Workshops planned to help customers navigate system

Fall foliage and crisp weather aren’t the only signs of autumn. Those who are Medicare-eligible should take note: Open enrollment begins this weekend (Oct. 15) and will run through Dec. 7 for those 65 or older.

That means decisions must be made regarding the seemingly infinite Medicare options from which to choose.

For instance, there’s Part A and Part B for hospitalization, doctor visits and medical supplies. Then there’s Part C, or the optional Advantage Plan. There’s Part D for pharmaceuticals. You need A and B to be eligible for C, but you can choose to do A, B and D without C, if you like.

Still working? Have a Health Savings Account? You may want to consider your employer’s group coverage and add Medicare to fill in the gaps.

Got it?

“The reason employers are starting to talk with employees is because it’s so confusing,” said Lynne Jones, vice president of business development and marketing with Colorado Springs Health Partners. “Add the [health insurance] exchange to that, and it’s another layer of things you need to know when you become Medicare eligible.”

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To help with the complexities of Medicare enrollment, CSHP is conducting 15 open houses (cshp.net/openenrollment) in Teller and El Paso counties through the conclusion of Medicare’s open enrollment period.

According to Sharon Roundtree, CSHP senior relations specialist, time is of the essence as 2016 draws to a close.

“For the employer groups we’re working with, we teach them this is time sensitive if they have employees who are turning Medicare eligible,” Roundtree said. “Many times employees don’t know they need to go to socialsecurity.gov or medicare.gov and sign up for Medicare Part A or Part B. We also see a lot of employees delaying enrollment because they are going to continue to work.”

The educational workshops aren’t just for businesses, according to Roundtree and Jones. But they will cover how enrollees can sign up and pay for some Medicare plans, what employees and employers should look for in choosing a plan, as well as the responsibilities of the employer leading up to open enrollment.

“The educational meetings are to teach everyone the steps so there are no late penalties,” Roundtree said, adding there’s a worksheet available at medicare.gov that can help walk new buyers through various situations and compare premiums.

“Now is the time to review your plan,” Roundtree said. “Look at drug coverage lists and make sure they meet your needs. Make sure your provider is still in your network and, if you’re not taking Medicare, take the next steps through [the] Social Security [Administration] if you want to opt out. If you are offered group coverage, look at the benefits and compare it against Medicare.”

Roundtree added that employers must provide a credible coverage letter to Medicare-eligible employees if they wish to opt out and remain on their group plan.

In addition to CSHP, resources include socialsecurity.gov or medicare.gov, as well as the Senior Health Insurance Program, or SHIP, offered through the Pikes Peak Area Agency on Aging, Jones said. Insurance brokers are also useful to compare plans, she added.

“I think people aging into Medicare often default to what seems easiest, rather than what’s probably in their best interest,” Jones said. “We started doing [Medicare] meetings 10 years ago when the Part D drug plan came out because there were 43 different options in Colorado Springs for Medicare drug plans.”

One challenge, Roundtree said, is those who are on Medicare often look to friends to guide their own coverage.

“Everybody’s situation is different,” she said. “Do you have a chronic medical condition? Are you a traveler and in and out of the service area often? Do you RV five months out of the year? There are a lot of factors that go into the decision.”