Amid all the news reports and pundit chatter bouncing around about government health care sign-ups, there’s another health care deadline that’s largely being ignored: Medicare.
This Saturday – Dec. 7 – is the annual deadline if you want to make changes in your current Medicare coverage. For those 65 and older (or younger recipients of Social Security disability), it’s a chance to switch carriers or coverage – but only if you need to.
But many seniors are stymied this year, due to all the noise and attention focused on the Affordable Care Act deadlines, say Medicare experts.
“There’s definitely a lot of confusion and misinformation out there,” said Elaine Wong Eakin, executive director of California Health Advocates, the state’s nonprofit Medicare information and advocacy center.
“Some people think they need to sign up for coverage. Worse, some have been told they’ll be penalized or even incarcerated for not buying a (Affordable Care) plan,” said Eakin.
None of that’s true, of course. Generally, you don’t need to make a change in your Medicare coverage, unless you want to switch providers or your prescription drug plan (Part D).
In some counties, your current provider may have dropped its plan, in which case you would have received a notice by the end of September. Or in other locations, like San Joaquin County, there may be new providers coming in, making it advisable to compare your current plan with other options.
“The No. 1 concern should be: Can you afford your meds (prescription drugs) and is there a plan that might be better?,” said Margaret Reilly, program manager for the Northern California office of the Health Insurance Counseling & Advocacy Program, known as HICAP.
Where to get answers
All 58 California counties are covered by HICAP offices, which offer free one-on-one appointments for counseling on Medicare enrollment. In the Sacramento region, the local HICAP office covers residents of nine counties: El Dorado, Nevada, Placer, Sacramento, San Joaquin, Sierra, Sutter, Yolo and Yuba counties.
But with the Dec. 7 Medicare deadline just days away, most of California’s HICAP centers are fully booked and not taking new appointments.
“We have a small number of appointments available in certain sites,” said Reilly. “We’ll respond to calls but it could take several days.”
At this point, she said, the best place to get help and compare Medicare plans is the official federal website: www.medicare.gov. Seniors can, for instance, compare plans offered in their county, as well as plug in their current medications to see which prescription drug plans work best.
Seniors can also call the (800) MEDICARE (633-4227) help line, but be prepared to wait.
“It’s not uncommon to wait on hold for 30 minutes, so be patient,” said Reilly. For those on the West Coast, she said, the best time to call the federal Medicare office is early morning or late at night. The 800 line is usually staffed 24 hours a day, seven days a week, she said.
Beware of scams
Especially during health care enrollment periods, seniors are warned to be wary of scam artists posing as Medicare advisers or benefits counselors. Typically, the callers offer to get your Medicare premiums reduced, issue a new Medicare card, arrange for medical equipment/services or handle enrollment issues. They try to get unsuspecting seniors to disclose their Medicare, bank account or credit card numbers.
In almost every case, those calls are fraudulent, said Reilly. To report an attempted Medicare scam, call the “Senior Medicare Patrol” (details below), a nationwide, free reporting line funded by the U.S. Administration on Aging.
Sit back, relax
The majority of seniors currently enrolled in Medicare can sit back and ignore the Dec. 7 deadline, says Reilly.
“If they’re happy with their current provider, like their doctors and don’t find their co-pays burdensome, they’re probably fine,” she said. “If you don’t need to make a change and are happy with what you have, relax. You’re covered.”
MEDICARE: WHERE TO GET HELP
All 58 California counties offer free counseling on Medicare enrollment through the Health Insurance Counseling & Advocacy Program. In the Sacramento region, the local HICAP office covers nine counties: El Dorado, Nevada, Placer, Sacramento, San Joaquin, Sierra, Sutter, Yolo and Yuba counties. For help, call (916) 376-8915. For other California counties, call (800) 434-0222. Online, go to: www.cahealthadvocates.org (search for HICAP).
California Health Advocates
The state’s nonprofit advocacy and information center on Medicare topics. It does not take consumer calls, but its website, www.cahealthadvocates.org, has helpful details and Q&As on numerous Medicare topics.
The federal government’s official website has Q&A advice and online tools for comparing Medicare plans, based on your ZIP code. Or call its help line: (800) 633-4227 (MEDICARE).
Senior Medicare Patrol
Part of a nationwide federal program, teams of trained volunteers help seniors who suspect they’ve been the victim of actual or attempted Medicare scams. In California, call toll-free: (855) 613-7080. Nationally, call (877) 808-2468 or go to: www.smpresource.org