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Medicare

Warby Parker Eyewear Now Available to People Enrolled in UnitedHealthcare Medicare Advantage Plans

UnitedHealthcare Medicare Advantage plan holders now have access to Warby Parker’s designer prescription eyewear either online at warbyparker.com, at nine locations in Texas or at more than 80 Warby Parker stores nationwide.

This marks the first time Warby Parker is accepting Medicare insurance. People enrolled in Medicare Advantage plans that include eyewear benefits through UnitedHealthcare Vision can purchase prescription eyewear from Warby Parker for little or no out-of-pocket cost, often for less than $50.

The expansion builds on an existing network relationship that provides people with employer-sponsored and individual UnitedHealthcare plans access to Warby Parker’s designer eyewear for only a copayment. UnitedHealthcare became the first insurance plan accepted by Warby Parker in 2017.

An Unexpected Way Seniors Can Steer Clear of the Hospital

Efrem Castillo, M.D., is the chief medical officer of UnitedHealthcare Medicare & Retirement

If you’re over 65 and notice that you’re trekking to doctor appointments more frequently than you used to or your medicine cabinet is growing increasingly crowded, you’re not alone.  

Most of us have accepted the reality that our bodies need more care and attention as we age, and so we dutifully do all the things we think we should to help maintain our health and independence for as long as possible: see our doctor regularly, take our medications as prescribed, try to eat a healthy diet and so on. The hope, of course, is that choosing a healthy lifestyle will let us do more of what we love and also avoid the fate so many of us dread: winding up in the hospital hampered with a serious health condition.

But according to new research, steering clear of the hospital could have a lot to do not just with your lifestyle choices but also your Medicare choices. Turns out, if you opted to sign up for a Medicare Advantage plan last fall during the Annual Enrollment Period, your odds of being hospitalized or needing care in the emergency room are significantly lower than if you chose Original Medicare.

Here’s how the study worked: Researchers with health care consulting firm Avalere Health set out to directly compare people enrolled in Medicare Advantage plans, which are offered by private health insurance companies, with those who enrolled in Original Medicare.

Because more than half of people enrolled in Medicare have four or more chronic conditions, they were especially interested in understanding how people with chronic conditions fare under each type of Medicare coverage. So they assembled a group of people with at least one of three of the most common chronic conditions in older adults: high blood pressure, high cholesterol and diabetes. About half the group were enrolled in Medicare Advantage plans. The other half chose Original Medicare.

The study found that people with chronic conditions enrolled in Medicare Advantage plans had 23 percent fewer inpatient hospitalizations and 33 percent fewer emergency room visits. Not only were they less likely to wind up in the hospital, but they were also more likely to get the preventive care services they needed. Compared to the people in Original Medicare, Medicare Advantage members had higher rates of preventive screenings and tests, including 5 percent higher rates of LDL cholesterol testing and 13 percent higher rates of breast cancer screenings.

The results were particularly promising for people with diabetes. As compared to the study participants with diabetes who chose Original Medicare, those enrolled in Medicare Advantage plans had a 52 percent lower rate of complications and a 73 percent lower rate of serious complications such as leg or foot amputation.

What makes the study findings even more impressive is that people who are at higher risk of being in poor health are more likely to choose a Medicare Advantage plan. The study showed that Medicare Advantage plans had higher proportions of minorities, people of low income and people with disabilities as compared to Original Medicare. People who chose Medicare Advantage also had a 57 percent higher rate of serious mental illness and a 16 percent higher rate of substance abuse disorders.

At this point you might be scratching your head, wondering how exactly Medicare Advantage has such an impact on health outcomes for people with chronic conditions. The Avalere Health researchers chalked the findings up, in part, to Medicare Advantage plans’ focus on preventive care, management of chronic conditions, and coordination of care for their plan members. Many Medicare Advantage plans offer extra benefits not available with Original Medicare that are designed to enhance people’s health and quality of life, such as disease management and wellness programs, gym memberships and in-home health care.

In short, Medicare Advantage plans tend to put more emphasis on ensuring their members are receiving appropriate care and support when they’re healthy and their conditions are under control, which in turn appears to lower the risk of needing more intensive care in the hospital down the line.

Intrigued? You’re in luck. Your opportunity to make a change to your Medicare coverage is right around the corner. Let this latest research serve as your motivation to check out all the options available in your area this fall during the Annual Enrollment Period, which begins on Oct. 15. The findings indicate that it would be well worth your time to consider whether a Medicare Advantage plan could be the right choice for your coverage, and your health, in 2019.

Efrem Castillo, M.D., is the chief medical officer of UnitedHealthcare Medicare & Retirement. Serving more than 12.3 million people enrolled in Medicare, UnitedHealthcare is the largest business dedicated to the health and well-being needs of seniors and other beneficiaries.

Dual Special Needs Plans Can Bring Added Benefits to the Aging, Simplify Life for Caregivers

Of the more than 40 million caregivers in the United States, about 90 percent are caring for an aging relative, often a parent, according to the Bureau of Labor Statistics. And their ranks are rapidly growing as the population ages.

Caregiving for an aging loved one can be incredibly challenging, encompassing a wide range of duties, from offering companionship and assisting with housework to providing medical care and serving as an overall advocate.

Much of the advocacy that caregivers do comes in the form of helping their loved ones with important health care decisions, including decisions about their Medicare coverage.

The Medicare Open Enrollment Period closed on Dec. 7, and caregivers might assume their opportunity to help their loved ones switch to a health plan that better meets their needs in 2018 is over. But if their loved ones are eligible for both Medicare and Medicaid, it’s important for them to be aware of a health plan option that offers both a convenient approach to managing their health care and the flexibility of enrolling at any time throughout the year. This option is called a Dual Special Needs Plan (DSNP), and it’s available to a growing number of people as new plans are being introduced across the country.

Coordinated coverage through a DSNP

Most people have heard of Medicare and Medicaid. Medicare provides health benefits for people over 65 and those under 65 who qualify due to a disability. Medicaid provides health benefits for people with low income.

About a third of people eligible for Medicare have opted to get their benefits through what’s known as a Medicare Advantage plan, which is offered by a private health insurance company approved by the federal government. Medicare Advantage combines a person’s Medicare benefits into one plan, including doctor and hospital coverage as well as Part D prescription drug coverage in most cases. The plans can also offer additional benefits above and beyond what’s available with Original Medicare, such as dental, vision and hearing coverage.

A DSNP is a special type of Medicare Advantage plan that provides health benefits for people who are “dually eligible,” meaning they qualify for both Medicare and Medicaid.

Why should a person consider a DSNP?

By coordinating Medicare and Medicaid benefits, DSNPs can make it simpler for caregivers and their loved ones to navigate the health care system. DSNPs encourage everyone involved in caring for a patient – including primary care doctors, specialists, hospitals and care managers – to work together, which can help improve people’s health as well as their experience with the health care system.

DSNPs usually offer additional benefits, which can include:

  • dental care, such as exams, X-rays, cleanings, fillings, crowns and extractions;
  • access to a health products catalogue to order over-the-counter items such as vitamins and first-aid supplies at a discount;
  • hearing exams and access to hearing aids at a reduced cost;
  • an annual eye exam and a credit for eyewear; and
  • transportation to health care visits and the pharmacy.

People who are eligible for a DSNP can usually enroll for no monthly premium, making it an affordable option.

Who qualifies?

Anyone who meets the eligibility criteria for both Medicare and Medicaid is qualified to enroll in a DSNP. Those who are eligible often face unique health needs. They may have a disabling condition, suffer from a mental disorder, receive care from multiple doctors, or be in need of in-home care providers or other health and social services.

How can someone learn more about DSNPs?

People who are eligible for a DSNP can enroll or switch to a new plan at any time during the year. To find out if a DSNP is available in your area, check out the Plan Finder on Medicare.gov. After entering some personal information, the secure online tool will show a list of private Medicare plans available in your zip code. Check to see if any of them include “Dual Special Needs Plan” in their name.

If you prefer to talk to someone about options, a trained insurance counselor through the State Health Insurance Assistance Program (SHIP) can help, or you can talk to a licensed insurance agent in your area who can meet in person or over the phone to determine whether a DSNP is a good fit.

UnitedHealthcare is the largest provider of Medicare Advantage plans, including DSNPs, serving nearly 4.4 million people nationwide.

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