Understanding Medicare is a little like drinking alphabet soup from a firehose. There are parts A & B of original Medicare, optional parts C & D, and the A, B, D, G, K, L, M, N, C, and F of Medigap supplemental coverage. Don’t even get me started on all the varieties of Medicare Advantage plans! If, like me, you’re approaching your 65th birthday, it can all seem overwhelming.
That’s where the State Health Insurance Benefits Advisors (SHIBA) volunteers come in. Unlike the deluge of hard-sell advertisements filling up my mailbox, SHIBA volunteers are impartial. They educate consumers to understand their options and make the right choices for themselves.
SHIBA is funded through the Washington State Office of the Insurance Commissioner. In King County, it’s managed by Solid Ground and the Chinese Information and Service Center (CISC), which does outreach to Chinese-speaking community members.
I recently attended an afternoon-long Welcome to Medicare virtual presentation on Zoom led by SHIBA volunteers Larry Cole and Connie Taylor. I came away from the session with a good sense of the how the Medicare alphabet soup spells out clear options, as well as some tools available to help me make good choices.
Larry and Connie were great presenters. They clearly laid out the timeframes in which I should make my decision and enroll, and how those can shift depending on things like ongoing employer-paid health insurance. The SHIBA information is presented in logical fashion and at a reasonable pace.
The two tag-teamed throughout so that one of them could be monitoring the chat and helping to identify and respond to questions. They clearly enjoy working together and created a congenial atmosphere that helped participants feel safe to seek clarification and ask questions. It was a group session that had a lot of personal touch.
Larry and Connie have teamed up on these presentations for a couple of years now, with Larry initially mentoring Connie. “I have just about worn poor Larry out! You know, I’m the mentee that will not leave!” Connie tells me on a follow-up Teams call I did recently with the two of them. “But I believe that we are helping each other at this point.”
The topics they covered in the workshop included:
- Original Medicare
- Prescription drug coverage
- Low-income programs to help pay for Medicare
- Medigap (Medicare Supplement) plans
- Medicare Advantage plans
- Medicare fraud and abuse
Understanding that this session was an introduction to a longer journey, Larry and Connie suggested best practices for continuing our research, organizing our findings, and moving toward a decision about what Medicare plans to enroll in. They also encouraged us to check back with SHIBA if we have questions or need more information.
“With a Medicare Advantage Plan, when they connect with brokers, there is usually some kind of commission arrangement. If a broker doesn’t get a commission from a specific plan, there is no incentive for them to tell you about it.” ~Larry Cole, SHIBA volunteer
The best thing about SHIBA is that the volunteers are objective and unbiased. They don’t sell or endorse anything.
Original Medicare (Parts A & B) is simple enough to understand (but I won’t explain them here. I encourage you to go to a SHIBA workshop or talk to a SHIBA counselor!). Much more complicated are the array of options you can purchase to supplement Medicare coverage. There are two broad groups of plans: Medigap Supplemental Coverage and Medicare Advantage plans. These are the products that folks like me get advertising pitches about online and in the mail.
“With a Medicare Advantage Plan, when they connect with brokers, there is usually some kind of commission arrangement,” Larry says during our interview. “If a broker doesn’t get a commission from a specific plan, there is no incentive for them to tell you about it. When brokers sell you a Medigap plan, they are rewarded as well, but nowhere near what a Medicare Advantage plan would pay them.
“So if a broker is hearing somebody say ‘Medigap, Medigap, Medigap,’ sure, they’ll talk to you about buying a Medigap plan because they are rewarded. But if there’s some kind of little doubt that you are trying to bounce back and forth, there is a higher reward, typically, for them to sell you a Medicare Advantage plan.
“There are so many different benefits. I use the term buffet or smorgasbord. They advertise the whole smorgasbord but don’t focus so much on what you can actually get on your plate.” ~Larry Cole, SHIBA volunteer
“The other thing that that makes that comparison so difficult is that a Medicare Advantage plan is very hard to sell in a succinct way. There are so many different benefits. I use the term buffet or smorgasbord. They advertise the whole smorgasbord but don’t focus so much on what you can actually get on your plate.”
SHIBA volunteers are motivated to help empower people to make the choices that are best for them. “It is the joy of helping people help themselves.” Connie says.
“When I give some information to a client and then they come back and say, ‘OK, I did this, now what happens next?’ I feel really hot about that, because I think, OK, this is a person who is going with it and they’re going to be OK. And, you know, we deeply, deeply, deeply want people to be OK.”
In addition to the Welcome to Medicare sessions, SHIBA can support consumers in other ways. Larry and Connie provided links to a number of easy-to-use web-based resources, including www.medicare.gov. SHIBA consultants are also available for one-on-one consultation to help consumers understand their options and sort through their decisions.
You can learn more about SHIBA’s Medicare and Medigap Help on Solid Ground’s website – including a calendar of upcoming events – or email SHIBA@solid-ground.org.
The Welcome to Medicare sessions, one-on-one sessions, and calls are all free and confidential. SHIBA keeps any personal information you share safe. Sessions and hotline operators are also available in languages other than English. Call 206.753.4806 for more information.
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