Sunday, 14 August 2022

Opinion

Cate Kortzeborn, Medicare’s regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. Courtesy photo.

Medicare helps pay for a wide variety of medical services and goods in hospitals, doctor’s offices, and other healthcare settings. But it doesn’t cover everything, and it’s useful to know what is and isn’t covered.

Services and goods are covered either under Medicare Part A or Part B. If you have both Part A and Part B, you can get many Medicare‑covered services whether you have Original Medicare or a Medicare health plan, such as Medicare Advantage.

Part A is Hospital Insurance and it helps pay for:

* Inpatient care in hospitals;
* Inpatient care in a skilled nursing facility (but not custodial or long‑term care);
* Hospice care;
* Home health care;
* Inpatient care in a religious nonmedical health care institution.

Part B (Medical Insurance) helps cover medically necessary doctors’ services, outpatient care, home health services, durable medical equipment such as wheelchairs and walkers, and other medical services.

Part B also covers many preventive-care services, such as vaccinations and cancer screenings.

You can find out if you have Parts A and B by looking at your Medicare card. If you have Original Medicare, you’ll use this card to get your Medicare-covered services. If you join a Medicare Advantage plan, in most cases you must use the card from the plan to get your Medicare-covered services.

Under Original Medicare, if the yearly Part B deductible ($198 in 2020) applies, you must pay all costs (up to the Medicare-approved amount) until you meet the Part B deductible before Medicare begins to pay its share.

After your deductible is met, you typically pay 20% of the Medicare‑approved amount of the service, if the doctor or other healthcare provider accepts assignment. (“Accepting assignment” means that a doctor or other provider agrees to be paid directly by Medicare, to accept the Medicare payment amount for the service, and not to bill you for more than the Medicare deductible and coinsurance.)

There’s no yearly limit on what you pay out-of-pocket under Original Medicare.

If you’re in a Medicare Advantage plan (like an HMO or PPO) or have other insurance, your costs may be different. Contact your plan or benefits administrator directly to find out about the costs.

Under Part B, Medicare pays for many preventive services that can detect health problems early when they’re easier to treat. You pay nothing for most covered preventive services if you get the services from a doctor or other qualified provider who accepts assignment.

However, for some preventive services, you may have to pay a deductible, coinsurance, or both.

Medicare doesn’t cover everything, of course. If you need certain services that aren’t covered under Part A or Part B, you’ll have to pay for them yourself unless:

* You have other insurance (including Medicaid) to cover the costs;
* You’re in a Medicare Advantage plan that covers these services.

Some of the services and goods that Medicare Parts A and B don’t cover are:

* Most dental care;
* Eye exams related to prescribing glasses;
* Dentures;
* Cosmetic surgery;
* Massage therapy;
* Routine physical exams;
* Long-term care;
* Concierge care (also called concierge medicine, retainer-based medicine, and boutique medicine);
* Hearing aids and exams for fitting them.

Cate Kortzeborn is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

I had a long conversation with a friend who is unable to find employment despite the multitude of jobs available.

She is not the first to seek out some advice in the past couple of weeks so I will put this out there in hopes it helps someone.

When I am looking for candidates and conducting interviews, I am looking for a “good fit” for our office.

First and foremost, I won't hire anyone that is negative. That upsets the current staff and I don't want to deal with it. Do not bad mouth current or past employer or coworkers during the interview. When you do, you are not telling the interviewer anything about your previous employment – you are speaking volumes about yourself though, and it is a deal-breaker.

Also, I view the application as your best effort to sell yourself. If you misspell words, use poor grammar and especially when you even misspell your own name, those are instant rejects for me. Have someone proof it for you.

Take the time to truly document your skills and experience. These are the tools used to get you in for an interview and it is shocking how many times, after a candidate is screened out, they call and explain they had more experience but just didn't include it on the application. Too bad, too late.

I have had multiple candidates that are equally qualified for a position and I always select the one I feel will be a team player, with a positive, “can-do” attitude.

With the many job opportunities available right now, any serious candidate should find a job. I advise people to take what they can to get a foot in the door. If you are good, you will promote quickly. Don't wait to try to start at the very top. I know staff that took entry-level positions to start and worked their way up to management positions within two years.

I hope this can help those that are struggling.

Jan Coppinger is the administrator for Lake County Special Districts, headquartered in Lakeport, California.

Cate Kortzeborn is Medicare’s new regional administrator for Arizona, California, Hawaii, Nevada and the Pacific Territories. Courtesy photo.

Did you sign up for a Medicare Advantage health plan last year only to find that it doesn’t meet your needs? Not to worry.

You still have time to switch to another Medicare Advantage plan or return to Original Medicare.

Between Jan. 1 and March 31 each year, you can make the following changes during the Medicare Advantage Open Enrollment Period:

• If you’re in a Medicare Advantage plan (with or without drug coverage), you can switch to another Medicare Advantage plan (with or without drug coverage).

• You can drop your Medicare Advantage plan and return to Original Medicare. You’ll also be able to join a Medicare prescription drug plan (also known as a Part D plan).

During this period, you can’t:

• Switch from Original Medicare to a Medicare Advantage plan.

• Join a Medicare prescription drug plan if you’re in Original Medicare.

• Switch from one Medicare prescription drug plan to another if you’re in Original Medicare.

You can only make one change during this period, and any changes you make will be effective the first of the month after the plan gets your request.

If you’re returning to Original Medicare and joining a drug plan, you don’t need to contact your Medicare Advantage plan to disenroll. The disenrollment will happen automatically when you join the drug plan.

In most cases, you must stay enrolled for the calendar year, starting on the date your coverage begins.

However, you can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These opportunities to make changes are called Special Enrollment Periods, or SEPs.

Rules about when you can make changes and the type of changes you can make are different for each SEP. You can learn more about SEPs here: https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods .

How do you switch? Follow these steps if you’re already in a Medicare Advantage plan and want to switch:

• To switch to a new Medicare Advantage plan, simply join the plan you want. You’ll be disenrolled automatically from your old plan when your new plan’s coverage begins.

• To switch to Original Medicare, contact your current plan, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

If you don’t have drug coverage, you should consider joining a Medicare prescription drug plan to avoid paying a penalty if you decide to join later. You may also want to consider buying a Medicare Supplement Insurance (Medigap) policy if you’re eligible.

You can find out more about Medigap here: https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/4-steps-to-buy-a-medigap-policy .

For more details about Medicare Advantage plans, visit www.Medicare.gov/publications to view the booklet “Understanding Medicare Advantage Plans.”

If you believe you made the wrong plan choice because of inaccurate or misleading information, including information from Medicare’s online Plan Finder, call 1-800-MEDICARE and explain your situation. Call center representatives can help you throughout the year with options for making changes.

A final note: If you enrolled in a Medicare Advantage plan during your Initial Enrollment Period (when you first became eligible for Medicare), you can change to another Medicare Advantage plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first three months you have Medicare.

Cate Kortzeborn is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Time and time again, President Trump has shown he will not make the hard choices or put in the long hours that result in progress for the American people.

Tuesday night’s State of the Union address was no different.

He did not even mention gun violence prevention and his party continues to stonewall H.R. 8 in the Senate, a bill that passed the House with bipartisan support and would help save lives right away.

He also ignored the threat of climate change, offering nothing to help us tackle this issue.

While I was glad to hear the president express some willingness to work in a bipartisan way on improving access to quality affordable health care and improving our nation’s infrastructure, the devil is in the details.

And we have already seen that this president and his administration are more focused on tearing down the Affordable Care Act and undoing the positive progress we have made under that law.

The administration has worked at every turn to take away protections for patients with pre-existing conditions.

Notwithstanding the president’s efforts to do away with these vital pre-existing conditions protections, I will continue my fight to improve the lives of people in our district and across our nation.

From defending the Affordable Care Act and its lifesaving protections for patients with pre-existing conditions, to drafting and passing legislation to modernize our infrastructure, and to ensuring we optimize our tax code to prioritize renewable energy and the reduction of greenhouse gas emissions, I will not stop in my work to help our community and our county move forward.

Congressman Mike Thompson is proud to represent California’s Fifth Congressional District, which includes all or part of Contra Costa, Lake, Napa, Solano and Sonoma counties. He is a senior member of the House Committee on Ways and Means where he chairs the Subcommittee on Select Revenue Measures. Rep. Thompson is Chairman of the House Gun Violence Prevention Task Force. He is also co-chair of the bipartisan, bicameral Congressional Wine Caucus and a member of the fiscally-conservative Blue Dog Coalition.

LAKE COUNTY, Calif. – The Lake County Democratic Party supports two candidates in the upcoming Board of Supervisors races. The date of California’s primary has been moved up to March 3 (in previous years, it was held in June).

At its Jan. 2 business meeting, the county party voted to endorse incumbent Tina Scott for the District 4 seat on the Lake County Board of Supervisors. Tina’s degree in sociology gives her specialized insight for ways to address the most vulnerable people living in Lake County. Prior to her current position, Tina served on the Board of the Lakeport Unified School District. She currently also serves as chair of Hope Rising, whose purpose is to leverage resources in a collaborative effort to find solutions to one of Lake County’s largest issues, poverty. And, she serves as a juvenile justice commissioner and a court-appointed child advocate.

Tina Scott has been an active supervisor who listens to the community, responding to questions and concerns with her open-door policy. She was awarded an Executive Leadership Certification with the National Society of Leadership and Success.

Jessica Pyska received the Lake County Democratic Party’s endorsement for supervisor in District 5. Jessica built a technology consulting business with her husband, rebuilt her family home lost in the Valley fire and currently educates children in a unique K-6 garden program while leading her community in disaster resilience and economic recovery.

Jessica serves on the Lake County Risk Reduction Authority Ad Hoc Committee. As economic development chair of the Cobb Area Council, she recently won a $200,000 grant, launched a micro-loan program for local businesses, and produced the Blackberry COBBler Festival. She provided community input on the County’s Hazardous Vegetation Abatement Ordinance, Dark Skies Proclamation, and the Tourist Improvement District. Her priorities on the Board of Supervisors are to increase the level of disaster resilience county-wide, strengthen the county’s economy and improve the health and safety of all residents, especially children and seniors, while maintaining what we love most about Lake County.

If elected, Jessica Pyska will work with state, federal and private foundation representatives to apply for Lake County’s fair share of federal, state and grant funds and ensure they are used wisely.

The Lake County Democratic Party is proud to support these candidates, who reflect our values and policies.

Now is a critical time for Democrats, especially at the local level, to guide the nation toward policies of fairness, tolerance, and better economic and educational opportunities for all of us. The Lake County Democratic Party is confident that our endorsed 2020 candidates embody these principles, and that their election will allow Lake County and California to continue to lead the nation in fostering the kind of communities we all want for ourselves and for our children.

The Lake County Democratic Central Committee serves as the official representative and governing body of the California Democratic Party in Lake County, carrying out such duties as are consistent with the Elections Code of the State of California and the by-laws and policies of the California Democratic Party and Democratic National Committee.

Lake County Democratic Central Committee voting members are Susan Cameron, Ron Green, Doug Harris, Sissa Harris, Shirley Howland, Vanessa Mayer, Ceva Giumelli, Deb Baumann, James Evans, Louie Rigod, John Sheehy, Trish VanDenBerghe, Larry Bean, Virginia Cerenio, Tom Jordan, Chloe Karl, Dave Rogers, Becky Curry, Adckinjo Esutoki, Mary Borjon, Juliana Vidich, Cathy McCarthy, Stephanie Pahwa, Dirk Slooten, Sorhna Li and Shao-Jia Chang.

As we head into the new year, I wanted to let you know how much your Medicare premiums, deductibles, and other out-of-pocket costs will be in 2020.

Each year, Medicare premiums, deductibles, and copayment rates are adjusted according to the Social Security Act. For 2020, the Medicare Part B monthly premiums and the annual deductible are higher than the 2019 amounts.

The standard monthly premium for Medicare Part B enrollees will be $144.60 for 2020, an increase of $9.10. The Part B premium in 2019 was $135.50.

The standard premium is what most people with Medicare pay. Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.

The annual deductible for all Part B beneficiaries is $198 in 2020, an increase of $13 from the annual deductible of $185 in 2019.

The increase in the Part B premiums and deductible is largely due to Medicare’s rising expenses for drugs administered in doctors’ offices. Current law requires Medicare to pay the average sales price for a Part B drug and also pays physicians a percentage of a drug's sale price.

This incentivizes drug companies to set prices higher and for physicians to prescribe more expensive drugs, since that leads to a higher Medicare payment. The Trump Administration is working to lower prices for Part B drugs through its drug pricing blueprint.

Since 2007, Part B premiums have been based in part on a beneficiary’s income, with higher-income beneficiaries paying higher premiums. These income-related monthly adjustment amounts affect about 7 percent of people with Part B.

The 2020 Part B total premiums for high-income beneficiaries can be found here.

Medicare Part A covers inpatient hospital, skilled nursing, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they paid Medicare payroll taxes for at least 40 quarters of employment.

The Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,408 in 2020, an increase of $44 from $1,364 in 2019. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.

In 2020, beneficiaries must pay a coinsurance amount of $352 per day for the 61st through 90th day of a hospitalization (versus $341 in 2019) in a benefit period and $704 per day for lifetime reserve days (versus $682 in 2019).

For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $176 in 2020 ($170.50 in 2019).

These premiums and cost sharing apply to people with Original or Traditional Medicare. Premiums and deductibles for Medicare Advantage and Medicare Part D Prescription Drug plans were previously finalized.

On average for 2020, Medicare Advantage premiums are expected to decline by 23 percent from 2018, and will be the lowest in the past 13 years while plan choices, benefits and enrollment continue to increase.

Cate Kortzeborn is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

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08.15.2022 5:30 pm - 7:30 pm
Community Visioning Forum Planning Committee
16Aug
08.16.2022 10:00 am - 1:00 pm
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20Aug
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Yard sale to benefit Sponsoring Survivorship
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Junior Ranger Program: Weather and climate
20Aug
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Farmers' Market at the Mercantile
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