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February 11, 2010

Senior Focus: Help with Medicare

By KATHLEEN GEST

President Lyndon Johnson made big promises when he signed Medicare into law in 1965.

"No longer will older Americans be denied the healing miracle of modern medicine," he said. "No longer will illness crush and destroy the savings they have so carefully put away over a lifetime so they might enjoy dignity in their later years ..."

Health care issues in the United States intensified in the early part of the last century. It took decades of national debate and the consideration of various approaches -- sound familiar? -- before one of the most important acts of the post-World War II era came to fruition.

Medicare provided health insurance to Americans age 65 or older and, eventually, to people with disabilities. For its part, Medicaid provided federal matching funds, so states could provide additional health insurance to many low-income seniors and people with disabilities.

Even though federal programs fund both, Medicare and Medicaid are very different.

Medicaid is for low-income, financially needy people, set up by the federal government and administered differently in each state.

Eligibility for Medicare is not tied to individual need. Rather, it is an entitlement program. However, after several revisions of the federal Medicare program, trying to understand Medicare in general and its parts in particular can be a frustrating experience.

Breaking Medicare into "parts," such as Medicare Part A, Part B, Part C and Part D, helps recognize the differences in these plans but it doesn't make the plans any easier to understand.

That's where the Traverse City Senior Center comes in -- making Medicare easier to understand and less frustrating.

The senior center has taken on an advocacy role by sponsoring volunteer Medicare/Medicaid counseling for seniors every Tuesday. Analyzing Medicare and Medicaid may seem daunting, but the more information you have, the more prepared you will be to make the right decision for you.

Karen Rogers, the counselor at the senior center, trained at the Area Agency on Aging. She is certified in the State of Michigan Medicare and Medicaid Assistance Program, which is Michigan's answer to the national network of State Health Assistance Programs. Rogers is also certified in the national network.

"The course was a-four day training period," Rogers said. "I take part in refresher courses three or four times a year, which keeps me up to date on everything. I use to work in a doctor's office and do insurance billing, so I had gained knowledge of the Medicare plans in that way also."

MMAP is a free service, designed to provide unbiased guidance, enabling seniors to find answers to their health insurance questions. The counselors are not affiliated with any insurance company or agency and they do not sell insurance. They are volunteer counselors who have completed intensive training to offer objective assistance in complete confidentiality.

The original purpose in having a counselor at the senior center was as an outreach program to assist lower-income seniors in applying for Lower Income Subsidy. However, the counseling sessions quickly became valuable to all seniors, whether they were on Medicaid or Medicare.

Besides counseling low-income seniors, Rogers also assists people with their Medicare coverage, supplements to coverage and the drug program, and helps seniors apply for Medicare savings programs, explore long-term care insurance options, report Medicare fraud, and help with problems that occur with any of the programs.

"Medicare is a difficult thing ... it's confusing, I think, especially when you read about the drug plans and even the difference between a supplement plan and the Medicare Advantage plan," Rogers said. "A lot of people don't understand. We only wish more people would come to us."

In a nutshell, Rogers' -- and the goal of the Traverse City Senior Center -- is to help seniors feel secure, get the plan that is right for them, save money on their plan and make understanding Medicare less frustrating.

Senior center members and non-members are eligible for appointments. Call 922-4911 or e-mail at: lwells@tcseniorcenter.com.

Kathleen Bellaw Gest is a freelance writer, who has been published in several local publications.

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