Counselors offer free Medicare advice by phone
The Medicare open enrollment period is in high gear, and state-trained volunteers throughout the region are helping seniors to navigate the complex system. Under a federally funded program known in Pennsylvania as APPRISE, these counselors assist both new Medicare beneficiaries and current participants.
In Montgomery County, a cadre of 30 APPRISE advisors has switched mainly to telephone consultations because of the pandemic. In previous years, they often met seniors face-to-face at sites throughout the county.
“It’s a lot more difficult because we’re not sharing a computer with a beneficiary at our side, looking at the same thing at the same time,” said Nancy Morris, an APPRISE counselor for seven years.
During the Medicare open enrollment period, which ends on Dec. 7, seniors using original Medicare, which includes separate health and drug components, have the opportunity to switch drug plans. Those using Medicare Advantage, the alternate approach that covers both health care and drugs, can change providers. And seniors can decide to change from original Medicare to Medicare Advantage.
“Just today I spoke to an 83-year-old who was paying a lot of money for his Medicare Supplement Plan,” Morris said. “I was able to help him find a company that he could switch to and save about $150 per month.”
How things have changed
“We’ve changed how we counsel this year,” said Douglas Keene, APPRISE coordinator for RSVP, which administers the program in Montgomery County. “More than 90 percent of our sessions are by phone, although we can share screens using Zoom. It comes in handy if you want to show the beneficiaries the Medicare.gov website. They can review their prescription plans or Advantage plans to see if anything has changed from the previous year.”
That process is often more difficult over the phone.
“It can be hard to explain without the senior seeing the information,” said seven-year veteran APPRISE counselor Amy Kokoles. “We need to enter their prescriptions in Medicare.gov, so we often ask them to email the information to us. If that’s too difficult they can call us with their prescription names and dosages.”
Most of the seniors she helps live in Norristown and surrounding communities.
“So far, there haven’t been as many calls as I expected,” she said. “It will pick up as we get closer to the Dec. 7 deadline. Please give us enough time to help you!”
Morris said she’s been pretty busy handling calls from her Montgomery villearea client base and the APPRISE general hotline.
“Some people aren’t very computer literate,” she said. “I have to do the research and mail or email them the results. It takes a lot more time to explain things and describe options over the phone.”
Keene noted several changes in Medicare for 2021.
“Just today I spoke to an 83-year-old who was paying a lot of money for his Medicare Supplement Plan,” Morris said. “I was able to help him find a company that he could switch to and save about $150 per month.”
– Nancy Morris
“So far, there haven’t been as many calls as I expected,” she said. “It will pick up as we get closer to the Dec. 7 deadline. Please give us enough time to help you!”
– Amy Kokoles
“With original Medicare and a supplement plan, you have a better sense of what your outof-pocket expenses will be, and you can go to any provider who accepts Medicare. With Medicare Advantage, because of deductibles and copays, your health care expenses for the year become more of an unknown, and you usually have a network of providers.”
– Doug Keene
“Some of the Medicare prescription drug plans and Medicare Advantage plans now offer insulin, which can be very expensive, with a $35 per month copay limit,” he said.
Plans are now required to enroll seniors with endstage renal disease, he added. For original Medicare, the annual premiums and deductibles have increased somewhat, as they have for some Medicare Advantage plans and original Medicare supplemental and drug plans.
Help is available
APPRISE counselors help Medicare recipients to review their plans. But they also help those about to turn 65 and older to enroll for the first time in Medicare.
“Many of our callers are looking for advice,” Keene said. “People are retiring later and later. The full retirement age for Social Security isn’t until 66. A lot of people aren’t ready to retire and are still getting medical benefits from their employer. Whether they are retired, ready to retire or planning for the future, we can help them understand Medicare.”
A key decision is whether to enroll in original Medicare with a supplement (Medigap) plan and a Part D Drug Plan, or whether to enroll in a comprehensive Medicare Advantage plan.
“With original Medicare and a supplement plan, you have a better sense of what your out-of-pocket expenses will be, and you can go to any provider who accepts Medicare,” Keene said. “With Medicare Advantage, because of deductibles and co-pays, your health care expenses for the year become more of an unknown, and you usually have a network of providers.
“Original Medicare with a supplement will often take a bigger bite out of your income, but you have the advantage of predictability.”
Counselors can help sort through the complexities of Medicare. For example, there are eight different Medicare supplement insurance (Medigap) plan options from 65 different insurance companies.
For 2021, Philadelphiaarea recipients can choose from among 33 prescription drug plans and 44 Medicare Advantage plans. Several additional programs can lower the cost for lowincome recipients.
When seniors first become eligible for Medicare Part B, if they do not enroll in a drug plan but obtain coverage later, they could pay a penalty in their premiums for the rest of their life. They can switch Medigap plans any time during the year — if underwriters at the new plan accept them. But because underwriting approval is required, seniors might not be able to switch from Medicare Advantage to a Medicare supplement plan.
“We counselors are still working, giving 100% of our effort, even if we’re doing it from home,” Kokoles said. “We want to help you find what works the best for you. We’re not paid by anyone to do this. It’s all volunteer work. If we don’t have an answer, we have an awesome network and we’ll reach out and find it.”
In Montgomery County, RSVP is compiling a list of those interested in becoming an APPRISE counselor in 2021. If interested, contact Keene at 610-834-1040, ext. 112, douglask@rsvpmc. org
RSVP improves the lives of vulnerable populations in the Greater Philadelphia area and beyond with programs focusing on education and wellness which utilize a dedicated pool of 1,200+ volunteers. To learn more visit www.rsvpmc.org.