How Medicare counseling can help you navigate the open enrollment period

This article was written for our sponsor, Kerr-Tar Area Agency on Aging.

The Medicare open enrollment period runs through Dec. 7, which means now is the time to enroll in or update coverage.

Because there are so many options when it comes to Medicare, you may be wondering exactly what to do. Should you enroll in Original Medicare or a Medicare Advantage plan? Do you need a Medicare supplement? Which Part D coverage do you need?

Fortunately, whether updating or enrolling for yourself or a loved one, you don't have to make these decisions alone. Free Medicare counseling is available to North Carolina residents through the Seniors' Health Insurance Information Program.

Here are answers to some questions you may have about the program and the Medicare open enrollment period.

What is the Seniors' Health Insurance Information Program?

SHIIP is a consumer information division of the North Carolina Department of Insurance, with the following goals:

• Help Medicare beneficiaries and their families understand the insurance products and services available.
• Give free, unbiased and factual health insurance information.

SHIIP has paid and volunteer counselors who are dedicated to helping those who qualify navigate the Medicare system.

Who is eligible to enroll in Medicare during open enrollment?

For those who were already enrolled in Medicare, they're able to change their plan during this time. For those who haven't enrolled before but are age 65 or older, or have been on Social Security disability for at least two years or have end-stage renal disease, you are eligible to enroll, according to Medicare.

Any changes made will take effect Jan. 1.

If you are enrolled in a Medicare Advantage plan, there is a second open enrollment period from Jan. 1 to March 31. Any changes made during that time take effect on the first day of the month after you make a change.

Who should use Medicare counseling?

Whether you are happy with your Medicare coverage or not, speaking with a counselor is helpful.

"Honestly, I think everyone should seek counseling every open enrollment period," said Lisa Barker, the northeast regional manager of SHIIP. "We save North Carolina residents millions of dollars each year. Last year we served over 62,800 clients and saved them over $37 million."

For example, Barker worked with a married couple who had each been enrolled in the same Medicare plan for about 10 years. When they enrolled, they were both taking generic medications and had no health problems. Since then, one of the spouses started needing expensive medication, and the drug plan covering it was going from $17 to $60 a month.

Barker helped the couple compare options, and each spouse enrolled in a different plan that would help them save $8,000 a year on medications.

"This program is designed to help save people money," said Barker.

What does a Medicare counselor do?

Medicare counselors help people compare options — and there are plenty of options out there. For example, if you live in Warren County and want to enroll in a Medicare Advantage plan, you can choose from 20 different Medicare options.

"Advantage plans are sold by private companies to people living in specific regions, and they cover healthcare offered by in-network providers," said Barker. "Your counselor might present you with several possible plans. Then you would have to do the legwork to determine if your current provider is in-network or if you need to find someone else nearby who is."

Because some Medicare plans are location-specific, a counselor can help you find one that fits your lifestyle.

"A person who travels between homes in different states might be counseled to choose an Original Medicare plan, which is not specific to in-network providers, making it more portable," said Barker.

Counselors will also help you compare the 26 Part D drug plans. You can privately share what prescription drugs you take, and the counselor will help you find the best coverage.

What is the first step?

If you want to do it yourself, enrolling in or updating Medicare starts with creating a profile or signing into an existing account at medicare.gov, where you can explore the newest plans.

If you would like the assistance of a trained local SHIIP counselor, call the Seniors' Health Insurance Information Program at (855) 408-1212 on Monday to Friday from 8 a.m. until 5 p.m. You will be directed to a local counselor and can set up a private, in-person or phone appointment.

The Kerr-Tar specialist can be reached with the contact information below.

Austin Caton; MS. Psy; ALCP
SHIIP/SCHMP & NC Options Counselor
(252) 436-2040 ext. 6072

This article was written for our sponsor, Kerr-Tar Area Agency on Aging.