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It’s Time to Review Your Medicare Coverage

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Seema Verma

Medicare’s annual Open Enrollment season is underway, and I want to encourage all people with Medicare to review their current health and prescription drug coverage.

Medicare Advantage plan premiums have fallen to historic lows, dropping an average of 34% over the last three years. Many plans are offering a new insulin benefit that limits the maximum cost to $35 for a 30-day supply. By shopping around, you may be able to save money and find a plan that better meets your needs.

Open Enrollment runs through December 7 each year. This is the time when you can change your Medicare health or drug coverage for the following year. You can switch to Original Medicare, or join or change a Medicare Advantage plan or Part D prescription drug plan. Any new coverage you select takes effect Jan. 1, 2021.

Our updated Medicare Plan Finder (www.Medicare.gov/plan-compare) can help you compare the prices and benefits of Medicare Advantage plans, Original Medicare, Medicare drug plans, and Medigap policies. This mobile-friendly tool works on smart phones, tablets, and desktop computers.

Many Medicare drug plans and Medicare Advantage plans that include drug coverage are participating in a new insulin savings initiative.

There are important differences between Original Medicare and Medicare Advantage. Here’s a brief summary:

Original Medicare

With Original Medicare, you can go to any doctor or hospital that accepts Medicare, anywhere in the U.S. In most cases, you don’t need a referral to see a specialist.

For services covered under Medicare Part B, you usually pay 20% of the Medicare-approved amount after you meet your deductible. You also pay a monthly premium for Part B.

If you choose to join a Part D drug plan, you’ll pay an additional monthly premium.

There’s no yearly limit on what you pay out-of-pocket, unless you have supplemental coverage, such as Medicare Supplement Insurance, also known as Medigap. Medigap can help pay your remaining out-of-pocket costs (like your 20% coinsurance). Or you can use coverage from a former employer or union, or Medicaid.

Original Medicare covers most medically necessary services and supplies in hospitals, doctors’ offices, and other health care settings. It doesn’t cover some benefits, including vision and most dental care.

 

Medicare Advantage

Medicare Advantage Plans are offered by private insurers that provide your Medicare Part A and B benefits, in many cases through a managed network, similar to an HMO.

In many cases, you’ll need to use doctors and other providers in the plan’s network and service area to get the lowest out-of-pocket costs.

You may need to get a referral to see a specialist, even if the specialist is in your plan’s network.

Out-of-pocket costs for Medicare Advantage vary, and plans may have lower out-of-pocket costs for certain services.

You may have to pay a monthly plan premium in addition to your monthly Part B premium. Some plans may have a $0 premium or may help pay all or part of your Part B premiums.

Plans have a yearly limit on what you pay out-of-pocket for services covered under Medicare Part A and Part B. Once you reach your plan’s limit, you pay nothing for services covered by Part A and Part B for the rest of the year.

Plans must cover all medically necessary services that Original Medicare covers. Most plans offer extra benefits that Original Medicare doesn’t cover, such as some vision, hearing, dental, benefits, as well as adult day health services, caregiver support, in-home support, and home-based palliative care.

In some cases, you have to get a service or item approved ahead of time for the plan to cover it.

If you’d like free, personalized counseling on what Medicare options are right for you, call the nonprofit State Health Insurance and Assistance Program, or SHIP. To find the SHIP program in your state, go to https://www.shiptacenter.org.

Or call us at 1-800-MEDICARE (1-800-633-4227).

Seema Verma is the administrator for Centers for Medicare & Medicaid Services.

Alameda County

DA Pamela Price Stands by Mom Who Lost Son to Gun Violence in Oakland

Last week, The Post published a photo showing Alameda County District Attorney Pamela Price with Carol Jones, whose son, Patrick DeMarco Scott, was gunned down by an unknown assailant in 2018.

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District Attorney Pamela Price with Carol Jones
District Attorney Pamela Price with Carol Jones

Publisher’s note: Last week, The Post published a photo showing Alameda County District Attorney Pamela Price with Carol Jones, whose son, Patrick DeMarco Scott, was gunned down by an unknown assailant in 2018. The photo was too small for readers to see where the women were and what they were doing.  Here we show Price and Jones as they complete a walk in memory of Scott. For more information and to contribute, please contact Carol Jones at 510-978-5517 at morefoundation.help@gmail.com. Courtesy photo.

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City Government

Vallejo Welcomes Interim City Manager Beverli Marshall

At Tuesday night’s Council meeting, the Vallejo City Council appointed Beverli Marshall as the interim city manager. Her tenure in the City Manager’s Office began today, Wednesday, April 10. Mayor Robert McConnell praised Marshall’s extensive background, noting her “wide breadth of experience in many areas that will assist the City and its citizens in understanding the complexity of the many issues that must be solved” in Vallejo.

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Beverli Marshall began her first day with the City on April 10. ICMA image.
Beverli Marshall began her first day with the City on April 10. ICMA image.

Special to The Post

At Tuesday night’s Council meeting, the Vallejo City Council appointed Beverli Marshall as the interim city manager. Her tenure in the City Manager’s Office began today, Wednesday, April 10.

Mayor Robert McConnell praised Marshall’s extensive background, noting her “wide breadth of experience in many areas that will assist the City and its citizens in understanding the complexity of the many issues that must be solved” in Vallejo.

Current City Manager Michael Malone, whose official departure is slated for April 18, expressed his well wishes. “I wish the City of Vallejo and Interim City Manager Marshall all the best in moving forward on the progress we’ve made to improve service to residents.” Malone expressed his hope that the staff and Council will work closely with ICM Marshall to “ensure success and prosperity for the City.”

According to the Vallejo Sun, Malone stepped into the role of interim city manager in 2021 and became permanent in 2022. Previously, Malone served as the city’s water director and decided to retire from city service e at the end of his contract which is April 18.

“I hope the excellent work of City staff will continue for years to come in Vallejo,” he said. “However, recent developments have led me to this decision to announce my retirement.”

When Malone was appointed, Vallejo was awash in scandals involving the housing division and the police department. A third of the city’s jobs went unfilled during most of his tenure, making for a rocky road for getting things done, the Vallejo Sun reported.

At last night’s council meeting, McConnell explained the selection process, highlighting the council’s confidence in achieving positive outcomes through a collaborative effort, and said this afternoon, “The Council is confident that by working closely together, positive results will be obtained.” 

While the search for a permanent city manager is ongoing, an announcement is expected in the coming months.

On behalf of the City Council, Mayor McConnell extended gratitude to the staff, citizen groups, and recruitment firm. 

“The Council wishes to thank the staff, the citizens’ group, and the recruitment firm for their diligent work and careful consideration for the selection of what is possibly the most important decision a Council can make on behalf of the betterment of our City,” McConnell said.

The Vallejo Sun contributed to this report.

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City Government

Vallejo Community Members Appeal Major Use Permit for ELITE Charter School Expansion

Vallejo community members, former Solano County judge Paul Beeman and his wife Donna Beeman, filed an appeal against the approval of the Major Use Permit for the expansion of ELITE Public Schools into downtown less than two weeks after the Planning Commission approved the permit with a 6-1 vote.

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Vallejo community members have appealed the Major Use Permit for the ELITE Public Schools Charter high school expansion in the downtown area. Photo by Kinyon and Kim Architects, Inc.

By Magaly Muñoz

Vallejo community members, former Solano County judge Paul Beeman and his wife Donna Beeman, filed an appeal against the approval of the Major Use Permit for the expansion of ELITE Public Schools into downtown less than two weeks after the Planning Commission approved the permit with a 6-1 vote.

ELITE Charter School has been attempting to move into the downtown Vallejo area at 241-255 Georgia Street for two years, aiming to increase its capacity for high school students. However, a small group of residents and business owners, most notably the Beeman’s, have opposed the move.

The former county judge and his wife’s appeal alleges inaccuracies in the city’s staff report and presentation, and concerns about the project’s exemption from the California Environmental Quality Act (CEQA).

The Beeman’s stress that their opposition is not based on the charter or the people associated with it but solely on land use issues and potential impact on their business, which is located directly next to the proposed school location.

The couple have been vocal in their opposition to the expansion charter school with records of this going back to spring of last year, stating that the arrival of the 400 students in downtown will create a nuisance to those in the area.

During the Planning Commission meeting, Mr. Beeman asked Commissioner Cohen-Thompson to recuse herself from voting citing a possible conflict of interest because she had voted to approve the school’s expansion as trustee of the Solano County Board of Education. However, Cohen-Thompson and City Attorney Laura Zagaroli maintained that her positions did not create a conflict.

“I feel 100% that the attorney’s opinion is wrong,” Beeman told the Post.

He believes that Cohen-Thompson has a vested interest in upholding her earlier vote as a trustee and is advocating for people to ratify her opinion.

Cohen-Thompson declined to comment on the Post’s story and Zagaroli did not respond for comment.

The Beeman’s further argue that the school’s presence in the commercial district could deter future businesses, including those who sell alcohol due to proximity to schools.

According to Alcohol Beverage Control (ABC), the department can deny any retail license located within 600 feet of a school. Only one alcohol selling business is located within that range, which is Bambino’s Italian restaurant at 300 feet from the proposed location.

The project’s proponents argue that the school would not affect current or future liquor-selling establishments as long as they follow the ABC agency’s guidelines.

The Beeman’s also referenced Vallejo’s General Plan 2040, stating that the proposed expansion does not align with the plan’s revitalization efforts or arts and entertainment use. They argue that such a development should focus on vacant and underutilized areas, in accordance with the plan.

The proposed location, 241 Georgia Street aligns with this plan and is a two minute walk from the Vallejo Transit Center.

The General Plan emphasizes activating the downtown with, “Workers, residents, and students activate the downtown area seven days a week, providing a critical mass to support a ‘cafe culture’ and technology access, sparking innovation and entrepreneurship.”

City staff recommended exempting the project from CEQA, citing negligible impacts. However, Beeman raised concerns about increased foot traffic potentially exacerbating existing issues like theft and the lack of police presence downtown. He shared that he’s had a few encounters with kids running around his office building and disturbing his work.

Tara Beasley-Stansberry, a Planning Commissioner and owner of Noonie’s Place, told the Post that the arrival of students in downtown can mean not only opportunities for surrounding businesses, but can allow for students to find their first jobs and continue to give back to the community in revitalization efforts.

Beasley-Stansberry had advocated for the students at the March Commission meeting, sharing disappointment in the way that community members spoke negatively of the teens.

“To characterize these children as criminals before they’ve even graduated from high school, that’s when I had to really take a look and I was kind of lost as to where we were as a city and as a community to where I couldn’t understand how we were viewing these children,” Beasley-Stansberry told the Post.

She added that the commissioners who voted yes on the project location have to do what is right for the community and that the city’s purpose is not all about generating businesses.

ELITE CEO Dr. Ramona Bishop, told the Post that they have worked with the city and responded to all questions and concerns from the appropriate departments. She claimed ELITE has one of the fastest growing schools in the county with mostly Vallejo residents.

“We have motivated college-bound high school students who deserve this downtown location designed just for them,” Bishop said. “We look forward to occupying our new [location] in the fall of 2024 and ask the Vallejo City Council to uphold their Planning Commission vote without delay.”

The Vallejo City Council will make the final decision about the project location and Major Use Permit on April 23.

 

 

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