Medicare annual enrollment is now open, and seniors (age 65+) have until December 7 to enroll for coverage. If this is you or your loved one’s first year of eligibility, chances are you have a lot of questions.
Let’s start with the basics: Medicare is a federal health insurance program that helps seniors cover their medical costs, including hospital stays, doctor’s visits, and preventive care such as mammograms, colonoscopies, diabetes treatment, and blood pressure screenings.
Having Medicare coverage is important, because seniors are more likely to have chronic conditions that require ongoing treatment, and are more likely to suffer from accidents, such as serious falls. But picking the right combination of Medicare options can be complicated—it’s different from senior to senior, based on individual needs.
An alphabet of choices
One of the biggest surprises to new enrollees is that Medicare is not just a single program: There are actually four different parts. Parts A and B are often called “Original Medicare”. Medicare Part C (or “Medicare Advantage”) is private health insurance that offers additional benefits to cover the gaps in Parts A and B, while Medicare Part D adds coverage for prescription drugs.
Adding to the stress, even for seniors who are already part of the system, are the strict deadlines. Any Part C or Part D changes must be made by December 7, so that coverage begins without interruption on January 1, 2019. Seniors who are late to enroll may face a lifetime of premium penalties.
It can feel overwhelming trying to wade through all the plan choices, premium costs, and options. Fortunately, you don’t have to figure it out alone. Free help is available through the Senior Health Insurance Benefits Assistance Program, also known as SHIBA.
How SHIBA can help
Oregon’s SHIBA program provides free health insurance counseling to explain how the Medicare program works, and helps you understand your enrollment options. This one-on-one counseling is free to new enrollees as well as seniors already in the program who are thinking about making changes.
SHIBA counselors are highly trained, certified, and unbiased volunteers who work under the guidance of SHIBA staff. They’ll help you and your loved one review and compare plan options, including Advantage Plans, Medigap supplemental insurance policies, and prescription drug plans. They can assist you in understanding a bill, help you file a grievance or appeal for a charge, explain timelines and circumstances for making changes in plans, and ensure that your loved one is receiving all the possible benefits they’re eligible for.
SHIBA also offers other helpful resources, including an annual Medicare guide. It’s available online now, and the printed version will be out by mid-November. (You can check out the federal plan-finder tool at medicare.gov/find-a-plan to get a preview and compare plans before you meet with your SHIBA counselor.)
Get connected with a counselor
To get started, visit SHIBA.Oregon.gov. This easy-to-navigate website answers common questions, has a link to get a copy of the 2018 Oregon Guide to Medicare Health plans, and offers Medicare education and enrollment events in your area.
To set up a meeting with an Oregon SHIBA counselor, call the toll-free SHIBA Helpline at 800-722-4134, or click the link on the website to find a SHIBA volunteer your area.
Hearthstone has a heart for seniors
Just like Oregon’s dedicated SHIBA volunteers, Hearthstone Senior Living communities have a genuine heart for serving seniors. Locally based and family operated, our two Beaverton communities are designed to help seniors live full and happy lives. We invite you to come see for yourself! Call or click to set up a personal tour today.
12520 SW Hart Road
Beaverton, OR 97008
10880 SW Davies Road
Beaverton, OR 97008