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Medicare shouldn’t give headaches

Enrollment open now, closes Dec. 31

Posted: November 23, 2008 7:06 p.m.
Updated: November 24, 2008 4:30 a.m.
 

When selecting a Medicare plan, seniors have a wide variety of choices, so it's important for them to research the options and choose a plan that will best suit their needs.

Seniors in the Santa Clarita Valley don't have to venture alone into the often-confusing Medicare world. The Supportive Services Department at the Santa Clarita Valley Senior Center is a team of individuals who can help guide seniors through the entire process.

"We help solve any problems (seniors) might be having," said Abe Sogbein, assistant director of the Supportive Services Department.

"Medicare is complex. To seniors, it's a lot of information. When they come in, we make it simple for them."

The Santa Clarita Valley Senior Center also hosts The Health Insurance Counseling and Advocacy Program, or "HICAP." This volunteer-supported program provides unbiased information to help Medicare beneficiaries make the best choices for their individual health care needs.

Here are some simple steps to help seniors start thinking about how to select the best Medicare plan:

Review medical spending from '07-'08
Before diving into Medicare options, seniors should do a "health care audit" of how much they spend on medical needs. Review records and receipts.

Don't forget to include charges from physicians, hospitals and pharmacies - they all count.

Many insurance companies provide annual summaries that track spending for each patient.

Seniors can also ask their doctors' offices or pharmacies for information.

If the information is hard to understand, the SCV Supportive Services Department can accompany seniors on their doctors' visits and translate the information.

"We go to the doctor's with them, too, because there is a lot of medical language they might not understand," Sogbein said.

Identify future health care needs
While seniors might not have a crystal ball to see what the next year will bring, a rough estimate of future health care services will help them make the right Medicare decision.

Seniors should assess their current conditions and consider whether they need ongoing care, whether they need to stay on their current medications, or whether they need annual screenings.

Again, seniors can talk to their doctors if they need further assistance (or ask the Supportive Services Department to accompany them for clarity).

Once a rough self-analysis has been done, seniors can use online resources such as the Family Health Budget (www.familyhealthbudget.com) to estimate likely future costs.

Medicare essentials
"The most important thing seniors need to consider is knowing what Medicare covers," Sogbein said.

There are several parts in Medicare and every Medicare plan has to be personalized to fit each senior and his or her specific needs.

In addition, seniors need to include other factors such as cost, benefits, networks and convenience.

n Cost - How much will premiums, deductibles and co-payments cost?

Plans with lower premiums may have higher out-of-pocket expenses (the amount paid when receiving care, such as co-payments, deductibles and co-insurance).

The inverse is also true: if seniors pay a higher monthly premium, the out-of-pocket costs may be less.

n Benefits - Each part will offer slightly different benefits.

The Supportive Services Department can help seniors in the Santa Clarita Valley dissect each part and figure out which benefits each individual qualifies for.

n Doctor and hospital choice - Often forgotten when considering a plan, it is important for seniors to check if their new Medicare plan will be accepted by the doctors, hospitals, pharmacies and other providers they typically use.

If not, it would be wise to check if the new providers that do accept the new plan are conveniently located.

Extra help is available for those who qualify
If seniors have limited income and resources, they may qualify for help paying their Medicare health coverage.

For information regarding qualifications for extra aid, talk to the Santa Clarita Valley Senior Center Supportive Services Department representatives and they can call the Medicaid office or the Social Security Administration to find out.

"We advocate seniors with our local Social Security office," Sogbein said. "We have a very good relationship with them."

If seniors are currently enrolled in a Medicare plan but are unhappy or unsatisfied with it, they can switch to a different one during the enrollment window, which is currently open until the end of the year (closes Dec. 31).

If no changes are needed, seniors will automatically be re-enrolled for the same plan for 2009.

For further information or to make an appointment with the Supportive Services Department or The Health Insurance Counseling and Advocacy Program, call The Santa Clarita Valley Senior Center at (661) 255-1588.

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