Stressful Time for Some Seniors

While Congress debates health care reform, seniors need to be aware of services they are eligible for now. Enrollment for Medicare coverage runs through December 31st. Those who qualify are encouraged to complete this process as soon as possible...to ensure that coverage is available without any delays. Pat Hernandez has the story.

Medicare coverage is available for people 65 and older...and anyone who has a certified disability for at least 24 months. Erin Page is senior vice president for TexanPlus. It is a Medicare Advantage Plan in Houston that serves about 45-thousand beneficiaries all over southeast Texas. She says this time of year people have to choose the best plan that meets their needs.

"The beneficiary will focus on choosing their drug benefit during this time. From January 1st through March 31st, we'll be in the open enrollment period, where the beneficiary can make a decision to move plans one time, and then they fall into what is known as 'locked in' until December 31st of the following year."

While seniors can do a search of the various plans through the Medicare website, Page says TexanPlus makes that a little easier.

"We actually offer several different types of benefits that are above and beyond traditional Medicare, and one thing that we're really excited for 2010 is that we were recently awarded the 'Senior Gold Choice Award."

PH: "What does that mean?"

Page: "That means for the financial value of the benefit offering to the beneficiary, we offer the best value of benefit."

Page says they encourage their members to have preventative care by their primary care physician. Dr Eric Tait is an internist...or a doctor for adults at Medical Associates of Houston. About 35-percent of his patients are over
the age 65.

"They're getting bombarded with tons of mailings from different people about their Medicare coverage is changing and not changing, and things of that nature. This is the time of year when patients ask me. I tell them they can enhance their Medicare benefits by getting either a prescription drug plan, or enrolling in what's called  a Medicare Advantage Plan and kind of give wrap around coverage around Medicare, give the patients some back stop, in terms of what it costs them for tests and prescriptions. In exchange for that, they'll be going to a network of doctors that are closely affiliated with their primary care doctor."

Tait says by law doctors are not allowed to recommend any plan unless patients ask.

"Patients have to initiate that conversation and ask their physician do they recommend anything? Is there anything
that they particularly like as a physician?"

PH : "Tell me doctor, how the plan that's most advantageous for patients, also benefits doctors?"

Tait : "Often times yes, doctors make a decision because in the end, we do have to pay our overhead. Our overhead, of which plans actually give patients the best coverage and also pay us the best, in terms  of their care."

More information on Medicare enrollment can be found  at www.medicare.gov or by calling 1-800-MEDICARE.
 
 

Bio photo of Pat Hernandez

Pat Hernandez

Reporter

Pat Hernandez is a general assignments reporter who joined the KUHF news staff in February of 2008...