Cover Story: Open enrollment keeps counselors busy

Adults listen to a presentation at a Medicare 101 class

By Gerald Hay

Kelly G. Loeb knows how to navigate through the informational maze in Medicare and Medicaid.

She was among four experienced, certified counselors to provide Medicare 101 basics at the Johnson County Central Resource Library in Overland Park. Sponsored by the Johnson County Area Agency on Aging, 26 people signed up for the class ahead of time. More than 50 attended the presentation.

The overflow attendance and interest were not surprising with the annual Medicare Open Enrollment from Oct. 15 to Dec. 7 just a few weeks away.

A 13-year counselor of the Senior Health Insurance Counseling for Kansas program, Loeb quips she’s fluent in three languages: “Trilingual – English, Spanish and Medicare!”

Her SHICK involvement began 13 years ago when Kansas Department for Aging and Disability Services (then known as the Kansas Department on Aging) was looking for someone who could provide education and counseling about Medicare in Spanish.

“I didn’t know much about Medicare at the time, but I am fluent in Spanish, so I learned doubly – how to understand and use Medicare in English, and then how to interpret/translate that for Spanish speakers,” Loeb said.

She along with Larry Nelson, Karen Mayse and Gayle Callahan are among a small cadre of trained SHICK counselors who will swing into action when open enrollment sends older adults, retirees and caregivers searching for help in Johnson County and across Kansas.

Federally and state funded, SHICK counselors, mostly volunteers, know first-hand about the complexity of Medicare enrollment and in receiving benefits. They are trained to know or how to find answers to questions about Medicare and other medical health care insurance issues.

Open enrollment is the busiest time for the counselors and the statewide SHICK program.

“The goal is to educate and assist the public to make informed decisions on what’s best for them,” said Rachel Winter, SHICK program coordinator at the Johnson County Department of Aging and Human Services and local AAA.

Nelson, a local SHICK counselor for four years, agreed.

“People need to review their coverages every year. In most cases, the biggest changes come in the drug plans. It only takes a short period of time to get your coverages reviewed, and you’ll save a lot of money and hassles by doing so in open enrollment,” Nelson said.

“No two people are alike, each person has their own unique medical needs and applying those needs to (Medicare) coverages is sometimes difficult.”

SHICK assistance is free and confidential.

According to Winter, counselors offer unbiased information on changing conditions in health care insurance and cut through the confusion about Medicare and Medicaid to new enrollees and other beneficiaries.

The trained volunteers do not work for any insurance company nor are affiliated with the healthcare insurance industry, Winter said, adding:

  • Counselors do not sell, recommend or endorse any specific insurance product, agent, insurance company or health maintenance organization.
  • They are not going to make any decisions for the Medicare beneficiary but will explain their options so that the enrollee may make an informed decision.
  • Volunteers are not financial planners.

Counselors also have access to state and federal Medicare information as well as the Kansas network of fellow volunteers and numerous online resources. Counseling for Spanish-speaking Johnson County residents is available during open enrollment.

“Open enrollment is a busy time. Our main flow of clients is those new to Medicare. Counselors set their own schedule but typically in a week, some of our counselors might put in 20-30 hours a week or more. Since it’s a relatively short-term timeframe and they expect it, I don’t think they mind putting in more time than usual,” Winter said.

Volunteers also are always in great demand for the SHICK program. The training is challenging, but the rewards are fulfilling.

“When people apply to be a volunteer, most often they have already been through the Medicare process and have learned what not to do. They feel a sense of responsibility to help others avoid the pitfalls they or family members have had to deal with. And they all tend to be natural problem solvers,” Winter said. “We generally see folks that are 65+. This isn’t a bad thing as I think a client would rather have a peer helping them.”

What does it take to become a SHICK volunteer?

“My three favorite values: kindness, grace and love! Medicare is a maze of complex, multiplex factors and being able to distill its most salient features in clear, user-friendly ways takes all three,” Loeb said.

“Add to that technological savvy, flexibility and compassion, and you’re describing what it takes to be a Medicare counselor.”

Mayse, who assisted at the Overland Park presentation, has been a SHICK counselor/volunteer and part-time employee at the North Central-Flint Hills AAA in Manhattan. She has been with the state program for 15 years.

“The most important skill is to be good at listening and use critical thinking to determine what the senior needs help with. Almost as important is a desire to take on a challenging subject and learn how to find answers within the system. Lastly, but just as important, is to have a desire to help people,” Mayse said

“SHICK counseling is one of the most rewarding things a volunteer can do because you can see how much money you help people save or how much stress you relieve when you help someone who is confused and intimidated.”

Callahan volunteered for SHICK four years ago after retiring from Johnson County Community College where she worked in student accounts for 27 years.

“I wanted to better understand Medicare, and based on my work experience, felt I was good at explaining complicated financial information to people. I like helping people new to Medicare understand all the pieces and parts and helping them make the best choices for them,” Callahan said.

“All my clients have remarked on how complicated Medicare is. I try to assist beneficiaries avoid pitfalls to avoid penalties that may incur for doing nothing because it is hard to understand.”

SHICK counselors are also trained at informing Kansans how to avoid fraud.

Nelson advises beneficiaries to seek referrals from friends and relatives on good insurance plans and reputable agents and not make their decisions from TV or radio ads or Google.

He worked as a financial director in a long-term acute care hospital helping patients who didn’t have the Medicare coverage they thought they had. According to Nelson, some patients were misled “by scam insurance people.”

To help address potential fraud issues, how to avoid scams and provide Medicare assistance, Winter hopes more people volunteer in the SHICK program by becoming a certified counselor or administrative volunteer.

“It’s a very fulfilling way to help our aging peers, and it’s truly a win-win for everyone,” she said.