Health insurance isn’t the easiest thing to understand. But if you have Medicare, there’s a variety of help resources you can turn to.
One is Medicare’s toll-free help line, 800.MEDICARE (800.633.4227). Trained representatives are available 24 hours a day, every day of the year to answer your questions about your Medicare coverage.
All people with Medicare receive a copy of the “Medicare & You” handbook in the mail each fall. This booklet has a wide range of information about what Medicare covers and what it costs. It includes details about Original Medicare as well as privately-run Medicare health and prescription drug plans that you can join.
Another useful resource is Medicare’s consumer-friendly website, at www.Medicare.gov. Among other things, the website has tools that let you compare Medicare health and drug plans. (You can also look for local hospitals, skilled nursing homes, home health agencies and dialysis centers that best fit your needs.)
Yet another terrific way to get your questions answered is to make an appointment with your local Health Insurance Counseling and Advocacy Program, or HICAP.
HICAP provides free, personalized counseling to people with Medicare. You can speak with a trained HICAP counselor over the phone or in person. The counselor will give you accurate, unbiased advice about your Medicare benefits and how to get the most out of them.
HICAP counselors can help you with questions about Original Medicare, Medicare Advantage plans, Medicare supplement (Medigap) policies, Medicare Part D prescription drug plans, the Medicare Savings Program and long-term care insurance.
Got a problem with a medical bill? HICAP can help you deal with it. HICAP counselors are volunteers and they’re often enrolled in Medicare themselves, so they know the issues. They can help you understand your Medicare rights, file a complaint if you feel you got inadequate care from a hospital or other healthcare provider, or file an appeal if your Medicare health or drug plan denied you a service.
With Medicare open enrollment season coming up (it runs from Oct. 15 to Dec. 7), you may be thinking about joining a Medicare health or drug plan, or switching from one plan to another. HICAP can help you choose a plan that best meets your needs in terms of cost, coverage and convenience. A counselor can sit down with you and help you compare various plans until you find the right one. They also can help you enroll in that plan.
Let’s say you take multiple prescription medications. A HICAP counselor can enter all your drugs into Medicare’s Plan Finder tool (available through www.Medicare.gov) and search for plans that cover your drugs. The counselor will then help you compare plans based on monthly premiums, co-pays, and any restrictions that may apply.
If you have a low income, the counselor can help you apply for the “Extra Help” program, which helps pay your costs in a Medicare drug plan.
You can reach the HICAP office nearest you by calling this toll-free number: 800.434.0222.
HICAP isn’t affiliated with any insurance company and won’t try to sell you insurance. (Funded through federal grants, the program is operated by the California Department of Aging.) Your name will never be passed along for commercial purposes and your personal health information will be kept strictly confidential.
HICAP’s only goal is to help you get the best possible health care under your Medicare coverage.
— David Sayen is the regional administrator for California, Arizona, Hawaii, Nevada and the Pacific Trust Territories for the U.S. Centers for Medicare & Medicaid Services. For answers to Medicare questions 24/7, call 1.800.633.4227.