KIDNEY CITIZEN Issue 12

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to a new plan, between January 1 andMarch 31.Should I enroll inMedicare Advantage?The answer is Maybe.6MedicareAdvantageNow Open forEnrollmentBetween now and December 7,dialysis patients are, for the firsttime, able to choose a MedicareAdvantage plan for their coverage.Medicare Advantage is an alternativeto traditional Medicare run by privateinsurance companies. To help kidneypatients explore their options, DialysisPatient Citizens has established DialysisPlan Choice, an online tool designed incollaboration with Consumers’ Checkbookfor dialysis patients to quickly and easilycompare their current Medicare Fee-For-Service plan with the options available tothem through Medicare Advantage.DialysisPlanChoice.org helpspatients and caregivers more easilyunderstand what plans are available tothem, the costs are associated with thoseplans, and, most importantly, which planswill include their care providers.Dialysis Plan Choice, available atwww.DialysisPlanChoice.org, providespatients with a convenient side-by-sidecomparison of their current Medicare Fee-For-Service plan and available MedicareAdvantage plans, including a costcomparison tool as well as information onwhether their current nephrologist anddialysis clinic are included in a MedicareAdvantage network. Using Dialysis PlanChoice, patients will also be able tosee whether their medications are onMedicare Advantage plan formularies andaccess information on additional benefitsthat are not available through traditionalMedicare plans, such as dental, vision andhearing services. All of this informationis displayed in a simple, mobile-friendlymanner that helps patients to easilycompare plans using their preferreddevices.Open Enrollment for Plan Year 2021 isavailable from October 15 until December7. Also, End-Stage Renal Disease (ESRD)patients who are already enrolled in MAplans now have the opportunity to switchMedicare Advantage plans provide all yourmedical care inside a restricted networkof doctors, hospitals, and other providers.Medicare Advantage plans may or maynot charge a monthly premium, but unlessyou have secondary coverage throughMedicaid, these plans require a copaymenteach time you use your benefits up to anannual limit each year.Medicare Advantage plans involve a tradeoff:Beneficiaries give up the completefreedom of choice of providers enjoyed inOriginal Medicare in exchange for all-inonecoverage, a cap on out-of-pocket costs,and additional benefits, such as eye ordental care. While DialysisPlanChoice.orgenables you to quickly determine whetheryour dialysis clinic and nephrologist arein a plan’s network, once you narrowdown your choices you should also lookto see if your other doctors and preferredhospital are in-network and calculate yourprojected out-of-pocket cost.Medicare Advantage insurers are paid aflat monthly fee for each enrollee. Thisgives the plans an incentive to emphasizepreventive care, but can also incentivizethem to limit expensive services. MedicareAdvantage plans may be beneficial forpatients with chronic diseases like ESRDbecause they are better equipped tocoordinate your care and have flexibilitiesin doing so. However, statistics show thatchronically ill beneficiaries are more likelyto disrenroll from plans and return toOriginal Medicare than healthy patients.Dialysis Patient Citizens advocated forESRD patients to gain the right to enrollin Medicare Advantage plans, but makesno recommendation as to whether ESRDpatients are better off in Medicare Advantageplans or Original Medicare. We do urgepatients to explore their plan options everyyear, and exercise your choice as to whatoptions and costs are best for you personally.You can contact your State HealthInsurance Assistance Program (SHIP) forhelp in evaluating your coverage options,and to find out if you are eligible for anyMedicare assistance programs.
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KIDNEY CITIZEN Issue 12

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