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COLUMN: Sometimes, where you live can impact cost of health care plans

The question came as an afterthought.

The Medicare beneficiary was wrapping up a session with a Senior Health Insurance Benefits Assistance (SHIBA) counselor when the question occurred to her.

“By the way,” she said, “in a year or so I want to move from Salem to be closer to one of my daughters. They live in McMinnville and Tillamook, and I’d be happy with either. Do they offer the same Medicare Advantage plans?”

The counselor logged on to the Medicare website to review Medicare Advantage plans in Yamhill and Tillamook counties. The counselor found that Yamhill County has 26 Medicare Advantage plans that help with both medical and drug costs. Seven had no monthly premium and nine others had premiums of less than $50.

By contrast, the counselor said, Tillamook County has one Medicare Advantage insurance plan that covers both medical and drugs, and its premium is $105 a month. The Medicare beneficiary said she thought that information could influence her relocation decision.

If you would like to make an appointment with a SHIBA counselor or to ask a question to be answered here, please see the end of this column.

Q: I was looking at insurance plans on the Medicare website. There’s a company there called Lasso. How does its insurance work?

These are high-deductible plans that were new this year to Medicare beneficiaries in Oregon. The company deposits an amount in a medical savings account from which you may draw for medical expenses. In one plan the deposit is $2,000.

If the account is exhausted, then the beneficiary is responsible for the next amount ($3,000 in this instance). After that, Lasso Healthcare will pay all medical costs at the Medicare-approved rate.

If a person enrolls later in the year, then the amount of the deposit is pro-rated. For example, if enrollment was effective April 1, then the deposit would be $1,500 instead of $2,000.

If money is left in the medical-savings account at year’s end, the insured may withdraw it and treat it as taxable income. Lasso plans don’t cover prescription drugs, but a Medicare beneficiary may enroll in a separate prescription drug plan to help with drug costs.

Q: I’m going to delay taking Social Security for a couple of years, but my Medicare will start this winter. That means I can’t have the Medicare Part B premium deducted from a Social Security check. A friend who did this said she pays her Part B premium by check. Does Medicare offer another way to pay?

Yes, and you might find the alternatives a bit easier.

One is to set up monthly payment through your bank. Your bank would need to know your 11-character Medicare number (no dashes, spaces or extra characters), the payee name (CHS Medicare Insurance) and the payee address (Medicare Premium Collection Center, P.O. Box 790355, St. Louis, MO 63179-0355). To avoid surprises, ask your bank whether it charges for this service.

A second alternative is to create your own account on the Medicare website, Medicare.gov, and use its free service called Medicare Easy Pay. This allows you to pay by credit or debit card or from your bank checking or savings account.

Q: A friend and I both have Medicare supplemental insurance. He bought his several years ago, and I enrolled last spring. I pay the annual deductible, but he says he doesn’t. Is it because we’re enrolled with different insurance companies?

You are referring to the Medicare Part B deductible of $203. The difference between you and your friend is not the companies, but the type of Medigap plans you have. Your friend most likely enrolled in a Plan F policy, which pays the annual deductible. Plan F is no longer available to new enrollees, and all other plans leave paying the Part B deductible to the insured. With Medigap, however, after paying the deductible you will very likely incur no other costs for Medicare-covered medical services.  

Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA phone appointment with a volunteer Medicare counselor, call 800-722-4134.