Elizabeth (Sarantos) Lemondes

October 7, 2020

Elizabeth (Sarantos) Lemondes, 97, of

Syracuse, passed away peacefully on Wednesday at Loretto. Born in Lowell, MA on June 19, 1923, she was the daughter of the late Peter and Mary Sarantos and received her education from the Lowell School District. Elizabeth retired from Chase Lincoln Bank after many years. She was a former member of St. Sophia’s Greek Orthodox Church. Elizabeth was predeceased by her husband, James Lemondes; son, Peter Lemondes; brothers, Charles, Ted, and Rev. John Sarantos; sister, Christine Economou. Elizabeth is survived by her son, Stacy Lemondes of East Syracuse; sisters, Dot Dinopoulos and Nora Vlahakis, both of

Dracut, MA; brother, George Sarantos of Lowell, MA; several nieces and nephews. Private services will be held. Contributions in Elizabeth’s memory may be made to St. Sophia’s Greek Orthodox Church, 325 Waring Road, Syracuse, NY 13224 or the Alzheimer’s Association of CNY, 441 W. Kirkpatrick Street, Syracuse, NY 13204.

FARONE & SON Inc Funeral Home has arrangements. Share condolences at www. faroneandsoninc.com.

In a couple of weeks, the Annual Election Period for Medicare will begin, and it will continue through Dec. 7. Then, on Jan. 1, the annual Open Enrollment Period begins. This can often cause confusion in terms of what should be done and when.

So, when can you enroll for and change your Medicare elections?

The first opportunity is during your Initial Election Period, or IEP. This is typically the period containing the seven months surrounding your 65th birthday, the three months before your birth month, your birth month, and the three months immediately after. This is typically the first shot at Medicare for most people, unless you have special circumstances, typically involving disability.

Most people, then, will enroll in Medicare during that IEP around the 65th birthday. Any time during that period, you may go online to Medicare.gov or any Social Security Administration office and enroll. In the past, when Social Security kicked in at age 65, beneficiaries were automatically enrolled in Standard Medicare (parts A and B). Now, however, you must actively apply.

Medicare Part A covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery and home health care.

The monthly cost is typically covered by your payroll taxes, assuming you had the minimum 40 quarters (10 years) necessary. If you paid Medicare taxes for fewer than 30 quarters, you may purchase Part A for $458 per month. If you paid between 30 and 39 quarters, the standard Part A premium is $252 per month.

In addition, Part A carries deductibles and coinsurance. The standard inpatient hospital deductible is $1,408 per benefit period. A benefit period begins the day you are admitted as an inpatient to a hospital or skilled nursing facility and ends when you have not received any inpatient hospital or facility care for 60 consecutive days. In addition to the deductible, you will have co-insurance after the first 60 days of $352 for days 6190, and $704 for each “Lifetime Reserve Day” after day 90 for each benefit period, up to 60 days per lifetime. After that, you pay 100%.

Medicare Part B typically covers doctor visits and preventive care, outpatient services, mentalhealth services, ambulance services, medical and lab services, and durable medical equipment and supplies. Part B has a base premium of $144.60 per month and goes up from there based on income. Part B deductibles are $198 per year, and after that, you will be responsible for co-insurance of 20% of the Medicare-approved amount for most doctor services, including those incurred while you are an inpatient at a hospital or skilled nursing facility.

You must enroll in Medicare Part B when eligible or potentially incur a penalty of up to 10% per year not covered when you do enroll. Exceptions do exist -- for example, when you have what’s known as “creditable coverage” from another source, such as a group medical plan. Coverage must be on par with the coverage provided by

Medicare to be considered creditable, so things like supplemental or temporary policies typically do not qualify.

Medicare Part D provides prescription-drug coverage. Like Part B, you must enroll when first eligible or have creditable coverage to avoid future penalties. Medicare Part D is offered through commercial health-insurance companies in coordination with the Centers for Medicare and Medicaid Services. Each Part D plan has what’s known as a “formulary,” which is a fancy name for the list of drugs covered. Plans must carry a range of generic and brand-name drugs, and must have at least two options for each therapeutic need. Drugs are separated into “tiers.” Tier 1 has the lowest copayment and comprises most generics; Tier 2 has a medium co-payment and includes preferred brand-name prescription drugs; and Tier 3 has the highest co-payment and includes non-preferred brand-name drugs. There is also a Specialty Tier that includes high-cost prescription drugs.

Part D involves a premium and, like Part B, is tied to income levels and carries a penalty for gaps in coverage. In the past, there was what was known as a coverage gap, or “doughnut hole,” which has been eliminated in 2020; however, there is still a threshold for each coverage period. Costsharing in 2021 will involve an annual deductible of up to $445 (varies by plan), along with 25% of the cost of prescriptions up to True Out of Pocket costs, or TROOP, of $4,130. After that, you move into catastrophic coverage, which has significantly reduced copays.

The above constitutes the minimum level of coverage provided by standard Medicare and Rx coverage. Beyond that, there are numerous supplemental plans that can cover out-of-pocket expenses.

These are largely broken down into two categories: Medicare Advantage, and Medigap, or Med-sup plans.

The more traditional Medigap plans, known as plans A through N, cover the deductibles and copays associated with standard Medicare. The various plans pay different amounts, which should be carefully considered when reviewing the plans. All these plans involve a monthly premium of $125 to $150 per month, or more, based on location and levels of coverage.

Medicare Advantage, aka Medicare Part C, plans are arrangements between Medicare and commercial health-insurance companies, whereby Medicare contracts with health insurers to provide your coverage.

You purchase a plan from a commercial insurer like Anthem, Humana, Harvard Pilgrim or others that provides an array of coverages, often including additional coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans require you to be eligible for Part A and enrolled in Part B.

As you can see, these choices are numerous and complex. If you have any questions, don’t hesitate to give us a call.