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At town hall meeting, seniors navigate complicated world of Medicare

SALISBURY — When the topic of Medicare comes up, and you’re suddenly talking about things such as Plans A, B and D, annual election periods, Advantage and Extra Help programs, drug and cost plans, it can be pretty overwhelming.

Or it’s like the old country saying: You feel like a short dog in tall grass.

“It is intimidating,” said Sarah Owen, who attended a free “town hall” event Wednesday at Rufty-Holmes Senior Center where people could ask their Medicare questions and also receive one-on-one help in determining what will be the best Medicare Part D prescription drug plan for them in 2015.

The annual election period has been open since Oct. 15 and runs to Dec. 7.

Owen attended with her daughter, Lora, and they stayed after the morning information session in hopes of connecting with one of seven counselors made available into the afternoon.

“We have wrestled with it,” Sarah Owen said of the Medicare decisions she has to make.

If one message came through loud and clear Wednesday, it’s that help in understanding Medicare and making choices that can save you money are available, locally and statewide.

The town hall meeting was one of eight scheduled in North Carolina by the state’s Seniors’ Health Insurance Information Program, more commonly known by its acronym, SHIIP.

N.C. Insurance Commissioner Wayne Goodwin usually attends these meetings, but he was tied up Wednesday in consent-to-rate hearings related to homeowners insurance.

SHIIP Director Van Braxton was present, and much of the nuts-and-bolts discussion fell to SHIIP Regional Manager Jeanie Schepisi, one of five regional managers in the state.

Medicare is a federal program, Braxton reminded his audience by way of introduction Wednesday, and “it’s probably more complicated than it should be.”

Throughout the year, SHIIP offers programs such as the town hall meetings, “Medicare 101” and “All About Medicare,” but it’s the annual election period when SHIIP’s office in Raleigh and all the Medicare coordinating sites in each county feel the crunch.

Rufty-Holmes Senior Center is the coordinating site for Rowan County, where Susan Davis and Steve Simpson are the coordinators. They oversee seven volunteer counselors, and the demand on their time has been so great this fall that all the available sessions for one-on-one counseling — some 300 time slots — have been filled through Dec. 7.

Davis and Simpson said people should still call them at Rufty-Holmes Senior Center with questions, and they’ll provide as much help as possible.

Meanwhile, SHIIP also has a call center to help seniors with their annual enrollment and to answer any other Medicare questions.

The call center, which adds staff during the enrollment period, has 14 to 15 people to work one-on-one with people over the telephone, from 8 a.m.-5 p.m., Monday-Friday.

SHIIP’s longtime toll-free number, which still works but is being phased out, is 1-800-443-9354. The new toll-free number is 1-855-408-1212.

The new number is for the entire N.C. Department of Insurance, so callers for SHIIP and Medicare help should choose option “1” on their telephones after reaching the recorded introduction.

During most periods of the year, SHIIP’s call center fields 3,000 to 3,500 calls a month. But during the enrollment period, calls increase to 8,500 to 10,000 a month.

“It kind of overwhelms us,” Braxton said.

Some people calling during the busy period will find they have a 15- to 20-minute wait before a live person is on the line, Braxton said.

He praised the more than 1,000 volunteers in the state who serve as counselors at the coordinating sites. In 2013, they provided help to some 100,000 citizens, representing 56,000 hours of face-to-face counseling, Braxton said.

The SHIIP director said he receives emails and telephone calls on a routine basis from citizens pleased with the service they receive from the call center and the coordinating sites. They often remark, he said, about having “peace of mind” about Medicare after those sessions.

“It’s what is good about government,” Braxton said of SHIIP.

All the information Medicare consumers share is confidential, and the services are free.

Braxton and Schepisi stressed the importance of seniors’ reviewing and comparing Medicare Part D prescription drug plans each year, to make sure they find the plan best for them in relation to the drugs they’re taking.

“It takes just a few minutes,” Braxton said.

The majority of people assisted by the SHIIP call center or through the local coordinating sites find a better Medicare plan and save money, Schepisi said.

Before the personal counseling sessions, Schepisi covered many items, such as the importance of the federal government’s “Medicare & You” books sent to qualifying seniors each year in the mail. “This is your owner’s manual,” she said. “… It’s a great resource.”

Schepisi also touched on programs such as Extra Help, which assists low-income people on Medicare in paying for premiums, deductibles and coinsurance related to prescription drug costs; and the Smart NC program for people between 62 and 65 who qualify for Social Security but do not have health insurance.

In addition, Schepisi stressed the importance of Medicare consumers taking advantage of preventive services that might be available to them such as annual wellness visits, mammograms, cardiovascular screenings, vaccines, diabetes screenings, prostate cancer screenings and glaucoma tests.

She compared it to shopping at a store, filling your buggy, paying at the cashier and leaving the buggy and things you purchased behind.

“Don’t leave your buggy at the cashier,” she said. “Take advantage of these preventive benefits. It’s part of your Medicare coverage.”

Schepisi spoke briefly on Medicare Advantage and things to consider in determining whether it’s right for the Medicare consumer.

From the audience, Harold Poole brought up what Schepisi called “the elephant in the room.”

In late September, some participants covered by Blue Cross and Blue Shield of North Carolina Medicare HMO plans received a letter saying the company was dropping them.

It affected Poole and others within 11 counties including, in this area, Rowan, Davie and Davidson.

Poole wondered whether the decision was based on what hospitals were dominant in the 11 counties.

Schepisi said it probably was more of a financial decision — Blue Cross and Blue Shield determined its Medicare HMO plan in those particular counties wasn’t self-sustaining.

A Blue Cross and Blue Shield spokesman said at the time the counties represented areas “with the most federal government reimbursement impact.”

The company’s action was an effort, the spokesman said, “to offer “sustainable products across the state.”

Braxton said SHIIP determined that some 50,000 Medicare consumers were affected in the 11-county area.

The company was, however, within its rights, Braxton said.

“You have choices,” he told the Medicare consumers in Salisbury, “and they have choices.”

Contact Mark Wineka at 704-797-4263.



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