It is very important for everyone becoming eligible for Medicare to get accurate information about coverage and delivery options, including supplemental health insurance, Medicare health plans and prescription drug coverage. If you are already receiving Social Security benefits, Railroad Retirement benefits, or Federal Retiree benefits, your enrollment in Medicare is automatic. Your Medicare card should arrive in the mail shortly before your 65th birthday.
If new to Medicare, click on the link below for more important information:
Medicare Part D Prescription Information:
Medicare’s Web site (www.medicare.gov) has a drug plan finder tool that helps beneficiaries sort all the drug plans to select the best option available and also helps individuals enroll. You can obtain this same information by calling Medicare (1-800-633-4227), contacting NC SHIIP (1-855-408-1212), or in New Hanover County, by setting up an appointment with a local SHIIP counselor (910-798-6442). The Seniors’ Health Insurance Information Program (SHIIP) is a division of North Carolina Department of Insurance which strives to assist Medicare beneficiaries in making well informed health insurance choices, offering free unbiased health information.
The best plan for you depends on the medications that you take. When comparing plans, note that the pharmacy you choose also affects cost. Make sure your pharmacy is preferred by the plan. If it isn’t preferred, but you would rather stay with your pharmacy than switch, compare the plans that your pharmacy does accept.
Most Medicare beneficiaries will add a Part D medication benefit to their traditional Medicare A (primarily hospital) and B coverage (primarily physician visits and outpatient services). You may opt, instead, to leave original Medicare and join a Medicare Advantage plan (Part C) to obtain your health and drug benefits.
Medicare Advantage plans are approved by Medicare and administered by dozens of private insurance companies. These plans provide Medicare Part A and B benefits and MAY include extras such as dental coverage. They come in many forms, including Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) that have provider networks, and also Private Fee-for-Service (PFFS) plans that do not have provider contracts.
These plans work especially well for people who don’t need many services or for those who cannot afford a Medicare supplement to fill in the gaps in original Medicare. However, a number of these plans are not widely accepted by healthcare providers (physicians, hospitals, home health agencies, rehabilitation facilities, etc.) in North Carolina. Selecting the wrong Medicare Advantage plan can mean denial of services or more costly medical care. In addition, the payment structure for policyholders is very different than traditional Medicare. Frequently, we see people who have enrolled in these health plans without truly understanding the pros and cons.
While our SHIIP Program provides Medicare insurance counseling year-round to those who are new to Medicare or who have questions, most beneficiaries can only change their coverage during the annual open enrollment period (OEP), Oct. 15 – Dec. 7. All Medicare beneficiaries are encouraged to examine their options each year, as policies and prices change – not to mention that the medication needs of an individual can change from year to year.
During the OEP for 2020, our SHIIP volunteers in New Hanover County will be providing one-on-one counseling by phone only with limited availability, due to the recent pandemic. To schedule an appointment, please call the appointment line at 910-798-6442.
If you have general questions about Medicare and Medicare Advantage Plans, you may also call our New Hanover County Medicare Information line coming soon in mid-October, 2020. Individual questions will be answered by one of our qualified SHIIP counselors.
A comprehensive list of on-line resources and relevant phone numbers is listed below.
2020 Medicare and YOU Handbook-
Medicare Basics flyer-
New to Medicare video-
Protecting yourself from Medicaid Fraud-
NC SHIIP website- www.ncshiip.com
NC Department of Insurance- www.ncdoi.com
COBRA Employee Benefits Security Administration (provides information regarding continuation of employer group health plans.)- www.dol.gov/ebsa
Medicaid and Medicare Savings Programs (MSP/ Federal health programs, but eligibility is determined at the local county Department of Social Services.)- www.dhhs.state.nc.us/dss/
NC Retired Governmental Employees’ Association (provides information for federal, state, or local government retirees.)- www.ncrgea.com
Railroad Medicare Part B (Processes claims and answers questions regarding Railroad Medicare benefits.)- www.palmettogba.com/medicare
Railroad Retirement Board (Administers comprehensive retirement-survivor and unemployment-sickness benefit programs for the nation’s railroad workers and their families.)- www.rrb.gov
Social Security Administration (Provides information on veterans’ claims and benefits.)- www.socialsecurity.gov
TRICARE for Life (Provides health coverage for retired members of the uniformed services, as well as the spouses and children of active duty, retired and deceased service members.)- www.tricare.mil
U.S. Department of Veterans Affairs (Provides information on veterans’ claims and benefits.)- www.va.gov
Federal Marketplace for NON-Medicare health insurance- www.healthcare.gov
Medicare (Provides information 24 hours a day/7 days a week about eligibility, enrollment, and coverage.) www.medicare.gov
Helpful Phone numbers:
Senior Resource Center
Main number- 910-798-6400
New Hanover County SHIIP appointment line- 910-798-6442
New Hanover County Medicare Information line- (coming soon in October, 2020)
Prescription Assistance Program (Assists seniors who may be unable to afford medications by obtaining medications at no cost from pharmaceutical companies, subsidy programs, physician samples, and other resources.) – 910-798-6422
Social Security Administration- 1-800-772-1213
Local Social Security Administration office- 1-866-964-6227
Department of Social Services (for Medicaid/Medicare Savings Programs)- 910-798-3400
NC SHIIP (providing individual assistance with Medicare coverage questions and enrollment, in addition to our local SHIIP office)- 1-855-408-1212