Retired professionals could work wonders

By Carol Harrison January 02, 2013 05:18 pm

Martha Johnson has one wish for 2103.

She’s hoping the quest for New Year’s resolutions leads a few retired professionals in Del Norte to the doorstep of the Health Insurance Counseling and Advocacy Program.

 “We need to recruit some volunteers, and retired professionals are our best bet because they are able to understand the technical information we deal with and they’re comfortable with computer technology,” said Johnson, the HICAP manager. “Understanding Medicare is not for sissies.”

The program provides free, unbiased Medicare counseling to 30,000 Medicare recipients on the North Coast. In the nine benchmarks HICAP is evaluated on for service, the HICAP for Del Norte and Humboldt counties has the “exemplary” rating that is tops, but Johnson is troubled by those HICAP doesn’t reach.

“We get to about 10 percent of the North Coast beneficiaries,” she said. “We need more volunteers, and we especially need volunteers in Southern Humboldt, in Willow Creek, and in Del Norte.”

Del Norte used to have two volunteers. Now, it’s zero. Nada. Zip. No one based in Crescent City to serve the county’s 5,000 beneficiaries. It’s the same story in many rural areas, where the lack of access to HICAP services can mean hundreds of dollars in additional costs to Medicare beneficiaries who are confused by health insurance plans and options that are ever-changing.

Example: Johnson and the 10 people she supervises, six of them volunteers, are less than three weeks removed from the chaos of Medicare’s annual enrollment period.  

From Oct. 1 through Dec. 7, HICAP conducted 1,455 individual appointments, fielded 1,524 phone calls, and completed nearly 300 Medicare Part D prescription drug plan worksheets. Nearly half of HICAP’s annual caseload takes place in the 10-week race to help clients find the plan that gives them the best coverage at the lowest cost.

“We saved clients $752,000 during that period,” Johnson said. “We saw lots of savings of $1,000, money that people would have had to come up with if they hadn’t used us to help them find a new insurance plan.”

Each year, the prescription drug plans available under Medicare Part D may change their premiums, covered drugs, deductibles, costs, limits, and pharmacy affiliations.  It was not uncommon, Johnson said, to see a monthly premium decrease for 2013, only to have fine print reveal overall costs to be higher.

“It’s gotten so complicated — too complicated — to really find the best plan,” she said. “We’ve had doctors and lawyers who can’t figure it out. Some people can do it themselves on the computer. Others get help from friends and family and some call Medicare directly.”

Another daughter of a beneficiary came in to confirm her findings: that her father’s premiums would go down more than $20 a month in a WellCare plan he was being folded into, but staying in that plan would result in more than $800 in additional costs annually compared to switching to SilverScript.

“You know the saying: if it’s too good to be true it probably isn’t? That was the case with Dad’s plan,” she said. “He was excited when the premiums dropped. Who wouldn’t be? But I told him there had to be a catch.”

She has helped her parents every year since the Part D program started, but this was the first time she asked a friend at HICAP to double-check her work.

“I figured I must have made a mistake,” she said.

Her father got his new enrollment card last week. 

“But we know there are a lot of people out there who were probably happy with their plan this year and even happier when they saw the premium went down,” Johnson said.

She figures they stuck with the 2012 plan and now may get a New Year surprise.

 “They may go to the pharmacy after Jan. 1 and discover the drug they used to pay $20 for is no longer covered and now costs $250,” she said. “They’ll be stuck for the year unless they switch to a generic, find another drug their plan covers, or are dually eligible for Medicare and Medi-Cal and have met either the share of cost requirement or are enrolled in the subsidy offered through Social Security called Extra Help or Low Income Subsidy.”

Those so-called dual eligibles can change plans every month.

“That’s not an option for everyone else,” Johnson said.

Expanding the volunteer base is a must to reach more people, she said.

“Our appointments for the enrollment period are full up by the middle of October, and we start seeing people on Oct. 1 — two weeks before the annual enrollment period formally starts,” she said. “Our volunteers are even taking worksheets home to help more people.”

Johnson said the “crazy time” is over for 2012, but the ever-expanding numbers of people turning age 65 and changes to health care insurance guarantee a busy 2013.

“All HICAPs have a mandate: continuous recruitment of volunteers,” she said. “But it’s not easy work. What we do is like a treasure hunt. We’re trying to find the correct piece of information in a sea of a lot of variables.”

Sifting through the variables can be tedious and repetitive, she said, “but it can also be rewarding to put an extra $80 to $100 a month in someone’s checking account and to help people understand how Medicare works and what choices they have.  We see a lot of gratitude for the help we provide.”

The next volunteer training — 30 hours of intensive preparation — begins in February. Volunteers also receive ongoing monthly trainings.  Call 444-3000 for more information.

Area 1 Agency on Aging paid Carol Harrison to write this article.