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Help seniors get the most out of Medicare Advantage open enrollment

 
“It’s a delicate matter,’’ Joe Baker of the Medicare Rights Center said of offering to help.
“It’s a delicate matter,’’ Joe Baker of the Medicare Rights Center said of offering to help.
Published Oct. 31, 2014

Do you think you have the power to stop somebody from making a really bad decision?

If so, you probably don't have kids.

But if you're dealing with a grownup, I think you have a much better shot of at least suggesting there might be a better option they could consider.

It's open enrollment season for people on Medicare, the time when they can drop a plan that doesn't serve them, and pick a new one that could save them serious money and aggravation. But studies show most people never switch their Medicare Advantage or drug plans once they have enrolled — even though the plans often change the doctors, hospitals and medications they cover.

Remember the uproar last year when United Healthcare dumped thousands of Florida doctors, as well as Moffitt Cancer Center and other providers, from its AARP managed-care plans?

During open enrollment, which lasts through Dec. 7, beneficiaries can go to a new Advantage plan (38 percent of all Florida Medicare beneficiaries are in these managed-care plans). Or they can switch to traditional Medicare plus a Medigap plan and avoid the limited network issue altogether, though Medigaps aren't cheap.

Medicare choices can be a pain. So hoping for the best is an understandable game plan, though not a wise one.

But how can you meddle in such a personal issue — we're talking about both health and money here — without getting thrown out of the house?

"It's a delicate matter,'' Joe Baker, president of the nonprofit Medicare Rights Center, said.

"I think the key is making a positive case for people,'' he said. "Not scaring them, but saying: 'Let's see if there are options. You don't have to do anything different, but let's see what's out there.' ''

Baker says knowing which type of person you're dealing with could help determine the best approach:

1. People who know they need to assess their Medicare options, and freely admit they could use some help. If this sounds like your loved one, your job is easy: Make sure they know about Florida SHINE (Serving Health Insurance Needs of Elders), which does a terrific job providing free, unbiased one-on-one counseling. Call them toll free at 1-800-963-5337. Either of you can make the call, or you can do it together.

2. People who understand what's at stake, but who are reluctant to talk about it or involve you. "Now's a perfect time to bring up the subject because the ads are everywhere,'' Baker said. "Ask if they're feeling overwhelmed, and if they are, make sure they know you're going to be there for them.''

So tell them about SHINE, and make it clear you're there to back them up, not control them or pry. Without support, many people are reluctant to act on even good information, Baker said. "It's like they get to the threshold, but they're afraid to step through the door.''

3. People who resist even the most sensible and loving interference. If the issue is pride or stubbornness, Baker said, your best strategy could be doing some research and gently showing them what you've learned. This can be particularly effective if your friend doesn't like their current coverage.

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If the trouble is cognitive issues or health problems that impair decisionmaking, you may need a medical professional to intervene. And if your loved one is considering something truly harmful — like ditching Medicare entirely — you might need to seek legal guidance to protect them.

Above all, take it easy.

"This is an adult you're dealing with,'' Baker said. "Don't take on the burden of telling yourself, 'If I don't make this happen I'm a failure as a child or friend.' ''

Fact is, you may not be able to prevent your friend's misstep any more than they can save you from some boneheaded move you're contemplating.

"A healthy 85-year-old has the ability to make the wrong decision,'' Baker said, "just as a healthy 45-year-old does.''