In the fall, many workers have the opportunity to change their health insurance coverage. That’s true for Medicare beneficiaries as well. Seniors and people with disabilities covered by Medicare have until the new year to review and make changes to their plans. And this year, there are plenty of changes complicating matters.
: Phones have been ringing off the hook at SHIIP - the Senior’s Health Insurance Information Program call center in Raleigh.
"Hello, Senior’s Health Insurance Information Program, my name is Birgitta how may I help you… "
"During November we had over 10,000 calls and already for the month of December, we’ve received 7200 calls…"
That’s Kevin Robertson, a deputy commissioner at the state Department of Insurance who oversees the advice program…
"I think last year, around the same time frame we were getting about 7000 during November."
Robertson says part of the reason for so many calls this year has to do with the fact that there are fewer Medicare drug plans for seniors to choose from. He says last year, there were 47 plans. This year, there are 33.
"Folks at CMS is the ones that asked the drug plans to really look at the plans that they are offering and sort of simplify them to offer less choices so it would not be so confusing to seniors."
As a result, about 80,000 people in the state have plans that are being eliminated this year. If those beneficiaries don’t choose a plan for themselves, CMS, the Centers for Medicare and Medicaid Services will choose one for them. And senior advocate Gina Upchurch says that’s a big mistake:
"It definitely pays to compare plans. We are saving people hundreds to thousands of dollars. Last year we conducted a study and about two thirds of the people needed to switch plans for significant savings."
Upchurch heads Durham’s Senior PharmAssist. It’s a program that originally started out helping seniors get access to medications. But since the federal government implemented Medicare Part D drug coverage in 2007, her organization has helped beneficiaries wade through the details and get the best deal.
"So folks coming in here who have been marketed to through the mail by lots of different companies and there is pretty massive confusion about which direction to turn."
Upchurch says seniors tend to focus on the cost of the monthly premium for prescription drug coverage. But she says there are other things to consider in Medicare Part D.
"The other part is whether there is a deductible or not. This coming year, 2011, there could be up to $310 deductible, meaning you pay all of that out of pocket before the Part D plan starts helping. That's a moving part. But the most important moving part is really the cost of the drugs, whether you're drug is covered and if it is, what the cost of it is."
So, Upchurch has been holding meetings to explain the changes in the drug program. But what she’s finding is that there are lots of questions, too, about what effect the new health reform law will have on Medicare. On one recent afternoon, about three dozen seniors peppered her with questions
"I hear the newly elected officials say that they will not fund the health care plan, has it been funded, is it up for funding, or what’s the case with…" a woman in the audience says.
Upchurch spent about an hour detailing what’s happening to Medicare – both the drug benefit and the overall program. By the end, folks in attendance said they felt reassured, like Jeanette Webb from Durham:
"What I heard today, we will get more health care and we will be putting out less money."
But that’s only if seniors take the time to check their drug plans and make the changes they need to before the deadline on December 31st.
RESOURCES FOR MEDICARE RECIPIENTS:
Call SHIIP: 1-800-443-9354 or 919-807-6900