Yes, it’s the time of year for Medicare information, counseling and decisions — all by Dec. 7 deadline

 

BY CHERYL ROMANO/YachatsNews

It’s that special time of year — family and friends gathering to give thanks, people sharing warm holiday wishes — and for folks near 65 and older dealing with Medicare health plans.

Although that last item isn’t on anyone’s festive “to do” list, the Dec. 7 deadline to enroll in or change Medicare plans is important. The right — or wrong — decisions can save or cost you major money.

Luckily for Lincoln County residents, there’s expert help just a phone call away. And it’s free.

Thanks to certified, volunteer counselors with Senior Health Insurance Benefit Assistance, anyone with a question about starting or continuing Medicare coverage can get knowledgeable guidance by calling 541-574-2684. On the other end are four trained people working under the authority of the federal government and the Oregon Department of Human Services. Via phone appointments, they’re qualified to help local residents navigate the often murky waters of Medicare.

Yachats resident Nancy Thorn is one of the four, and she’s been plying the murky waters of Medicare for 10 years. Part A, Part B, Part C, Part D, Advantage plans, prescription drug coverage, Medicare supplements — it’s a maddening menu of choices and “Everyone comes to us confused,” she says.

Prior to the Covid pandemic, Thorn was able to meet clients in person at the Yachats Library. Now all the work is done by telephone.

“We can get more done for more people by phone,” she says, which is especially important in these last few enrollment weeks. “This is our busiest time of year. We’re short-staffed, so when you call, leave a message and you will get a call back.”

While a lengthy appointment can be tough to get right now, Thorn says “You can get a counselor if you call as soon as possible. If you have just one quick question, you can often get through pretty quickly.”

Like her three colleagues covering Lincoln County (one of whom can do Zoom calls if needed), Thorn completes 12 hours of continuing education each year to stay updated on the ever-changing Medicare scene. In addition, all volunteers have to pass a criminal background check, and are trained to be scrupulously careful with clients’ sensitive information.

“Medicare 101” class, websites help

Preparing before calling the SHIBA phone line can help move things along.

“If you need help signing up with a drug plan, for example, you should know what prescription medications you take, the dosage, and your Medicare number,” Thorn advises.

Two websites can offer a wealth of information: one is SHIBA’s website and the other is the Medicare site run by the federal government.

In addition, anyone interested may attend a free, “Medicare 101” class from 10 a.m. to noon Thursday, Nov. 30, at the Samaritan Center for Health Education, 740 S.W. Ninth St., Newport. For those able to act quickly enough, there is also a Medicare information session at 2 p.m. Friday, Nov. 17 at the Newport 60+ Activity Center, 20 S.E. Second St., Newport.

“At the very least, everyone on Medicare should review their coverage in the fall,” says Thorn. “This is the time to make changes. If you don’t, in general, you’ll be stuck with what you have for the whole year.”

This year, people choosing a Medicare Advantage plan in Lincoln County don’t have to wrestle with changes — the only option is Samaritan Advantage. Two former competitors, MODA and Regence Blue Cross of Oregon, have stopped offering Advantage plans in the county. Samaritan also announced it is treating the popular AARP-sponsored United HealthCare advantage plans as “out of network” for billing purposes.

As a result, Thorn says most people calling now are seeing if they can afford the much more expensive Medicare supplement plans or do they just go with Samaritan;s plans.

When necessary, people can book SHIBA appointments for others. “A lot of times, I’ll work with a daughter or son on behalf of a parent,” says Thorn.

Watch the calendar

The biggest no-no in Medicare is ignoring the calendar, according to the woman who coordinates the SHIBA volunteers in Lincoln, Linn and Benton counties.

Based on what she hears from her squad of volunteers “Being aware of timeliness is incredibly important,” says Taylor Thorn of Albany, who is no relation to Nancy Thorn of Yachats. In Lincoln County alone last year, her volunteers logged 900 hours of answering questions and helping resolve Medicare issues.

“Whether you’re about to retire, approaching age 65, or moving to another county, it’s vitally important to follow the Medicare schedule for enrolling, and for making changes,” she said.

There’s a three-month window before and after turning 65 that requires Medicare action, along with several other deadlines. Failing to meet these deadlines can bring on financial penalties that hurt.

“We are here year ‘round to talk as many times as you need,” she says. “Don’t hesitate to reach out.”

It was a missed Medicare deadline that drew Nancy Thorn into volunteering with SHIBA 10 years ago. A friend who was collecting a medical disability needed to get on a drug plan — but she didn’t know she needed to sign up years prior, and was faced with a high monthly price for her tardiness.

“We got rid of her penalty,” says Thorn. “The longer you go without coverage, the higher the penalty.”

In another Thorn client case, an 80-year-old woman without a drug plan was diagnosed with diabetes. “She had gone 15 years without a drug plan and couldn’t afford her medication,” says Thorn. “We finally found a family member who helped pay the cost.”

One of the most common questions Nancy Thorn hears is, “’Will Medicare happen automatically?’ If you’re already on Social Security, then yes, it’s automatic. If not, you need to be proactive. Don’t assume a Medicare card will fall out of the sky.”

• Cheryl Romano is a Yachats freelance reporter who contributes regularly to YachatsNews.com. She can be reached at Wordsell@gmail.com

For help or more information, call the SHIBA phone line at 541-574-2684.