From Today's Tampa Tribune...
http://m2.tbo.com/content/2011/feb/06/PMENEWSO1-medicare-maze/news-metro/
Published: February 6, 2011
TAMPA -This was one game Nancy McCoy decided she couldn't and wouldn't lose.She hadn't been able to afford health insurance for nearly a year. But her 65th birthday in October made her eligible for Medicare, the government's hospital and medical coverage for seniors.
A type 2 diabetic, McCoy submitted the initial paperwork for Medicare months in advance, thinking it wouldn't be long before she would visit her longtime physician for her annual physical.
She interviewed a slew of friends about getting additional insurance to cover what Medicare can't. She researched dozens of plans. She drew flow charts on poster boards and hung them on the wall of her small Tampa apartment, comparing plans that met her medical needs and her monthly budget.
McCoy's 65th birthday came and went, but it wasn't until Jan. 28 that she received confirmation that she has both Medicare and supplemental insurance coverage. She's still waiting to see her doctor; the first available appointment is in March.
"It's hard," she said of the Medicare enrollment process. "And it shouldn't be hard."
Regardless of today's political debate about health care and the future of Medicare, the long-anticipated tidal wave of seniors becoming eligible for benefits is starting to surge. Many of the 2.5 million babies born in 1946, the first of the baby boom generation, are ready to apply. They have been contributing for years to Medicare, established during Lyndon Johnson's presidency.
McCoy's quagmire is a sign of what the estimated 7,000 Americans turning 65 every day could face in 2011 as they enter the bureaucratic maze of Medicare eligibility.
"This is a rude awakening for those who haven't done their homework," she said.
Medicare is health insurance for American workers who contributed part of their paychecks for at least 10 years. Starting at age 65, those contributions, and taxes paid by the rest of the American work force, are supposed to cover 80 percent of the cost of hospital and medical care. A monthly premium also is deducted from a recipient's Social Security check for the medical care, known as Medicare Part B.
But boomers who ignore enrollment deadlines and a series of initial Medicare questions could end up shelling out for penalties, or paying premiums for insurance they don't want or need, said Jim McCulahy, a Tampa Bay area coordinator for Serving Health Insurance Needs of Elders, or SHINE, hotline. The warning applies to everyone turning 65, including those still working full time.
"I'm sure a lot of these baby boomers will keep working until they're 70 because of the economy and the way it is," McCulahy said.
Timing is critical. Experts suggest contacting Medicare, operated by the Center for Medicare and Medicaid Services, three months before your 65th birthday. It can be done in person, by mail, at www.medicare.gov and through the Social Security Administration.
Do this early and the government's benefits should be in place by your birthday. But wait three months after your 65th birthday and the window to sign up closes, forcing you to wait until Jan. 1 of the next year to enroll in Medicare.
"You want to sign up, but you can't. You have to wait," said McCulahy, who warns that those who are late also face a permanent penalty on the monthly premium taken from Social Security.
Doing nothing has more consequences. If workers don't indicate Medicare plans at 65 and are signed up for Social Security, the government automatically enrolls them in Medicare hospital care known as Part A and the Part B medical care, McCulahy said. That means a monthly deduction of $115.40 from Social Security. That's an enormous mistake for people who are still working and paying premiums for an employer's health insurance plan, he said.
Nancy McCoy didn't have that choice. The mortgage company she worked for left Tampa in 2009, so she opted to retire early. The $1,000-a-month health insurance available to the 65-year-old would have consumed nearly all of her $1,624 Social Security check. So she started the countdown to Medicare eligibility.
Signing up for Medicare was simple, McCoy said. It was deciphering the myriad supplemental and private insurance options to accompany Medicare that left her feeling insecure and isolated. Depending on location, the number of companies authorized to offer insurance for Medicare recipients can number from a few to dozens.
Specifically, McCoy was frustrated by how hard it was to get private supplemental insurance, the additional coverage for the 20 percent of medical costs Medicare doesn't cover. It took countless phone calls, assistance from an area insurance agent and inquiries from a reporter before her contract was confirmed with United Healthcare.
"It was frustrating and difficult," she said. "It was annoying."
Matthew Burns, a United Healthcare spokesman, said the company strives to serve all its Medicare recipients well. The company also offers educational assistance on its website to help people interpret their options.
Private insurers are playing an increasingly significant role in Medicare. In particular, they're combining the multiple pieces of hospital, medical and prescription drug coverage into packages under the umbrella called Medicare Advantage.
The convenience of Medicare Advantage still requires a lot of homework for first-time enrollees, McCulahy said. Most important is making sure your current physicians and pharmacists are included in the plan and that the plan offers what you need.
Also, the uncertainty surrounding the health care debate in Washington is causing many doctors to reign in the number of Medicare patients they treat. Even if you have been seeing the same doctor for 30 years, remember that your insurance is changing. McCulahy said.
"It's really important you make those phone calls," he said.
www.SellMedicareByPhone.com
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