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ADRC training helping seniors navigate Medicare Part D

Whether it’s for a new cellphone carrier or car insurance, comparison shopping on a good day can be aggravating and confusing.

For seniors, annually comparing plans for Medicare Part D prescription coverage can be especially challenging, but it is something worth doing, according to experts in Medicare benefits.

Each year since the inception of Medicare’s Part D prescription drug insurance plans in 2007, the onus of choosing the right plan has fallen to consumers, those 65 and older eligible for Medicare.

During open enrollment, consumers have the option of staying with their current plan or changing to a new one. But unless they look at the changes, they may find their old plan — especially their prescriptions — costs them more this year, noted Carolyn Feldt, manager of elder and disability services for the Aging and Disability Resource Center.

“Part D is wholly privatized, which further complicates the situation,” Feldt said.

Many plans, networks

In the Kenosha market, there are currently 25 Medicare Part D prescription plans and 20 Medicare Advantage plans. “They all have different tiers, premiums and deductibles,” she said.

To add to the complexity of the situation, Feldt noted that this year, for the first time, insurance plans are negotiating “preferred networks” with specific pharmacies. “Five years ago, very few plans had preferred pharmacy networks; today, about 90 percent do,” Feldt said.

Because of this connection, consumers who do not comparison shop during open enrollment may experience “sticker shock” at the pharmacy next year because the pharmacy they usually patronize is no longer affiliated with their Part D plan.

“This is so much more complicated than employer insurance,” Feldt said. “Then, take all of that complexity and put it on elders.”

One-on-one counseling

To assist those 65 and older with the process during the open enrollment window, the ADRC offers one-on-one advice counseling. This year, for the first time, it has facilitated group training sessions at the Kenosha County Job Center.

The plan is for Medicare Part D recipients to be informed about new choices in their plans during the open enrollment period, Feldt said. Enrollment for 2018 ends on Dec. 7.

“Last year, about 200 people sought advice during open enrollment,” Feldt said.

In a recent session, those seated at computers were walked through the online process at by Heather Vanoss, ADRC benefit specialist coordinator.

Vanoss explained the concepts of coverage, deductibles and premiums, and let the attendees plug in their own information for search results and choose criteria for selecting the plan that best meets their needs.

“Prices are dependent on a person’s specific prescriptions; one size (or plan) doesn’t fit all,” Feldt said.

“The algorithm calculates the cheapest plan according to overall costs for a 12-month period,” Feldt explained. “It’s a very powerful website.”

Four other benefit specialists were on hand to guide attendees with specific questions along the way.

For most, the training sessions take a little under an hour.

Reactions positive

Charleen Williamson, 75, of Kenosha, attended this week’s training session. “I have cancer, and I’m in the fact-finding stage of (comparing plans),” she said.

Williamson said the session helped her narrow her insurance plans down to two that she will call next week.

For the Calins, of Trevor, the training was a chance for Debbie to get ready for Medicare for when she turns 65 next year. Her husband, Andy, 68, had gone through comparison shopping previously through a company resource.

“I wouldn’t have known how to compare all the pharmacies,” Debbie said. “I’m glad there was a benefit counselor here to help us navigate.”

Feldt said that a high percentage of Medicare recipients do not compare their plans. “I’m so proud of these people who are willing to come to training.”

Exit surveys from attendees of this year’s sessions have been “nothing but positive,” Feldt said. “We’re seeing big savings this year over previous years.”

She reported that as of two weeks ago, Medicare consumers who had comparison shopped during the ADRC enrollment training had collectively realized savings of $15,000.

“We feel comfortable because (consumers) can now do it themselves; it empowers them to make decisions,” Feldt said.

“This resource is phenomenal, and I hope more people take advantage of it,” Williamson said.

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