When a 65th birthday arrives, so does eligibility for Medicare — and a bunch of decisions about health care plans.
That can be a challenge, say three presenters at Northwest Indiana Medicare seminars.
Seniors who want to change plans for 2020 must do so between Oct. 15 and Dec. 7.
“There are many options and plans, so it can be difficult for some to navigate the process by themselves. It can be very overwhelming and confusing,” said Barbara Rossi, insurance consultant for Senior Promise, a social group affiliated with Franciscan Alliance for those 55 and older.
Christel Snow, volunteer supervisor at State Health Insurance Assistance Programs, or SHIP, agrees. “Choosing the right plan based on what you can afford and your health care needs are big concerns for seniors.” SHIP is a neutral party that doesn’t sell, solicit or endorse insurance policies, Snow said.
She conducts seminars at Community Healthcare System’s Hartsfield Village retirement community in Munster, and SHIP provides trained volunteers for seminars at other Northwest Indiana facilities.
It’s also a challenge making sure a provider network includes the seniors' doctors, said Dane Buckley, of Dane Buckley Insurance in Crown Point.
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“Continuing with the same doctors seniors have had doesn’t always happen, unless they buy a supplement. But they have to be able to afford that monthly premium,” said Buckley, who presents twice-monthly seminars at Methodist Hospitals as well as one-on-one appointments with clients. That varies by individual, he noted, “and most people on Medicare have limited retirement and limited income."
Buckley said navigating prescription drug plans (Part D) is usually the most difficult aspect. “Not all formularies carry the drugs the client may be on, and then there are (drug) tiers and deductibles,” he said.
Helping seniors navigate Medicare is the goal of the seminars, which are free and open to the public to provide general information about Medicare, including tips on how to sign up for it and about Part D.
Rossi said common questions at the seminar include when to sign up for Medicare and whether Parts A and B are required.
Basically, Part A, which covers inpatient care, is automatic with Medicare. Part B, which is optional, covers outpatient care. Snow said an optional Medicare Advantage plan turns over Medicare A and B for one year to a private insurance company. The company gets a stipend, and the senior has to use its facility. Some advantage plans come with a Part D component.
Snow said the No. 1 thing she hears about from seniors is the cost of Part B, currently $135.50 per month. “Married people are surprised to learn that’s the cost for each of them," she said. She added that seniors are also surprised to learn that the number of days covered in skilled nursing care is limited to 100 per year.