• Triton College Annuitants Association

    Health Issues & Insurance

    Click the link below to read the article about transitioning to Medicare, for those approaching 65.

    Medicare Article - Part 1 by Ken Piwower  Transitioning to Medicare - Part 1 by Ken Piwower

    Open Enrollment Period for TRAIL
    The Open Enrollment period for TRAIL, the State's Medicare Advantage Plan, is Oct 15 to Nov 15, 2014. Coverage will be effective Jan 1, 2015.

    Attention current Annuitants with Medicare Part A and B. Members who as of Sept. 30, 2014, are enrolled in Medicare Parts A and B will be required to elect coverage under the CIP Medicare Advantage Program, or else elect to opt out of all CIP coverage. Eligible annuitants were sent TRAIL information packages in early October, 2014 by the Dept of Central Management Services. This coverage will include health, behavioral health, prescription, dental, and vision coverage. For more info regarding the Medicare Advantage Trial program, go to: www.cms.illinois.gov/thetrail

    If you are over sixty-five and have Medicare and choose the Medicare Advantage program the state is offering, please remember that you no longer will use the Federal government's Medicare card, but you will have the Medicare Advantage program being offered by the State of Illinois. You will still pay the Medicare premium each month to the federal government. Please be aware Medicare Advantage programs are regionally specific so be careful in the one you choose. This is why I always recommend planning and talking with someone who has been through this process. It just keeps you sane. Do not just throw your hands up in the air, seek assistance. Lots of individuals with the expertise are there to assist you.

    -Bob Witherspoon

    Click this link for more info on the State's Medicare Advantage Plan, called TRAIL. This includes a list of the TRAIL seminars being offered throughout Illinois during October, 2014.

    Click here for the link to the SUAA blog on the State's Medicare Advantage Program.

    Eleonore Weber
    Message from Eleonore Weber, Insurance Broker

    April 23, 2014

    Dear TCAA Members:

    Once again, thank you for your invitation to participate in your semi-annual meeting on April 15. I was delighted to see familiar faces as well as the opportunity to meet new TCAA members. Additionally, I appreciated the opportunity to meet Linda Brookhart, the Executive Director of the State Universities Annuitants Association (SUAA), and hear her share with the group the recent updates regarding the association’s pending pension issues and healthcare coverage options for members.

    The topic of healthcare is a personal and sensitive subject for most people, as it touches our lives, our well-being, and our loved-ones, and it affects our financial security and future. Health care has changed dramatically over the last several years due to rising costs, greater preventive protection due to the ACA, and the rapid growth of boomers entering their retirement stage.

    TCAA members were therefore confronted with new healthcare options presented by CIP; hence you were required to dissect, digest and assimilate the various options, then decide on a positive outcome for your future. As a result, it was a difficult and daunting decision to make by the end of 2013, and perhaps a few of you are still struggling with questions. This week I had a question from a couple of members, and it was “Can I switch from the State Employee Sponsor program to the Original Medigap (the traditional Medicare Supplement)”? The answer was yes we can. It is a process, yet we are able to switch to a comprehensive Medicare Supplement solution.

    Please feel free to call me with your questions; there is no cost for this service or for your “Peace of Mind”.

    Best Wishes,

    Eleonore Weber,

      Your Life Security.

    Licensed Insurance Broker - Disability, Health, Life and Long-Term Care Insurance
    Mobile (312) 952-1706
    Web site: www.yourlifesecurity.com
    Email: eleonore.weber@yourlifesecurity.com


    Medicare “observation status” warning.
    In the last several months, I have reviewed several articles on the Medicare “observation status” which all of us should be aware of when we are going to the hospital. As I have read the various articles, it appears those Medicare administrators who complete audits of hospitals are applying some pressure on hospitals to place individuals in “observation status” and not “inpatient status." What this means is if you are going to the hospital and will be there more than one night, if they put you in “observation status,” Medicare may not be responsible for the cost; thus the bill becomes yours.

    Medicare treats “observations status” as the same as “outpatient.” This type of visit is not covered under Medicare Part A. Instead, you are billed under Medicare Part B, so you must pay 20 percent of the bill for each service after reaching your deductible. You may also be charged with your medications while there, and this is not covered under Part B. It would only be covered if you are covered under Part D or have a separate plan that covers your medications.

    Over the past six years, the use of “observation status” has doubled in hospitals. The federal Medicare auditors decide later that the “inpatient status” should have been “outpatient.” When this happens, the hospital must return the Medicare payments received.

    What should you do if you are admitted to the hospital?
        • Ask the case management department at the hospital to clarify your status. (Don’t be put off.)
        • If it is “observational status,” ask your regular doctor to get your status changed to “inpatient status.”

    If charged, then you need to appeal your charges which were not covered under Medicare Part A. (An appeals kit may be downloaded free from MedicareAdvocacy).

    -Bob Witherspoon

    The Center for Medicare & Medicaid Services has announced that Medicare Part B premiums in 2014 will be $104.90, and the Part B deductible will be $147. Part A Deductible is $1,216 for 2014. Note that Part A and Part B premiums are on a sliding scale depending on income.

    Individuals who did not pay into social security or have some quarters (now known as credits) may receive Part A and B, but it is more expensive. Speak to your local Social Security Office.