Medicare enrollees see changes in program

Medicare coverage consultation
Volunteers of America Minnesota community outreach social worker Linda Walker, right, assisted Mary Joan Kelly of Minneapolis with entering data and choosing the right Medicare part D coverage at Southwest Senior Services in Minneapolis, Minn. Thursday, Nov. 11, 2010.
MPR Photo/Jeffrey Thompson

Open enrollment begins Monday for the 735,000 Minnesotans on Medicare, the nation's health insurance program for Americans 65 and older. There are a couple of important changes to the program that they'll have to take into account this year.

Topping the list of changes this year is a sharp reduction in the number of Medicare Advantage plans.

Medicare Advantage is a version of the health insurance program sold mostly by private, for-profit insurance companies. For a fee, the insurance companies will manage your Medicare coverage.

Government studies have concluded the "advantage" in many of the Medicare Advantage plans goes not to the policy holders, but to the bottom line of the insurance companies selling the policies, and there's a move by the government to phase them out.

Jean Wood, the executive director of the state-operated Minnesota Board on Aging, is one of Minnesota's go-to people for Medicare answers. She's been a state health care counselor for 18 years.

Wood says 44,000 Minnesotans have Medicare Advantage policies. But with the federal government trying to phase them out, Wood says many of those Minnesotans will need to make a decision about switching to a new plan.

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On the other hand, if they forget or don't want to, Wood says it's not the end of the world.

"I could heat my home for the winter with all the mail I'm getting for supplementary plans."

"If they don't do anything, they will be returned to just the plain, old Medicare fee-for-service plan," she said.

The other significant change this year is more prescription drug coverage for many, but not all, Medicare beneficiaries enrolled in the voluntary drug plan.

The change is mostly good news for seniors.

Lawrence Landherr of Rochester recently reviewed his Medicare pharmacy coverage, and discovered that making some changes can save some serious money.

"I was able to save something in the neighborhood of $150 a month," said Landherr.

But Medicare doesn't cover all medical expenses, and as a result, many beneficiaries buy so-called supplemental health coverage policies to cover the gap. It's a big and profitable business for the insurance companies.

People approaching the Medicare enrollment age of 65 discover they are very popular with companies who want to sell them the supplemental coverage.

"I could heat my home for the winter with all the mail I'm getting for supplementary plans," said Richard Novack of Edina, who just turned 65 and enrolled in Medicare this year.

Novack said he's receiving a steady stream of invitations to seminars and luncheons from insurance companies, claiming they'll supply him with reliable answers to his questions.

Objective Medicare advice is an issue because the huge program can be very confusing, and some recipients say their best guidance came from a program called Senior Linkage, which is operated by the Minnesota Board on Aging.

The people answering the phone are trained to give objective answers to Medicare questions. The board also trains a small army of volunteers, including Dick Stokke of Eden Prairie.

Stokke and the other volunteers go to senior centers for one-on-one question and answer sessions. and even meet with individuals in their homes to walk them through their Medicare choices.

Stokke, 75, a retired businessman, has been volunteering for years. He says the one situation that still takes him aback is when he counsels someone who can't afford to buy Medicare supplemental coverage.

"There's help available for everybody that can't afford the insurance if they don't have money," said Stokke. "So many people don't know about that. A simple form, it goes in, and it doesn't take a long time to get it approved."

A program as sprawling as Medicare attracts a lot of scam artists. Jean Wood of the Board on Aging cautions a lot of people operate scams over the phone to try to bilk the system.

No one with legitimate Medicare business, Wood says, ever calls beneficiaries on the phone.

"If anyone contacts you and says you need to go through them to enroll in either Medicare or a Medicare Advantage plan, or a drug coverage plan, hang up the phone. Do not talk to them," said Wood.

The Medicare open enrollment season is the ground-level, grassroots part of the program. At higher levels, there's another swirl of activity and controversy. One big issue on the horizon is the proposal starting December to cut Medicare reimbursement to medical doctors by up to 23 percent.

Then there's the long-running question of Medicare's solvency. The first of the baby boom generation is turning 65, swelling the program ranks. that, along with rising medical costs, pose fiscal challenges that some observers say must be addressed with higher premiums and reduced services.

The open enrollment period for the Medicare Advantage plans and prescription drug coverage continues through Dec. 31.