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Getting Answers About Medicare HMOs

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By ADON TAFT

Life to the Fullest

Published: May 27, 2008

QUESTION: An aunt with restricted mobility retired from a major company which recently discontinued prescription drug coverage for retirees. My concern is that in haste she signed with a Medicare Heath Maintenance Organization. I wonder if she will have adequate medical and prescription drug coverage.
Should she stick with the company insurance and seek supplemental drug coverage?

L.P.
Brooksville

ANSWER: When contemplating enrolling with an HMO, the most important considerations are whether you are comfortable with the doctors and hospital available through the HMO and whether you are willing to accept the fact that, with the exception of emergencies, coverage is limited to a small geographic area — usually one to three counties.
The HMO likely covers most, if not all or maybe even more, of the things covered by the company policy. But to be sure, it would be wise to check with the counselors at SHINE, the Serving Health Insurance Needs of Elders program of trained volunteers working with the Florida Department of Elder Affairs and the Area Agencies on Aging.
Throughout the state, those counselors are qualified to provide free information and assistance about Medicare health plan choices; Medicare eligibility, enrollment and coverage issues; supplemental insurance policies (Medigap); Medicare appeal rights; long-term care options; prescription assistance resources; Medicaid; or Medicare prescription drug plans.
No appointment is needed if you want to meet with a counselor in person. They are available in this area from 11 a.m. to noon on Tuesdays at the Brooksville Enrichment Center, 670 S. Broad St.; or Thursdays at the Spring Hill Enrichment Center at Oak Hill Hospital; 11375 Cortez Blvd.; or from 1:30 p.m. to 2:30 p.m. Wednesdays at the East Hernando Library, 6457 Windmere Ave., Ridge Manor.
If you can't travel to one of those sites at those times, you can call the Elder Helpline at 1-800-262-2243 or 1-800-963-5337. A local number that is helpful is 688-0869.

QUESTION: I have not filed a tax return and didn't intend to. Now I'm worried if I should. I know you have written about when a person can stop filing income tax returns. Can you repeat that information?

L.G.
Pompano Beach

ANSWER: It always is best to discuss your tax situation with your accountant, tax attorney and/or the Internal Revenue Service. But generally speaking, you do not have to file a federal income tax return this year if:
* As an individual under the age of 65, your gross income in 2007 was less than $8,950 or if you are 65 or older and your gross income was less than $10,300.
* As a married couple filing jointly and both under age 65 and your joint gross income was less than $17,900 or one of you was at least 65 years old and your income was less than $18,950 or you both are at least 65 years of age and your gross income was less than $20,000.
However, there may be other factors such as foreign holdings that affect your status.
It may be best to file a return whether or not you need to. By filing a return, according to Stephen W. Miller, a CPA in Birmingham, Ala., you close out your account for that year and it cannot be reopened by the IRS after three years. If you do not file a return, the account remains open.

If you have questions about any issues connected with aging, except medical conditions, please write to Life to the Fullest, Hernando Today, 15299 Cortez Blvd., Brooksville, Fla. 34613, or send e-mail to adontaft@yahoo.com. Please include your name and address.

Adon Taft is a resident of Brooksville.

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TOPICS IN THIS ARTICLE

medicare health plan • health plan choices • florida department of elder affairs • supplemental insurance policies • prescription drug coverage • elder helpline • medicare prescription drug • cortez blvd • medicare eligibility • enrichment center • prescription assistance • windmere • assistance resources • coverage issues • appeal rights • maintenance organization • three counties • company insurance • care options • oak hill hospital

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