Medicare beneficiaries have a number of options when it comes to insurance coverage, including Medicare Advantage plans, original Medicare with supplemental Medigap policies and Medicare Part D drug plans.
Susan Harris, executive director of Jayhawk Area Agency on Aging in Topeka, said Senior Health Insurance Counseling for Kansans — or SHICK — can help walk Medicare beneficiaries through the various options and “help weigh pros and cons of each option and make sure that the individual understands the policy and insurance they have.”
It’s possible to do comparison shopping for Medicare plans.
“(Medicare.gov) is a great resource where folks can do comparison shopping for their Medicare Part D plans for drugs and also Medicare Advantage plans,” Harris said. “If a person determines that original Medicare is the choice they want, a supplemental or Medigap plan is often needed or wanted to pick up the costs that are the beneficiaries’ share under original Medicare.”
The Kansas Insurance Commission website, ksinsurance.org, also has a tool for price comparison shopping.
When it comes to original Medicare and supplemental policies, Harris said, the policies with the same letter have the same coverage and are standardized. The only difference is the cost, which she said can “vary greatly from company to company.”
SHICK counselors can assist individuals by explaining the coverage of each policy and providing information about costs so beneficiaries can make an informed decision.
Medicare beneficiaries need to understand how deductibles, co-payments and co-insurance work with regard to the policies they have, Harris said. Some Medicare Advantage plans have zero-dollar premiums but have other out-of-pocket expenses, such as co-payments and co-insurance, of which they may be unaware.
Harris said it’s difficult to compare “apples to apples” when shopping for insurance, because insurance policies other than Medigap policies are typically not standardized and have different coverage options and levels.
For example, Medicare Part D drug plans have a “minimum standard of coverage” that each company must follow when developing plans.
“However, costs and coverage can vary greatly,” Harris said.
Marketplace navigators also can assist individuals seeking insurance through the Affordable Care Act at the healthcare.gov website. The navigators guide a person through the health care process but aren’t allowed to recommend a policy or explain benefits.
Gina Ochsner, director of network development and regional relations for Stormont Vail Health in Topeka, said it can be “very difficult” for seniors to compare Medicare plans and other available options.
“Working with an insurance agent as a trusted adviser is highly recommended,” said Ochsner, who is trained and certified for Medicare plans. “There are also many opportunities in the community to learn about Medicare, including free seminars or other educational events.”
For more information about SHICK, call (800) 860-5260 or visit kdads.ks.gov/commissions/commission-on-aging/medicare-programs/shick.