Need assistance with Medicare decisions? There is unbiased help in Virginia, and it is free!

Medicare options are among the more impactful decisions facing many older Americans each year, and those choices are often among the more difficult to navigate. The Medicare Open Enrollment period that runs through Dec. 7 allows recipients to annually consider changes to their plans. Counselors like Russell Schiavone are trained to assist the many Virginians uncertain how to best proceed and seeking help to better understand their options.

“There are so many things. I think that people get confused because there are a lot of variables,” said Schiavone, a volunteer counselor with VICAP, the Virginia Insurance Counseling and Assistance Program. VICAP is charged with providing state residents with “free, unbiased, confidential and personal assistance” through one of Virginia’s statewide Area Agency on Aging locations. More than anything else, the confusion he frequently sees involves Medicare Advantage plans, also known as Medicare Part C.

“People don’t always understand that when they enroll in a Medicare Advantage plan, every medical concern they have runs through the insurance company that runs their plan,” Schiavone said. “All the doctors’ and hospital claims go through that insurance company. Nothing gets submitted to Medicare because the insurance company becomes their medical manager, and a lot of people don’t realize that.”

Many people are quite happy with their Medicare Advantage plans, Schiavone said. They typically promise benefits not available through original Medicare like vision, dental and prescription options along with supplemental medical coverage. That allows those choosing such a plan to have all medical benefits and coverage under one financial roof.

But he said that in many cases, there are other factors to consider. Treatment options, for instance, must be approved by the insurer. Unlike original Medicare, Part C provider networks may be limited in number and geographic range. In addition, Schiavone said, if you later decide to return to original Medicare you may encounter difficulties in regaining supplemental coverage.

“The (supplemental) insurance company (often) has the right to charge you a higher rate or deny you coverage. If you have health issues, it could be more difficult.”

Another common question he hears involves prescription plans. This year, the available options in Virginia are reduced in number, and the costs may vary by plan from the current year.

No matter what Medicare, prescription or Medicare Advantage plans you have, make sure to carefully look over annual changes that all providers must send to you in advance of every early enrollment period, Schiavone said.

“It’s very important to read those changes, and that is a start as to whether or not you should consider changing your plan for the coming year,” he said.

As for those nearing the day to enroll in Medicare programs for the first time, Schiavone urges them to start the process well in advance; there is a lot to understand and consider.

No matter whether you are about to join Medicare programs or are already enrolled, Schiavone is among the many VICAP volunteers who are prepared to help you understand and navigate your way through your options. They are always looking for new volunteers to help out.

Virginia funds 25 regional Area Agency on Aging offices across the state where the trained and annually certified volunteers are ready to assist.

To find your nearest office and learn more about VICAP assistance, visit: https://www.vda.virginia.gov/aaamap.htm, or call (800) 552-3402.

If you are uncertain or confused about your Medicare options, Schiavone said you are hardly alone. While he and his VICAP colleagues do not make specific recommendations, their mission is to help you possess the knowledge you need to make a decision that is best for you.

“I did so several times already today,” he said in a recent noontime conversation. “It is very rewarding.”