LOFASO Enterprises

Valhalla Lions Club sponsoring a blood drive Jue 17,2025 to address the NewYork blood emergency.
Your donation can helop save a life!
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NEW YORK BLOOD CENTER DECLARES BLOOD EMERGENCY, SHARP DECLINE IN LOCAL DONATIONS

Hundreds of units sent from other states as NY faces widening and dangerous donor gap heading into summer trauma season

Unhappy with your Medicare Advantage plan? Is your Dr Out of Network? Are your Medications not covered?

Now is your chance to change plans during Open Enrollment Period (OEP) from Jan 1 through Mar 31.

Your can change 1) to different Medicare Advantage plan, 2) switch to traditional Medicare with or without adding a sepearate Prescription Plan, or 3) switch to traditional Medicare, adding a Medicare Supplement (MEDIGAP) plan and add a separate Prescription Plan if you so desire.

Typically, once you make a choice to either stay with your current plan or enroll in a new one, that is the plan you will be with until next year.

As summer end approaches it is time to focus on your Medicare coverage for 2022. If you have either a Medicare Advantage or Prescription Part D plan you should be receiving a notice in August/September called the Annual Notice of Change (ANOC). This document details any changes to your plan for the upcoming new year.

The changes could be either for costs or coverage or both. Usually this notice is accompanied by the plan’s Evidence of Coverage which details the costs and coverage benefits for next year.
Plan changes might be as follows:

* Deductible -
This is an amount for which you are responsible to pay for before coverage begins. Note that your maximum out of pocket costs may change as well.
* Networks -
Your doctor, hospital, specialist and/or pharmacy may no longer be in network. You may pay more or may not have coverage to see these providers. Check with your providers to verify that they will remain in the network rather than be surprised on your visit.
* Formulary -
This is a list of drugs that the plan covers. The list can change every year. The cost of your medication can change up or down by moving to a different tier level. The medication may no longer be covered by the plan. This is definitely an item to carefully review.

One should review this information and determine if the plan still meets your expectations and health care needs. If not, you can make changes during Annual Enrollment Period (AEP), Oct 15-Dec 7, for next year choosing another plan in your area for which you are eligible.

Medicare Omission

There are Medicare TV ads claiming great savings and extra benefits and CALL NOW! Many of these ads are directed toward the DUAL Eligible beneficiary, those with both Medicare and Medicaid coverage. These beneficiaries can be drawn to call for such savings. While the savings and extra benefits may be very enticing, the problem comes in that many times a switch in carrier plans takes place without validating the client’s medical providers are in network for that plan. Changing plans is stressful enough without needing to change Doctors as well!
I have been approached a few times this month to assist people with just such an experience. The tele-sales agent’s main purpose is to assist you in enrolling in the plan, so generally are not inquiring about your current providers. While there may be other in-network providers to treat you, you should know up front that this would be the case and your decision to accept or reject the offer.
This Error of Omission emphasizes the warning of Buyer Beware. Always validate that your current providers (doctors, hospitals, pharmacy etc) are in-network before enrolling in the plan.