Medicare assisters: The key to enrollment?

This July, President Obama will celebrate the 50th anniversary of Medicare, Medicaid and the Older Americans Act at the White House Conference on Aging.

The event offers an important opportunity to recognize the value of these programs while also discussing the issues that will help shape the future landscape for older Americans.

Beloved by seniors for providing access to needed care, Medicare has grown rapidly since its inception in 1965. Far too often, however, the decisions seniors face when enrolling in Medicare can be confusing and overwhelming, especially when first aging into the program, with questions like "Should I sign up for traditional Medicare or Medicare Advantage?" "Which Part D plan will meet my needs?" "What are Medicare Medical Savings Accounts Plans?" "Am I eligible for low-income assistance?"

A study by the National Association of Insurance Commissioners found that 64 percent of respondents did not even know that Medicare eligibility begins at age 65, nor did they understand Medicare's basic structure. In 2013, the Medicare Rights Center fielded more than 15,000 questions on its national helpline, with nearly a quarter of the calls from individuals experiencing difficulties enrolling in Part B, which deals with medical insurance. Twenty-eight percent of callers did not understand enrollment periods and 13 percent were unsure whether they were Medicare-eligible.

Inaccurate or insufficient information can lead to late enrollment penalties, gaps in coverage, increased financial burden and delayed treatment for newly eligible beneficiaries. Low-income beneficiaries, communities of color and New Americans/immigrants in particular face a unique set of difficulties: a 2012 survey by the Kaiser Family Foundation found that 35 percent of low-income seniors did not know about the open enrollment period, compared to 11 percent of higher-income seniors. The same poll found an even wider racial disparity, with 42 percent of African American and nearly 50 percent of Latino seniors reportedly unaware of the open enrollment period, compared to 18 percent of white seniors.

Between 2014 and 2050, the Medicare population is projected to grow from 54 to 93 million beneficiaries. This surging population, as well as the increasing number of geriatricians and other providers that care for older patients, need information about how best to meet the needs of these beneficiaries. And as more and more citizens age into Medicare programs, ensuring that seniors have the information they need to receive the correct benefits will be crucial to overall health of the country.

To address the widespread confusion surrounding Medicare enrollment, policies and benefits, the White House Conference on Aging should consider creating a "Medicare Assisters" program to help seniors better navigate and understand the complex choices involved in Medicare enrollment.

At its heart, a Medicare Assisters program aims to create a common experience for every Medicare recipient – regardless of age, location, native language or socioeconomic status – through a national network of professional and culturally sensitive in-person assisters, supported by a centralized customer relationship center that serves as an unbiased, independent source of trusted advisers.

While Senior Health Insurance Plans (SHIPs) do help seniors and their caregivers, more support is needed, and creating a Medicare Assisters program would supplement and enhance the performance of the Medicare Compare tool, 1-800-Medicare, and the SHIPs, helping to reduce their administrative burdens, enabling seniors and their caregivers to better understand and navigate their Medicare options and benefits, and providing a single point of access to targeted, needs-based assistance where, when and how the client needs it – in-person, on the web or over the phone.

Medicare Assisters would provide seniors and their caregivers with personalized information about program benefits and their costs from initial eligibility through the life of their relationship with the program – creating a "one stop shop" for seniors looking to cut through the confusing array of trustworthy and untrustworthy information currently provided.

Medicare Assisters would help increase coverage for the growing number of America's seniors, especially those from minority populations, and make the Medicare system more accessible, culturally sensitive and easier to manage for the seniors who are aging into the program. This is what we need as we look to the next 50 years of Medicare.

Elena Rios, MD, MSPH is the President & CEO of the National Hispanic Medical Association. Rios is a member of the National Hispanic Leadership Agenda, Care First Blue Cross Blue Shield, Better Medicare Alliance and Nurse Family Partnerships Boards of Directors. Prior to working at NHMA, Rios was an Advisor for Regional and Minority Women's Health for the US Dept of Health and Human Services Office on Women's Health from 1994-1998 and at the White House Outreach Groups Coordinator in 1993. Rios received her BA from Stanford University, MD from UCLA School of Medicine, MPH from UCLA School of Public Health and Internal Medicine Residency from Santa Clara Valley Medical Center and White Memorial Medical Center and NRSA Fellowship from UCLA.

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