When Kansans become eligible for Medicare, the process can be intimidating. But friendly volunteers are available to guide seniors through the maze of enrollment.
“I see some scared looks,” Erin Petersilie said as her “Medicare Basics” program got underway Tuesday at the K-State Extension office in Great Bend. “Don’t be overwhelmed.”
The Kansas Commission on Aging created SHICK — Senior Health Insurance Counseling for Kansas — to provide information and assistance. A few years ago there were no certified SHICK counselors in Barton County, so Great Bend residents Donna and John Krug took the training. Since then, Volunteers In Action/RSVP Director Linn Hogg and other RSVP volunteers have also earned the certification.
Donna Krug is director of K-State Research and Extension’s Cottonwood District. This week she and Petersilie from the Walnut Creek District in Rush County led the Medicare workshop in Great Bend.
“Medicare really has four pieces,” Petersilie said. Part A is hospital insurance, Part B is medical insurance, Part C includes supplemental policies and Part D is Medicare Prescription Drug Coverage. Parts C and D come from private insurers.
Medicare supplement insurance can help cover the expenses that come with the gaps in Medicare, such as co-payments and deductibles.
There are a number of standard Medicare supplement options — Plans A through N, at a wide range of prices. These and the other many choices are what make Medicare enrollment so daunting for some people. There isn’t one size that fits all.
“You can’t go on what your neighbor has, or even your spouse,” Krug said. “Ask questions.”
One type of supplement that the SHICK counselors do not recommend for area residents is Medicare Advantage — plans like Health Maintenance Organizations and Preferred Provider Organizations.
“Medicare Advantage plans are not an advantage to us here in western Kansas,” Petersilie said.
Parts A and B are consistent, “like a marriage,” Petersilie said. “Part D is a dance.” Each year, people enrolled in Medicare Part D can review their policy, compare the drugs they take to what their insurance company offers, and shop for a better deal.
Who receives Medicare?
Medicare is for three groups of people:
- 65 and older
- Under 65 with certain disabilities
- Any age with End-Stage Renal Disease (ESRD)
Most people 65 and older are enrolled through the Social Security Administration or Railroad Retirement Board.
“If you get Social Security, your Medicare card will come to you and you’ll be automatically enrolled in A and B,” Petersilie said. People who are 65 years old but still working can enroll online.
“You can call Social Security and have someone walk you through it,” she said. Or, a certified SHICK counselor can help. In Barton County, appointments can be made with the Krugs by calling the extension office, 620-793-1910, or by calling the VIA/RSVP office, 792-1614.
“If you’re not retired, you can sign up three months before age 65,” Petersilie said. This is the start of the “open enrollment” period that continues to three months after one turns 65.
When the Medicare card arrives, keep it and accept Medicare Parts A and B, or return it and refuse Part B. Part A has no premiums for people who worked 10 years or more over their lifetime, but Part B comes at a cost; in 2017 it is $134 a month for most incomes.
The option of whether to enroll in Part A but not Part B while still working will depend on the individual, Krug said.
“It’s a big decision. For some it will be cheaper; for some, it’s a big adjustment. A lot of times a Human Resources person at your company can assist you.”
Things to consider with Part B:
• Sometimes you must have Part B. Talk to your employer’s benefits administrator for more guidance.
• With Veterans benefits it’s optional, but you may pay a penalty if you sign up later.
• Delaying Part B may mean higher premiums or paying for your health care out-of-pocket.
Ask your doctor
Not every health-care provider accepts Medicare. When you go to your doctor, there are two questions you should ask, Petersilie said.
The first is, “Do you accept Medicare?” and the second question is “Do you accept assignment?”
If the answer is “yes,” that doctor, provider, or supplier agrees to accept the Medicare-approved amount as full payment for covered services. Those who don’t accept assignment can tack on up to 15 percent, Petersilie said.
Now that Barton County has several certified SHICK counselors, there are people who can steer you to the answers.
At RSVP, Hogg said, knowledge equals the power to choose wisely.
“We save people a tremendous amount of money,” she said. “Medicare enrollment is such a scary puzzle. Just being able to talk it over with someone who is knowledgeable is very beneficial.”
SHICK counselors can provide information and can be reached at the Extension Office in Great Bend, 620-793-1910, or RSVP/VIA, 792-1614.
More information can also be found on the “Kansas Insurance Department Medicare supplement insurance shopper’s guide.” It can be found at the Kansas Insurance Department website, www.ksinsurance.org. Go to the “Help With ...” section and click on “Finding a Publication.” This will take you to several publications on Medicare & Long-Term Care. For questions or assistance understanding insurance issues, contact the Kansas Insurance Department’s Consumer Assistance Hotline toll-free at 800-432-2484.
This story was modified on Aug. 31, 2017, to correct information about Medicare Part C.
Part A Coverage
• Inpatient hospital stays
• Skilled nursing facility care
• Home health care
• Hospice care
• If you worked 10 years or more, no premiums
Part B Coverage
• Doctors’ services
• Outpatient hospital care
• Physical, occupational and speech therapists
• Durable medical equipment
• Deductible - $183 in 2017
• Cost - $134 for most incomes
- Individual annual incomes over $85,000 or married annual incomes over $170,000 pay higher premiums