July 23, 2019

Helping Your Patients with the Medicare Maze

Oaklawn Center on Aging

By Kathy Packard, MS, M.Ed., LPC
Oaklawn Center on Aging


As a healthcare professional, you may be asked questions regarding Medicare. If your patients are approaching their 65th birthday or currently enrolled Medicare, they may be receiving daily mail with Medicare information, supplemental insurance and prescription drug plans (Part D).   With open enrollment in October you may want to keep Medicare information available for your patients. The information being mailed out to your patients can be overwhelming and very confusing for someone who does not know how to navigate the Medicare system.  This is the reason it is called the Medicare maze.  As their provider, patients may feel comfortable asking you questions regarding their Medicare coverage.  Therefore, you need to be prepared to help them navigate this maze.

There may be special programs for some patients.  Older individuals who have difficulty affording medications, may qualify for a federal program, extra help, a state program, or a Medicare Savings Program.  These programs are based on financial need and can assist paying Medicare and prescription drugs costs, premiums, deductibles, coinsurance and copayments for Part A, B and D.  Arkansas uses the baseline federal income and resource limits.  If you think your patient may qualify, have them call the Senior Health Insurance Information Program (SHIIP) office (1-800-224-6330) and they will direct the caller to a counselor who is trained to make application for them.

Remember: October 15, 2019-December 7, 2019, is open enrollment for all parts of Medicare.  To research the Medicare part D plans in your patients’ area of the state, they can go online to www.medicare.gov to view and compare available plans. To research parts A, B & C (Medicare Advantage plans) they can go online to www.insurance.arkansas.gov or call SHIIP counselors at 1-800-224-6330.

In addition to the maze of decisions, Medicare recently changed the format of their card to protect against identity theft. Most new Medicare beneficiaries turning 65 will apply for Medicare by going online to www.ssa.gov or by calling their local Social Security office. After the application is complete, Medicare cards will be received prior to or the month of their 65th birthday.   The new Medicare card has a unique number for each recipient, they no longer use Social Security numbers as the identifying number.  All Medicare beneficiaries have until December 31, 2019 to obtain the new card and will be required to use the new Medicare card no later than January 2020. Most medical practices and healthcare facilities began taking the new Medicare card this year.   Current Medicare beneficiaries should have received their new Medicare card by now, but if they haven’t, they should call 1-800-Medicare to order one.

Assisting Medicare beneficiaries has a positive health benefit. By taking away the stress of making these confusing decisions by themselves, you may well decrease their blood pressure and improve their health and health services!