December 22, 2024
Column

EAA to help Medicare recipients shop for policy

I was talking about Medigap coverage to a friend and her teenage daughter overheard me. She asked, “Medigap? What’s that – a trendy clothing store for medical workers?” She burst out laughing at her own wittiness and her reference to an imaginary version of the popular store at the mall.

Cute. Moving on.

Many of you may be well-versed in Medigap and may even have a policy of your own. Or maybe you have heard of it but are wondering what it’s all about.

Stacie Sparkman, Medicare part D specialist at Eastern Agency on Aging, has the answers and some good news. But stay with me – we are about to play the alphabet game.

“Most Medicare beneficiaries know all about standard fee-for-service Medicare, which covers hospitalization, part A, and physician services, part B,” said Sparkman. “But there are still many costs that the consumer is responsible for, which is why Medigap policies are so important.”

Medigap, or supplemental, policies are federally regulated, she added, and up until Dec. 31, 2005, there were 10 standard policies, A-J. Each plan covered different “gaps” in standard fee-for-service Medicare.

“Plans H, I and J all had prescription drug coverage, but because of the new Medicare prescription drug coverage that started Jan. 1, 2006, no new H, I or J policies can be sold,” said Sparkman. “Two new plans, K and L, were introduced in January. Because the plans are federally regulated, each letter plan – A through G, K and L – regardless of the insurance company, must cover the services for that letter.”

For instance, if you purchased the C plan in Maine and your sister purchased the C plan in California, you both have the same coverage. The plans are exactly the same.

“The only difference between the plans is that the insurance companies who sell them can charge whatever they want,” said Sparkman. “It is up to each consumer to be a savvy shopper, and this is where Eastern Agency on Aging can help. We can look at the 17 different insurance companies that sell Medigap policies in Maine and help you choose the one that works best for you based on your needs. We might be able to help you save some money.”

Save money is right.

“A couple came into EAA today with a Medigap policy J through an expensive company, for which they paid $565 per month,” said Sparkman. “The husband has VA coverage for prescriptions, so we put them both into a plan F through another company for $228 a month. That is a saving of $337 per month. The couple now has better coverage than they did before with a huge saving on top of it.”

While this may be a dramatic example, it is not isolated. You might also save money by buying or switching policies.

“Medigap policies should be reviewed every few years like other types of insurance,” said Val Sauda, director of outreach at EAA. “We welcome Medicare beneficiaries to come to the next clinic at Bangor High School on Saturday, March 11, from 10 a.m. to 2 p.m.”

At this clinic, not only will EAA staff help you with a Medicare D plan, they can also check out your Medigap policy.

“Come see us at Bangor High,” said Sparkman. “Enter through the administration door, follow the signs down the hallway, where you’ll be met by agency staff. We’ll discuss your options and guide you through the process. You just might walk away with extra money in your pocket every month.”

For more information on this clinic, call EAA at 941-2865.

Carol Higgins is director of communications at Eastern Agency on Aging. For information on EAA, call 941-2865, e-mail info@eaaa.org or log on www.eaaa.org.


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