Free seminars help seniors choose the right coverage Medicare Mysteries

November 3, 2011 at 12:00a.m.

WHERE TO GET FREE HELP

Many places offer free help to people who are signing up for a Medicare plan. Consider these:

Free one-on-one counseling is available through the Medicare/Medicaid Assistance Program, a statewide organization that works in partnership with Medicare to explain options. You can attend a seminar, or you can get an individual appointment or phone consultation with a trained counselor. The focus of these seminars is to provide helpful, impartial information. Call 800-803-7174.

Call 800-MEDICARE (800-633-4227) for a booklet on Medicare options, including a detailed explanation of covered benefits and monthly premiums of plans. The site also gives star ratings for many of the Medicare plans. If you need individual help, you can call the Medicare hot line to talk to a counselor who will help you search for options over the phone and will mail you a summary of what you discuss. You also can go to www.medicare.gov and do the comparison yourself.

Retiree groups for large work forces, such as automakers, also may have Medicare meetings. So do companies that specialize in advising consumers, companies and unions on insurance benefits.

Talk to your pharmacist. Many offer in-person or online help. CVS pharmacies, for example, offer an online Medicare Part D calculator that gives comparisons of Part D plans at www.cvs.com/medicare.

Try other online tools. EHealthInsurance.com, an online source for health insurance, has help at www.eHealthMedicare.com. The site offers various services to compare Medicare plans, as well as a counseling line at 866-646-7654.

By Patricia Anstett

Detroit Free Press

DETROIT

Keith Gresham, a self- employed painter who hasn’t had health insurance for nearly a decade, couldn’t wait to turn 65 this year. It meant that he was finally eligible for Medicare.

“It was a godsend,” said Gresham, of Detroit, who is catching up on getting healthy after skipping yearly physicals and dental cleanings and not buying the new eyeglasses he needs.

Trouble is, the federal program that insures 47.6 million Americans is confusing to him and millions of others. Health insurance, after all, is an industry with complicated terms, dozens of products and rules and benefits that change frequently.

The task of choosing a Medicare plan is a new one for millions of baby boomers such as Gresham. He is getting free counseling about his options through a network of seminars scheduled through December through the federally funded Medicare/Medicaid Assistance Program.

The events allow seniors to sit with counselors for one-on-one advice about the best plans for them by comparing the price of drugs a senior uses and other benefits. The seminars also help eligible seniors apply for financial help for Medicare programs, including programs that give deep discounts or even free medicines to low-income seniors.

That help, along with a much-improved Medicare website (www.medicare.gov), are among the new or expanded offerings for this fall’s Medicare Open Enrollment season — the annual time when most seniors can make changes in their plans for benefits they will receive in 2012.

This year, open enrollment began Oct. 15 and runs through Dec. 7, earlier than previous years.

There are other important changes, including:

Gold-star ratings. For the first time, Medicare is giving gold stars to easily identify the best plans. Ask about a plan’s rating or look up the information on the Medicare website. The site also lets users chart their Medicare spending and medical appointments.

Expanded preventive benefits. Medicare now provides nearly two dozen free prevention services, including a yearly wellness exam, a visit that covers many but not all measurements of a routine physical. Some services, such as mammograms, flu shots and glaucoma tests, are covered yearly while others — such as heart screenings every five years and colonoscopies every 10 years — are covered less often.

More benefits and lower or steady costs for Medicare Advantage (Part C) plans. Medicare Advantage plans, which are all-in-one plans with more extensive benefits, are growing and hope to enroll more seniors with expanded wellness and other services — from discounts on glasses and hearing aids to coupons on vitamins, car rentals and sporting events.

Some examples: United Healthcare is adding heavily discounted prices on hearing aids. Health Alliance Plan has added worldwide emergency services for its Medicare Advantage and supplemental Medicare beneficiaries. Priority Health now will pay for some dental coverage and give seniors a chance to get other dental care at a higher cost.

Nationwide, these plans are growing steadily, particularly among baby boomers more comfortable with getting health care through networks that may limit their choice of a doctor or hospital, yet provide counseling for chronic diseases and other services, said Mark Owen, vice president overseeing Medicare for Blue Cross.

Bigger discounts are in store for Part D prescription plans. As it moves to eliminate large out-of-pocket costs for drugs, Medicare will give seniors who reach a spending limit known as the doughnut hole a 14-percent discount on generic drugs and a 50-percent break on brand-name drugs. Other plans have teamed up with drug and retail chains to keep prices low.

For example, the Humana Walmart-Preferred Rx Plan offers a $15.10 per month Part D plan, with copayments for preferred generic drugs as low as $1, after deductibles are paid, and no co-payments after deductibles for prescriptions filled through Humana’s mail-order service.

Aetna and CVS also have a new, $26-a-month prescription-drug plan in 43 states that offers no deductibles for generic drugs. Out-of-pocket expenses are as low as $3 for preferred generic drugs and $10 for non-preferred generic and brand-name drugs.