Almost 65? You need to consider ; your health care choices; A county resource offers free Medicare counseling

"Everyone needs to think about Medicare three months before turning 65," said Amy Rubino, the Anne Arundel County Department of Aging and Disabilities' SHIP (State Health Insurance Assistance Program) director. "This is your health insurance. Everyone on the cusp of 65 needs to consider their healthcare choices as there are so many variables. You need to have a discussion about Medicare's features and benefits before you are 65. Medicare has been around since 1965. Created by the U.S. Congress, its structure has remained the same, but it has been added on to and costs have gone up."

"There is not one answer for everybody."

Rubino said, "People ages 65 and older can qualify for Medicare, as can those who are under 65 and disabled or who have an end stage renal disease requiring dialysis or a kidney transplant."

Over 5,000 people each year in Anne Arundel County become age eligible for Medicare. "And the numbers are trending up," said Rubino.

She noted about 3,000 residents annually ask SHIP for advice, which does group presentations to help people navigate their decision. It also has three full-time staff members and 11 trained volunteers who conduct one-on-one meetings to discuss Medicare. Trained over a four- to six-month period with continual updates, they hold weekly sessions at the Department's two locations or they visit some of the county's Senior Activity Centers by appointment.

Retiree Bruce Morgenstern, 66, is one of the 11 volunteers. He said the Medicare, Medicaid and Medical Assistance programs are filled with jargon, terms, conditions and deadlines that can be confusing. He and the other volunteers and full-time staff members are ready to help.

Morgenstern emphasized the volunteers are highly skilled. Two have provided counseling for over 20 years. "Medicare is so complex, we're in training every month in order to understand its concepts, rules and exceptions. We're focused on what's here and now, what's in place. We'll deal with changes as they occur."

"There is no 'one size fits all' solution for Medicare," he said.

Basic information is needed to work with a resident seeking assistance understanding Medicare: age, marital status, if they have Medicaid or any assistance and current income.

Morgenstern said, "If you turn 65 and don't take Medicare and don't have group health insurance with your employer, when you do decide to take Medicare, you may be subject to a penalty for Medicare's Part B of 10 percent of the current premium for life."

"Part A: Hospitalization is free," he said, "if you worked 40 quarters (three-month periods totaling 10 years) and paid into Medicare or Social Security."

"When you have scheduled a one-hour session with us, bring your Medicare card, if you are on Medicare. If on Medical Assistance, bring that information. Also come with a list of medications, and their dosages and frequency. Plus, any questions about Medicare you may have," he said.

"If you are employed, we'll help you prepare the questions you need to ask your HR (Human Resources) Department at work."

Seniors on Medicare should examine their Prescription Drug Plan/Part D each year. "Every year insurance companies change their formulas, premiums and deductions. The best program is the least expensive one for their specific medication."

He said people should know:

*If someone starting with Medicare is interested in the Medicare Supplement, also known as Medigap, during the first six months after Part B goes into effect, they cannot be asked medical questions and cannot be refused care. "We encourage people to explore their options when they first become eligible for Medigap," he said.

*If they have medical retirement benefits as a result of their employment.

Medicare is not free. For Part A, if you worked 40 quarters the premium is free but it has deductibles and co-insurance. Part B, for most people, has premiums, deductibles and co-insurance. Part D is handled by private insurers.

Medicare does not provide routine care for eyes, hearing or dental.

"We try to take the confusion out of Medicare through our one-on-one counseling," said Morgenstern. "We've found the counseling is more effective than general presentations."

"People need to know there is help," said Rubino. "We can help you. There are pitfalls in the program - we'll work with you to get through them. The biggest mistake is if you don't time it right, you could be uninsurable."

Credit: By Wendi Winters - wwinters@capgaznews.com

Caption: Bruce Morgenstern, a retiree who is a very active volunteer in the county public schools and for local organizations, is one of the county Department of Aging and Disabilities' 11 trained volunteers who provides free advice about Medicare benefits in one-on-one meetings by appointment, in group presentations or over the phone.

Amy Rubino, the SHIP Director (State Health Insurance Assistance Program) offered by of the Anne Arundel County Department of Aging and Disabilities, leads a cadre of trained volunteers who provide free advice about Medicare benefits on the phone or in person by appointment.

photos by Wendi Winters/Capital Gazette