Medicare Helps Make the Golden Years Golden

There are many things in life we can control. Aging is not one of them. Simply viewed as part of life, we often try not to ignore the issues that come with getting older, like health problems, for example.  Medicare provides seniors with assurance that if they do struggle with health-related issues, they have safety and security for the coverage needed. 

Medicare is the federal health insurance program for individuals who are 65 or older, under 65 and receiving Social Security Disability Insurance (SSDI), and certain younger people with disabilities. Unlike Medicaid, Medicare is available to all individuals who qualify, regardless of income.

Nationwide, there are more than 55 million people enrolled in Medicare. In Arizona, there 1.1 million Medicare recipients.

Enrolling in Medicare is a simple process. However, selecting the right coverage can be challenging for some. Here are some basics one should know when enrolling:   

• Once an individual turns 65, the National Social Security Administration (NSSA) automatically enrolls them in Medicare.
• Those who do not qualify for Medicare will be notified four months prior to their 65th birthday (will receive instructions on what needs to be done).
• There are four parts to Medicare
  
  • Part A – Automatic enrollment for hospitalization coverage (no cost)
  • Part B – Selecting personal care physicians (cost of $150)
  • Part C – Supplementary medical insurance
  • Part D – Prescription cost coverage

The Medicare enrollment process can be daunting and some individuals need someone to help navigate the process. That someone is Patricia Emblem, the Department’s State Health Insurance Assistance Program (SHIP) coordinator.

Emblem’s primary duties consist of responding to information requests regarding Medicare enrollment and options.

“On average, we receive 5,000 [Medicare] information requests per month, especially during open enrollment,” she said.  “Last year, we assisted 40,000 individuals, and we are on pace to serve approximately 55,000 recipients.”

One of the biggest challenges facing Emblem is informing the public about the Medicare process.

“We addressed this issue by going out and presenting in the community,” she said. “In 2015, we delivered 878 presentations and distributed information pamphlets in English, Spanish and Russian.  We also have retired [trained] professionals working here one to two days a week.”

In addition to responding to Medicare inquiries, Emblem’s office also responds to claims of provider fraud.

“We have developed a database of incidents of fraud. If we suspect fraud, we report it to the Office of Inspector General (OIG),” said Emblem.

What advice she would give to someone enrolling in Medicare?  Emblem recommends they assess their health and picked options best for them. 

The efforts of Pat Emblem and her volunteers embody the DES People First, People Always philosophy that drives at Our Great DES. Assuring that seniors have the necessary information to make the best choices for themselves is what drives Emblem to do her best each day.

If you have questions regarding your Medicare coverage call 1-800-432-4040 or visit www.AZLINKS.gov.

By Vance Phillips