Medicare 101 and navigating Medicare session planned

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By Christina Knoell, Kay Kaylor and Susan Wright  | San Juan Basin Area Agency on Aging

Medicare is complicated. It is important that you know your benefits, rights, options, deadlines, possible penalties and where to find the information you need. 

Did you know that assistance is available in Pagosa Springs through the nationwide State Health Insurance Program (SHIP)? Trained and certified Medicare counselors are available to guide you when dealing with Medicare enrollment, questions and problems. Just call (970) 264-0502, ext. 4 for an appointment. 

One of the San Juan Basin Area Agency on Aging (SJBAAA) Medicare counselors, Susan Wright, will offer a free Medicare 101 class for an hour or so at 1:30 p.m. on Feb. 27 in the Ruby M. Sisson Memorial Library. Enjoy some snacks and treats while Wright gives you an overview of Medicare and answers your questions. 

Medicare help has been offered in Archuleta County at the Pagosa Senior Center for more than 15 years. SJBAAA is the sponsoring agency for free Medicare counseling services at the Senior Center (the west end of the Ross Aragon Community Center) on Hot Springs Boulevard. On most Mondays, called Medicare Mondays, counselors are available by appointment. Counseling occurs on additional days during the annual Part C and D Open Enrollment Period, Oct. 15-Dec. 7, and sometimes by phone or appointment on other days. 

Please call the phone number above to make an appointment or to ask questions. Some SJBAAA counselors are also trained as Senior Medicare Patrol counselors, and they can help with possible health care fraud, errors and abuse. You can also report abuse, like all those annoying phone calls from private insurance companies, by calling (888) 382-1222 or visiting www.donotcall.gov.

Medicare eligibility begins at age 65 unless you are younger and have been on disability for almost two years. Three months before (and until three months after) your birth month, you can enroll in Medicare and start making decisions about your options. Some of the questions you need to consider follow:

• Are you eligible for Medicare Part A and Part B? Do you need both? 

• Do you have a retirement plan that will work with Medicare? 

 • Do you want a Medicare supplement (also called Medigap)? 

• Would you prefer coverage through a Medicare Advantage plan from an insurance company? 

• Do you want a Part D drug plan to avoid a monthly penalty? If so, which plan would work best for you? This varies depending on which drugs you take. 

• Do you qualify for help with part B or D premiums?

Generally, you can enroll in Medicare online at www.ssa.gov or by calling the Social Security Administration in Durango, (888) 472-6115. If you are already receiving a Social Security check, you will be automatically enrolled in Part A and Part B, but you will need to enroll in Part D and Part C, or supplements, yourself. 

You can compare and enroll in plans at www.medicare.gov. If you are already on Medicare and have a Part D drug plan or a Part C supplement it’s prudent to review that plan each year during the open enrollment period. Plan premiums and coverage of drugs change each year. Medicare counselors can help you during that time, or you can go to www.medicare.gov to review your plan. 

Also, contact Medicare at (800) Medicare, (800) 633-4227, if you did not receive a Medicare card when you turned 65. You can sign into MyMedicare.gov to see if your card was mailed and, if so, print out an official card. 

The above Medicare number can help with any questions you may have. It is available 24 hours a day, seven days a week (except for some federal holidays).

If you are receiving Social Security disability, you will probably be eligible for Medicare starting 23 months after your disability begins. You will have a limited period to enroll in a Part D drug plan. It is important to take advantage of opportunities to enroll so that you have the coverage and not the penalties. 

The state trains people to provide you with the information and tools to navigate Medicare with as little stress as possible. Wright would enjoy helping you understand your benefits, so join her at 1:30 p.m. on Feb. 27 at the Ruby Sisson Library. RSVP at (970) 264-0502, ext 4. We’ll have door prizes, too.