taking a stroll through the MEDICARE MAZE

By RAELYNN RICARTE

News staff writer

July 13, 2005

Adult Center hosts a seminar to help seniors untangle the Medicare system

The Hood River Valley Adult Center wants to help senior citizens navigate their way through a new “Medicare maze.”

Next week the center hosts a seminar to explain how the new federal prescription drug coverage program works. Bruce Westphal, marketing manager of Clear Choice Health Plans, will provide basic information and field questions at 1 p.m. on July 21 in the facility located at 2010 Sterling Pl.

There is no charge to attend the forum that will explain Medicare options and both the costs and savings involved with each alternative.

Heidi Musgrave, center director, said Westphal has offered to clarify issues that are creating confusion for some seniors. The federal program goes into effect on Jan. 1 and the Medicare-sponsored plans are entirely different than the drug discount cards now offered through private companies.

According to Musgrave, seniors must sign up for one of the available coverage plans when they are first eligible in order to avoid being penalized with higher premiums for life.

“The kicker here is that people may not need the new card because they don’t take any drugs at the age of 65. But their premium could then increase from $37 to $75 each month if they wait until they do need it 10 years later. I think the government is counting on all eligible people buying into the coverage to help fund the program,” she said.

There is an exception to the 1 percent increase in enrollment costs for each year after eligibility, said Musgrave. She said no penalty is imposed if a senior can clearly show that he/she had equal or better coverage through another source, such as an employer.

Musgrave said the new prescription drug coverage financially benefits those taking several expensive medications. And that, said Musgrave, can be a valuable service for a senior living on a fixed income.

She said in Hood River County, the average monthly Social Security check falls between $600-$800.

From those limited funds, Musgrave said seniors pay monthly Medicare premiums of $77.90, up 17 percent since 2004.

In addition, she said many elderly residents pay an additional average of about $85 per month for supplemental insurance to fill in the gaps not covered by government health care.

To aid seniors in research that can make their limited dollars stretch further, Musgrave has also netted about $4,000 in grant funds for new computers, printers and DLS lines.

In September, Gorge seniors will be able to go online in two locations to check out their Medicare options. The money obtained from Senior Health Insurance Benefits Assistance (SHIBA), of which Musgrave is the regional coordinator, has been allocated for a terminal at the Community Action Council offices in The Dalles and another at the center in Hood River.

Anyone interested in accessing the local computer can make an appointment for a time slot by calling Musgrave at 386-2060.

Volunteer assistance to access these programs, or provide answers to any health benefit questions, is also available by appointment.

“We’re aware that it could be a frustrating experience to learn about this program. That’s why several of us attended a training program in Salem to learn the rudimentary elements so that we can walk people through the process,” said Musgrave.

Seniors in fee-for-service Medicare need to enroll in a federal prescription drug coverage plan between Nov. 15 and May 15, 2006.

After that date, all enrollees but those on Medicaid can drop a plan or change coverage only once a year between Nov. 15-Dec. 15, except in certain situations. In most cases, if a senior is already enrolled in a Medicare Advantage Plan, such as through a preferred provider, he/she will receive their Medicare prescription drug coverage through that option.

This fall all eligible seniors will be sent a Medicare & You 2006 handbook, which will list the plans available in their area.