Articles / Publications
Chambliss Law Firm Monthly Editorial – November 2016
You're Not Alone in the Medicare Maze
by Amy Boulware, Elder Care Planning Manager, (LAP MSW)
"Have you ever seen so much mail in all your life?" asked Mary Jane as she dumped a box of envelopes, mailers, flyers, and booklets on the table. Mary Jane had come to me seeking help with the world of Medicare choices. To be honest, the box had so much paper in it that we could have probably used it to wallpaper her entire house three times over if we wanted.
Mary Jane was several months away from her 65th birthday, and as a result, her name was on the mailing list of every insurance company that has anything to do with Medicare. She knew there were decisions to be made and these decisions were time sensitive, but that was as far as she got. In fact, she shared with me that her close friends recently had dinner together, and all they could talk about was Medicare and turning 65. None of them felt properly informed, and in fact, they were all frightened— not frightened about the prospect of turning 65, although some might have been, but frightened about making a bad decision and having to live with it for the next 30 years.
There are decisions that need to be made regarding Medicare on a yearly basis, which makes it even more confusing for many seniors. Last week, the Center on Aging at the American Institute of Research (AIR) released a set of issue briefs detailing the complexities of enrolling in Medicare.
"The report finds that as the next Medicare annual open enrollment period approaches—October 15 to December 7—millions of Medicare beneficiaries must decide whether to change their coverage options. This may include switching from original Medicare (Part A and B) to Medicare Advantage, shopping for a new Medigap policy, or changing to a different Part D prescription drug plan. In this qualitative study with volunteer counselors, consumer advocates, and insurance brokers, AIR researchers found that many beneficiaries are overwhelmed by Medicare’s complexity and could benefit from one-on-one counseling to help them make better choices."
Although there are many printed and web-based materials available to help beneficiaries make more informed decisions, beneficiaries may be surprised by Medicare Advantage’s out-of-pocket costs and network limitations. They may be unaware of the limitations on switching Medigap plans back to original Medicare from Medicare Advantage. Beneficiaries may not realize they need to purchase a separate Part D drug policy. For these reasons, it is important for Medicare beneficiaries to seek advice from qualified advocates who are looking out for the individual's best interest and understand how decisions work in the healthcare arena. Many people are used to being in an insurance plan that is employer-based and does not differentiate between family members. This is not the case with Medicare. Medicare is individual. What is good for one spouse may not be the right choice for the other.
In my role at Chambliss as Elder Law and Special Needs Care Manager, I sit down with our clients and assist them with Medicare decisions from start to finish. Clients come to me for education on Medicare options and how Medicare works in a practical sense. I outline what choices are available and help them choose the best solution for their own unique situation. For many clients, having a navigator who is unbiased and who does not sell any of the plans helps them feel more comfortable and confident in the decision-making process.
If you or someone you know is struggling with the Medicare maze, please reach out to me by phone (423.321.0403) or by email (firstname.lastname@example.org).