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-- Programs and Services -- Contact Information "Seniors and health insurance: You can’t ask too many questions!"
One of the things I find most enjoyable about Elder Services' SHINE (Serving the Health Information Needs of Elders) program is the chance to speak to people about their real concerns and help them with complicated and confusing health information. I notice at least half of the questions and calls we receive begin with the phrase “I’m sorry to bother you, but...,” or “I’m sorry to bother you again, but...”
That’s what we’re here for! And you’re not bothering us; you’re asking a question about a very important aspect of your life, your health insurance or prescription drug coverage, and need understandable answers, and sometimes need them fast.
One major problem with the new Medicare Discount Drug Card program is its complexity, which results in many elders thinking it is their fault they can’t understand all of its ins and outs. Not so. Any program that requires those over 65 to choose among 38 products using an Internet-based program where one must know the spelling of, dosage for and administration frequency of a series of pharmacy products is, by definition, not user-friendly. SHINE counselors were trained for months to be able to give even the most basic descriptions of the card program, and we’re all still learning.
Massachusetts’ Prescription Advantage Program is relatively easy to explain, but that doesn’t mean there aren’t still a lot of questions including those about “open enrollment,” “involuntary loss of prescription coverage,” and “qualifying events.” When the program began, anyone 65 or older could enroll at any time. Once the program was established, the system became like other health insurance programs and limited new applications to a specific period of the year, called an “open enrollment period.” (This year open enrollment for Prescription Advantage is September 1 to September 30, 2004. See next column.) The only individuals who can enroll before or after that time period are individuals between 65 and 66, or those who have recently involuntarily lost prescription coverage or those who are new residents of the state. So there are a lot of reasons why someone would call and ask questions about whether they qualify, or if they should even enroll at all.
Health insurance and prescription drug coverage options change so frequently that it is a good idea for all elders to review their coverage at least every two years. Changes in health status, income level or marital status might potentially trigger a different option. So please feel free to call the SHINE Program at Elder Services at 499-0524 or 1-800-544-5242 anytime you want to ask a question or re-examine your options. We’re here to help you and we welcome your questions.