The open enrollment period for Medicare will continue through Dec. 7 as volunteers with the Statewide Health Insurance Benefits Advisors (SHIBA) take calls and provide information to senior citizens about the basics of the program, prescription drug plans and Medicare fraud.
Mikayla Springbob, the Area Agency on Aging and Disabilities of Southwest Washington’s community services program manager, said the open enrollment period allows people to make changes to their Medicare plan.
“That can mean adding on a Medigap plan, changing to a Medicare advantage plan or just sticking with original Medicare,” Springbob said. “So it’s basically the time of year where you get to re-evaluate your Medicare options and decide what works best for you in the next year.”
Medicare is the primary health insurance for a lot of older adults and the different programs and options can cover a variety of different areas.
“Parts of it are kind of one-size-fits-all and then other parts of it you can really dive down into what is going to be the best fit for you based on your current health care, current status, current coverages and what you anticipate your needs being going forward,” Springbob said.
Springbob explained that original Medicare is “part A” and “part B,” with the former being hospital insurance and the latter being medical insurance. Then there are Medicare advantage plans, which are known as “part C,” that are bundled plans that include part A, part B and part D, which focuses on insulin costs. The advantage plans require being in network and can have lower out-of-pocket costs. They offer extra coverage benefits like vision, hearing and dental, Springbob said.
Medigap is Medicare supplemental insurance sold by private companies, which helps fill gaps in the original Medicare plan, like paying for co-payments, co-insurance and deductibles. The plan also applies to the part A and part B original Medicare plan.
“Medigap and Medicare advantage are different, and so that’s one of the ways that the SHIBA program can actually really help people is our volunteers are trained in the differences in those programs and they can help somebody kind of walk through which program option is going to be the best for them based on their circumstances,” Springbob said.
She said an obstacle seniors often face is how convoluted Medicare can be.
“It’s a really big, unwieldy beast, and … when you go down a rabbit hole on it, you can end up somewhere kind of far from where you started, and so unfortunately it is not designed in such a way to make it easily accessible to folks. It’s very confusing,” she said.
Springbob also noted inflation has increased, while Social Security has stayed relatively the same, which has made it harder for some people to pay for Medicare. She said one solution is to make people aware of programs that help assist people. Those include extra help or a low-income subsidy program, which helps with the costs associated with Medicare.
Since the COVID-19 pandemic has made people more isolated, Springbob believes it has limited people’s access to information regarding Medicare since in-person meetings became less frequent. Many older adults have trouble using computers or accessing the internet so Springbob said the technology barrier creates added challenges for some people who are looking to access information.
Thanks to new laws, some changes are on the horizon. The Inflation Reduction Act will change Medicare part D insulin costs, which will start in January 2023. Springbob said the act declares that Medicare plans cannot charge more than $35 per one month’s supply for Medicare part D-covered insulin and also can’t charge a deductible for insulin, which she said will be a “huge factor” for a lot of older adults.
For more information, call the Area Agency on Aging and Disabilities of Southwest Washington at 360-735-5720 or reach out to SHIBA at 800-562-6900.