A6 BAKER CITY HERALD • THuRsDAY, NovEmBER 3, 2022
PAID ADVERTISEMENT
Summit Health takes a
community-first approach
to serving seniors
Medicare vs. Medicare
Advantage – What’s the
difference?
The local company delivers care through comprehensive
Medicare Advantage plans
Wading into the world of Medicare can feel a little
daunting – but it doesn’t need to. A little basic
understanding can go a long way in taking some
of the confusion out of picking the plan that’s right
for you.
Benefits and costs differ between
insurance plans
A good place to start? Knowing the difference
between traditional Medicare and Medicare
Advantage plans.
According to the Centers for Medicare & Medicaid
Services, traditional Medicare includes Medicare
Part A (hospital insurance) and Part B (medical
insurance). Prescription drugs are covered by
plans under Part D. Medicare Advantage (Part C)
is more of an all-in-one plan that includes Part A,
Part B and usually Part D. It also usually includes
additional benefits, including vision, hearing,
dental and others.
Because they include additional benefits, Medicare
Advantage plans may have additional premiums.
While that’s something to consider, seniors would
be wise to think about the importance of benefits
like vision, hearing and dental. Those costs can
add up fast, so having a Medicare Advantage plan
that includes such benefits can often be the better
way to go to help manage the cost of health care.
Sean Jessup, president of Summit Health, with breakaway champion Jacey Fortier at the Pendleton Round-Up.
When it comes to comprehensive,
high-quality medical care in Eastern
Oregon, Summit Health believes in an
approach that’s all about being local.
And that starts with Summit itself.
Formed in 2020, Summit Health specializes in
Medicare Advantage plans for Eastern Oregon. Its
local focus runs through the entire organization,
starting with the fact that it is owned by a group
of regional organizations who’ve been meeting
the health care needs of communities in Eastern
Oregon for decades.
More Benefits
Summit’s Medicare Advantage plans include
standard medical coverage as well as extra benefits
like vision, hearing, dental and other health and
wellness programs. Three of the four plans come
with Part D prescription coverage.
“Choosing a plan doesn’t have to be a complicated
effort,” said Walter Burkhartsmeier, director
of Medicare programs at Summit Health. “Our
experienced team is happy to help folks find their
way to the right plan and the right care they need
based on the lives they lead.”
Staying Active and Healthy
“For us, it really is
“For us, it really is about meeting
Summit’s Medicare Advantage
about
meeting the
the needs of the people in the
plans are designed to not only
needs of the people
communities we serve,” said Sean
offer health care, but to also help
Jessup, president of Summit Health.
in the communities
seniors lead active lives. On top
“We’re a part of those communities.
we serve.”
of no-cost eye, hearing and dental
We work with local institutions like
- Sean Jessup, president,
exams, Summit’s plans include
the Pendleton Round-up and Eastern
Summit Health
gym memberships and wellness
Oregon University – and people
resources from the exercise and
recognize our provider partners because they
healthy-aging program Silver&Fit. Summit plans
have been in these communities for a long time.”
also include access to alternative care, so seniors
can get routine chiropractic services, acupuncture
Local Caregivers
and naturopathic services as well.
Today, Summit Health is made up of a network
of local caregivers who offer a full suite of services
to area residents. The partners include Good
Shepherd Health Care System, Grande Ronde
Hospital and Clinics, Saint Alphonsus Health
System, GOBHI, CHI St. Anthony Hospital, Eastern
Oregon IPA and Yakima Valley Farm Workers Clinic.
Last year, Summit also expanded its network
to include St Luke’s providers and facilities in
Oregon and Idaho. Summit’s Medicare Advantage
plans are now available throughout Eastern
Oregon Counties, including Baker, Gilliam,
Grant, Harney, Lake, Malheur, Morrow, Sherman,
Umatilla, Union, Wallowa and Wheeler.
“With our Medicare Advantage plans, we can help
meet the unique needs of the people of Eastern
Oregon,” Jessup said. “These are our communities,
and we’re glad to be here, helping seniors get the
health care they need to live healthy, happy lives.”
Plans are available during the Oct. 15 to Dec. 7
annual enrollment period and are designed to
help people get high-quality care from providers
they have already built relationships with over the
years.
“I think it’s really important for people to
understand all the costs, including premiums
and benefits when they’re looking for plans,” said
Margaret Thornburg, vice president of customer
service for Summit Health. “That way, they’ll be
able to choose the best plan for the care they’ll
need throughout 2023.”
Here’s a little more on the differences between
traditional Medicare and Medicare Advantage.
The costs: Because they bundle multiple coverages
together, many Medicare Advantage plans
have lower out-of-pocket costs than traditional
Medicare. With traditional Medicare, there is no
annual out-of-pocket limit on what you will spend
unless you purchase supplemental coverage. With
Summit Health’s plans, once you reach your plan’s
limit, you pay nothing more for Part A and Part
B covered services for the remainder of the year.
The coverage: Traditional Medicare covers basic
medical services in hospitals and clinics. Most
Medicare Advantage plans go above and beyond
and include not only basic medical services, but
annual routine vision, hearing and dental exams,
health and wellness programs and, in some cases,
gym memberships.
The extras: Seniors who choose a Medicare
Advantage plan from Summit Health can also get
access to chiropractic and naturopathic health
services, as well as acupuncture.
“It’s also important to note that Medicare
Advantage provides all-in-one plans that are often
more convenient and easier to navigate than
traditional Medicare,” Thornburg said.
For more general information on Medicare and
Medicare Advantage, visit www.medicare.gov.
You can learn more about Summit Health and their
plan benefits at yoursummithealth.com.
Medicare costs will be lower in 2023
Monthly premiums, prescription prices coming down
While significant changes are rare from year to
year with Medicare, there are often some tweaks
that people should be aware of as they prepare to
pick their plans for the coming year. And this year,
the changes are looking pretty good.
For starters, costs are coming down.
“With costs increasing for most goods and
services, we focused on how we could lower
upfront costs,” said Emily Camp, senior Medicare
product manager for Summit.
The roughly 3% cost savings will vary from plan
to plan, but each one will be offered at a lower
premium than last year. In addition, Summit
Health has eliminated the copay for visiting a
primary care provider on three of the four plans
offered and reduced the cost of prescriptions
for members who order a 90-day supply of their
medications. For example, a member who was
paying $30 for a 90-day supply will now only
pay $25.
Also new for cost-saving in the coming year will
be a $35 cap on the copay for insulin for plans with
Part D prescription drug coverage.
Additionally, Summit has removed all referral
requirements for its Medicare Advantage plans
for 2023. That means members will be able to save
some time when they’re referred for specialty
care. Removing the referral requirements will
also be beneficial to practitioners, as well.
“We heard from the physicians that referrals take
time and can delay getting people the care they
need,” said Walter Burkhartsmeier, Medicare
program director for Summit Health, “so we
made the decision to remove those.”
One thing that won’t change for 2023? Summit
Health’s commitment to caring for the people of
Eastern Oregon.
“We have long-term partnerships with providers
in the community,” Camp said, “and those
relationships help us all work together to support
community health and make sure everyone can
get the care they need when they need it.”
Summit Health Plan, Inc. is an HMO with a Medicare contract. Enrollment in Summit Health Plan, Inc. depends on contract renewal.
Other providers are available in our network.
H2765_EORAD123A_M