MyEagleNews.com
Wednesday, October 20, 2021
A7
- PAID ADVERTISEMENT -
Local, familiar providers
offer Medicare Advantage
plans for Eastern Oregonians
Summit Health’s plans aim to help seniors live life to the fullest
No big changes for
Medicare in 2022
Plans and providers are just
trying to keep things stable
for now
Some years, the changes to Medicare can be
significant. Two years ago, for example, some
Medicare plans added benefits to cover meal
deliveries and alternative pain treatments.
But this year, the changes to Medicare don’t look
like they’ll be anything too disruptive – and that’s
a good thing.
“Considering the climate we’re all in, we’ve just
tried to keep things as stable as possible for
everyone,” said Emily Camp, senior product
manager for Summit Health. “There have been
some changes leading to more selection and
lower costs for prescription medications, some
additional telehealth options and some lower
premiums, but by and large there’s nothing too
major that’s changed.”
Cost savings
Walter Burkhartsmeier, Medicare Program Director for Summit Health, at the Pendleton Round-Up.
Seniors in Eastern Oregon need not
look far to find high-quality, affordable
Medicare Advantage plans that will
help them lead healthy, active lives.
enrollment period, are designed to help people
get high-quality care from providers they have
already built relationships with over the years.
Medicare plans with prescription drug coverage
can now offer a seven-tier formulary structure to
include preferred specialty drugs, which in some
cases can lower costs for members. The new
structure offers a mix of brand and generic drugs
in a way that should make some specialty drugs
less expensive.
Plans include medical benefits covered by
traditional Medicare in addition to Part D
prescription drug coverage. As a private insurer,
Summit is able to offer Medicare Advantage plans,
most of which cover extra benefits Medicare
does not, including vision, hearing, dental and
other health and wellness programs.
Additionally, Camp said Summit Health has been
focused on lowering costs wherever it can on its
Medicare Advantage plans. Premiums on some
plans have either stayed the same or gone down,
deductibles on some plans have decreased and
cost-sharing on drugs has been reduced.
“There’s no denying that the world of Medicare
“We’ve been serving the residents of these
can be a complex one,” Burkhartsmeier said. “Our
communities for a long time. They know us, and
experienced team is incredibly knowledgeable
we are grateful to have earned their trust,” said
and can help folks find their way to the right plan
Walter Burkhartsmeier, director of Medicare
and the right care they need based
programs at Summit Health.
We’ve designed our
on the lives they lead.”
“Providing Medicare Advantage
plans is just another way that we’re
plans to meet the
He also said that Summit’s
taking care of the folks who call
unique needs of the
Medicare Advantage plans are
Eastern Oregon home.”
people of Eastern
designed to not only offer health
Oregon.”
care, but to also help seniors lead
Formed in 2020, Summit Health
active lives. On top of no-cost eye,
encompasses Good Shepherd Health
- Sean Jessup, president,
hearing and dental exams, most
Care System, Grande Ronde Hospital
Summit Health
of Summit’s plans include gym
and Clinics, Saint Alphonsus Health
memberships and wellness resources from the
System, GOBHI, CHI St. Anthony Hospital, Eastern
exercise and healthy-aging program Silver&Fit.
Oregon IPA, Yakima Valley Farm Workers Clinic
For an extra $5 a month, seniors can also get
and Moda. This year, Summit has also expanded
routine chiropractic services, acupuncture and
its provider network to include St Luke’s providers
naturopathic services.
and facilities in Oregon and Idaho. Summit’s
owners and additional providers throughout
“We’ve designed our plans to meet the unique
Eastern Oregon comprise a provider network
needs of the people of Eastern Oregon,” said
that offers a full suite of health services.
Sean Jessup, president of Summit Health. “We
understand Eastern Oregon, and we consider it
Summit specializes in Medicare Advantage
an honor to be able to provide residents the care
plans for Eastern Oregon, including Baker,
they need to live life to the fullest.”
Gilliam, Grant, Harney, Lake, Malheur, Morrow,
Sherman, Umatilla, Union, Wallowa and Wheeler
You can learn more about Summit Health and their
counties. The company’s Medicare Advantage
plan benefits at yoursummithealth.com.
plans, available during the Oct. 15 to Dec. 7 open
“We have really been focusing on lowering the
out-of-pocket costs and, more importantly, on
keeping things stable for folks overall,” she said.
“I think that’s what a lot of people are looking for
and counting on right now.”
That’s because Summit Health, which specializes
in Medicare Advantage plans for Eastern Oregon,
is owned by a group of regional providers
who’ve been meeting the health care needs of
communities in Eastern Oregon for decades.
Increased telehealth
In recent years, telehealth has become an
increasingly popular way to deliver care while
keeping people out of hospitals and medical
clinics. Some plans have increased their
telehealth services and coverage, even offering
telehealth for specialties like dermatology,
cardiology and behavioral health.
“I think telehealth is also really helpful when it
comes to letting beneficiaries know whether they
need to come into the clinic to get care or when
they can simply stay at home,” Camp said. “Some
plans include 24-7 access to telehealth services.
That’s particularly helpful for people in the rural
parts of the state.”
For example, Summit Health’s Medicare
Advantage plan allows members to be seen by a
physician remotely, get a prescription and order
a 90-day supply of their medication through the
mail.
Medicare vs. Medicare Advantage –
What’s the difference?
Plans offer different services, different costs
“Be sure to understand all the costs, premiums
and benefits in order to make the decision that
is best for you,” said Margaret Thornburg, vice
president of customer service for Summit Health.
It’s true that while traditional Medicare plans
may have lower premiums, they don’t include
coverage for things like dental, hearing and
vision, which many Advantage plans do. Once
you start adding up those additional costs,
Medicare Advantage plans start to look a lot more
attractive.
Here’s a little more on the differences between
traditional Medicare and Medicare Advantage.
The basics: 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.
The costs: Because they bundle multiple
coverages together, many Medicare Advantage
plans have lower out-of-pocket costs than
traditional Medicare plans. 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.
S264940-1
There’s a lot to consider when choosing between
a Medicare plan and a Medicare Advantage plan.
For starters, traditional Medicare plans have
no out-of-pocket spending limits, while most
Medicare Advantage plans do. So taking a little
extra time to compare plans – including costs
and coverages – is important.
Find out more: www.medicare.gov
Summit Health Plan, Inc. is an HMO with a Medicare contract. Enrollment in Summit Health Plan, Inc. depends on contract renewal.
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