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TownTalk: Preparing For Medicare Open Enrollment

Open Enrollment for Medicare begins next week – a time for people to evaluate their plans and coverage and to make changes if needed. Insurance can be complicated, but Lisa Barker said the state’s SHIIP counselors can help Medicare beneficiaries make sense of the different plans that are available.

SHIIP – Seniors Health Insurance Information Program – is a consumer information division that operates under the N.C. Department of Insurance. Barker is SHIIP’s Northeast regional manager. The open enrollment period runs from Oct. 15 to Dec. 7.

There are SHIIP coordinating sites in each of the 100 counties across the state, she said. “We are not insurance agents and we don’t sell insurance,” Barker told John C. Rose on Wednesday’s TownTalk.

Rather, SHIIP counselors assist people who do receive Medicare with questions they may have, whether it’s Medicare, Medicare Part B, supplements or understanding long-term care insurance.

“We provide a non-biased comparison for those shopping” for new plans or who just want to make sure they’re getting the best coverage at the best price, Barker said.

With 2.3 million Medicare beneficiaries in the state, Barker said it’s important to understand that it’s important to review plans and coverage each year. Here is a list of phone numbers for coordinating sites in the four-county area:

By sitting down with a SHIIP counselor, Barker said individuals can review their current medications and physicians to make sure they don’t need to switch to a different plan.

“Medicare beneficiaries can compare all the plans and determine if they want to switch for the new year,” she explained.

“We can assist enrolling them in a new plan,” Barker continued. “Even if they’re happy with their current plan, it’s just a good idea to come in and talk – just so you know your money is being spent in the best way possible.”

Changes must be made by Dec. 7 to guarantee coverage continues without interruption on Jan. 1, 2023.

“Medicare plans and prices change, N.C. Insurance Commissioner Mike Causey said. “It is important for Medicare beneficiaries to take advantage of the Open Enrollment period by contacting local SHIIP counselors to save money, improve your coverage or both.”

Make sure you contact your local SHIIP counselor before deciding about coverage because you may be able to receive more affordable and better Medicare health and/or drug plan options in your area. For example, even if you are satisfied with your current Medicare Advantage or Part D plan, there may be another plan in your area that covers your health care and/or drugs at a better price.

Barker said she’s been involved in SHIIP in one way or another since 1998. She recalled an older couple who came to her a few years ago to review their plans. Plans had changed since they were initially enrolled in Medicaid, and their monthly premiums were going from $17 to $60.

Upon review of medications and copays, Barker said, the couple could continue with their current plan, but it would be much more expensive. Barker helped them find a new plan, which saved them more than $6,000 a year – and had lower copays.

“I tell this story often because, for them, it comes down to the cost of insurance versus food and electricity…the hugs from them and the relief on their face was priceless,” she added.

Making an appointment with a SHIIP counselor is one way to stay updated and educated on the changes in Medicare and the all the other pieces of the insurance puzzle.

But Barker cautioned individuals about sharing their personal information with others who claim to be working on your behalf, but who may really be trying to gain that personal information to be used in fraudulent ways.

“You want to make sure you’re protecting yourself,” she said. “If they’re asking you for too much personal identifying information,” be wary.

“The North Carolina Department of Insurance or SHIIP is never going to go door-to-door asking for information,” she said. Make sure you’re not giving out that information to someone who contacts you – whether by phone, personal visit, email, text or other written correspondence.

“If you have questions about something you received that is questionable, that’s a really good time to reach out to SHIIP, 855.408.1212.

Roughly $68 billion is lost each year to Medicare fraud.

Individuals also should regularly review their Medicare Summary Notices to verify that all charged listed are actually for the services that were provided by your healthcare professionals.  Ask questions if you think something looks suspicious.  It doesn’t hurt to question a charge.  Also, simple mistakes can happen.  When typing the number 10 someone could accidently hit the zero a second time and make the charge 100.  SHIIP can help individuals file a Medicare fraud claim.

Visit www.ncshiip.com to learn more.

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