What To Do When You Need Help With Health Insurance

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What To Do When You Need Help With Health Insurance

Mrs. Thompson (not her real name), a 76-year-old Virginia woman, suffers from Alzheimers. Recently her former employer, a major tobacco company, cancelled its retiree health insurance program, but continues to pay retirees a monthly allowance for an individual Medigap policy. To get help finding replacement insurance, Mr. Thompson called the health insurance counseling program at their local Area Agency on Aging. Because both Mr. and Mrs. Thompson are disabled, the agency arranged for a counselor to meet with them in their home.

Sally Mank, an insurance counselor, visited the Thompsons and provided them with information about Medigap insurance. With Sally's help, Mr. Thompson was able to avoid having his wife's Alzheimers disqualify her for coverage. He learned that he had 63 days from the termination date of his wife's last policy to obtain replacement health insurance. Based on the information provided, Mr. Thompson was able to select a Medigap plan that provided coverage similar to that in the cancelled company policy. Acting promptly, the Thompsons had the new policy in place when the company plan ended, with no exclusions for the pre-existing condition.

If you need help with Medicare, Medigap insurance, or Medicaid, free health insurance counseling is available through your local Area Agency on Aging. Specially- trained staff and volunteers help you wade through the often-confusing language of insurance policies. They can explain Medicare and Medigap insurance, and help resolve questions about payments and claims.

One invaluable service is help selecting Medigap insurance that provides the coverage you need and fits within your budget. Guidance in how to select long-term care insurance is also available. The volunteers and staff are not connected with any insurance company, nor are they licensed to sell insurance. Their purpose is to serve you objectively and confidentially. Training and program oversight are provided by the state Agencies for the Aging and state insurance commissions.

Your local Area Agency on Aging is a good place to go for guidance if your Medicare HMO is discontinuing its Medicare program. You will find out about other choices available to you and about the time limits for getting the best coverage.

Area Agencies on Aging are non-profit organizations which cover all communities in the United States and its territories. They receive support from local contributions, federal programs, and private foundation grants. You can reach your local agency by calling the Eldercare Locator at 1-800-677-1116 or go to http://www.eldercare.gov.

Editor's note: Sally Mank is the health insurance counseling coordinator at Jefferson Area Board For Aging in Charlottesville, Virginia. We are very pleased to have her expertise on our advisory panel.

This article first appeared in Volume 5, Issue 3 of "The Social Security and Medicare Advisor" newsletter (February/2000). To receive future editions of "The Advisor" in its special, free e-mail version, please click here.