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Seniors get help sorting out Medicare choices

SHIBA offers one-on-one advice on prescription drug plans.

Bombarded by mailings and pamphlets from insurance companies, it was no wonder Shirley Green couldn’t figure out which Medicare prescription drug plan to sign up for.

“I felt paralyzed,” Green said. “There was so much literature to read, it was just overwhelming.”

And, Green added, she didn’t know what to believe – among a dizzying 46 choices.

Helping senior citizens such as Green pick the right prescription drug plan is a free service of SHIBA, the State Health Insurance Benefits Advisors.

A one-on-one appointment with a SHIBA volunteer is available free at the Bainbridge Island Senior Center by calling the center at 842-1616. Plan sign-ups for those who are now 65 or older must be completed by May 15 to avoid a penalty.

“Most seniors need some kind of coverage,” said Charlene Mizenko, a SHIBA volunteer. “If you aren’t taking prescription drugs you should still sign up to avoid the penalty in case you do need it.”

Green’s new plan saves her $65 a month for her three major medications.

For seniors enrolled in a drug plan, Mizenko expects it to reduce monthly medication costs for seniors to be competitive with pharmaceuticals from Canada. The plans address burdensome drug costs that forced some to choose between medicine and food, or take less than the prescribed dosage.

Plans are offered by private insurance companies and overseen by the federal government.

What drugs are covered, the cost of the premium, the size of the deductible and co-payment vary depending on the plan. For those who struggle with the cost, state and federal help is available.

Although a website is available at www.medicare.gov to assist people with choosing a plan, it’s not enough help for most, and waiting times on the Medicare hotline, (800) 633-4227, average 25 minutes, Mizenko said.

That’s where she and fellow volunteers step in.

Given a list of medications a person is taking, SHIBA volunteers will find three plans that most closely fit the applicant’s need and then process the enrollment once the applicant has picked a plan.

Mizenko even makes house calls. She enjoyed helping one nearly blind woman, living at a local retirement home. Before Mizenko knew it, six or seven of the woman’s neighbors came by for advice as well.

Sign up

To be eligible for the new prescription drug plans, a person must be at least 65 or on Medicare disability or on Medicare and Medicaid, which helps very low-income people. The new plans replace coupons that the state Department of Social and Health Services used to issue.

It is important to note, Mizenko said, that people whose existing insurance does a better job than Medicare of covering drug costs do not need to sign up and should have received a letter informing them so.

Mizenko urges other seniors ages 65 and older to sign up for a prescription drug program as soon as possible. Those not currently on medication can sign up for the least expensive plan – around $6.93 a month – and switch to a different plan later when they do need it, without being penalized.

From her experience, Mizenko says that most people over 75 take at least five or more medications.

And, processing of enrollments is slow, Mizenko said. Because the plan providers are being inundated with sign ups, it takes two to three weeks to get an enrollment acceptance letter that will enable people to use the benefits at the drugstore.

Those who fail to sign up by the May 15 deadline will pay higher premium rates permanently – an additional 1 percent increase to monthly premiums for each month that an eligible person does not sign up.

The next “enrollment period” is not until 17 months later in November or December 2007. That means, with a minimum 17 percent increase. A premium that was $30 a month, would become $35.10 a month.

Those turning 65 have the three months before or after their birthday to sign up.

Though she may be a volunteer, “I get paid every day I work with people,” Mizenko said. “I love helping seniors, and I believe what goes around comes around.”

* * * * *

Choices, choices

To schedule a one-on-one with a volunteer to help you choose a Medicare prescription drug plan, call the Bainbridge Island Senior Center at 842-1616. Bring a list of medication being taken. Or, call the State Health Insurance Benefit Advisors at (800) 562-6900 or see www.medicare.gov.

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