Will Medicare Cover Your Mental Health Care Needs?

old_happy_coupleAnnual enrollment for Medicare ends on December 7, 2013. There has been a lot written about the mental health parity final ruling and the ACA or Obamacare. It is important to note that these new regulations do not apply to Medicare. In order to maximize mental health care seniors, should look carefully at their supplemental policies.

To better help seniors navigate their options, we are reposting excerpts from several relevant posts from the Center for Medicare Advocacy, Inc. (CMA) and providing links to this valuable information.

The Health Care Reform Marketplace is NOT for People with Medicare!
Beware of Scammers Trying to Sell Marketplace Plans to People with Medicare

The Health Insurance Marketplace, created by the Affordable Care Act (ACA), opened for business on October 1, 2013. Uninsured people can shop for and purchase health insurance on the Marketplace. They can also apply for public programs on the Marketplace like Medicaid and tax credits to help pay for the costs of private insurance. People with Medicare DO NOT need to visit the new Health Insurance Marketplace. According to the Department of Health and Human Services, it is illegal for a broker, agent or health insurance company to sell someone with Medicare an ACA marketplace plan. 

Scam Alert

The Federal Trade Commission has reported several recent scams targeted at older people. Scammers are calling and emailing people with Medicare and telling them Obamacare requires them to change their insurance and buy a marketplace plan. Oftentimes, these scammers will ask for personal information like Social Security numbers or bank accounts. Do not give them this information! The CMA encourages beneficiaries and their advocates to report all attempts at scams to the Federal Trade Commission at https://www.ftccomplaintassistant.gov/

Coverage for Mental Health Prescriptions

Remember, the Marketplace does not offer Part D prescription drug plans, Medicare Advantage Plans or Medigap plans. If a Medicare beneficiary has questions about Medicare or would like to change their Part D or Medicare Advantage plan during the Annual Election Period (Oct 15 through Dec 7), they should visit www.medicare.gov or call 1-800-MEDICARE.

Avoid Unexpected Out-of Network Expenses

Don’t assume that mental health care services are covered in a Medicare supplemental plan. If they are, be sure you are receiving coverage from in-network providers. The CMA reports that they frequently hear from Medicare beneficiaries in Medicare Advantage plans who unknowingly go out of network and face unexpected charges. The CMA states that this problem doesn’t exist with traditional Medicare. Thus, they encourage Medicare beneficiaries to enroll in traditional Medicare – Parts A and B. You can find more information on their website or through your State Health Insurance Assistance Program (SHIP)

For more information

The CMA provides the following tips to receive help reviewing coverage options:

  • Visit www.medicare.gov to see plan coverage and costs available in various geographic areas, and to enroll in a new plan or make a change.  Open Enrollment information is available in Spanish.
  • Call 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options.  TTY users should call 1-877-486-2048.  Multilingual counseling is available
  • Review the 2014 Medicare & You handbook.  It is accessible online at www.medicare.gov/pubs/pdf/10050.pdf, and it has been mailed to the homes of people with Medicare
  • Get one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP).  Local SHIP contact information can be found:

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