Monday, October 7, 2013

Seniors Beware . . .

Fall has come and besides the weather changing, other changes are imminent.  It's time to make sure that everything is in order before the winter sets in.  Outdoor furniture and fixtures put away.  Gardens put to bed for the fall and winter.  Remember not to neglect yourself while you're getting everything done, it may cost you if you do.

Well October 1 marked the beginning of what we affectionately call Obamacare for the individual side of the plans.  The reason Seniors need to beware are for the following reasons:

  1. Medicare has reduced payments (again) to doctors.  Doctors were already limiting the number of Medicare patients they would see but now many are opting out entirely.  If you don't have a primary care physician GET ONE NOW.  Waiting my make it difficult for you to find anyone that will take you on as a new patient.
  2. Medicare rates are going up for all participants.  Premium increase notices have gone out.  In addition to premium increases are also co-pay increases.  Make sure you understand these increases and that your current plan is best for you.
  3. Drug formularies and prices are changing.  Many plans do not cover certain drugs.  In addition, the increase in generic co-pays could rise to $10/per prescription per month.  Go to Walmart where generics can still be got for $4/mo or $10/3 months.  Some plans offer mail order, see if yours does and if you can get your drugs for free by using it.  BE CAREFUL!  Mail order only sends out 3 month supplies so even if you save money, it can put a crunch on your budget.  Some drugs are costly enough that budgets can handle the monthly much easier than a three month payment.  You can pick and choose which prescriptions go through mail so if some are best to get through your drug insurance and others at the pharmacy you can do that.
There are resources that you can use for help.  SHIBA is paid through CMS (Medicare) but has people that will help you with forms or figuring out the best plan for you.  With the myriad of concerns SHIBA gives an impartial opinion on what would work best for you based on your specific situation.  Don't forget if you have medical equipment to make sure you see how your plan covers that as well.  

To contact SHIBA in Idaho:

SHIP Name: Idaho Senior Health Insurance Benefits Advisors (SHIBA) 
SHIP Director: Ms. Genii Hamilton 

Program Phone Number: 

Program Address: 
Idaho Department of Insurance 
700 West State 
Third Floor 
Boise, ID 83720-0043 

SHIP Web Address: 
State Hosting Agency:   SHIBA is housed in the Idaho Department of Insurance. 

    • Boise                      208–334–4353       1–800–247–4422 
    • Coeur d’Alene        208–666–6847       1–800–488–5725 
    • Pocatello                208–236–6044       1–800–488–5784 
    • Twin Falls              208–736–4713        1–800–488–5731 
If you live outside the State of Idaho visit: 

Before you make an appointment with SHIBA it's helpful to know if you qualify for any cost assistance, you can get to the online form by visiting:  

or you can call:  Medicare's Limited Income Newly Eligible Transition (NET) Program at 1-800-783-1307 for more information. TTY users should call 711.

Make sure you don't put off getting the information, the deadline for changing your enrollment information is December 15.  The longer you wait the more likely you are to have to pay the first premium up front if you're changing plans.  To find out if you qualify for assistance please complete the forms as soon as possible.  Generally it takes 30 days to find out if you are qualified.  You have time but don't procrastinate.  Remember, SHIBA will also help you with this if you need it.