Published: November 01, 2007 11:07 pm            

Medicare closing the gap

ANDOVER, Mass. — A Korean man approached Donghee “Teresa” Ahn, a Korean-speaking counselor, at a Medicare information session and handed her a letter dated May 10.

“He said, ‘I received this letter, but I don’t know what to do with it,’” Ahn said.

It was a letter from the government saying the man appears to be eligible for a low-income subsidy and inviting him to apply.

Ahn told the man, “Oh, you could get a lot of benefits.” She explained the subsidy would probably pay his premium for drug coverage and dramatically lower his medical costs.

But when Ahn asked the man what he did with the letter, he replied, “Nothing.”

The man is just the type of person the federal government was trying to reach with the recent information session at the Boston Korean United Methodist Church in Andover.

It has been two years since Medicare rolled out the new Part D prescription drug coverage plan, and local health insurance counselors say the initial confusion has long since died down.

But as the Nov. 15 open enrollment period nears this year, Medicare is focusing on finding those seniors who are eligible for the low-income subsidy, known as “extra help,” but haven’t applied.

“For whatever reason, we haven’t reached them all, despite our best efforts,” said Roseanne Pawelec, a spokeswoman for the New England office of the Centers for Medicare and Medicaid Services. “These numbers, they are not huge, but these are populations that are among the absolute most difficult to reach. We have a concerted effort to find these folks.”

An estimated 3,502 seniors in Massachusetts’ Essex County and 1,477 seniors in New Hampshire’s Rockingham County haven’t claimed the benefit to which they are entitled, Pawelec said.

“Some people simply don’t know about it,” she said. “Others may fear that they’ll lose other benefits, like food stamps or housing subsidies, which is absolutely not true. Some people aren’t aware that their homes don’t count (in the asset test), that their cars don’t count, in terms of resources.”

“We also heard there are some areas of New England where people incorrectly view this as a handout,” she said. “It’s not. It’s a federal government program that everybody pays for through their own tax dollars. It’s your money and people are literally leaving that money on the table when there’s no need for that.”

The Korean community in Massachusetts is just one of several groups Medicare is targeting in its efforts to bring the subsidy to more people. Medicare counselors are also reaching out to the Latino community and residents of rural northern New Hampshire, among others.

“(We’re trying) to reach these small, but very important pockets of people who have not applied for a benefit that can make an important difference in their health,” Pawelec said.



Julie Kirkwood writes for The Eagle-Tribune of North Andover, Mass. E-mail her at jkirkwood@eagletribune.com



Who qualifies for ‘extra help’?

The federal government offers an “extra help” subsidy program worth, in some cases, $3,300 or more a year for seniors enrolled in a Medicare prescription drug plan whose:

Income is $15,315 or less for an individual or $20,535 for a married couple.

Combined savings, investments and investment real estate are not worth more than $11,710 for an individual, or $23,410 if you are married and living with your spouse, not including your primary residence, your car and up to $1,500 per person saved for burial expenses.

How to apply: Call 800-MEDICARE (800-633-4227) or go to www.ssa.gov/prescriptionhelp



Open enrollment: Who needs to pay attention?

Medicare’s annual open enrollment period for the Part D prescription drug program is Nov. 15 through Dec. 31.

Pat Paradis, a senior health insurance counselor with the SHINE program in Massachusetts’ Essex County said it’s a good idea for every senior to take a look at their health coverage now and decide if they want to make changes.

Here are some of the reasons you may want to consider taking advantage of open enrollment to sign up for a new plan or change the plan you already have:

New plans are available that may be better than your current plan.

“It doesn’t hurt to check every year," Paradis said, "even if you’re satisfied with your plan.”

Your medical condition changed. If you are taking different prescription drugs now than you were last year, you may be able to find a plan that offers better coverage for those particular drugs.

Your employer-sponsored health insurance plan has changed.

You’re on Medicaid and you were automatically enrolled in a Medicare drug plan when you turned 65. Now is a good time to make sure that plan is the best deal for your individual situation.

For help: Call 800-MEDICARE (800-633-4227), visit www.medicare.gov or contact your local senior center.



— Julie Kirkwood

        

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