Questions to consider if you’re choosing a Medicare plan

Oct. 23--Confused about Medicare?

It's not just you.

Listen to Joel Stich, senior director of government markets at Blue Cross and Blue Shield of Minnesota:

"I've been doing this now for 11 years but can actually say it is very complicated," Stich said last week.

Or Jacob Roberts, Medicare and retirement sales director for United Healthcare: "Medicare definitely is confusing," he said. "We recently did a survey and found that two out of every five seniors had a poor understanding of how Medicare works."

If Medicare -- the government health insurance plan for people 65 and older -- is confusing, it's little wonder that the annual election period we're in now can make heads spin.

Adding to the confusion, for many, are a couple of wrinkles that are affecting this year's Oct 15-Dec. 7 enrollment period.

First, in much of Minnesota, the popular Medicare Cost Plus plans are gone, meaning a lot of Minnesotans are shopping for new plans. Cost Plus still is available in 21 counties, including all of Northeastern Minnesota, but errant information distributed ahead of the enrollment season led beneficiaries to believe the change affected the entire state.

Second, those on the EssentiaCare plan offered by UCare received letters saying their plans wouldn't be renewed, followed by letters saying the plan was being expanded to Wisconsin and that Minnesota residents could re-enroll.

Cost plans

More on that later, but first Cost Plus. It's a form of Medicare plan that originated in the 1980s but that the federal government has been pulling away from, said Brian Eck, associate vice president of sales at UCare.

The first legislation to end the plans was passed in 2003, Eck said, and final rules to sunset them came out in 2015. They had the plans ending this year, with the exception of counties where less than two of the Medicare Advantage plans were available as an alternative. That's why in 21 Minnesota counties, people can keep Medicare Cost Plus.

This is a much bigger deal in Minnesota than it is anywhere else. Across the nation, only about 600,000 people have Cost plans, Roberts said, and 400,000 of those are in Minnesota.

Why they're so much more popular here than elsewhere is a bit of a mystery, Eck said. But several of the people interviewed for this story said snowbirds -- Minnesota senior citizens who spend the winter in warmer places -- have something to do with it.

Cost Plus plans often come with generous travel benefits, said Marjori Bottila, contact center coordinator in Duluth for Senior LinkAge Line, the Minnesota Board of Aging's free information and assistance service. "It meant that when somebody from Minnesota was in one of the Cost plans, they could be a snowbird and be living somewhere else and be virtually getting the same coverage at the same cost."

Advantage Plus plans are supposed to offer similar costs and benefits, Bottila said, but there could be differences in the details.

In any event, the change doesn't affect Northeastern Minnesota. But letters from the U.S. Centers for Medicare and Medicaid Services and Blue Cross Blue Shield wrongly informed residents that it did, said Buddy Robinson, staff director for Minnesota Citizens Federation Northeast and co-coordinator of the Greater Minnesota Health Care Coalition.

The misinformation was corrected quickly in follow-up letters, Bottila said, but some uncertainty remained.

"When they get these letters, they still want to talk to another person," she said. "Because it's confusing -- and/or if they've already been used to using a certain service like Senior LinkAge Line, they want to hear it from us, too."

Likewise, employees at the Blue Cross Blue Shield retail center in downtown Duluth report a number of individuals coming in to be reassured that they can keep their plans, Stich said.

EssentiaCare

EssentiaCare, meanwhile, is a Medicare plan marketed to Essentia Health patients, Eck said. The complication this year was that UCare expanded the plan to include Wisconsin residents. But because of regulatory requirements, that meant they had to cancel the existing plan and offer a new plan available in both states.

The unfortunate result, Robinson said, was that EssentiaCare beneficiaries received letters dated Oct. 2 saying their plan wouldn't be offered in 2019. About a week later, the same people received letters explaining that the plans still would be available, but they'd have to re-enroll to continue their coverage.

"It's parallel to the people on the Cost plans and the scare that they got earlier this year," Robinson said.

Eck said UCare was aware the letters might cause some confusion. Because of that, UCare tried to call all of its EssentiaCare beneficiaries before the letters came out. "Unfortunately, we did not get ahold of 100 percent of the people," he said.

Medicare shopping

The upshot of all of this is that Medicare beneficiaries in Northeastern Minnesota don't have to change their plans this year if they don't want to. But it's a good idea to shop around anyway, experts say.

"Even if you're happy with your plan, it's good to make sure that your plan is still going to meet your needs," Roberts said. "Things can be added or removed. New plans can come into the market that might better serve your needs."

People tend to focus on premiums, Eck said, but he and others interviewed for this story said there are additional question that ought to be asked:

--Will my prescription drugs be covered?

"Just this week we had someone who was covered by a Part D plan but a really expensive drug that they were taking was not covered," Bottila said. "Just putting them in a new drug plan -- literally, if they had stayed where they were at they were going to pay $15,000 more a year."

--Are your providers in the plan's network?

"Does it work with my doctor's office, my clinic?" Bottila asked. "Does it work with my pharmacy? ... You could find the best plan, (but) you don't want to change your doctor or your pharmacist."

--What do you want in your plan?

"Something like hearing aid benefit or gym membership -- is that something that's important to you?" Roberts asked. "It's really what you want out of a plan."

--What happens if I'm out of town and need care?

"It's going to matter to snowbirds, certainly," Bottila said. "Of course everyone by law is going to get urgent and emergency care. But what if ... you do live somewhere for several months regularly and you want to do some basic doctoring? If paying out of pocket or higher co-pays isn't a concern, that's OK, too, but for the majority of the people, it is a concern."

Black Monday

Although some Medicare beneficiaries have made their choice for 2019 already, many are waiting, the experts say.

"We kind of are a people that overall like to wait," Bottila said. "When we start to get closer to the end of an enrollment period, call volume is increasing. You might put off something that is unsavory."

Both Stich and Eck said they've traditionally noticed an upswing in enrollments just after Thanksgiving. It appears some parents like to talk over their options with their grown children who are home for the holiday, both suggested. Eck said all of the UCare sales team is on the job on Black Friday, expecting a heavy influx of calls.

For Blue Cross and Blue Shield, it's even heavier three days later, Stich said.

"Instead of Black Friday, we kind of see a Black Monday," he said.

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Medicare information

Several insurers and agencies provide workshops and other service to help both beneficiaries during the open enrollment period and those who are entering the program for the first time.

Here's a partial list of what's coming soon:

--Senior LinkAge Line offers one-on-one sessions by appointment on specific days and at specific places. Coming next month -- Nov. 1 at Our Savior's Lutheran Church, 4831 Grand Ave.; Nov. 7, 14, 21 and 28 at the Missabe Building, 227 W. First St., Suite 103. To schedule an appointment, call (800) 333-2433.

--MN Citizens Federation NE is offering one-and-a-half-hour seminars on how to comparison shop for Medicare policies at the following times, dates and places: 2 p.m. today at Portman Community Center, 4601 McCulloch St.; 1 p.m. Thursday and 7 p.m. Monday at Peace United Church of Christ, 1111 N. 11th Ave. E.; 7 p.m. Nov. 1 and 2 p.m. Nov. 5 at Hope United Methodist Church, 301 W. St. Marie St. There's an attendance fee of $25 per household. For more information or to register, call or email (218) 727-0207 or [email protected].

--UCare is offering "enrollment fairs" at 10 a.m. Thursday at Pier B Resort, 800 W. Railroad St.; and at 10 a.m. Saturday and 10 a.m. Nov. 3 at its Hermantown location, 4310 Menard Drive, Suite 600.

--Blue Cross and Blue Shield of Minnesota has frequent Medicare workshops at its Duluth retail center, 425 W. Superior St. Visit www.bluecrossmn.com or call (855) 579-7658.

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