This time of year could try any senior’s soul. Between Oct. 15 and Dec. 7, adults 65 and up who are eligible for Medicare can switch from one health plan to another without penalty.
During this open enrollment period, seniors are deluged by TV ads, letter campaigns and e-mail messages encouraging them to switch medical plans.

The reason? During this time, if you are not completely satisfied with your current plan—or if your health needs have changed—you can look for a plan that better meets your needs. This also is also the time when you can switch from one prescription drug plan to another without complications.
Below are a few explanations that may clarify some of these terms:

Medicare. This is a federal program that pays for certain health care expenses for people aged 65 or older, and for some younger people who meet special criteria. Medicare Part A covers hospitalization and nursing home care. Medicare Part B covers doctor visits, outpatient medical procedures, and some medical tests. The special enrollment period allows you to change your type B coverage, although your decision could impact your hospital or nursing homes coverage as well.

Medicare Part B. This is also referred to as Original Medicare. This program requires you to pay a monthly premium of $104.90, and an annual deductible of $147. After these costs are met, Medicare B will cover 80 percent of most medical exams and procedures; you or yet another health plan must pay the rest. Part B coverage includes most preventative-care services, annual physicals, depression screening, HIV screening, mammograms, prostate cancer screening, flu shots and diabetes tests.

Medicare Part B also covers most medical equipment, home health care, outpatient physical, occupational and speech therapy, outpatient mental care services and emergency transportation.
It is important to note that Medicare Part B does NOT cover most dental care, eye exams, hearing aids, alternative medicine and cosmetic surgery. It also does not cover prescription drugs. Many of these services can be added to your care by applying for a Medicare Supplemental Insurance plan, often called a Medigap plan.

Medigap plans. These are private health insurance plans designed to supplement Medicare. They cover such costs as copayments, coinsurance and annual deductibles. The names of some Medigap plans are: AARP Medical Supplement, Humana Medical Supplement and Emblem Health Medical Supplement. Their costs and coverage vary, depending on what they offer, but enrolling in one of these plans will provide you with the 20 percent payment not covered by Medicare—and may also provide additional coverage of such services as vision, hearing and dental care. Every Medigap policy must be clearly identified as “Medicare Supplement Insurance.”

Medicare Part C (Medicare Advantage) plans. These plans are administered by private companies that are approved and regulated by the federal government’s Centers for Medicare and Medicaid Services (CMS). The emphasis here is on “private.” They are plans that the government contracts; they offer policies that cover doctor visits, hospitalization and, sometimes, prescription medication. Medicare Advantage plans must offer benefits on par with traditional Medicare, but many providers include more as a way to attract customers. Some of these services may include vision, hearing and dental care. The most common types of Medicare Advantage include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Private Fee-For-Service (PFFS) plans.

Medicare Advantage plans require you to pay the same monthly premium you would pay for Medicare Part B. Many include additional services under this fee, while other plans offer “tiers” of service at varying cost levels. Some even include gym or health club memberships. In exchange for these extra benefits, these plans may require that you adhere to a limited “network” of providers. If you decide to purchase a Medicare Advantage Plan, find out what additional services are actually included before signing up. A plan that includes vision care, for example, may only reimburse an annual eye exam, but not glasses. Remember that you will rarely get more from a similarly priced program without giving up other benefits.

Medicare Part D. This is the prescription drug program. Private pharmaceutical companies approved and regulated by the federal government provide Medicare Part D plans. These programs require payment of monthly premiums ranging from $15 to $165, plus small co-payments for each drug. People who enroll in traditional Medicare must also select a Medicare Part D prescription program. Many Medicare Advantage plans include a drug plan or plans. If not, you must select one as well.

Before you switch plans, it’s important to evaluate your needs.

8 Questions to ask before changing health plans

How much will I have to pay for premiums, deductibles, doctor visits or hospital stays?

Are all the services I need covered under this plan? If not, is there a way to obtain coverage without paying large additional amounts?

Are my doctors in this plan? If not, can I continue to see an “out of network doctor” even if it costs a bit more?

What services will I give up if I switch plans?

Will I have to choose my hospital and health care providers from a limited network?

Are the hospitals/nursing facilities in my network convenient to me? Do they have good ratings?

Will I need physician referrals to visit specialists?

Are my prescription drugs on the plan’s formulary? What is my prescription medication copayment?

Does the plan I selected have a good quality rating?

Joanna Leefer is an eldercare advisor with 10 years experience working with aging issues. She was the primary caregiver for her parents for over seven years and worked for FRIA Inc. (Friends and Relatives of Institutionalized Aged) an advocacy organization for the elderly. For more information on her services, log onto www.joannaleefer.com. Her book Eldercare Basics will be available in spring 2013.

SHAKESPEARE’S LADIES
Just about all of Shakespeare’s characters are iconic symbols of the human condition,
and the same can be said of the heroines within his tales. The experimental Shakespeare ensemble Dark Lady Players will be performing Shakespeare’s Annunciation parodies Sunday, March 25, at 5 p.m. at West-Park Presbyterian Church, 165 W. 86th St. The event is free to attend and will feature actors portraying Juliet, Desdemona, Olivia and Ophelia in part-comic religious allegories for the Virgin Mary.
WILD BIRDS NEED CASH
The Wild Bird Fund’s wildlife rehabilitation and education facility, located on the Upper West Side, will be NYC’s first wildlife rehabilitation and education center. To raise money  for equipment and medical supplies, the fund will host “Wild Bird Fund Takes Flight,” Tuesday April 3, 6:30–9 p.m., at “Birdie” Vanderbilt’s mansion at 60 E. 93rd St. The group is hosting a multitude of events that evening, including a speech from acclaimed author Jonathan Franzen.

Other events will include a self-guided tour of the historic Vanderbilt residence and the Carlton Hobbs antiques gallery, a video tour of the new center, a performance by Dzul Dance, jazz renditions by Jennifer Dudley of the song “It’s for the Birds,” a showing of baby birds, squirrels, owls and hawks, a silent auction and hors d’oeuvres and wine. Tickets are $100 and can be purchased by contacting Beverly Mastropolo at 917-848-0044 or online at http://bit.ly/GCXNPr.

FAMED DEBATERS ON GOD, GAYS AND GUNS
On Thursday, March 29, Dr. Cornel West and the Rev. Osagyefo Sekou will host a discussion about Sekou’s new book, Gods, Gays, and Guns: Essays on
Religion and the Future of Democracy, at West-Park Presbyterian Church, 165 W. 86th St. West is one of the nation’s most prolific authors and a known critical activist who participated at Occupy Wall Street last year. Sekou is considered one of the most influential religious leaders of the current generation. His work as an on-the-ground activist has landed him in post-Katrina New Orleans and the World Culture Center in Berlin. There is no advance ticketing and doors open at 6:30 p.m. For more information, call the Rev. Bob Brashear at 646-541-3329.

LOCAL COUNCIL CANDIDATE HIRES BIG GUN
Ken Biberaj, the latest candidate to declare for the soon-tobe-vacant Upper West Side City
Council seat, has hired veteran political consultant firm Sheinkopf Ltd. to work on his campaign. The hire signals a serious move from a largely unknown candidate; Hank Sheinkopf has worked on many high-profile political campaigns, like President Bill Clinton’s re-election and Mayor Michael Bloomberg’s last election.

“As an Upper West Sider myself, I’m thrilled to work with a candidate who has such a compelling vision for the neighborhood’s future,” said Sheinkopf in a statement.

“We’re working hard, speaking with voters and small business owners to convey my campaign’s message,” Biberaj said.

Biberaj previously told the West Side Spirit in an interview that one of his top priorities is to get out in the community and introduce himself. Biberaj, who serves as vice-president of the Russian Tea Room and works in commercial real estate, is up against three other candidates who have each served on Community Board 7 and
are arguably more familiar faces on the Upper West Side.

JAPANESE RHYTHM: Taiko drummers from Soh Daiko perform during Japan Fest at the American Museum of Natural History. Visit www. nypress.com for more photos of the group in action. Photo Credit: Andrew Schwartz

FREE TAX HELP ON THE UWS

Sitting down to go over the taxes is an event most would equate with torture. However, residents of the Upper West Side can rest easy with several free sessions that condense the processes behind filling out tax forms. The AARP will host a number of sessions at several libraries and community centers during tax season to educate the public about filing their taxes:

• The Bloomingdale Library, 150 W. 100th St., will host classes every Friday through April 13 from 10:30 a.m. to 2:30 p.m. Call 212-222-8030 for more information.

• The Morningside Heights Library, 2900 Broadway, will host a session every Monday and Saturday through April 16 from 10:30 a.m. to 2:30 p.m. Call 212-666- 5099 for more information.

• The Riverside Library, 127 Amsterdam Ave., will hold classes every Thursday through April 12 from 11 a.m. to 3 p.m. Call 212-870-1810 for more information.

• The Project FIND Hamilton Senior Center, 141 W. 73rd St., will hold classes every Tuesday through April 17 from 10 a.m. to 2 p.m. Call 212-787-7710 for more
information.

• The West Side Campaign Against Hunger, 263 W. 86th St., lower level will hold classes every Tuesday through April 17 from 10 a.m. to 12 noon and 1 p.m. to 3 p.m. Call 212-362-3662 for more information.

• Community Tax Aid at Goddard Riverside Community Center at 647 Columbus Ave. near 92 Street will cater to single adults with income of up to $25,000 or families with income of up to $45,000. Bring last year’s tax forms and other relevant documents. Class will be held every Tuesday through April 10 from 6–8 p.m.

“No, I’m not; it’s this new lighting!”

So went a tenant exchange in our newly renovated lobby. No one older than, say 35, likes to be told they look tired, but naked emperors worldwide will soon ban kindly incandescents for the so-called energy savers which make everyone/every thing they zap look tired when they’re not. Fluorescents are a visual depressant, plus they accent the slightest bit of wear, tear or soil—which is good for the cosmetic, therapy and repair/cleaning businesses.

Ah, how long you and I have argued against doing harm in the process of conserving energy and reducing the carbon footprint. (And this even more dangerously applies to the future banning of safer motor vehicles—instead of reducing the speed limit and giving all out support for affordable/readily available mass transit and passenger train service.)

But to stop the light blight, we must bombard Minnesota Rep. Michele Bachmann with calls to reintroduce her Light Bulb Freedom of Choice bill, which naked emperors likely ordered her to drop (202-225-2331). And make our own lawmakers see the overwhelming need for reducing the decades of excessive watt use, not sacrificing light that enhances for one that deforms. By the way, warm-whites deform less than cool-whites.

Kindly lighting was still found at the Gracie Mansion celebration of the 25th anniversary of the East 79th Neighborhood Association and its undaunted and tireless president, Betty Cooper Wallerstein. The city is surely a safer, cleaner and more neighborly place for the group’s myriad endeavors, which include a long and desperately sought by yours truly and others traffic signal on our corner.

Benevolent lighting is still found at many restaurants, especially Rafina’s on York Avenue between East 78th and 79th streets. But alas, its 20/20 visioned, singing proprietor Dennis Spilios is leaving on June 1, after serving the Upper East Side for nearly three decades. How grateful my family and I are for Rafina’s most kindly lighting and décor, and especially for the quietly welcoming personnel and friends there. The food is nourishing, too. And unforgettable is my birthday party at Dennis’ former restaurant, Le Panto, which he insisted on doing for far less than it cost him. So many such stories could be told about his generous if sometimes quixotic nature.
Especially endearing to me is the song he dedicates to the mother he loved so deeply, and his strong belief in close ongoing family connections “so no one is left out.”

And so we wish Dennis, his wife and family extended, and his work (music mission!) whatever they need most—with heartfelt affection and thanks.  Rafina’s so able and gracious staff, thankfully, remains under the restaurant’s new ownership.

And do read, disperse and respond to the May AARP Bulletin story, “Under One Roof.” Yup, the recession has more three-, even four-family generations sharing households, which this piece finds fairly positive—unlike advice-gurus like radio’s Dr. Joy Browne. My letter to the editor called for “More such features, please!—with lots of communication/relationship-skills information to help the ‘getting along.’” AARP’s preoccupation with couple bonds and “younger older” people may not find it “fit to print.” But AARP (212-407-3700) and all power-wielders need reminding that caring, ongoing family/social support/interaction is healthcare maintenance and preventive medicine of the very first kind—for all ages and backgrounds.

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dewingbetter@aol.com