Managing the Medicare Maze
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By Michelle Carter
West Alabama Regional Commission
Area Agency on Aging
Picture this. Your kids are grown, it’s just you and the love of your life at home, enjoying retirement. But, when one, or both, of you turns 65 your world goes slightly sideways. Suddenly, the insurance coverage you had, perhaps finally, gotten to understand is changed. Now you are faced with so many choices your head spins and that peaceful, laid-back retired life is replaced with forms and information and decisions that have to be made. One wrong choice and you could be locked into paying more for insurance than you have to. Sounds like a nightmare? For seniors age 65 and older this may be actual reality.
Each year beginning Oct. 15 and running through Dec. 7 Medicare has their open enrollment period. It’s a time for Medicare beneficiaries to review their coverage and healthcare needs and decide if they need to make any changes to their Medicare plan. This statement sounds simple enough BUT with a vast number of insurance companies offering an extensive list of plans, simplicity is not the adjective for this process. It’s been accused of causing tears, feelings of overwhelming anxiety and confusion. The silver-lining to all this dizzying information is that you don’t have to navigate it alone.
The West Alabama Area Agency on Aging provides a Medicare Counseling program through the State Health Insurance and Assistance Program (SHIP). This program provides unbiased guidance to weed through the variety of choices so you can make an informed decision about your health care options. Last year during open enrollment, a team of trained counselors at the West Alabama Area Agency on Aging helped a total of 1,601 clients save nearly $800 each on average, a grand total of over one million dollars. “Not only have you saved us money but you have taken the worry and confusion out of our insurance needs.” Richard Hicks said. He and his wife, Pixie, have been coming to Medicare counseling at the agency for the past four years.
For many seniors who are, or will be turning 65, and on a fixed income, the stress of Medicare decisions can be even more dire when they factor in the cost of medications vital to their well-being. “You shouldn’t have to decide between food or medication that you have to have to be healthy and live.” SHIP client Denise Crandall said. Crandall gives her testimony on www.shipatcenter.org. “Before I turned 65 – several months before I turned 65 – I received so much information and materials in the mail. It was really frustrating and overwhelming and I felt like throwing all the mail away. They just keep sending you all this stuff, and I was telling somebody how confusing it all was, and how I didn’t really know what to do, and so they suggested I call a Medicare counselor, that it was a free service.” Crandall said.
It’s a free service yet many seniors are unaware of it. SHIP was created in 1990. “The Program oversees a network of more than 3,300 local SHIP programs and over 15, 000 counselors, 57% of whom are highly trained volunteers” according to the Administration for Community Living. It’s not common to change your health coverage annually prior to Medicare enrollment so many seniors may not re-evaluate their coverage after initial enrollment. “Being an octogenarian and not receptive to change, we just stayed with the current carrier we had for Medicare supplement and soon found out that, after a year, there were many differences in the premiums” SHIP client Eloise Dennis said. Her testimony is available on www.shipatcenter.org as well. “One year a drug was $41. The next year it was $3 with another company. This doesn’t seem right but it’s so. And so, it was to our benefit that the Medicare counselor was able to head us in the right direction. But what was interesting was every year I went back; and almost every year, it was to our benefit to change carriers.” A local SHIP client, Sedelle Dockery, exclaimed, “The counseling services provide you with choices on where you can save the most on your prescriptions! With limited funds this is a lifesaver! I really appreciate your service!”
George W. Harris is a Social Security attorney in Tuscaloosa. He has been referring clients to the Medicare counseling at the West Alabama Area Agency on Aging for over 15 years. Harris also personally uses SHIP counseling since he turned 65. The following is an excerpt from a letter he wrote advocating for the SHIP program. “As a Social Security disability attorney, I have referred many clients to this program for reliable advice when making decisions about Medicare options. Additionally, I have referred professionals, both in and outside the state, to this national program. This includes lawyers, physicians, educators, etc. who all agree that their advanced degrees are no match for the complexities of the Medicare system. Because I have seen the value of this program first-hand, I turned to SHIP for guidance when I reached Medicare age.” Harris sought SHIP guidance specifically for managing his out of pocket expenses related to Medicare’s “Donut Hole.” He saves a minimum of $500 per year now that he no longer reaches the “Donut Hole.”
Be mindful that local help is available at the West Alabama Area Agency on Aging. SHIP provides a local face for Medicare. Their purpose is to explain your options so you can make an informed choice or decision about what is best for you. Please contact the West Alabama Area Agency on Aging for more information or to make an appointment with a SHIP counselor by calling 205-333-2990 or visit our website at www.westalabamaaging.org.
