Timing of Medicare and Covered California enrollment collide, causing confusion among seniors

North Oakland Senior Center

At the North Oakland Senior Center, seniors are directed to the local HICAP for help enrolling in Medicare. Photo credit: Richard Parks.

When Barbara Witney, a 65-year-old marriage and family therapist, tried to sign up for Medicare last week, she was dismayed to find herself baffled.

“I’m a pretty educated person and it was confusing for me,” she said.

Witney, whose existing health insurance premium is expected to double this January, had the misfortune of turning 65 during the debut of Covered California, the state’s online healthcare marketplace – which for the first time will overlap with the annual enrollment window for Medicare, the federal health insurance program for seniors and people with disabilities.

According to Janet Van Deusen, who manages Oakland’s Health Insurance Counseling and Advocacy Program (HICAP), counselors across California are inundated with calls every fall during the annual Medicare enrollment period. But this year, she says, counseling centers are receiving an even larger number of callers confused about whether they should enroll through Covered California or Medicare.

In Alameda County alone, Van Deusen says, HICAP receives anywhere from 50 to 60 calls a day, most of them from people who simply cannot navigate the various health plan options in tandem with changes outlined in the Affordable Care Act.

Other HICAP centers across the state are even more overwhelmed, with more than half already over capacity; they’re so swamped by calls and in-person appointments that they’re forced to direct seniors elsewhere for help. Medicare enrollment doesn’t close until December 7th.

Van Deusen said the flurry of activity surrounding Covered California and the chaotic roll out of the federal government’s healthcare.gov website has caused additional confusion for Medicare-eligible seniors.

“Medicare enrollment is confusing every year, and it’s upsetting for people whose plans are being dropped,” Van Deusen explained. “But this year it’s augmented by Covered California’s opening, because it collides with Medicare enrollment. They’re both called open enrollment but they’re for different people and for different purposes.”

While seniors are receiving pamphlets in the mail and seeing advertisements around town promoting Covered California’s marketplace, Medicare benefits are changing. Some people may see their copays go up, others are eligible to add or drop existing benefits, and some people may even have their existing plan dropped entirely, meaning they will have to select a whole new plan and find new doctors.

Wendy Peterson, who directs the Senior Services Coalition based in Oakland, said that managing these types of changes can be daunting.

“It’s not like a young healthy person who just sees one doctor. Many seniors have a number of specialists for different things,” she said. “A lot of seniors have a particular doctor or specialist and that doctor might not be on an advanced plan.”

To top it off, partners at the Senior Services Coalition are still hearing reports from seniors about health insurance scams, where fake Covered California representatives attempt to solicit personal information over the phone or in person.

“It’s sort of like that game, whack-a-mole,” Peterson said about the insurance scams. “They just keep coming back.”

Contrary to what some scam artists are pedaling, most seniors don’t actually qualify for the new plans under the Covered California marketplace. It is illegal to have coverage through a Covered California plan in addition to a Medicare plan because of provisions under the Affordable Care Act that expand Medicare coverage.

“It’s a very confusing time of year for people to be getting the information about changes to their Medicare plan with all the other plans that are out there vying for their attention,” Van Deusen said.

 

 

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