MEDICARE MAZE

Jun. 20--Turning 65 later this year? It's never too soon to study all the Medicare options.

Be prepared to spend some time. The Medicare maze has flummoxed many people.

In 2017, the Medicare Rights Center, a national advocacy group, reviewed 16,000 calls and found many seniors didn't know how to enroll in and navigate Medicare Part B, an important component of Medicare that covers outpatient and doctor visits. They also were confused by other important parts of the Medicare system.

"This analysis of our national helpline data makes clear that too many people with Medicare struggle to navigate the complexities of the Medicare program and to afford their coverage," Joe Baker, president of the Medicare Rights Center, said in a March 2, 2017, press release.

Medicare has been described as alphabet soup. There's Medicare Part A, B, C and D. Then, in Kentucky, there are supplemental plans A, B, C, D, F, G, K, L, M and N.

Mike Harl of Owensboro went on disability three years before he turned 65, the age when seniors enroll in Medicare. Harl, now 68, takes heart and diabetes medications.

He couldn't make heads nor tails of the Medicare system, so he went to someone he trusted -- Dana Peveler, executive director of the Senior Community Center of Owensboro-Daviess County. Harl volunteers at the center and knows Peveler.

When it comes to Medicare, she received training at the Green River Area Development District. Many seniors come to her for assistance, especially during open enrollment periods.

In the end, Peveler's knowledge of the Medicare system helped Harl receive excellent benefits for reduced monthly payments.

"She got me a lot of help I wouldn't have gotten on my own," Harl said.

Medicare and its insurance options change often, Peveler said. She recommends that seniors review their Medicare insurance coverage annually.

AARP reported in November 2017 that older citizens are more likely to comparison shop for cable TV services and gasoline than Medicare insurance plans. According to AARP, only one-third of older Americans shop around for the most cost-effective health insurance plans, as compared to 54% who compare prices before buying groceries.

Lee Ann Edmonson is the program assistant for GRADD's State Health Insurance Assistance Program. Edmonson, of Owensboro, works Mondays, Tuesdays and Wednesdays only. It's her job to help residents understand their Medicare coverage and options.

A lack of knowledge can cost seniors a lot of money, Edmonson said. For example, if people don't enroll in Medicare Part B (outpatient and doctor visits) at the right time, they can face penalties the rest of their lives and risk a gap in coverage down the road.

When seniors turn 65, they have a seven-month window -- three months before their birthdays, the month of their birthday and three months after -- in which to enroll in Medicare. Even those who continue to work and depend on their employers' health plans beyond age 65 need to enroll in Medicare Part A and delay Part B until they retire.

"Once they retire, they have eight months to pick up Part B without a penalty," Edmonson said.

She recommends enrolling in Medicare at least a month before turning 65 so there are no delays in coverage.

She helps people decide whether Medigap or Medicare Advantage would be best for them. And she assists with decisions about the many supplemental plans available in Kentucky.

"You really want to make sure you get on the best Medicare supplement plan you can afford during your initial open enrollment period because the next year you have to be underwritten," Edmonson said.

That means insurance companies can request up to five years of medical records and ask lifestyle questions, which may raise monthly premiums.

Those who started drawing Social Security prior to their 65th birthday are automatically enrolled in Medicare.

Even Medicare Part A, which covers hospitalization, can be confusing, Edmonson said.

Part A has a deductible of $1,364 this year. That covers one to 60 days in the hospital. However, if a patient is readmitted to the hospital after a period of six weeks, the $1,364 deductible applies again.

It is possible for a patient to pay the Part A deductible several times in a year.

Also, many people assume Medicare Part A is free for all seniors. That's true for people who worked at least 40 quarters or 10 years. However, for those who worked 30 to 39 quarters, the cost is $240 a month. Seniors who worked less than 30 quarters pay $437 a month for their coverage.

Edmonson can help residents apply for the Medicare Savings Program if they earn 135% of the federal poverty level, or a one-person household that earns $1,425 a month or a couple that earns $1,922 a month. The Medicare Savings Program waives the $135.50 monthly Part B premium.

Seniors who want to learn more about Medicare can visit Peveler, Edmonson or go to medicare.gov.

AARP (aarp.org) and the Medicare Rights Center (medicarerights.org) offer a variety of information as well.

Renee Beasley Jones, 270-228-2835, rbeasleyjones@messenger-inquirer.com

___

(c)2019 the Messenger-Inquirer (Owensboro, Ky.)

Visit the Messenger-Inquirer (Owensboro, Ky.) at www.messenger-inquirer.com

Distributed by Tribune Content Agency, LLC.