Medicare Enrollment Information: Part 4 - Advantage Plans
TGB Elders and the 2012 Election

Medicare Enrollment Information: Part 5 – Where to Get Help

category_bug_journal2.gif This is the last part of the TGB Medicare Enrollment Information series. I had no idea when I committed myself to breaking down Medicare enrollment rules into simple, understandable language how difficult it would be – what a long learning curve it was.

I actually believed I would be able supply what most people need in one medium-sized post. (Can you hear me laughing maniacally?)

There is an update/correction to Part 4 about Medicare Advantage plans – specifically in the section about switching from an Advantage plan back to traditional Medicare.

I could repeat all the details, but the Medicare Rights Center has a clear, online, one-page explanation about it [pdf].

However, it does not explain the actual steps involved to disenroll from an Advantage plan. The clearest explanation of those I've found is from the California Health Advocates. Scroll down to the section titled, Medicare Advantage Disenrollment Period (MADP).

Please, please read these carefully and I would urge you to call Medicare (800.MEDICARE) to be sure you understand what to do.

Here, then, is what today's post is for:

There are hundreds, maybe thousands of places online offering help and information with understanding Medicare. When looking for answers, I urge you to be careful of the sources. I found a lot of wrong information while I was researching this series.

It is good to stick with organizations you trust and whose reputations rely on supplying good and accurate information for elders. Also, because some rules and details for Medicare change every year, do not trust any website that does not date its pages.

In Person Medicare Help
SHIP (State Health Insurance Assistant Program) is a national service with free, one-on-one counseling to Medicare enrollees and their families.

SHIP is paid for by a grant from the federal Department of Health and Human Services (HHS) and some other sources. Trained counselors are local and the services exist in all 50 states plus the District of Columbia, Guam, Puerto Rico and the Virgin Islands.

SHIP will not tell you which plan to buy, but they will explain your options and tell you what is the best value for your dollar.

Some states provide additional funding and those SHIPS may go by different names such as SHIBA, HICAP, SHINE, etc. You can locate SHIP counselors in your state and county at the SHIP website.

MEDICARE is, of course, the mother ship. For personal information about anything related to your Medicare needs, you can telephone 1-800-MEDICARE (TTY: 877-486-2048) and a real, live person will handle your questions.

It is my experience that Medicare telephone customer service representatives are well-trained, knowledgeable and patient. They are available 24 hours a day, seven days a week.

When you call, be sure to have your Medicare cards (Medicare, drug, Advantage, Medigap) with you as you will be asked for those numbers along with your name, birthdate and, sometimes, the start date of your Medicare coverage (on your Medicare card).

If you are required to wait for your turn with a customer service representative, recorded voices will incessantly yack at you with a variety of messages. They never shut up. If your wait is longer than a couple of minutes, it can be deeply irritating so bring your patience with you.

INDIVIDUAL COVERAGE PROVIDERS for Part D, Advantage and Supplemental (Medigap) policies are usually patient, helpful and well-informed.

I know it sounds odd to go to an insurance company for information, but when you have honed your options for the private coverage sections of Medicare to two or three, they can clarify questions that are puzzling you.

When I was trying to figure out Medigap policies six years ago, I was deeply confused with all those lettered options (A, B, C, D, F, G, etc.) After narrowing my choices as best I could, I telephoned one company and threw myself on the representative's mercy: “This is my first time at this,” I said. “And I am totally lost as to how to choose a Medigap plan.”

The woman walked me through each and every one. She was not doing a sales job on me; she just patiently explained the differences among each lettered choice and as I recall, we spent 30 or 40 minutes together. When we finished, I told her I wanted to think it over and she did not pressure me to buy.

I called a second provider and was treated equally well but by then, I understood my options and didn't need more explanation. The first one had the best price and given that the rep was so helpful to this newbie, I gave them my business.

So, whether it is general information on a privately-insured part of Medicare or an explanation of that particular provider's coverage, they can be extremely helpful.

LOCAL INSURANCE AGENCIES can be an in-person help for the private Supplemental (Medigap) coverage. Keep in mind, however, that they don't make money without selling insurance.

You can find lists of local agents who specialize in Supplemental coverage state-by-state at the American Association for Medicare Supplement Insurance website.

Some LOCAL SENIOR CENTERS hold free educational Medicare enrollment seminars with SHIP counselors or other experts who will explain details and answer personal questions. Check to see if any in your area have scheduled these meetings.

Other Medicare Information and Help
Considering the vast amount of information it needs to cover, the MEDICARE website is remarkably easy to use (and gets better each year). The navigation bar at the top of the main page can quickly get you to a section you need - Sign Up, Your Medicare Costs, What Medicare Covers, Claims and Appeals and more with dropdown menus for more detailed choices.

It is also my experience that the site search functions better than on most websites.

By giving the website some personal information, you can sign up for Medicare for the first time, find out what your current coverage is, use the physician compare tool and much, much more.

It is well worth spending some time to become comfortable with the Medicare website. Given how complicated the program is, the web designers have done a fantastic job of building a useful website.

MEDICARE AND YOU 2013 is the annual official Medicare handbook that you should have received via postal mail a month or more ago. If not, you can find it online here [pdf].

Right up front you will find all the new stuff and what's changed for next year followed by sections explaining a lot of what you need to know. The back pages (of the print edition) list the prescription drug plans available in your state.

If you believe Medicare has wrongly denied payment or is remiss in some other manner, try The MEDICARE RIGHTS CENTER, an independent, nonprofit consumer rights organization based in New York. It offers information and free legal help on Medicare issues (including Part D appeals) to Medicare beneficiaries throughout the country.

Visit the website or call its toll-free consumer hot line at 800-333-4114.

I trust the KAISER FAMILY FOUNDATION MEDICARE website that is packed with accurate, up-to-date information you can use for the annual enrollment period.

In addition to the hard data and details we need to make informed choices of coverage for next year, there are reports and research on public policy, politics and surveys of attitudes related to Medicare.

Kaiser sells private coverage but not at this website. Check it out here.

Undoubtedly there are other good online websites for Medicare information, but the ones I've listed, along with the in-person resources should cover most of what you want to know.

Medicare Enrollment Information: Part 1 - The Basics
Medicare Enrollment Information: Part 2 - Medigap
Medicare Enrollment Information: Part 3 - Prescription Drugs
Medicare Enrollment Information: Part 4 - Advantage Plans

At The Elder Storytelling Place today, Ross Middleton: Whose Backbone?


Ok, now you deserve to prop your feet up and relax. Tonight eat cheese and wine and watch a tv show.

And thanks!

I can only say again how much this is appreciated. This installment points me to the info for disenrollment from an AP and re-enrollment in a drug plan. The California site is especially helpful.

How you find time and energy to do all of the research and write it ... well, you deserve a medal and really excellent cheese and wine.

I'm printing out and saving all these postings.

Good for you, Ronni. This information was badly needed and deeply appreciated.

Thank you for all the research and preparation you did for our benefit.

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