HYANNIS – The health insurance maze can be a confusing journey along a road of paperwork that never seems to end. Take a wrong turn and you’re starting all over again.
The good news is there is assistance to help you travel the path of least resistance.
The financial counselors at Cape Cod and Falmouth hospitals and a community-based organization, SHINE (Serving the Health Insurance Needs of Everyone) can assist you with the travails of signing up for health coverage.
“It is the best hour they will spend pursuing help with their insurance,” said John Matakanski, financial counselor at Cape Cod Hospital.
“Every person we talk to who has a need for health insurance is screened for MassHealth and the Health Safety net,” said Matakanski. This is especially important since Massachusetts residents are required to have health insurance by law.
But circumstances may prevent some from getting insurance, some may not have it due to high costs, high deductibles, or get it for their children and not themselves. Others may be unemployed or work at a small business that does not offer coverage.
Counselors are contacted by the hospital Emergency Centers or a registrar who encounters a patient with little or no health insurance. Residents can also make appointments to meet with a financial counselor, if they have questions about insurance or they need to apply.
Fill It Out
When it comes to filling out the paperwork to apply for health insurance, the counselors have a mantra, “When in doubt, fill it out,” said Matakanski.
The financial counselors often go to the Emergency Center or a patient’s hospital room to assist them with health insurance information and guidance.
“We find a lot of times, when we go into a patient’s room and we introduce ourselves, a sense of relief comes over them,” said Matakanski.
Kim Pina and Pam Viera, financial counselors at Falmouth Hospital, encourage residents and patients to be proactive getting health insurance.
“If patients wait until they get a bill from the hospital after an emergency room visit or admission, it’s too late,” said Viera.
Financial counselors will also help patients make arrangements with payment plans to pay hospital bills and balances.
While the hospital financial counselors provide information, assistance and counseling for all ranges of health insurance, the SHINE program works with Medicare beneficiaries of all ages and their caregivers.
Medicare beneficiaries are not necessarily 65. Anyone under 65 who has been receiving Social Security disability for 24 months automatically gets placed on Medicare in the 25th month, said Sheila Curtis, Regional SHINE program manager.
Baby Boomer Concerns
The big issue are the baby boomers who are turning 65 and have not signed up for Medicare benefits, said Curtis. Those are the residents the SHINE program would especially like to reach. Even if you are still working, don’t plan to retire, or are not collecting Social Security, you should contact SHINE to see if you should sign up for Medicare and what your options are, Curtis said.
When you sign up for Medicare Part A (hospital insurance), which is usually free if you paid into Medicare, you have the option of turning down part B (medical insurance), which has a monthly premium. But if you decide to get Part B later, there may be consequences.
“If you don’t sign up for Medicare Part B when you are first eligible, there is a 10% penalty for every 12- month period you don’t sign up,” said Curtis. “It’s 10 percent of whatever the Part B monthly premium is per year for the rest of your life.”
You can delay signing up for Medicare Part B and avoid this penalty if you or your spouse are actively working and have health insurance through the employer. The word is “actively” working, said Curtis. Those who have coverage through the Consolidated Omnibus Reconciliation Act (COBRA) are not protected from the penalty, she said.
Medicare has many rules and specific enrollment periods so it is very important to be proactive and aware of deadlines, Curtis emphasized.
Residents can apply for Medicare through Social Security either online by phone or by appointment at a Social Security office.
For further information or to make an appointment contact:
Cape Cod Hospital financial counselors: 508-862-7019
Falmouth Hospital financial counselors: 508-495-7156 or 508-495-7157
Sheila Curtis, Regional SHINE program manager: 508-375-6762
SHINE services are also available at all of the Council on Aging centers on the Cape and Islands except Wellfleet.
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