Seniors say medicare options are complicated
In the year since prescription drug coverage has been added to
Medicare insurance for senior citizens and those on disability,
many Hollister residents say they understand their options even
less.
Seniors say medicare options are complicated
In the year since prescription drug coverage has been added to Medicare insurance for senior citizens and those on disability, many Hollister residents say they understand their options even less.
“There are so many plans,” said Sadie Hernandez, 71. “I hear some people say they pay a dollar and others say they pay nothing. I think I pay $12 a month.”
While the Centers for Medicare and Medicaid Services publish books to guide seniors and their families through the choices now available, the nearly 150 pages on plans and coverage options are overwhelming for some.
Medicare officials, including Centers for Medicare and Medicaid Services Regional Administrator Jeff Flick, went the extra step Dec. 11 and stopped in Hollister along a tour of senior centers in California. With their Medicare bus, they brought along brochures on plans; laptop computers and counselors who could walk seniors through the options and help them choose the best for their needs.
The variety of prescription drug plans offer varying premiums, deductibles and copays.
Seniors who want to change their plan for 2007 have until Dec. 31 to do so.
“They need to make a decision this month to stay with their current plan or to change to a new plan,” Flick said. “If they want to stay [with their current plan] they don’t have to do anything and their coverage will continue next year.”
The confusion for many seniors comes with the number of options now available. Seniors have a variety of Medicare plans to choose from that cover hospital stays, outpatient and doctors visits. Medicare now offers “Advantage Plans” that allow seniors to enroll in HMOs and PPOs. The new prescription drug coverage plans have added to the confusion for some seniors.
There are more than 50 prescription drug plans to choose from in Northern California. In addition to the varying out-of-pocket expenses, the plans cover different prescription drugs and work with different pharmacies.
“I wish the government would have just given us one option,” said Mary Guttirez, a 60-year-old Hollister resident, who showed up at the senior center to gather information for her parents. “It’s hard to find out what companies cover and how much they cover.”
Hernandez agreed. A doctor prescribed an osteoporosis medication to her this year, but it would have cost her $150 a month for the once-weekly pills.
“That would have come out of my pocket,” Hernandez said. “The worse thing is by the time we need [prescription drug coverage], we are at the point where it’s not simple to understand.”
Still, during the first year Medicare offered prescription drug coverage, seniors who enrolled saved an average of $1,100 a year, Flick said. Low-income seniors are also eligible for “extra help,” a program that covers the cost of premiums and some copays.
“This year we have better coverage in the donut hole,” Flick said. “We have new plans coming every year.”
Jovenes de Antano and the San Benito Health Insurance Counseling and Advocacy Program, a California health advocacy program that helps Medicare members understand their coverage, will continue to offer help to seniors who need more information about Medicare plans.
“What we are doing is laying the groundwork,” Flick said. “Help will always be available. There are a lot of permanent resources.
Open enrollment for Medicare plans continues through Dec. 31. For more information, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov. The Health Insurance Counseling and Advocacy Program can be reached at 1-800-434-0222. Booklets on choosing the right plan are available at Jovenes de Antano, 300 West St. in Hollister
Melissa Flores can be reached at [email protected].
