Medicare Open Enrollment

It is that time of year for Medicare Open Enrollment!  The Open Enrollment period goes from October 15th ending December 7th.  There are changes this year that you should be aware of when making decisions about your coverage.

The Medicare Advantage Disenrollment Period (January 1 – February 14 every year) will be replaced with a different arrangement. This will be effective starting in 2019, according to the Centers for Medicare & Medicaid Services (CMS).

The Medicare Advantage Disenrollment Period lets you drop your Medicare Advantage plan and return to Original Medicare (Part A and Part B). It also lets you sign up for a stand-alone Medicare Part D Prescription Drug Plan.

In 2019, a new Medicare Advantage Open Enrollment Period will run from January 1 – March 31 every year. If you’re enrolled in a Medicare Advantage plan, you’ll have a one-time opportunity to:

  • Switch to a different Medicare Advantage plan
  • Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B
  • Sign up for a stand-alone Medicare Part D Prescription Drug Plan (if you return to Original Medicare). Most Medicare Advantage plans include prescription drug coverage already. Usually you can’t enroll in a stand-alone Medicare Prescription Drug plan if you already have a Medicare Advantage plan, but there are some situations where you can. Call your Medicare Advantage plan if you have questions.
  • Drop your stand-alone Medicare Part D Prescription Drug Plan


Here are seven improvements to Medicare that that AARP has identified.  They will take effect in 2019. Some of the changes will affect all beneficiaries while others will apply just to individuals who select Medicare Advantage plans.

Donut hole 

An expensive element of the Medicare Part D prescription drug benefit requires enrollees with high prescription costs to pay more for their medicines after they reach a certain level of spending in one year. This creates a coverage gap – also called the “donut hole.” After a beneficiary’s out-of-pocket spending reaches a second threshold, they enter catastrophic coverage and pay substantially less. Under the Affordable Care Act (ACA), the donut hole was scheduled to close in 2020. But the spending bill Congress passed in March will close the donut hole for brand-name drugs in 2019. The gap will close for generic drugs in 2020.

Therapy cap gone

Beneficiaries of original Medicare won’t have to pay the full cost of outpatient physical, speech or occupational because Congress permanently repealed the cap that has historically limited coverage of those services.

Better information

Medicare is updating the handbook it sends to beneficiaries every fall. It will include checklists and flowcharts to make it easier to decide on coverage. The online Medicare Plan Finder tool will be easier to use and an improved “coverage wizard” will help enrollees compare out-of-pocket costs and coverage options between original Medicare and Medicare Advantage.

More telemedicine

Medicare is steadily broadening the availability of telehealth programs that let patients confer with a doctor or nurse via telephone or the internet. In 2019, it will begin covering telehealth services for people with end-stage renal disease or during treatment for a stroke.

Lifestyle support

Beginning in January, Medicare Advantage plans have the option to cover meals delivered to the home, transportation to the doctor’s office and even safety features in the home such as bathroom grab bars and wheelchair ramps. To be covered, a medical provider will have to recommend benefits such as home-safety improvements and prepared meals.

In-home help

Medicare Advantage plans also will have the option to pay for assistance from home health aides, who can help beneficiaries with their daily activities including dressing, eating and personal care. These benefits represent a revised and broader definition of the traditional requirement that Medicare services must be primarily health related.

Plan test drives

New regulations will let people try an Advantage plan for up to three months and, if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare. Congress required this flexibility in the 21st Century Cures Act, designed to accelerate innovation in health care.


Age Friendly Survey

I am happy to announce that AAA4 is partnering with AARP to roll out an Age Friendly Survey.  We want to reach the 977,000 people age 45+ living in our region and hear what they have to say about whether they live in an “age friendly community”.  We know that a great majority of Americans want to continue living in their own homes as they age.  It is important to stay active and engaged in every way.  All ages want to live safely and affordably, buy healthy food, socialize and find services they need while aging in place.

Beginning September 1, 2018 the Age Friendly Survey will be available on this website.  It takes about 20 minutes to complete.  In mid-September the survey will appear as an insert in many local newspapers in the region, including the Sac Bee.  The insert will be entitled “What Makes a Community Great?”  Please take the time to complete and the survey and pass this information along to family and friends.  We want to hear from you.  Your voice is important to us.

June 2018 is Elder Abuse Awareness Month

June is Elder Abuse Awareness Month.  Elder Abuse is much more common than people think.  There are warning signs that may indicate an older adult is being abused.  Some of those signs are:

  • A lack of basic amenities
  • A cluttered or filthy living environment
  • Unexplained or uncharacteristic changes in behavior
  • Unexplained sexually transmitted diseases
  • Unpaid bills, new credit cards and/or increased cash withdrawals
  • Harassment, coercion, intimidation or humiliation
  • A caregiver who isolates an elder

The State of California recognizes 8 forms of elder abuse:

  1. Self-Neglect – Refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precaution.
  2. Physical Abuse– The use of physical force that may result in bodily injury, physical pain, or impairment; or any physical injury to an adult caused by other than accidental means.
  3. Neglect by Others– Failure to provide the basic care, or services necessary to maintain the health and safety of an adult: this failure can be active or passive.
  4. Sexual Abuse– Sexual contact with a non-consenting adult or with an adult considered incapable of consenting to a sexual act.
  5. Financial Abuse– The illegal or unethical exploitation and/or use of an elder’s funds, property, or other assets.
  6. Mental Abuse– Verbal or emotional abuse includes threatening significant physical harm or threatening or causing significant emotional harm to an adult through the use of: Derogatory or inappropriate names, insults, verbal assaults, profanity, or ridicule; or harassment, coercion, threats, intimidation, humiliation, mental cruelty, or inappropriate sexual comments.
  7. Abandonment – the desertion or willful forsaking by anyone having responsibility for care.
  8. Isolation– Preventing the individual from receiving mail, telephone calls, or visitors.


If you suspect an older adult is being abused please report it immediately to Adult Protective Services or Law Enforcement.  Help us protect members of this vulnerable population.


April 15th to 21st is National Volunteer Week

April 15th to 21st is National Volunteer Week.  We need volunteers more now than ever who can focus on the needs of older adults. Our nation is on the cusp of one of the most dramatic demographic shifts in its history as a projected 71.5 million people will be age 65 or older by the year 2030.  And we recognize that aging is, for many, a complex and fearful unknown – but it doesn’t have to be.

What is powerful about volunteering is it helps the older adult avoid isolation and loneliness, as well has being a tremendous benefit to the volunteers themselves. New research shows that the volunteers are enjoying health benefits after just one year of service, including decreases in anxiety and depression, loneliness and social isolation. They also report enhanced physical capacity and higher life satisfaction. A study of Americans over age 60 found that those who volunteer reported lower disability and higher levels of well-being relative to non-volunteers. The effects of volunteering were found to be greater than other factors including income, education level, or marriage (Morrow-Howell et al., 2003).

There are many opportunities to volunteer in the aging network.  Some ideas are senior centers and day programs, home repair and homemaker services, information and referral, Meals on Wheels and congregate meal programs. Other ideas are transportation, companion services, HICAP counselling and the Long Term Care Ombudsman Program.

To quote President George H. W. Bush:

Every problem that the country faces is being solved in some community by some group or some individual. The question is how to get connected so that the whole nation can solve problems. A volunteer is a person who can see what others cannot see; who can feel what most do not feel. Often, such gifted persons do not think of themselves as volunteers, but as citizens – citizens in the fullest sense; partners in civilization.