May 20, 2016

SMAA program offers assistance navigating Medicare - By Elizabeth Richards

Are you getting close to Medicare eligibility and wondering how to sort out all the options? If it all seems too confusing, help is available. The Southern Maine Agency on Aging (SMAA) has offered a service to navigate the options for over five years at the Our Lady of Perpetual Help Church in Windham.
John Holland, a longtime Windham resident and volunteer for the agency is a certified State Health Insurance Assistance Program (SHIP) counselor. He said that in 2010, the agency realized they needed to have a regular presence in the Lakes Region. After considering many options, a committee decided the church was the best location, and they have been holding the program there ever since. Holland said the facility has met their needs well. It is handicap accessible, the large hall they use can be divided for privacy, and they have the televisions and wireless connection necessary for their presentations. 

“The Church has been very gracious in letting us use the facility,” he said. 

The programs offered by SMAA in the Lakes Region currently focus on Medicare. There are two different pieces to this program, a Welcome to Medicare Seminar and one-on-one counseling. The seminar, which Holland called “Medicare 101” gives a general overview of the entire Medicare program. “A lot of the feedback we get is that [Medicare] is very complicated and people are sometimes overwhelmed. We walk them through the whole thing,” said Holland. They even go online to show attendees the Medicare website and different plans available at the end of the seminar. 

After people have attended the seminar, they have an option to sign up for a one-on-one consultation to go over the particulars of their specific situation. Holland and another volunteer certified SHIP counselor, Windham resident Nancy Gordon, conduct these consultations.

The busiest time, Holland said, is during open enrollment which runs from October 15th to December 7th each year. Open enrollment is when changes can be made for those who are already on Medicare. Holland said they highly recommend that people come in to review their coverage because so many things can change from year to year, particularly around prescription plans. The counseling can make a real difference. During open enrollment for 2015, the SMAA programs saved $857,871 for their clients by reviewing the options to find a better fit, said Holland.

The SMAA programs are a resource for local seniors. “It’s important for folks to understand that as SHIP counselors we’re totally impartial,” said Holland. “We don’t sell any products, we don’t endorse any products. We’re simply giving people information so that they can make an informed decision. It’s entirely up to them how they do it. We just try to lay it out in a logical way.”

Holland said that through the program they can present folks with lots of choices that not only save money but more adequately meet their needs. “Whenever you make any sort of long term decision, I think it’s important to understand what’s at stake,” he said. 

For instance, he pointed out, if someone doesn’t enroll in Medicare when they are first eligible, a window of three months before and three months after the month of their 65th birthday, they may end up having to pay a penalty when they do enroll, sometimes for the rest of the time they are on Medicare. “There’s all these sort of little twists and turns. That’s where the one-on-one is useful,” Holland said. 

The counselors also have a lot of resources at their disposal, he added. If he’s working with someone and a question comes up he can call the agency hotline or the state helpline. Though all SMAA programs in Windham center on Medicare at the moment, they are exploring the possibility of a similar program called “Respecting Choices” that focuses on advanced care planning. 

In Windham, the seminars are held on the first Tuesday of each month, along with some one-on-one sessions. One-on-one sessions are offered on the third Tuesday of each month. During open enrollment, these one-on-one sessions are offered every Tuesday. A donation of $40 is requested, which covers both the seminar and a one-on-one consultation.

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