Annual Medicare Enrollment Period has Arrived
Monday, 14 October 2019

EDITORIAL NOTE: This is so far from comprehensive as to be a joke but I hope it will give you an overview of the basics of Medicare and how they apply in the annual enrollment period.


Because this post is longer than usual, I've used bolding and lists to make it easier to navigate and get to the sections that interest you most.


* * *

It's that time again – Medicare Annual Open Enrollment begins tomorrow, 15 October, and lasts through 7 December. During this period of 54 days you can:


⏺ Switch from traditional Medicare to Medicare Advantage (MA)

⏺ Switch from Medicare Advantage to original Medicare

⏺ Select a different Medicare Advantage plan if you have one now

⏺ Enroll in a Part D prescription drug plan

⏺ Change to a different Part D plan if you already have one
If you are new or newish to Medicare, it can be daunting. Medicare is a massive program and I'm pretty sure that even people who are certified to help the rest of us figure it out don't know all of it.


In that regard, there is a short list of links at the bottom of this post for more detailed or personalized information.


Here are the various Medicare parts:


Part A: Part of traditional Medicare, it covers hospital and hospice care along with some skilled nursing services after a hospital stay. There is no premium for Part A.


Part B: Part of traditional Medicare, it covers doctor visits and certain outpatient services. The Part B premium is deducted from your monthly Social Security payment and will be about $144.30 in 2020, up from $135.50 in 2019. The exact amount has not been announced yet.


Parts A and B constitute traditional Medicare. You may choose any doctors who accept Medicare.


Part C: Medicare Advantage (MA), issued by private insurance companies, is required to include traditional Medicare Parts A and B (at the same premium as traditional Medicare) and often includes Part D along with limited coverage for vision and dental care, for example.


MA takes the place of traditional Medicare. (Some companies charge no premium.) You are restricted to their network doctors.


Part D: Helps pay for prescription drugs. Part D is private coverage for which you pay a separate monthly premium if you have traditional Medicare.


Medigap: Also called Medicare Supplemental, is private coverage that helps pay for what Medicare does not, such as co-payments, co-insurance and deductibles. Restrictions apply as to who can buy Medigap coverage and when.


MEDICARE AND YOU HANDBOOK
The Medicare and You Handbook has many explanations and answers. You can download an electronic copy online. There is a wide choice of editions: PDF, large-print PDF, ebook for your Kindle, iPad, etc. You can also telephone to have a CD audio version, a Braille version or the paper edition mailed to you.


The telephone number is 800.633.4227 or visit the webpage.


This booklet is well organized, clearly written and as easy to use as anything related to Medicare can be.


MY MEDICARE
The official Medicare website is at medicare.gov. Check the dropdown menus at the top of the page for many specific questions.


If you have not signed up for My Medicare which personalizes the Medicare website for you, you can do that on this page. It can help a lot.


When I signed in to My Medicare to check my Part D coverage a couple of days ago, all my current prescriptions were already listed for me – names, dosages, quantities for each refill, and frequency of refills. All of it was correct.


If any of my prescriptions had changed, this is were I could edit them or add and subtract drugs as needed.


In my state, there are 28 Part D plans available, most with a deductible. With just a mouse click, I could see details of each plan and select up to three-at-a-time to compare with one another and check that my drugs are still covered.


That's important. It can change from year to year and, of course, each company's formulary is unique to it.


A recent mailing from that plan advised me that if I wish to continue for 2020, I don't need to do anything. My plan will roll over to next year.


You can also check drug prices of plans at several pharmacies near you and at mail-order pharmacies.


It took me about two hours to work through all the information and make my choice. I use seven prescription drugs. If you have more, it will take longer but the interface makes it relatively easy with one caveat: the plan finder is newly updated and may contain some glitches.


The above applies only to Part D in connection with traditional Medicare. If you have Medicare Advantage or are switching to it, you're on your own. MA is a mystery to me but Medicare's MA Plan Finder works similarly to the Part D Plan Finder.


PERSONAL SUGGESTION NO. 1: If you do not use any prescription drugs, choose the least expensive plan. Since there is no way to predict what might go wrong and therefore what drugs you would need, nothing else makes sense.


When I was diagnosed with cancer and began using prescription drugs, there was one not covered by my plan. Fortunately, it was not too expensive but in the next enrollment period, I chose a Part D plan that covered all my drugs.


(Yes, it is a stupid idea to make people choose a plan when they don't know what they will need it for. Complain to your representatives in Congress.)


PERSONAL SUGGESTION NO. 2: I was prescribed a new inhaler this year. When I was told my part of the price, I nearly passed out – about $500 per month. I told the pharmacist that was out of the question and prepared to see what else the doctor could recommend.


But the pharmacist told me that drug companies will reduce the price considerably in many circumstances, that I would need a declaration signed by my physician and that they, the pharmacy, would take care of all the paperwork.
In less than a week, the drug company approved me and the price dropped to just over $100. So if the price is high, ask what can be done. Pharmacists are well informed and helpful.


WHAT'S NEW IN MEDICARE FOR 2020

Medicare Advantage may now cover such items grab bars, rides to and from medical appointments, acupuncture, massage therapy and more. They are offered at the plan's discretion and only for certain health conditions. This applies only to Medicare Advantage and not to traditional Medicare.

At last, the Medicare Part D doughnut hole (coverage gap) goes away completely in 2020. However, the new limit for out-of-pocket expenses increases from $5100 in 2019 to $6,350 in 2020. Part D plan members will now pay 25 percent of the cost of generic and brand name drugs. Once you have reached that $6,350 threshold, you pay five percent of a drug's cost.

WHERE TO FIND PERSONALIZED MEDICARE HELP
You can get personalized help as you ponder your open enrollment decisions.


MEDICARE

Medicare.gov has an online chat feature available during open enrollment, and the Medicare hotline, 800-MEDICARE (800-633-4227), is open 24 hours a day, seven days a week during the annual enrollment period.


SHIP (State Healthcare Insurance Assistance Program)

These state-based organizations offer help with Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance along with help for joining or leaving a Medicare Advantage Plan, any other Medicare health plan, or Medicare Prescription Drug Plan (Part D).

Locate a SHIP representative in your state here.

Another SHIP list by state from Seniors Resource Guide. This list is up to date as of October 2019.

by Bridget Small
Consumer Education Specialist, Federal Trade Commission

To everyone who hangs up on unwanted calls, learns about the latest scams, and checks with friends about suspicious offers: good news!

People who did all those things were less likely to lose money to a scam than people who didn’t, according to Exposed to Scams: What Separates Victims from Non-Victims?, a report from the FINRA Investor Education Foundation, the BBB Institute for Marketplace Trust, and the Stanford Center on Longevity. The groups surveyed more than 1,400 people who had reported a scam and found several differences between people who did and didn’t lose money.

The people who avoided scams:

• 1) Didn’t engage with a scam offer. Nearly half the people surveyed said they had ignored emails, thrown away mailers, and deleted friend requests. They had also hung up on bogus tax and debt collection calls, and imposter phishing scams.
• 2) Learned about scams and scammers’ tactics. People who knew more about specific scams and scammers’ tactics were more likely to reject an offer and avoid losing money. News stories were the top way to get information about frauds and scams for the majority of people surveyed.
• 3) Talked to someone. The people who had someone to talk with about the offers were less likely to lose money. Some people who were caught up in scams were helped by store cashiers, bank tellers, or wire transfer employees who talked them out of sending money. Sometimes sharing what you know can help protect someone you know from a scam.

Wells Fargo pushes wrongly accused N.J. pastor toward arbitration

         A New Jersey pastor who was falsely arrested because of errors made by Wells Fargo employees may be forced to resolve legal claims against the bank in arbitration, renewing questions about banks' use of the process.
 . . .

Edwards deposited four checks in an ATM one afternoon in April 2018. Later, a photo of Edwards depositing his checks was falsely linked to a series of fraudulent checks deposited in the same machine on the same day. The photo of Edwards was posted on a New Jersey State Police Facebook page, prompting one of his parishioners to point him to the page, telling him he had a twin. The actual owner of the account into which the fraudulent checks were deposited was a 20-year-old woman.

The bank later admitted it was at fault and offered an apology. Edwards asked the bank to explain what happened and pay his legal fees; the bank refused.

...
For his part, Edwards is angry the bank is now trying to take the case to arbitration.
“It's a frustrating sense of not being able to get justice and having it all postponed,” Edwards said in an interview. “They threatened my reputation and put me through a great deal of angst and anxiety about the threat and the uncertainty of where this all was headed. So I would like some compensation for that. I would like an explanation for how they could have allowed this to happen. And then there’s the fact that they made a mistake initially and they seemed to just double down when they were asked about the mistake. There should have been ample reason to call into question their initial discernment that I was the person who cashed the fraudulent checks.”

Edwards also said he worries that this could happen to someone who doesn't have the means to hire a lawyer or who has a criminal record.

“In my experience dealing with the state police, I was pressured to confess to something I did not do,” Edwards said. “I can easily imagine how someone would cave in to that, if they did not have my advantages.”

Last year, wildfires burned more than 846,000 acres, and about 4,000 Oregonians had to evacuate their homes. The 2019 wildfire season is far from over, that means now is the time to help your friends, neighbors, and customers get prepared.
September is National Preparedness Month, and the Oregon Division of Financial Regulation is excited to announce
Sept. 1-7 as Home Inventory Week.

To help Oregonians take active steps towards disaster preparedness, we are encouraging everyone to do two simple tasks:
1) Make a home inventory of all their personal property

Wildfire season proves the importance for all Oregonians to be ready for disaster. Building a home inventory and checking your insurance coverage are two of the most important aspects of a disaster readiness plan.

Thank you for all you do to help Oregonians reach their financial goals, and thank you for helping your neighbors prepare for disaster.
Kind Regards,
Andrew Stolfi
Oregon Insurance Commissioner

July 16, 2019 In Blog

Major Victory in Oregon Vindicates Class Actions
By Paul Bland

After years of battling, an enormous victory for cheated Oregon consumers was finally brought to a conclusion last week. The case demonstrates the vital importance of class actions in achieving justice when consumers are ripped off.


A team led by Oregon attorney David Sugerman brought a class action--Scharfstein v. BP West Coast Products, LLC—against BP West Coast Products on behalf of over two million consumers who were overcharged on their debit cards when buying BP gasoline. After winning a jury verdict for over $409 million against the company in 2014, Sugerman and his team fended off multiple appeals by BP. Over seven years after the complaint was filed, BP finally agreed to settle and compensate their customers for the money they had stolen. Starting this month, over 1.7 million people in Oregon will be sent the first of two checks totaling at least $185. As the facts of the case show, a class action was the only conceivable way for these cheated customers to get recovery, and for BP to be punished for its misconduct.


For over two years, from 2011 to 2013, customers using debit cards at BP-franchised ARCO and am/pm stations across Oregon would see one price at the gas pump, but another, higher price after they filled their tanks and went inside to pay. Upon arriving at the register, customers were told there was a 35-cent debit card fee. Not only was this fee not advertised at the pump, but the independent operators of the gas stations were prohibited by BP rules from advertising the fee on signs visible to drivers. Bank records revealed during litigation that at least 2,046,500 customers were charged this unfair fee. BP continued to charge the fee about 13,000 times a day even after the lawsuit began, only stopping at the conclusion of the trial in January 2014.


Such a small fee may have a minimal impact on individual customers, but that’s exactly what cheating companies like BP want. By taking just a small cut per cheated customer, they hope their misconduct will go unnoticed or excused, while inflating their profits and giving them an unfair advantage over smaller, more honest businesses. And if customers do notice and care, the damage to them individually is too small to justify the hiring of an attorney to get compensation. This kind of cheating is rife through our economy, cumulatively stealing many millions of dollars from Americans. The only way customers can afford the costs of litigating against companies like BP is when they are able to band together in class actions.


That’s exactly what Sugerman and his clients did. They filed a class action against BP in late 2011 under Oregon’s Unlawful Trade Practices Act. Contrary to the accusations of many class action critics that these kinds of cases never go to trial, and are settled under closed-door conditions, the case against BP went to trial in January 2014.

A jury held that BP violated the Unlawful Trade Practices Act by failing to disclose the fee on signs or at the pumps, and charged the class more than the total indicated on the gas pump. Under the Act, consumers who suffer any kind of loss are entitled to actual damages, or $200, whichever is greater. This put BP on the hook for $409,300,000. BP is also permanently enjoined from charging the debit card fee in addition to its price for gasoline unless it is clearly and conspicuously advertised on its signs and pumps. Indeed, it is prohibited from charging more than the total amount shown at the pump for gas.


While Sugerman and his team worked to locate class members to distribute their compensation, BP pursued a strategy of delay. After losing the jury verdict, the company appealed to the Oregon Court of Appeals, which eventually upheld the verdict against BP in May 2018. BP again refused to own up to its misconduct, and attempted to get the Oregon Supreme Court to review its case, which it refused. All the time it avoided paying up to its victims, the damages BP owed were accruing 9% annual interest under Oregon state law, amounting to nearly $100,000 a day.


Although BP announced its intention to appeal all the way to the United States Supreme Court, it perhaps sensed that the writing was on the wall, and reached out to Sugerman and his team to seek a settlement. In order to achieve prompt recovery for their clients—who had been waiting five years for their compensation—the team made two small concessions to BP: the interest applied to the damages was reduced from 9% to 3% and BP was permitted to break its payments to the class in two. The company will still pay the face amount of the jury’s judgment against it. 17.5% of those payments will go to attorneys’ fees, and customers will each get at least $185. Corporate advocates often claim that lawyers are the only ones who benefit from class actions and consumers supposedly get nothing. This case shows the lie to those claims, with 1.7 million Oregon residents receiving checks for at least $185.


The Scharfstein case is also a model of how good class counsel can reach class members. In this case, 84% of the customers overcharged by BP were located, a total of 1,716,229 people.


As to the 16% of the damages that could not be distributed to class members, about $66 million, those funds will also be spent to advance the interests of the cheated Oregon consumers. Under Oregon’s cy pres law, half of the unclaimed damages will go to the Oregon State Bar for the funding of legal services to low income individuals, while the court determined that the remaining funds should go to an organization that would support consumer protection.


$33 million is a great deal of money, and not all organizations have the capacity to effectively absorb and utilize that kind of funding. So after carefully considering evidence set forth by Sugerman and his team, the court decided to allow for the creation of an entirely new organization, tentatively named the Oregon Consumer Protection Center. The Center will work to further consumer protection through advocacy (including legislative and regulatory advocacy, as well as litigation), research, and education. In addition to unfair practices such as those committed by BP, the Center’s mandate includes areas such as securities and investment fraud, cyber fraud, insurance fraud, antitrust law, and trade regulation.


This case is clearly much more than just a triumph for customers cheated by BP, although they certainly had a big win. This victory is also a vindication for consumer class actions generally. BP would still be cheating its customers and getting away with it if not for this class action suit, but now it and other companies know that illegal practices come with a hefty price tag. And the leftover funds have led to the creation of a whole new, well-funded organization solely dedicated to consumer protection in Oregon that will benefit the entire state. As well, millions of dollars have gone to fund legal aid, promoting access to justice for all. This is win for all of Oregon and all those who seek justice.