{"id":20441,"date":"2019-01-24T10:00:03","date_gmt":"2019-01-24T17:00:03","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=20441"},"modified":"2024-08-05T13:16:26","modified_gmt":"2024-08-05T19:16:26","slug":"medicare-help-its-not-one-size-fits-all","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/medicare-help-its-not-one-size-fits-all\/","title":{"rendered":"Medicare help: It\u2019s not one-size-fits-all"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_20449\" aria-describedby=\"caption-attachment-20449\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20449\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny.webp\" alt=\"Women talks on the phone at her computer desk with Medicare paperwork laid out.\" width=\"1200\" height=\"800\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny-1024x683.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny-768x512.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/21092815\/Medicare_CHI_UCHealth_Blocker_tiny-200x133.webp 200w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-20449\" class=\"wp-caption-text\">Kim Ferro, community health coordinator with UCHealth in northern Colorado, helps a client over the phone with their Medicare questions. Through UCHealth Aspen Club, counselors assist people, free of charge, with their Medicare benefits and help to objectively answer questions. Photo by Joel Blocker Photography, for UCHealth.<\/figcaption><\/figure>\n<div class=\"su-callout-box col-xs-12 col-sm-6 right\" style=\"background-color:#dce4e7; color:#2e3b44;\">\n<p>Medicare 101 presentations run monthly. Find a Medicare 101 session near you by clicking <a href=\"https:\/\/www.uchealth.org\/events\/?action=search_events&amp;category=0&amp;country&amp;em-date-start&amp;em_search=medicare%20101&amp;near_distance=20&amp;near_unit=mi&amp;scope%5B0%5D&amp;scope%5B1%5D&amp;town\">here.<\/a><\/div>\n<p>If George Montoya doesn\u2019t take his medication daily there are life-threatening ramifications. When he arrived at his pharmacy to pick up his prescription and was told that it wasn\u2019t covered by his insurance, Montoya started to panic.<\/p>\n<p>\u201cIf I don\u2019t have it within 24 hours, I\u2019m dead,\u201d he said.<\/p>\n<h2><strong>Grappling with insurance plans<\/strong><\/h2>\n<p>Montoya, who recently turned 65, had a benign pituitary tumor removed in the early 1980s. As a result, he\u2019s on medication to help his heart, liver and thyroid function properly. He recently switched from Medicaid to Medicare. Medicaid no longer paid for his medications, and his Medicare prescription drug plan through an insurer became troublesome at the pharmacy.<\/p>\n<p>The issue that day was that Montoya recently moved. He had not noticed that that his bill hadn\u2019t arrived at his new home in Estes Park. Because he hadn\u2019t paid his premium, his prescription insurance was canceled. Without it, his lifesaving medication was going to cost him a few hundred dollars.<\/p>\n<p>\u201cI\u2019m 100 percent disabled on a meager income,\u201d Montoya said.<\/p>\n<h2><strong>Finding help<\/strong><\/h2>\n<p>Montoya is a pastor and has volunteered for the past two decades at many area ministries, from prisons to outreach programs. This time, though, he needed help.<\/p>\n<p>\u201cI had to go home that day without my prescriptions,\u201d he said. \u201cI looked to see what I had left and had only a few days\u2019 worth. I got into prayer right away, and the Lord brought me Kim.\u201d<\/p>\n<p>After a phone call or two, Montoya found Kim Ferro, community health coordinator with UCHealth in northern Colorado.<\/p>\n<h2><strong>Medicare help and assistance program<\/strong><\/h2>\n<p><a href=\"https:\/\/www.uchealth.org\/services\/community-health\/\">UCHealth Community Health Improvement<\/a> is a designated site for the State Health Insurance Assistance Program, or SHIP, in Larimer and Weld counties. Through the <a href=\"https:\/\/www.uchealth.org\/services\/community-health\/aspen-club\/\">UCHealth Aspen Club<\/a>, counselors assist people, free of charge, with their Medicare benefits and help to objectively answer questions.<\/p>\n<p>Montoya left a message with the office.<\/p>\n<p>\u201cHis call sounded so desperate, and I was thinking how I had to call this gentleman right back. But I think in his panic, he forgot to leave his number,\u201d Ferro said.<\/p>\n<p>After a bit of searching, Ferro was able to find Montoya\u2019s number and spoke to him on the phone. As a SHIP counselor, she was able to log into Medicare and discuss with him his plans and coverage. And with a bit of investigative work, she got him the help he needed.<\/p>\n<h2><strong>Back on track<\/strong><\/h2>\n<p>\u201cI think it was heaven-sent,\u201d Montoya said. \u201cI was in prayer, and she came through on the phone. We need more people like Kim (Ferro) out there.\u201d<\/p>\n<p>Ferro sees all sorts of similar situations.<\/p>\n<p>\u201cThis is a real typical example, and these people are in absolute panic,\u201d she said. \u201cThis was early October, so I told George I would call him back after October 15 when open enrollment (for Medicare) began so we could make sure he was in the most cost&#8211; effective plan for him for the following calendar year.\u201d<\/p>\n<h2><strong>Open enrollment assistance<\/strong><\/h2>\n<p>\u201cWe did end up changing his plan to save him money,\u201d Ferro said. \u201cDrug plans change from year to year, including, premiums, deductibles and formularies. Personal prescribed medications also change throughout the year \u2014 nothing about Medicare is one-size-fits-all. We don\u2019t want to assume one plan is best for all. We want to choose a plan based on their medications, health needs and personal budget. It\u2019s that individualized care that we provide.\u201d<\/p>\n<p><a href=\"https:\/\/www.uchealth.org\/services\/community-health\/aspen-club\/\">UCHealth Aspen Club<\/a> offers community members one-on-one appointments with counselors trained through the state. Appointments take place over the phone or in person.<\/p>\n<h2><strong>New to Medicare?<\/strong><\/h2>\n<p>If new to Medicare, Ferro suggests one should start with a Medicare 101 class, a 90-minute, one-time presentation offered monthly January through October at <a href=\"https:\/\/www.uchealth.org\/events\/\">UCHealth locations in Fort Collins, Loveland, Greeley and Estes Park.<\/a><\/p>\n<p>\u201cFor those who are coming up to the 65-year age, the Medicare 101 class should be their first step,\u201d she said. \u201cWe go over all the basic information and many frequently asked questions.\u201d<\/p>\n<p>During the annual open enrollment period from Oct. 15 to Dec. 7, people can set appointments to review their prescription and Medicare Advantage plans.<\/p>\n<p>\u201cMany times people don\u2019t know where to begin and what questions to ask,\u201d Ferro said. \u201cThat\u2019s where our one-on-one appointments help. We can help to contact Medicare and other agencies, along with the consumer, and ask the right questions. We\u2019ve done this before and can help figure out where to begin.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If George Montoya doesn\u2019t take his medication daily there are life-threatening ramifications. When he arrived at his pharmacy to pick up his prescription and was told that it wasn\u2019t covered by his insurance, Montoya started to panic. \u201cIf I don\u2019t have it within 24 hours, I\u2019m dead,\u201d he said. Grappling with insurance plans Montoya, who [&hellip;]<\/p>\n","protected":false},"author":2164,"featured_media":20449,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[4750,708,1479,3921,710,4864,3853,1210,3997,9171],"class_list":["post-20441","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-access-to-care","tag-adults-65-plus","tag-aspen-club","tag-community-benefits-report","tag-community-health","tag-estes-park","tag-health-insurance","tag-medicaid","tag-medicare-help","tag-senior-care"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - 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