| Photo courtesy of NAPCA
NEW YORK — The Philippine Daily Mirror, in cooperation with the National Asian Pacific Center on Aging (NAPCA), has adopted “Ask NAPCA” as a monthly feature to inform Asian Americans and Pacific Islanders (AAPI) elder communities of available programs and services they may need wherever they live in the US.
This month, NAPCA selected some questions about Medicare Open Enrollment.
The annual Medicare Open Enrollment Period runs from October 15, 2024, to December 7, 2024. Additionally, the State Health Insurance Marketplace Open Enrollment Period takes place from November 1, 2024, to December 15, 2024, with some states extending it to January 15, 2025.
<Question 1> Why is this fall’s Medicare Open Enrollment Period essential?
<Answer 1> Positive changes to Medicare make it especially important to check your plan.
Starting in 2025, the annual out-of-pocket limit for all Medicare-covered prescription drugs will drop significantly from $8,000 to $2,000. No matter how many medications you need, you won’t pay more than $2,000 for your prescriptions in a year. The $2,000 cap and the ability to spread out payments means that high out-of-pocket costs, many refer to as “Donut Hole,” are gone in 2025.
Next, check if you can receive full assistance from Extra Help. Beginning in 2024, if you are single with a monthly income up to $1,883 or a couple with a monthly income up to $2,555, you could qualify for Extra Help, which covers most of your prescription drug costs, such as deductibles, copayments, and premiums.
Take a close look at your current plan’s coverage, costs, medications it covers, doctors and hospitals in its network, and personal health needs to see if it is still the best fit for you. By comparing other options during the OEP, you might find one that offers better coverage, saves money, or both. Please call us if you need any help.
<Q2> If I am under 65 and uninsured but not eligible for Medicare, can I still enroll in a health plan?
<A2> Yes, anyone who is uninsured and not yet eligible for Medicare can sign up for health insurance during the Affordable Care Act (ACA) Open Enrollment Period (OEP). This period is also an excellent chance for people who missed signing up during their Special Enrollment Period (SEP), which may have been offered after reporting specific life events such as marriage, childbirth, or job loss.
For 2025, OEP runs from November 1, 2024, to December 31, 2024 (or January 15, 2025, depending on your state). If you apply for a health plan and select your plan within this time window, your new plan will begin on January 1, 2025 (or February 1, 2025).
During this period, you can explore various health plan options through the state’s Health Insurance Marketplace. If you are single with an annual income under $60,240 or a married couple earning less than $81,760 per year, you may be eligible to lower your premiums or out-of-pocket costs based on a sliding scale. If your income is low enough, you might also qualify for Medicaid.
It’s essential to check your STATE’s specific dates and enrollment guidelines to ensure you don’t miss the opportunity.
<Q3> I haven’t heard much news about COVID-19, but do I still need vaccination?
<A3> -19 is still a serious health risk, causing thousands of hospitalizations and deaths each year. According to the CDC (Centers for Disease Control and Prevention), from October 1, 2023, through June 1, 2024, approximately 44,000 people died from COVID-19 in the US.
Immunity acquired from vaccination or prior infection may decrease over time, and new virus variants can make earlier vaccines less effective. This is why getting the COVID-19 vaccine each year, like the flu shot, is recommended to protect yourself and your loved ones.
It is especially important for older adults, as they often have chronic health issues and weaker immune systems, which makes them more vulnerable to severe illness and slower recovery.
Also, remember that Medicare and most private health insurance plans cover the COVID-19 vaccine at no cost. It is still a good idea to check with your specific insurance plan for any exceptions or provider network rules.
If you have questions about public benefits, here are three ways you can reach us today:
Call: (English) 1-800-336-2722, (Chinese Mandarin) 1-800-683-7427, (Chinese Cantonese) 1-800-582-4218,
(Korean) 1-800-582-4259, (Vietnamese) 1-800-582-4336
Email: askNAPCA@napca.org
Mail: NAPCA Senior Assistance Center, 1511 3rd Avenue, Suite 914, Seattle, WA 98101
National Asian Pacific Center on Aging (NAPCA) is collaborating with the Asian and Pacific Islander American Health Forum (APIAHF) and the Champions for Vaccine Education, Equity, and Progress (CVEEP) on a vaccine outreach initiative.
–With Jay Domingo/PDM
