You've got questions, we've got answers
By Margie Ware
The SHINE (Serving Health Information Needs to Elders) Program recently had calls about two different, but related situations.
In one situation, the individual received a letter from her Medicare Part D provider and panicked. The letter said that she was going to have to pay $24 per month for her plan. She couldn’t afford it. So she called up the company, and cancelled her coverage.
The truth was she didn’t have to pay the premium because she belonged to Prescription Advantage, which had always paid her premium, but the letter, which came from a national company, didn’t say that. She thought something had changed.
She also had family members who could have told her not to worry. They are happy to assist her with health insurance questions and get a great deal of comfort from knowing that they’ve helped their loved one to make good choices and that she is well taken care of. But she didn’t talk to them before she picked up the phone. Maybe it’s because she didn’t want to ask for help.
In the second situation, the individual got her quarterly health insurance bill. She realized that the insurance was getting too expensive for her. So she too cancelled her insurance. She didn’t have family with whom to talk and she wanted to be self-sufficient.
The problem was, she had a series of doctor’s appointments, and now she didn’t have supplemental insurance. She began to receive bills for physicians’ services. And, as it turned out, there would have been a less expensive kind of insurance from her same carrier
that would have met her needs. But she didn’t ask her carrier for help in learning about other alternatives, and she didn’t call Elder Services SHINE Program until the bills started rolling in.
Luckily for her, all the Medigap companies are in “continuous open enrollment” for the time being. This means that one doesn’t have to wait until a special time of the year to sign up for supplemental Medicare insurance. (There is still a special period to sign up for Part D prescription plans – November 15 to December 31.) She will have insurance again, but she paid a very high price for deciding to “act first and ask for help later.”
It’s OK to call an agency, or call a family member, and say “I think I understand this, but I wanted to run it by you.” Or, “I’m really confused about this situation, and I need your help to explain it.” Even harder is admitting to someone that you have some fairly official-looking mail sitting on your dining room table and you’re too scared to open it. If that mail is a request to verify your income, and you ignore the mail, you could lose your Mass Health or some other government benefit on which you depend. But your family member or friend would prefer you ask them for help before a crisis rather than months later, when there are many fewer alternatives.
If you’re traveling remember to ask questions before you leave. We received a call from an individual who became ill overseas, and there were problems about whether her Medicare card might not cover her in Europe. If she had planned ahead, or asked some questions, she would have discovered that she could have bought travel insurance to cover her against an unexpected illness.
Stop. Think ahead. Ask for help. Listen. Evaluate. Those who care about you will appreciate that you asked for help. And if they need help, they can also call Elder Services and ask for the SHINE Program to receive free, unbiased and up-to-date health insurance information, counseling, and assistance to Medicare beneficiaries of all ages and their caregivers at 499-0524 or 1-800-544-5242.
Margie Ware is the Elder Services’ Regional SHINE Program Coordinator.
