WellesleyWeston Magazine

FALL 2018

Launched in 2005, WellesleyWeston Magazine is a quarterly publication tailored to Wellesley and Weston residents and edited to enrich the experience of living in two of Massachusetts' most desirable communities.

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Rubin advises clients to review their health and past care needs. "Figure out how many times you go to the doctor," she'll say to clients. Look at plans and calculate what you would have paid in copays based on your previous year's health and future expectations. If you have a history of hospital visits, outpatient surgery and high-tech medical tests, you might save money by being on a Medigap plan. The Safety Nets While Wellesley and Weston are famed for their million-dollar homes, not all of the residents are in the one percent. Indeed, SHINE counselors see clients who qualify for federal and state subsidies. While MassHealth generally applies asset tests, principal residences and cars aren't counted. Assistance programs may cover virtually all your health costs, pay for your Part B premiums and/or lower your drug costs. Couples with incomes as high as $82,300 can qualify for participa- tion in the state's Prescription Advantage program, which offers ben- efits such as a one-time opportunity to change drug or Medicare Advantage plans outside the fall open enrollment period. Unfortunately, changes in our health needs don't pay attention to Medicare signup deadlines. If your doctor prescribes medication not covered by your health plan, SHINE counselors can help you file appeals, sign up for Prescription Advantage, or find other alternatives. One woman I helped was taking a drug for an off-label use. Her insurer refused to cover it, even though her doctor stated no other drug would do as well. Her income was too high for Prescription Advantage. We could have considered one of the handful of plans allowed to accept new members outside the enrollment period, but I found that she'd be better off buying the drug without insurance. Internet sites, such as goodrx.com, compare prices at pharmacies and provide coupons. We found a month's supply for around $30. A Final Word If you've gotten this far in the article, you're either relieved or more scared than ever of turning 65. If it's the latter, don't be. In most cases, even after you've purchased supplemental insurance, you'll pay less for greater coverage under Medicare. "One thing I find I'm telling people," said Rubin, "is that whatever plan they take, they're going to be all right." But remember to mark your calendars every year for the open enroll- ment period, October 15 through December 7, and to review your pol- icies with a Shine counselor. FOR MORE ON THE SHINE PROGRAM, visit www.mass.gov/health-insurance- counseling or call your local senior center for an appointment. P H O T O S Y N C ( P C H ) Remember to mark your calendars every year for the open enrollment period, October 15 through December 7. 126 W e l l e s l e y W e s t o n M a g a z i n e | f a l l 2 0 1 8 Baffled by Medicare?

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