LifeTimes October 2020 by Times Publishing Company

Living well after 50 Tampa Bay Times | Wednesday, October 28, 2020

2021

Medicare

The open enrollment period is here. If you are 65 and over itâ€™s time to review and update your health care coverage with help from our annual guide.

CROSSWORD Cutting Remarks, by Merl Reagle ACROSS 1 5 9 14 18 19 20 21 22 25 26 27 28 30 31 38 41 42 43 44 45 46 48 52 57 58 59 60 61 63 64 66 71 75 76 81 82

Exam givers Little food Powders Old Egyptian symbol revived in the 1960s Empty-room eﬀect Betray, in a way Lazy in the extreme Belter Turner Wag’s meat-market request One side of World War II Out-pore-ing? Bird’s murmur College deg. Many times Wag’s meat-market observation Eight, to Enrique Debts of a sort Nasser’s nation, once: abbr. Zip Back again Sch. for the younger set Traits of a tribe, e.g. Pitching people Wag’s meat-market query Prize One who takes potshots Asian isthmus (or backwards, a boat) 10 percent, for one Confer A word about Yorick Had a stable job? Wag’s meat-market query 16 Down, for one Virginia dance Error (made by backward students?) Charge car VCR maker

84 Sitting room 86 Legend maker 87 Wag’s meat-market query 91 One ___ other 92 Actor Alain 93 CEO’s colleague 94 ___ Paulo 95 Little guy 97 Unchangeable memory 98 Tire surface 100 King Tut was one 101 With 115 Across, wag’s meat-market comment 107 Good name for a tow truck driver 108 Unaccompanied diner 109 Shelley’s Queen ___ 110 Up, in poker 113 ___ Domini 115 See 101 Across 122 Be an eager beaver? 123 Large rooms with skylights 124 Narrow passage 125 Ride to the Ritz 126 Motown’s Marvin 127 Very unpleasant 128 Role for Jodie 129 Hefty chunk

DOWN 1 2 3 4

___ Moines Newspaper pioneer Eats Townships near Johannesburg 5 Shrimping area 6 O.J. judge Lance 7 Big-billed bird 8 Registers 9 Toledo uncle 10 Arbor preceder in Michigan 11 Section of a relay race 12 Piece of bread?

13 Netter Edberg 14 ___ standstill 15 Oliver Stone political drama 16 Steak need 17 Impulsive 19 Add again 23 Start of a tile game 24 Also 29 Faux identity 32 Parking garage levels 33 This’ll teach you a thing or two 34 This’ll teach you a thing or two 35 Pearl Harbor island 36 Party dress 37 Veteran 38 The gift ___ 39 Actor Russell 40 ___ a pistol 45 Equips 46 Reader’s woe 47 Boot camp barker, brieﬂy 49 A word for the Mrs. 50 Deco designer 51 Have to have 53 Homers and Whistlers, e.g. 54 Bitterness 55 Mineral springs 56 Nostrils 62 Spin 65 “A government ___” (John Adams) 67 Spanish hero 68 That girl’s 69 Slippery 70 Funny outtake 71 Nineteen-sixty incident 72 Asian goat that anagrams into a deer

The crossword puzzle solution is on Page 20.

73 74 77 78 79 80 83 84 85 88 89

Oﬀ-ramp Cozy corners Hosp. section Place for valuables Bears, to Brutus Cry, the Beloved Country author “God is ___” (R. Buckminster Fuller) Chaperoned events Bucolic First word out of your mouth The Time Machine race

90 Mao’s military 96 Card game 98 Without exception 99 Blast aftermath 100 Govt. securities 101 Lieutenant on Perry Mason 102 Hair tint 103 Pig Latin veto 104 Maestro whose ﬁrst name starts with Z 105 Singer Sumac 106 Anagram of 105 Down 111 Hit the high seas

112 Austen novel 114 Have to pay 116 Org. you have to pay 117 Rest 118 Frito partner 119 Quite queasy 120 Choice: abbr. 121 Try to pick an apple from a tub, on the 31st

TIMES TOTAL MEDIA LifeTimes is produced and designed by the Marketing department of the Tampa Bay Times. EDITOR: Marti Galloway, magalloway@tampabay.com ATTENTION BUSINESSES: Reach more than 467,800 LifeTimes readers* To advertise, call 1-880-333-7505, ext. 8725 or email sales@tampabay.com To submit story ideas, email lifetimes@tampabay.com *Source: 2019 Nielsen Scarborough Report (r2)

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LIFETIMES Medicare 2021

This special section is online at tbtim.es/medicare2021

Be sure your plan is all you need it to be It’s time for people 65 and over to review their coverage. The open enrollment period is from Oct. 15 to Dec. 7. BY MEGAN REEVES Times Staff Writer

ore than 4.6 million Florida residents receive health coverage through Medicare, and the time to review their beneﬁts is here. The process will look a bit different this year because of the coronavirus pandemic. Enrollment often happens face-to-face, at crowded events and inside offices where beneﬁciaries can ask questions and get help. This year, though, those interactions are mostly happening online and over the phone. Insurance companies have trained staffers on new processes and say they’re geared up for open enrollment, which is currently underway.

Then through Dec. 7, people covered by Medicare, the federal insurance program designed for those 65 and older, can evaluate their options and decide whether to make changes. Beneficiaries can use this time to switch from Original Medicare to a Medicare Advantage plan, which offers an alternative way to receive Medicare benefits through a private insurance company. Or they can do the reverse and return to Original Medicare. They also can switch Medicare Advantage plans, or change prescription drug plans, known as Part D. Plus, those who did not enroll in Part D when they were first eligible can do so during this period. Two new Medicare Advantage plans are being offered locally by

BayCare Health System, the nonprofit hospital chain, which started offering insurance in 2019. BayCare has gained about 8,000 members since, and that’s expected to grow to about 12,000 in 2021, said Larry J. Costello, president of BayCare Health Plans. One of the new plans is offered only in Pinellas County and the other is available in Hillsborough, Pasco and Polk counties. Like other providers, BayCare says it is ready to be flexible to meet beneficiaries’ needs, whether they want to meet in person with masks or enroll over the phone or computer, Costello said. Representatives will do home visits with protective gear if that’s what a member prefers. “However they want to do it,

that’s how we’re going to do it,” he added. “We really have put all the options on the table.”

How Medicare works

The most popular programs are Part A and Part B. They offer the most free services for those who qualify. • Part A covers inpatient hospital care, nursing home care, hospice and at-home care. The services are usually free, meaning there’s no premium to pay. • Part B covers outpatient hospital care, doctor bills, physical therapy and more. It is optional and costs most people a monthly premium, which is projected to be

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$144.60 for most enrollees in 2021. The cost can be higher for some, depending on income. It can also be lower for those who have the premium deducted from their Social Security check. It’s wise to sign up for Part B when you ﬁrst become eligible for Medicare, even if you’re healthy, unless you are still on an employer’s health plan. If you don’t, your monthly premium could go up by 10 percent for each year you could have had Part B but didn’t sign up. This applies to those with both Original Medicare and Medicare Advantage plans. . See MEDICARE, 4

| Wednesday, October 28, 2020 |

LIFETIMES Medicare 2021 . MEDICARE

continued from 3 • Medicare Advantage plans are known as Part C. They are managed by private insurance companies through either an HMO (Health Maintenance Organization) or a PPO (Preferred Provider Organization). They offer bundles that include Part A, Part B and usually the Part D prescription drug program. Monthly premiums for 2021 are projected to be between $0 and $145.50. Medicare Advantage enrollees often must choose their doctors from a plan’s predetermined list of providers. But there’s a limit on out-of-pocket expenses each year, and these plans are known to carry extra beneﬁts, like vision, hearing, dental and more, that Original Medicare does not. More and more people have opted for Medicare Advantage plans in

recent years. This past year saw a 6 percent increase in enrollees. More are projected to enroll for 2021, according to the Centers for Medicare & Medicaid Services, a federal agency known as CMS. About 42 percent, or 26.9 million, of beneﬁciaries across the U.S. are expected to choose Medicare Advantage plans, the agency says. In Tampa Bay, nearly 50 Medicare Advantage plans are available in 2021. This enrollment cycle will be the ﬁrst time that those with end-stage renal disease, or kidney failure, can choose a Medicare Advantage plan rather than Original Medicare. And new perks are popping up in plans across the board, said Kathy Feeny, president of Florida Blue Medicare. Like BayCare, Florida Blue has plans that offer meal delivery. But it also has partnered with Zipongo, a digital nutrition platform that members can access, to learn how

| Wednesday, October 28, 2020 |

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to make better choices about what they eat. Feeney said she expects people to continue moving toward Medicare Advantage plans, especially because of the pandemic. “With the stock market the way it’s been and how 401ks have been hurt, income has gone down, so people are looking at how they can still afford their health care,” she said. “Overall, Medicare Advantage plans cost less, so people are going to make the switch.” Florida Blue’s zero-dollar exclusive provider plan, which requires beneficiaries to get health care services from certain doctors and hospitals, is the fastest-growing plan in the state, Feeney said. Florida Blue has increased its staff to meet the demand, making sure safety protocols are in place for enrollment. At the same time, the number of Medicare Advantage plans has tripled since 2017. The average number per county will increase from about 39 plans in 2020 to 47 plans in 2021, according to CMS. “The benefits are getting better,” said Deb Galloway, president of Humana in north and central Florida. “There’s more competition and there’s much more access to getting information.” Several of Humana’s plans for 2021, including all of those offered in Tampa Bay, have expanded transportation benefits, for example. The service is one piece of the company’s Social Determinants of Health Value-Based Program, created for members experiencing food insecurity, social isolation, loneliness and housing instability. With it comes $500 a year that a care manager will help a member use to address environmental or situational barriers to their health, Galloway said. A beneficiary might use it to install a support bar in their bathroom, or to pay for transportation services that aren’t already covered by their plan. Galloway pointed out that those with a Medicare Advantage plan have a grace period of sorts to change their benefits past the close of open enrollment. They can switch between plans from Jan. 1 through March 31, giving them more flexibility than Original Medicare. The average monthly premium for Medicare Advantage plans is expected to decrease by 11 percent, to $21, in 2021, the lowest it’s been since 2007, according to CMS. • As for prescription drugs, more than 47 million people are enrolled in Medicare Part D plans, the agency says. The average monthly cost is $30.50 for 2021, down 12 percent since 2017. Enrollment in Part D

has increased by 16.7 percent in that same period. Unless you already have prescription drug coverage through an employer, a union or the Department of Veterans Affairs, it’s important to get it when you pick a plan. It’s accessible through either a Part D drug plan if you are on Original Medicare or through a Medicare Advantage plan that covers drugs. It’s smart to secure drug coverage even if you don’t currently use any prescription medications. You could get sick and need expensive drugs. Plus, if you decline the coverage now and try to sign up later, the cost will go up for each year you didn’t have it.

What kind of plan should I choose?

Medicare Advantage is often less expensive than Original Medicare, and some plans offer additional benefits that Original Medicare does not. But there’s a lot less flexibility when picking providers. With Original Medicare, you can pick any doctor or hospital in the country where Medicare is accepted. Advantage plans tie you to a network and you have to pay a fee if you get services outside it. Beneficiaries who want to continue seeing a certain doctor, going to a certain hospital or taking a certain drug should make sure they are on an Advantage plan that covers them. Plans can and do change from year to year. It’s important to review your options in detail. The plan with the cheapest premium isn’t always best, as it could provide less coverage for important services, like hospital visits.

The gap

Part D comes with a catch called the “donut hole” that could cause some enrollees to pay more for prescription drugs. Medicare beneﬁciaries reach the donut hole once they spend a certain amount of money on medications for the year, causing insurance providers to stop covering as much of the cost of their prescriptions. They exit the donut hole once they reach the out-of-pocket threshold that causes drug prices to drop. The donut hole begins at a slightly higher amount for 2021 than this year, up $110 to $4,130. The out-ofpocket threshold starts at $6,550, up $200 from this year. Not all beneﬁciaries will reach the donut hole. Those who do will pay 25 percent of both generic and brand-name prescription drug costs while in it, just as enrollees did this year.

Comparing costs

Costs vary depending on the services and drugs you use. The best way to ﬁnd which plan is best for you and your particular situation is to use Medicare’s online Plan Finder (medicare.gov/plan-compare), which allows you to factor in your health conditions and the medications you take.

Extra help

Those with limited income and resources can apply for Medicare’s Extra Help program, which reduces out-of-pocket costs for drug coverage so long as the person is enrolled in Part A and Part B. To qualify, a person’s combined savings, investments and real estate must not exceed $29,160, if they are married and living with a spouse. The threshold is $14,610 for singles and those who are not living with their spouse. If you think you qualify, contact the Social Security Administration toll-free at 1-800-772-1213 or apply online at socialsecurity.gov. The federal government also offers Medicare Savings Programs — called QI, QMB and SLMB — that help low-income people pay their premiums. Each program has different parameters but, generally, the lower your income, the more help you will likely get. To see if you qualify or to ﬁnd out how to apply, call Florida’s Medicaid office toll-free at 1-866-762-2237, apply online at socialsecurity.gov/i1020 or call Social Security toll-free at 1-800772-1213. Ask for information about Medicare Savings Programs.

Still confused?

Florida’s SHINE program has volunteers who are experts in Medicare and can help you ﬁnd the plan that is best for you. The letters stand for Serving Health Insurance Needs of Elders, and the free service is offered by the Florida Department of Elder Affairs and the local Area Agency on Aging. Call them toll-free at 1-800-963-5337 or visit ﬂoridashine.org. You can also get help directly from Medicare by calling toll-free 1-800-633-4227, but the government workers there generally have less time to spend with you than the SHINE volunteers do. Also, SHINE volunteers have no bias toward any particular plan. It’s important to have a list of all your doctors, medications, dosages and monthly usage before contacting SHINE. Contact Megan Reeves at mreeves@tampabay.com

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| Wednesday, October 28, 2020 |

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| Wednesday, October 28, 2020 |

STEP BY STEP Sally Anderson

Photos by Dan Canoro

MYTH BUSTING

Your Move | Demonstrated by Deborah Jones STANDING FULL BODY EXERCISES Reverse Wood Chop

One fact that is true and what I believe we can all agree upon, is that exercise is good for both our mental and physical health. But as we take the journey to achieve our desired fitness goals, we may encounter a few bumps in the road. It’s good to take pause and recognize the difference between fitness facts and fiction. There are many exercise myths and misconceptions floating around that can negatively impact your fitness progress. Since October is National Physical Therapy Month, this is a good time to bring awareness to some of the popular fitness myths and misunderstandings that continue to invade the health and fitness environment.

Hold weight with two hands. Begin with a squat, feet shoulder-width apart. While squatting, bring weight to outside of left leg. Exhale as you stand, pivoting left foot while lifting weight diagonally across your body toward right shoulder. Move with a feeling of control, avoiding momentum. Repeat movement 8-10 times. Repeat on opposite side.

Myth: Performing ab exercises will get rid of abdominal fat.

Overhead Circles with Ball

Exercising ab muscles may develop strength and endurance but sadly for the exercisers who indulge in hundreds of abdominal exercises to get ﬂat abs, there is no such thing as spot reducing. You simply cannot target your fat burn. When you are exercising, your body gets its energy from the whole body not just from the part you are working. If you want to lose body fat, you need to perform whole body movements and eat a healthy low-calorie diet. And even then, you cannot control where you will lose that body fat. That depends on many things out of our control, such as genetics, hormones, and age.

Standing, feet hip-width apart and abdominals contracted, hold a medicine ball overhead. Have a slight bend in knees. Circle ball to the right in as large a circle as you can, while maintaining a stable torso. Make circle with ball 5 times to the right, then 5 times to the left.

Myth: If women lift weights they will get “bulky.”

Repeat several times.

One of the main ingredients for muscle growth is testosterone which men have in signiﬁcant amounts. While women may have some testosterone, they don’t have nearly the same level that men do. For the average woman to bulk up, she would have to be involved in extreme training and follow strict eating habits.

A calming stretch for relaxation

Myth: Muscle will turn into fat when you stop exercising.

Muscle cells will grow larger when you are exercising and when you stop exercising, muscles will atrophy and become smaller. They don’t magically convert into a different cell type and turn into fat.

Free weights allow you to perform compound movements, activating more muscles with every repetition, which can lead to more calorie burn. Free weights will also help with balance and coordination and can get a full body workout in less time. However, machines are better if you are rehabbing an injury and need to isolate speciﬁc muscles.

Myth: You need to static stretch as a warmup.

The purpose of an exercise warm-up is to gradually rev up your circulation by increasing blood ﬂow to muscles. A static stretch is a challenging stretch that is held for a period of time. It does not elevate core temperature or heart rate and temporarily decreases muscle strength. Dynamic stretching which is stretching with movement is preferred for warm-up. Check with your doctor before starting a new exercise program. Sally Anderson is happy to hear from readers but can’t respond to individual inquiries. Contact her at slaﬁt@tampabay.rr.com. | Wednesday, October 28, 2020 |

Tampa Bay Times

Standing tall with feet hip width apart, interlace your ﬁngers above your head with palms facing ceiling. Move arms to the right, feeling a stretch down left side. Hold 15-20 seconds then stretch to left side. Repeat several times on each side.

Myth: Exercise machines are better than free weights.

Side Stretch

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Reverse Lunge with Twist Standing tall, feet hip-distance apart, hold medicine ball with both hands, arms stretched in front of you, shoulder height. Abdominals contracted, bend knees, taking a large step back with right foot. Lower body until front thigh is parallel or near parallel to floor. Back leg is extended to the back with a bent knee; heel lifted off floor. Lowering into a lunge, rotate torso and arms to the left. Standing, return to center, bring feet together. Repeat movement by stepping back with left leg. This completes one repetition. Repeat 8-10 times for one set.

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| Wednesday, October 28, 2020 |

LIFETIMES

Medicare 2021

SHINE: Serving Health Insurance Needs of Elders BY MEGAN REEVES Times Staff Writer Medicare, with all its plans and parts, can be daunting for people in search of health insurance. But there’s help available across Florida and Tampa Bay. SHINE, which stands for Serving Health Insurance Needs of Elders, has more than 500 volunteers throughout the state who are ready to answer questions now that open enrollment is underway. People 65 and older as well as those with disabilities have until Dec. 7 to make a choice. Because of the coronavirus, SHINE’s in-person information sessions and consulting appointments have moved online and over the phone. The program has built a robust schedule of virtual events enrollees can access to learn about their options and ask questions about coverage, said Tampa-based SHINE manager Amy Hagel. She spoke with the Tampa Bay Times about SHINE’s work, and shared speciﬁcs about how the state program plans to assist seniors in a way that keeps them safe from COVID-19. Here’s what she said:

When was SHINE created and what is its mission?

SHINE, a program within the Florida Department of Elder Affairs, has been helping seniors with Medicare enrollment since 1992. It is the only Medicare-sponsored source of one-on-one counseling in the state and aims to help beneﬁciaries make informed choices to maximize their health care beneﬁts.

Who are SHINE volunteers and where are they located?

There are 11 SHINE offices across Florida and together they serve all 67 counties in the state. SHINE volunteers “come from all walks of life,” Hagel said. Most are retirees from all sorts of careers who “want to find a meaningful way they can really give back” to the community. Their help is free and confidential. The volunteers are not affiliated with any insurance provider, so the guidance they give is unbiased and only in the interest of beneficiaries, Hagel said. “The best advice people

can get is from a SHINE counselor, because they do not gain anything but the satisfaction of assisting you.”

What services do SHINE counselors offer?

Volunteers will look at a beneficiary’s existing benefits and coverage and evaluate whether it is the best option for the coming year. They will go through the client’s medications to ensure their prescriptions will continue to be covered. If not, they will help them find another Medicare plan that does cover them. Counselors also will check whether a beneficiary’s doctors will continue to take their insurance. And they can help people apply for assistance programs.

How is the coronavirus pandemic changing how SHINE helps seniors?

Usually, SHINE offers in-person events and counseling for Medicare beneﬁciaries. But those have been canceled to prevent spread of COVID-19. The services will continue, but they will be done over the phone and computer. Volunteers have been trained on the new processes to ensure there are no gaps in service. One-on-one counseling sessions last about an hour and a half.

How many people does SHINE help each year?

In 2019, SHINE helped about 55,000 Floridians enroll in Medicare plans.

How do people get in touch with SHINE?

Medicare beneﬁciaries can reach SHINE by calling the state office at 1-800-963-5337 or emailing information@elderaffairs.org.

How do people ﬁnd SHINE’s online sessions?

A complete schedule of SHINE’s virtual events is updated weekly at ﬂoridashine.org. There are various presentations on the basics of Medicare, speciﬁc parts of Medicare and more. Reservations are required for some of the events and contact information for each can be found on the schedule.

1-800-963-5337 or email information@elderaﬀairs.org 10

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Medicare Advantage plans with drug coverage What’s in the chart Type: This chart shows three types of health plans with drug coverage: HMO, PPO and HMOPOS. They are explained below. Premium: The monthly charge for the plan. This is in addition to the standard Part B premium most beneficiaries pay to Medicare, which is projected to be $148.50 for 2021. Part B reduction: Some plans pay part of your monthly Part B premium. This “premium reduction,” also called a rebate or a “premium give back,” is considered an additional benefit offered by a plan. It’s usually returned to consumers as part of their monthly Social Security check. The chart indicates whether or not a plan offers a premium reduction. Since reductions can differ based on each beneficiary’s situation, you will need to contact the insurer for the amount. Drug deductible: In some plans, you pay a deductible before drug coverage kicks in. A drug deductible might not apply to all drugs or tiers. Doctor copay: This is your cost every time you see a doctor. The first dollar figure is for primary care physicians; the second is for specialists. Costs are listed for physicians inside the network (Net) and outside the network (Out). Hospital copay: This is your cost for each inpatient hospital admission — both inside the network (Net) and outside the network (Out). For outpatient hospital coverage, refer to Medicare’s Plan Finder. Yearly cost (Est.): Medicare’s estimate of your out-of-pocket costs under this plan, including your Part B premium and drugs. It is based on an average person in good health, but could vary greatly depending on the actual drugs and services you need. The best way to project costs is with Medicare’s Plan Finder. Out-of-pocket cap: Your maximum payment for the year inside the network (Net) and outside the network (Out). The lower the cap the better. IMPORTANT: These out-of-pocket limits do not apply to your prescription drug costs. Generics in the gap: Whether a plan pays for generic drugs in the coverage gap, or “donut hole,” which in 2021 will begin when total drug costs hit $4,130. You will exit the donut hole when your out-of-pocket costs reach $6,550. Rating: Medicare rates plans from 1 to 5 stars, based on customer satisfaction and certain health measures. The top rating is a 5. People with Medicare can switch into a 5-star plan at any time during the year, even if it’s not during an enrollment period.

What’s not in the chart Private Fee for Service Plans (PFFS) and Special Needs Plans (SNPs): See explanation below and medicare.gov for details.

Medicare supplement plans: Also known as Medigap, this coverage helps pay some of the health care costs that Original Medicare doesn’t cover. Go here to shop for these plans. Copayments for other services: Plans usually charge copayments for drugs, skilled nursing homes, ambulances, emergency rooms and many other services. Check individual plans for these details. Goodies: Some plans offer some dental, hearing and vision coverage, exercise classes, transportation to the doctor and other extra benefits. Check plans for details. Health plans without drugs: A few plans are cheaper because they do not offer drug coverage. Unless you have comparable coverage elsewhere, using these plans can result in stiff penalties if you ever want Medicare drug coverage in later years.

Health plans: how they differ Medicare allows several types of private health plans, which cover all your care. Here is how they diﬀer: HMO (Health Maintenance Organization): Generally requires you to use providers within a network. A personal physician usually coordinates your care and may need to approve visits to specialists. PPO (Preferred Provider Organization): Encourages you to use providers within a network, with low copayments, but also allows you to use providers outside the network at a higher cost. Usually allows you to see specialists within the network without prior approval of a personal physician. Some bigger companies allow you to use their PPOs in other states. Verify before signing up. HMO-POS (HMO-Point of Service): A hybrid between an HMO and PPO. Usually requires you to stay within a network and may require you to seek approval of a personal physician before seeing network specialists. It may cover some care outside the network. Some POS plans approve very little coverage outside the network, so check plans for details. PFFS (Private Fee for Service): Has network, but also allows members to get care outside the network if the provider will accept the plan’s payment, which many do not. Make sure provider will accept payment before incurring bills. Special Needs Plans: People with certain chronic conditions like diabetes and COPD can sometimes qualify for a Special Needs Plan, which may include extra services for managing their disease. Make sure you qualify before purchasing. People living in nursing homes may also qualify for special plans, as can people on Medicaid.

LIFETIMES Medicare 2021

Medicare Advantage plans with drug coverage HOSPITAL COPAY

YEARLY COST (EST.)

OUT-OF POCKET CAP

GENERICS IN GAP?

RATINGS OUT OF 5 STARS

PLAN

TYPE

AARP Medicare Advantage H1045-028 Contact: 800-555-5757

HMOPOS

Her., Hills., Pasco, Pin.

Net: $0, $35 Out: N/A

Net: $280 daily for 6 days Out: N/A

$3,127

Net: $4,900 Out: N/A

★★★ 1/2

AARP Medicare Advantage Choice H2406-011 Contact: 800-555-5757

PPO

Her., Hills., Pasco, Pin.

$150

Net: $5, $35 Out: $45, $70

Net: $295 daily for 5 days Out: 40%/stay

$3,199

Net: $5,500 In and Out of network: $10,000

★★★ 1/2

AARP Medicare Advantage Choice Plan 2 R0759-001 Contact: 800-555-5757

PPO

Her., Hills., Pasco, Pin.

$395

Net: $10, $50 Out: $40, $70

Net: $395 daily for 4 days Out: 40%/stay

$3,631

Net: $6,700 In and Out of network: $10,000

★★★ 1/2

AARP Medicare Advantage Focus H1045-045 Contact: 800-555-5757

HMO-POS

Hills., Pasco, Pin.

Net: $0, $20 Out: N/A

Net: $195 daily for 5 days Out: N/A

$2,947

Net: $3,400 Out: N/A

Yes

★★★ 1/2

Aetna Medicare Choice H1609-028 Contact: 833-859-6031; TTY 711

HMO-POS

Hills., Pin.

$195

Net: $0, $40 Out: N/A, $5

Net: $350 daily for 4 days Out: 50%/stay

$3,211

Net: $6,700 In and Out of network: $10,000

Yes

★★★★

Aetna Medicare Premier H5521-033 Contact: 833-859-6031; TTY 711

PPO

Her., Hills., Pasco, Pin.

$300

Net: $15, $50 Out: $50, $50

Net: $395 daily for 4 days Out: 50%/stay

$3,439

Net: $6,700 In and Out of network: $10,000

Yes

★★★★

Aetna Medicare Premier Plus H5521-270 Contact: 833-859-6031; TTY 711

PPO

Her., Hills., Pasco, Pin.

$150

Net: $0, $35 Out: $55, $70

Net: $295 daily for 4 days Out: 50%/stay

$3,175

Net: $5,500 In and Out of network: $10,000

Yes

★★★★

Aetna Medicare Select H1609-034 Contact: 833-859-6031; TTY 711

HMO

Her., Hills., Pasco, Pin.

Net: $0, $20 Out: N/A

Net: $75 daily for 7 days Out: N/A

$2,707

Net: $3,200 Out: N/A

Yes

★★★★

BayCare Plus Complete H2235-001 Contact: 877-549-1741; TTY 711

HMO

Hills., Pasco, Pin.

Net: $0, $15 Out: N/A

Net: $175 daily for 5 days Out: N/A

$2,827

Net: $3,500 Out: N/A

Too new to measure

BayCarePlus Premier H2235-003 Contact: 877-549-1741; TTY 711

HMO

Pin.

$33

Net: $0, $10 Out: N/A

Net: $150 daily for 5 days Out: N/A

$3,103

Net: $2,800 Out: No

Too new to measure

BayCarePlus Rewards H2235-H2235-002 Contact: 877-549-1741; TTY 711

HMO

Hills., Pasco, Pin.

Yes

Net: $0, $35 Out: N/A

Net: $250 daily for 6 days Out: N/A

$1,771

Net: $4,500 Out: N/A

Too new to measure

BayCarePlus Signature H2235-004 Contact: 877-549-1741; TTY 711

HMO

Hills., Pasco

$28

Net: $0, $10 Out: N/A

Net: $150 daily for 5 days Out: N/A

$3,043

Net: $2,800 Out: N/A

Too new to measure

BlueMedicare Choice R3332-001 Contact: 844-396-2763; TTY 800-955-8770

PPO

Her., Hills., Pasco, Pin.

$47.90

$250

Net: $10, $50 Out: 50%, 50%

Net: $345 daily for 5 days Out: $495 daily for 27 days

$4,230

Net: $6,500 In and Out of network: $10,000

Yes

★★★ 1/2

BlueMedicare Classic H1035-021 Contact: 844-396-2763; TTY 800-955-8770

HMO

Her., Hills., Pin.

Net: $0, $40 Out: N/A

Net: $225 daily for 7 days Out: N/A

$3,079

Net: $4,900 Out: N/A

Yes

★★★★ 1/2

PREM.

PART B DRUG REDUCT. DEDUCT.

DOCTOR COPAY (PER VISIT)

COUNTIES SERVED

Chart continued on page 13

Note: Shading on the chart indicates plans oﬀered by the same company.

SSP Tampa Bay Times

| Wednesday, October 28, 2020 |

Tampa Bay Times

SSP

LIFETIMES Medicare 2021

continued from Page 11

Medicare Advantage plans with drug coverage COUNTIES SERVED

PREM.

PART B DRUG REDUCT. DEDUCT.

DOCTOR COPAY (PER VISIT)

HOSPITAL COPAY

YEARLY COST (EST.)

OUT-OF POCKET CAP

GENERICS IN GAP?

RATINGS OUT OF 5 STARS

PLAN

TYPE

BlueMedicare Premier H1035-034 Contact: 844-396-2763; TTY 800-955-8770

HMO

Her., Hills., Pasco, Pin.

Net: $0, $20 Out: N/A

Net: $125 daily for 8 days Out: N/A

$2,635

Net: $3,400 Out: N/A

Yes

★★★★ 1/2

BlueMedicare Saver H1035-037 Contact: 844-396-2763; TTY 800-955-8770

HMO

Hills, Pin.

Yes

$50

Net: $0, $45 Out: N/A

Net: $275 daily for 7 days Out: N/A

$2,563

Net: $6,700 Out: N/A

Yes

★★★★ 1/2

BlueMedicare Select H5434-002 Contact: 844-396-2763; TTY 800-955-8770

PPO

Hills, Pin.

$146.80

$305

Net: $5, $45 Out: 40%, 40%

Net: $225 daily for 7 days Out: $200 daily for 27 days

$4,973

Net: $5,900 In and Out of network: $10,000

Yes

★★★ 1/2

BlueMedicare Value H5434-035 Contact: 844-396-2763; TTY 800-955-8770

PPO

Her., Hills., Pasco, Pin.

$150

Net: $10, $45 Out: 50%, 50%

Net: $325 daily for 6 days Out: $50%/stay

$3,331

Net: $4,500 In and Out of network: $10,000

Yes

★★★ 1/2

Bright Advantage Choice H3281-003 Contact: 877-930-3323; TTY 711

PPO

Pasco

Net: $0, $20 Out: $0, $20

Net: $250 daily for 5 days Out: 40% daily for 90 days

$3,055

Net: $5,400 In and Out of network: $10,000

Yes

Too new to measure

Bright Advantage Health Dollars H4709-003 Contact: 877-930-3323; TTY 711

HMO

Pasco

Net: $0, $0 Out: N/A

Net: $190 daily for 7 days Out: N/A

$2,383

Net: $3,400 Out: N/A

Yes

Too new to measure

Bright Advantage Part B Savings H3281-010 Contact: 877-930-3323; TTY 711

PPO

Pasco

Yes

$400

Net: $0, $40 Out: $0, $40

Net: $295 daily for 6 days Out: 30% daily for 90 days

$2,311

Net: $6,700 In and Out of network: $10,000

Yes

Too new to measure

CareFree H1019-104-2 Contact: 800-794-4105

HMO

Hills., Pasco, Pin.

Yes

Net: $0, $20 Out: N/A

Net: $125 daily for 4 days Out: N/A

$1,243

Net: $2,750 Out: N/A

★★★★★

CareOne PLATINUM H1019-111 Contact: 800-794-4105

HMO

Hills., Pasco, Pin.

Net: $0, $10 Out: N/A

Net: $50 daily for 5 days Out: N/A

$2,479

Net: $3,400 Out: N/A

Yes

★★★★★

CareOne PLUS H1019-103-2 Contact: 800-794-4105

HMO

Hills., Pasco, Pin.

Net: $0, $5 Out: N/A

Net: $20 daily for 5 days Out: N/A

$2,431

Net: $1,900 Out: N/A

Yes

★★★★★

Cigna Preferred Medicare H5410-029 Contact: 855-980-3046

HMO

Her., Hills., Pasco, Pin.

Net: $0, $0 Out: N/A

Net: $150 daily for 6 days Out: N/A

$2,707

Net: $3,650 Out: N/A

★★★★★

Cigna Preferred Savings Medicare H5410-030 Contact: 855-980-3046

HMO

Her., Hills., Pasco, Pin.

Yes

Net: $0, $15 Out: N/A

Net: $175 daily for 6 days Out: N/A

$1,651

Net: $3,950 Out: N/A

★★★★★

Cigna Primary Medicare H5410-035 Contact: 855-980-3046

HMO

Her., Hills., Pasco, Pin.

$18

$445

Net: $0, $0 Out: N/A

Net: $500/stay Out: N/A

$2,898

Net: $3,500 Out: N/A

★★★★★

Devoted Health Core Greater Tampa Bay H1290-004 Contact: 800-376-5889

HMO

Her., Hills., Pasco, Pin.

Net: $0, $10 Out: N/A

Net: $90 daily for 7 days Out: N/A

$2,599

Net: $2,900 Out: N/A

Yes

Too new to measure

Chart continued on Page 14

Note: Shading on the chart indicates plans oﬀered by the same company.

SSP Tampa Bay Times

| Wednesday, October 28, 2020 |

LIFETIMES Medicare 2021

continued from Page 13

Medicare Advantage plans with drug coverage COUNTIES SERVED

PREM.

PART B DRUG REDUCT. DEDUCT.

DOCTOR COPAY (PER VISIT)

HOSPITAL COPAY

YEARLY COST (EST.)

OUT-OF POCKET CAP

GENERICS IN GAP?

RATINGS OUT OF 5 STARS

PLAN

TYPE

Devoted Health Essentials Greater Tampa Bay H1290-016 Contact: 800-376-5889

HMO

Her., Hills., Pasco, Pin.

Yes

Net: $0, $30 Out: N/A

Net: $195 daily for 6 days Out: N/A

$1,639

Net: $3,400 Out: N/A

Too new to measure

Devoted Health Prime Greater Tampa Bay H1290-009 Contact: 800-376-5889

HMO

Her., Hills., Pasco, Pin.

$31

$445

Net: $0, $0 Out: N/A

Net: $0 Out: N/A

$2,873

Net: $3,400 Out: N/A

Too new to measure

Freedom Medicare Plan Rx H5427-060 Contact: 800-401-2740

HMO

Hills., Pasco, Pin.

Net: $0, $35 Out: N/A

Net: $150 daily for 7 days Out: N/A

$3,271

Net: $3,400 Out: N/A

Yes

★★★★

HumanaChoice R5826-005 Contact: 855-795-9488

PPO

Her., Hills., Pasco, Pin.

$105.00

$100

Net: $5, $45 Out: $65, $65

Net: $250 daily for 7 days Out: 40%/stay

$4,687

Net: $6,700 In and Out of network: $10,000

★★★ 1/2

HumanaChoice Florida H5216-072 Contact: 855-795-9488

PPO

Her., Hills., Pasco, Pin.

$150

Net: $5, $40 Out: $65, $65

Net: $343 daily for 4 days Out: $495 daily for 27 days

$3,463

Net: $4,900 In and Out of network: $10,000

★★★★

HumanaChoice R5826-074 Contact: 855-795-9488

PPO

Her., Hills., Pasco, Pin.

$395

Net: $35, $50 Out: 50%, 50%

Net: $625 daily for 3 days Out: $725 daily for 14 days

$4,015

Net: $7,550 In and Out of network: $10,500

★★★ 1/2

Humana Gold Plus H1036-025 Contact: 855-795-9488

HMO

Her., Hills., Pasco, Pin.

Net: $0, $5 Out: N/A

Net: $25 daily for 5 days Out: N/A

$2,347

Net: $1,900 Out: N/A

Yes

★★★★ 1/2

Humana Gold Plus H1036-265 Contact: 855-795-9488

HMO

Her., Hills., Pasco, Pin.

Yes

Net: $0, $25 Out: N/A

Net: $150 daily for 8 days Out: N/A

$1,315

Net: $2,750 Out: N/A

★★★★ 1/2

Optimum Gold Plus Plan H5594-032 Contact: 866-245-5360

HMO

Her.

Yes

Net: $0, $20 Out: N/A

Net: $125 daily for 7 days Out: N/A

$1,399

Net: $1,900 Out: N/A

Yes

★★★★ 1/2

Optimum Gold Rewards Plan H5594-001 Contact: 866-245-5360

HMO

Her., Hills., Pasco, Pin.

Yes

Net: $0, $20 Out: N/A

Net: $150 daily for 7 days Out: N/A

$1,495

Net: $1,900 Out: N/A

Yes

★★★★ 1/2

Optimum Platinum Plan H5594-002 Contact: 866-245-5360

HMO

Her., Hills., Pasco, Pin.

Net: $0, $5 Out: N/A

Net: $0 Out: N/A

$2,731

Net: $1,500 Out: N/A

Yes

★★★★ 1/2

Premier by Ultimate H2962-001 Contact: 855-858-7526

HMO

Her., Hills., Pasco, Pin.

Yes

Net: $0, $20 Out: N/A

Net: $125 daily for 5 days Out: N/A

$1,255

Net: $2,800 Out: N/A

Yes

★★★★

Premier Plus by Ultimate H2962-014 Contact: 855-858-7526

HMO

Her., Hills., Pasco, Pin.

Net: $0, $0 Out: N/A

Net: $0 Out: N/A

$2,431

Net: $1,500 Out: N/A

Yes

★★★★

Simply More H5471-078 Contact: 888-870-7138

HMO

Her., Hills., Pasco, Pin.

Net: $0, $10 Out: N/A

Net: $50 daily for 8 days Out: N/A

$2,287

Net: $3,450 Out: N/A

Yes

★★★★

Chart continued on Page 16

Note: Shading on the chart indicates plans oﬀered by the same company.

Wednesday, October 28, 2020 |

Tampa Bay Times

SSP

SSP Tampa Bay Times

| Wednesday, October 28, 2020 |

LIFETIMES Medicare 2021

continued from Page 14

Medicare Advantage plans with drug coverage COUNTIES SERVED

PREM.

PART B DRUG REDUCT. DEDUCT.

DOCTOR COPAY (PER VISIT)

HOSPITAL COPAY

YEARLY COST (EST.)

OUT-OF POCKET CAP

GENERICS IN GAP?

RATINGS OUT OF 5 STARS

PLAN

TYPE

Simply Select H5471-099 Contact: 888-870-7138

HMO

Her., Hills., Pasco, Pin.

$30.80

$445

Net: $0, $5 Out: N/A

Net: $25 daily for 8 days Out: N/A

$2,669

Net: $3,450

Yes Out: N/A

★★★★

SOLIS SPF 009 H0982-009 Contact: 844-447-6547

HMO

Hills.

Net: $0, $5 Out: N/A

Net: $80 daily for 7 days Out: N/A

$2,779

Net: $3,400 Out: N/A

Yes

Too new to measure

WellCare Dividend Prime H1032-200 Contact: 866-527-0056

HMO

Her., Hills., Pasco, Pin.

Yes

Net: $0, $20 Out: N/A

Net: $100 daily for 5 days Out: N/A

$1,416

Net: $2,500 Out: N/A

Yes

★★★★

WellCare Elite H1032-201 Contact: 866-527-0056

HMO

Her., Hills., Pasco, Pin.

Net: $0, $5 Out: N/A

Net: $50 daily for 10 days Out: N/A

$2,599

Net: $1,200 Out: N/A

Yes

★★★★

WellCare Premier H5199-012 Contact: 866-527-0056

PPO

Her., Hills., Pasco, Pin.

$100

Net: $0, $25 Out: $0, $0-$275

Net: $225 daily for 6 days Out: $225 daily for 6 days

$3,223

Net: $3,400 In and Out of network: $5,100

Yes

Too new to measure

WellCare Prime H5199-010 Contact: 866-527-0056

PPO

Her., Hills., Pasco, Pin.

$75

Net: $0, $15 Out: $0, $15

Net: $100 daily for 6 days Out: $100 daily for 6 days

$3,715

Net: $1,700 In and Out of network: $5,000

Yes

Too new to measure

Note: Shading on the chart indicates plans oﬀered by the same company.

| Wednesday, October 28, 2020 |

Tampa Bay Times

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SSP Tampa Bay Times

| Wednesday, October 28, 2020 |

LIFETIMES Medicare 2021

Stand-alone drug plans What’s in the chart

Monthly premium: The monthly charge for each Medicare Part D drug plan. This is in addition to Medicare’s monthly Part B premium. Annual deductible: What you pay out of pocket before coverage begins. Generics in the gap: Whether a plan pays for generic drugs in the coverage

PLAN

gap, which begins when drug costs hit $4,130 for the year and ends when your out-of-pocket expenses reach $6,550. Some plans oﬀer generics in the gap for select brands only. Rating: Medicare rates plans from 1 to 5 stars, based on customer satisfaction and certain health measures. The top rating is a 5.

MONTHLY PREMIUM

AARP MedicareRx Preferred S5820-010 Contact: 800-850-6807; TTY 711 AARP MedicareRx Saver Plus S5921-356 Contact: 800-850-6807; TTY 711 AARP MedicareRx Walgreens S5921-383 Contact: 800-850-6807; TTY 711 BlueMedicare Complete Rx S5904-002 Contact: 888-509-2537; TTY 800-955-8770 BlueMedicare Premier Rx S5904-001 Contact: 888-509-2537; TTY 800-955-8770 Cigna Secure Rx S5617-053 Contact: 800-997-1654; TTY 711 Cigna Secure-Essential Rx S5617-290 Contact: 800-997-1654; TTY 711

$88.70

$54.20

$35.40

$172.00

$73.70

$30.50

$24.00

ANNUAL DEDUCT.

$0.00

$445.00

$0.00

$405.00

$445.00

GENERICS IN GAP?

Yes

RATING: OUT OF 5 STARS

ANNUAL DEDUCT.

GENERICS IN GAP?

RATING: OUT OF 5 STARS

★★★ 1/2

Humana Basic Rx Plan S5884-105 Contact: 800-457-4708; TTY 711

$45.00

$445.00

★★★ 1/2

Humana Premier Rx Plan S5884-157 Contact: 800-457-4708; TTY 711

$66.10

$445.00

★★★ 1/2

Humana Walmart Value Rx Plan S5884-190 Contact: 800-457-4708; TTY 711

$17.20

$445.00

★★★ 1/2

Mutual of Omaha Rx Plus S7126-010 Contact: 800-961-9006

$86.00

$445.00

★★ 1/2

Mutual of Omaha Rx Premier S7126-080 Contact: 800-961-9006

$25.90

$445.00

★★ 1/2

SilverScript Choice S5601-022 Contact: 833-537-3386; TTY 711

$24.80

$305.00

★★★ 1/2

SilverScript Plus S5601-023 Contact: 833-537-3386; TTY 711

$62.70

$0.00

Yes

★★★ 1/2

SilverScript SmartRx S5601-186 Contact: 833-537-3386; TTY 711

$7.30

$445.00

★★★ 1/2

WellCare Classic S4802-083 Contact: 800-960-2530; TTY 877-247-6272

$26.60

$445.00

★★★★

WellCare Medicare Rx Saver S5810-045 Contact: 800-960-2530; TTY 877-247-6272

$49.80

$445.00

★★★ 1/2

WellCare Medicare Rx Select S5810-285 Contact: 800-960-2530; TTY 877-247-6272

$26.40

$445.00

★★★ 1/2

WellCare Medicare Rx Value Plus S5768-134 Contact: 800-960-2530; TTY 877-247-6272

$77.80

$0.00

★★★

WellCare Value Script S4802-146 Contact: 800-960-2530; TTY 877-247-6272

$15.60

$445.00

★★★★

WellCare Wellness Rx S4802-180 Contact: 800-960-2530; TTY 877-247-6272

$14.70

$445.00

★★★★

★★★ ★★★ ★★★ 1/2 ★★★ 1/2

$58.80

$100.00

Yes

★★★ 1/2

Clear Spring Health Premier Rx S6946-037 Contact: 877-364-4566

$13.50

$445.00

Too new to measure

Clear Spring Health Value Rx S6946-008 Contact: 877-364-4566

$26.90

$445.00

Too new to measure

Elixer RxPlus S7694-011 Contact: 866-250-2005; TTY 711

$61.90

$445.00

★★★ 1/2

Express Scripts Medicare-Saver S5660-227 Contact: 855-513-0708; TTY 800-716-3231 Express Scripts Medicare-Value S5660-113 Contact: 855-513-0708; TTY 800-716-3231

$84.30

$27.20

$26.80

$100.00

$285.00

$445.00

Source: Centers for Medicare & Medicaid Services

| Wednesday, October 28, 2020 |

Tampa Bay Times SSP

Yes

Medicare health costs: Drug plans are for people on Original Medicare, who also have expenses for doctors, hospitals and, sometimes, supplemental plans. People with higher incomes may also pay higher Part B premiums and drug plan premiums.

Total drug costs: Out-of-pocket costs can vary widely depending on which drugs you use. For an estimated total cost of diﬀerent plans, enter your speciﬁc drugs into Medicare’s online Plan Finder and search for drug plans.

MONTHLY PREMIUM

Cigna Secure-Extra Rx S5617-256 Contact: 800-997-1654; TTY 711

Express Scripts Medicare - Choice S5660-181 Contact: 855-513-0708; TTY 800-716-3231

What’s not in the chart

★★★ 1/2 ★★★ 1/2 ★★★ 1/2

PLAN

SSP Tampa Bay Times

| Wednesday, October 28, 2020 |

TV word search A D F S P E E A L U O N A D

N V N G U B K N Z D N O E R

S E A L J K W E L R U S G E

U N W D R E H D A O P N E S

M S U P E T E R U E U W C T

F C H X E C C M R V E T M A

S H C P V H A A I Q X C W K

D E I U E P T E E U C E O I

T M C L S I O P S R K L D H

X I E R O W B L O T A E A Z

A N Y N E U Q R I V E R W U

R G S A R T Y M K T M C N V

V E U S C R S I V I I H K E

A R F Y P K P R A J E C N E

H E E G R E E N E M N K S H

“Roadkill on Masterpiece” on PBS (Words in parentheses not in puzzle)

Peter (Laurence) Charmian (Pepper) Dawn (Ellison) Helen (Laurence) Duncan (Knock)

(Hugh) Laurie (Sarah) Greene (Helen) McCrory (Saskia) Reeves (Iain) de Caestecker

Politics Scheming Outwit Secrets Desperation

CROSSWORD ANSWERS puzzle page 2

Wednesday, October 28, 2020 |

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ASTRONOMY November Sky Calendar by Daryl L. Schrader Nov. 1: Daylight-saving time ends at 2 a.m. Nov. 8: Last quarter moon. Nov. 10: Mercury is at greatest angular distance from the Sun in the morning sky. Nov. 12: Look to east-southeast to see Venus below a thin crescent moon before dawn. Nov. 13: Look to east-southeast to ďŹ nd Mercury below a very thin crescent moon just before sunrise. Brilliant Venus is to their upper right. Nov. 14: Moon is at a perigee (closest) of 222,350 miles from the Earth. Nov. 15: New moon. Nov. 17: Leonid meteor shower peaks in the morn-

ing sky. You may see 10-15 meteors/hour under dark skies. Meteors will radiate from the south. Nov. 18: In the south-southwest Saturn, Jupiter, crescent moon and Sagittarius form a diagonal line in the sky. Nov. 21: First quarter moon. Nov. 25: In early evening Mars is above the moon. Nov. 26: The moon is at its farthest (apogee) distance from the Earth at 252,211 miles Nov. 30: Full moon. Daryl L. Schrader is professor emeritus at St. Petersburg College and has taught astronomy at the University of South Florida.

SSP Tampa Bay Times

| Wednesday, October 28, 2020 |

LIFETIMES Medicare 2021

Fad or future? Telehealth expansion eyed beyond pandemic Associated Press WASHINGTON — Telehealth is a bit of American ingenuity that seems to have paid off in the coronavirus pandemic. Medicare temporarily waived restrictions predating the smartphone era and now there’s a push to make telemedicine widely available in the future. Consultations via tablets, laptops and phones linked patients and doctors when society shut down in early spring. Telehealth visits dropped with the reopening, but they’re still far more common than before. Permanently expanding access will involve striking a balance between costs and quality, dealing with privacy concerns and potential fraud, and figuring out how telehealth can reach marginalized patients, including people with mental health problems. “I don’t think it is ever going to replace in-person visits, because sometimes a doctor needs to put hands on a patient,” said Seema Verma, head of the Centers for Medicare and Medicaid and the Trump administration’s leading advocate for telehealth. Caveats aside, “it’s almost a modern-day house call,” she added. “It’s fair to say that telemedicine was in its infancy prior to the pandemic, but it’s come of age this year,” said Murray Aitken of the data firm IQVIA, which tracks the impact. In the depths of the coronavirus shutdown, telehealth accounted for more than 40% of primary care visits for patients with traditional Medicare, up from a tiny 0.1% sliver before the public health emergency. As the government’s flagship health care program, Medicare covers more than 60 million people, including those age 65 and older, and younger disabled people. A recent poll of older adults by the University of Michigan Institute for Healthcare Policy & Innovation found that more than 7 in 10 are interested in using telehealth for follow-ups with their doctor, and nearly 2 out of 3 feel comfortable with video conferences. But privacy was an issue,

| Wednesday, October 28, 2020 |

Tampa Bay Times

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especially for those who hadn’t tried telehealth. The poll found 27% of older adults who had not had a telemedicine visit were concerned about privacy, compared with 17% of those who tried it. Those who tried telehealth weren’t completely sold. About 4 in 5 were concerned the doctor couldn’t physically examine them, and 64% worried the quality wasn’t as good. “After the initial excitement, in the afterglow, patients realize ‘I can’t get my vaccine,’ or ‘You can’t see this thing in the back of my throat over the computer,’ ” said Dr. Gary LeRoy of Dayton, Ohio, a primary care doctor and president of the American Academy of Family Physicians. For Medicare beneﬁciary Jean Grady of Westford, Vermont, telemedicine was a relief. She needed a checkup required by Medicare to continue receiving supplies for her wearable insulin pump. Being in a high-risk group for COVID-19, Grady worried about potential exposure in a doctor’s waiting room, and even more about losing her diabetes supplies if she missed Medicare’s checkup deadline. “I would have had to go back to taking insulin by syringe,” she said. Grady prepared for the virtual visit by calling her clinician’s tech department and downloading teleconference software. She says she would do some future visits by video, but not all. For example, people with diabetes need periodic blood tests, and their feet must be checked for signs of circulatory problems. Still, quite a few follow-ups “could be done very efficiently and be just as useful to the physician and myself as going in and seeing them in person,” Grady said. Many private insurance plans, including those in Medicare Advantage, offer some level of telemedicine coverage. But traditional Medicare has restricted it to rural residents, who generally had to travel to specially designated sites to connect. . See TELEHEALTH, 23

LIFETIMES Medicare 2021 . TELEHEALTH

continued from 22

Under the coronavirus public health emergency, the administration temporarily waived Medicare’s restrictions so enrollees anywhere could use telemedicine. Patients could connect from home. Making such changes permanent would require legislation from Congress, but there’s bipartisan interest. Sen. Lamar Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, says he’d like to see broader access, without breaking the bank. “Our job should be to ensure that change is done with the goals of better outcomes and better patient experiences, at a lower cost,” said Alexander, R-Tenn. That’s a tall order. Payment will be a sticky obstacle. For now, Medicare is paying clinicians on par for virtual and in-person visits.

“Policymakers seem to be in a rush to pass legislation, but I think it is worth taking a little more time,” said Juliette Cubanski, a Medicare expert with the nonpartisan Kaiser Family Foundation. “Fraud is one big area that policymakers need to be cognizant of.” Fraud-busters agree. Telehealth is so new that “we don’t have at this point a real sense of where the huge risks lie,” said Andrew VanLandingham, a senior lawyer with the Health and Human Services inspector general’s office. “We are sort of in an experimental phase.” Despite the risks, advocates see opportunities. Expanded Medicare telehealth could: —help move the nation closer to a long-sought goal of treating mental health the same as physical conditions. Sen. Ron Wyden, D-Ore., wants to use telemedicine as a springboard to improve mental

health care. IQVIA data shows 60% of psychiatric consults took place by telehealth during the shutdown. —increase access for people living in remote communities, in low-income urban areas and even nursing homes. Medicare’s research shows low-income beneﬁciaries have had similar patterns of using telehealth for primary care as program enrollees overall. —improve coordination of care for people with chronic health conditions, a goal that requires patient and persistent monitoring. Chronic care accounts for most program spending. University of Michigan health policy expert Mark Fendrick says Medicare should ﬁgure out what services add value for patients’ health and taxpayers’ wallets, and pay just for those. Telehealth “was an overnight sensation,” said Fendrick. “Hopefully it’s not a one-hit wonder.”

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| Wednesday, October 28, 2020 |

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