Medicare enrollees in search of a free, unbiased and informed look at the myriad of health care options for people 65 and older can once again turn to the trained staff and volunteers of the Council on Aging – Southern California.
But unlike in years past, they won’t be able to meet in person to go over the coverage and plans being offered for 2021.
All one-on-one sessions that the Council on Aging will offer as part of the Health Insurance Counseling & Advocacy Program, known as HICAP, will be conducted by phone. Same with community education forums that are planned; they’ll be done using Zoom.
The change is due to coronavirus health and safety measures.
Virtual realities
Senior centers and Council on Aging offices in Orange, Riverside and San Bernardino counties have been closed to in-person visits since March. The nonprofit’s staff members, and the volunteers who assist in answering questions about Medicare, are all working remotely.
The annual Medicare enrollment period isn’t changing, though. It begins Oct. 15 and ends Dec. 7, a time to explore all the benefit and plan options available in order to choose a provider and coverage that works best.
The Council on Aging encourages anyone eligible for Medicare to contact them now and schedule appointments ahead of time for the enrollment period.
The nonprofit is getting the word out in newsletters published by senior centers, via fliers included with food box and home-bound lunch distributions, posting on county government and 2-1-1 websites, or mailing letters directly to existing clients. Senior centers also will serve as the virtual nexus to engage people in the community education forums.
“We’re contacting everyone we know to let them know we are still here and still taking people over the phone,” said Tamiko Perry, HICAP program manager for Riverside County.
One-on-one sessions are blocked out in one-hour increments, Monday through Friday, between 9 a.m. and 4 p.m. If more than one Medicare beneficiary in a household wants counseling, separate appointments are required since individual needs and coverage may differ.
For more information on appointments, go to the Council on Aging’s HICAP page at coasc.org/programs/hicap/. The Orange County office has a dedicated line to call for appointments, at 714-619-4361. In Riverside and San Bernardino counties call 909-256-8369 .
Los Angeles County residents can get free Medicare counseling services through the Center for Health Care Rights, also only by phone. Call 800-824-0780.
There’s also a statewide number to call to be steered to the appropriate HICAP office: 800-434-0222.
What’s new for 2021?
There are two significant changes coming up that will affect certain people, said Linda Cardoza, HICAP program manager in Orange County.
One new program affects those who take insulin.
Medicare in 2021 will include certain drug plans and Medicare Advantage plans that will help with the cost of insulin, a drug used by diabetics. In the United States, the price of the most commonly used forms of insulin has skyrocketed over the past two decades, to the point where it costs 10 times as much in the U.S. than in other countries, according to a 2019 Mayo Clinic analysis.
Cardoza said that updated information on Medicare plans will be released next week and the Council on Aging will be able to determine then which plans will offer the special program, known as the Senior Savings Model, that lowers the cost of insulin.
The other major change impacts people with kidney disease or end stage renal disease. Rule changes for 2021 will allow them to enroll in Medicare Advantage programs, which are offered by private insurers, such as Kaiser Permanente or SCAN, to cover Parts A and B of Medicare, and can include prescription, vision, dental and other perks.
Those beneficiaries will need to understand what the copays for dialysis will be under Medicare Advantage plans and other differences from original Medicare coverage, Cardoza said.
Solicits arrive in bunches in the mail this time of year from private insurers with their own financial interests at play. The services offered through HICAP are intended as advocacy on behalf of Medicare recipients.
“We are here to help people make an informed decision on their coverage,” said Dimitri Lara, who started out as a volunteer four years ago and is now HICAP program manager for San Bernardino County. “We’re not biased.”
Savings to be had
November has traditionally been the busiest month for HICAP services.
Last year, the Council on Aging helped about 1,300 people in Orange County with Medicare choices in November. The Inland Empire office, located in Rancho Cucamonga but serving both Riverside and San Bernardino counties, assisted a total of 254 people in 2019.
For many Medicare recipients, the prescription drug plan can be the most expensive part of their coverage, Cardoza said.
“This is the time to look at it and see if it makes sense to make a change.”
There have been instances of HICAP counselors helping Medicare recipients save upwards of $10,000 in drug costs by switching plans.
Before, when face-to-face counseling took place, people were asked to bring their medications with them in a paper bag so that the HICAP counselor could see the prescriptions, frequency taken and dosages before checking formulary charts and drug costs of available plans. This year, that information has to be communicated over the phone.
If specially requested, Zoom chats can be arranged. But security risks – because volunteers are using their own cellphones – and confidentiality concerns may limit Zoom capability, Cardoza said.
One-stop My Medicare accounts that beneficiaries can set up on Medicare.gov allow beneficiaries to view all their prescriptions, claims and payment status, and other personalized data. Such accounts could be a visual help in remote counseling, but not everyone has created one.
In any case, people with long prescription drug lists will be asked to mail or email that information in ahead of their counseling appointments, Perry said.
“It’s going to be really tricky this year.”
Source: Orange County Register
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