Support needed when navigating health options

Medicare. Medicaid. Supplemental insurance. Prescription coverage. Donut Hole. Part B. Outpatient. Part C. Medicare Advantage. Part D. Deductible. Co-pay. Toss in dental insurance options and fitness riders and it’s enough to make one’s head spin with all the choices out there for anyone 65 years or older when it comes to health care coverage.

Medicare. Medicaid. Supplemental insurance. Prescription coverage. Donut Hole. Part B. Outpatient. Part C. Medicare Advantage. Part D. Deductible. Co-pay. Toss in dental insurance options and fitness riders and it’s enough to make one’s head spin with all the choices out there for anyone 65 years or older when it comes to health care coverage.

“It can be life changing,” said Michelle Apodaca, campus community relations director at Living Court Assisted Living Community and Expressions at Enumclaw. “You need to support your family members as they make these decisions.”

Apodaca said anyone who is preparing to retire or is well into their golden years needs help and resources are available. The tricky part, she said, is predicting the future and what a person’s needs may be for adequate coverage.

Aric Walker, senior adviser, and Logan Mallory, director, of Senior Planning Solutions, were at Living Court Thursday evening presenting information for a small group. Enumclaw-based Senior Planning Solutions works with people who are in or near retirement.

“Health and finances are two of the biggest issues people deal with in retirement,” Walker said.

It’s important to realize one size does not fit all.

“When we talk Medicare and Medicaid there are different options out there and they don’t all fit,” Walker said.

Choosing health coverage can be more confusing than doing taxes. Yet, many seniors go it alone.

Education is key.

“The bottom line is you need an advocate,” said Suzanne Lewis, a physical therapist with In Home Rehab of Enumclaw. She and business partner Katey Lent, who were in attendance, along with Apodaca, said it’s often hard for seniors to travel outside of the Plateau for services, so finding coverage that offers local services is important.

“If none of their staff is in our network it’s going to be a headache,” Lent said.

For example, a senior who falls and breaks a hip, will likely need to go from the hospital to a nursing home and then once at home need home health care and outpatient therapy. Without the right insurance coverage that senior will either pay additional costs, or could be at a nursing home facility, for example, outside their comfort zone and away from their support system like Renton.

There are other instances, the trio said, where an organization notes it will send care providers to the Plateau, but doesn’t actually have the staff to follow through.

Asking local providers which plans they accept is a good start in the decision-making process.

Research can make the difference, but, as Apodaca points out, even Internet-savvy seniors can have trouble navigating the web for answers.

Like Senior Planning Services there are many businesses and service organizations that can help. For those who elect that route, Lewis, Lent and Apodaca recommend finding one that can offer several selection options.

A good resource is Statewide Health Insurance Benefits Advisors. SHIBA representatives are often at area senior centers offering free help. For information, visit the website at www.insurance.wa.gov or call 1-800-562-6900.

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