that dictates your medical and prescription coverage. The Medicare Assistance Program at the Oklahoma Insurance Department may be reached at 800-763-2828. Ray Walker, Divisional Director, Medicare Assistance Program, Oklahoma Insurance Department, and Eunice Khoury, Principal/ Insurance Advisor, Well-Preserved Advisory Group provided information and guidance for this article.