People in the United States reach the age of 65 with various goals and emotions but with one thing in common: Nearly all may be eligible for Medicare. But they may wonder, “What is Medicare and what do I have to do?” For the past 13 years, Harvard resident Terry Morton has been answering those questions.
Now, with new priorities, Morton is easing into retirement, and he is hoping another town resident will volunteer for the role. He said someone from outside can step in, but it would be nice to have a fellow resident helping others in town. “It’s a fun and satisfying job,” said Morton in a recent conversation.
Morton is a counselor with SHINE—Serving the Health Insurance Needs of Everyone—a national program, though with different names, that is managed by private enterprises. Its purpose is to help people understand the broad scope and critical details of Medicare, the federal government’s health insurance for anyone age 65 and older and some people under 65 with certain disabilities or conditions. In Harvard’s case, SHINE is administered by Minuteman Senior Services in Burlington, which serves a region of 16 towns.
A SHINE counselor receives 40 hours, partially online, of initial certification training and mentoring, during which volunteers learn all the ins and outs of Medicare, parts A (hospital), B (medical), and D (prescription drugs). They are reminded to be sensitive to issues like hearing impairment and not to make assumptions that the client is understanding everything they are explaining. Monthly two-hour hybrid meetings keep counselors abreast of ongoing changes in Medicare and resource options. “I enjoyed talking with others at those meetings, and I learned a lot from them,” said Morton.
From there, a counselor works on a flexible schedule, meeting with clients in person or answering questions by phone. Most of the cases come through the director and outreach workers at the town Council on Aging, and the COA provides a meeting room. COA Director Debbie Thompson said of Morton: “He has been a huge asset to us; he has helped countless seniors through the maze of information so they can make decisions on what plans are right for them.” Morton said that he liked to meet in people’s homes, too; it was often more comfortable for people and they had the added advantage of access to their computers to look up one of the many informational sites he might suggest.
An alternative to the ‘thick Medicare book’
There is a lot of variety in the cases, said Morton. Some people who have a retiree plan through the company or organization they worked for just want to go over what benefits are covered and what they are paying for. Meeting with a SHINE counselor is “more helpful than reading through that thick Medicare book that comes in the mail every year,” said Morton. Other people with a plan want to see if they are getting the best deal for their money. People who did not have a retiree health plan want to know what their options are and how to get the best coverage. A smaller number need help with their eligibility requirements for Medicare for those disabled, Medicare Savings plans, and MassHealth, and with information on prescription drugs and other cost-saving resources.
It’s the SHINE counselor’s role to explain the parts of Medicare, the rules, and what is covered. “I never tell anyone what to do; I just lay out the choices and walk people through them,” Morton said. “In part it’s a question of your insurance philosophy.” You can pay more each month and have complete coverage, anywhere, or choose a pay-as-you-go approach with a low premium network plan, then pay for services as needed (doctor and hospital co-pays). A discussion about the options helps people understand the choices and they can relate them to their own health and financial situations. “I tell clients the choice is what they’re comfortable with,” Morton said.
Morton said he saw 50 to 60 people a year, about two-thirds of whom were interested in learning “Medicare 101” while the rest were considering making changes in their plans. In addition, he had about 30 phone calls to answer, from people who had a specific question, such as why their premium had increased. He filled out paperwork on each case with information about the client and the kinds of issues that were discussed.
The busiest time was the open enrollment in the fall, the one time of the year that people can change their health plan. Some people came every year to see if anything was new. Some people had encountered a change in their health, their finances, their prescription drugs, or their doctors, and they wanted to explore better coverage because of the changed circumstances. Many people had concerns about what might happen to them and didn’t want to worry about their health needs affecting their children.
“I enjoyed the job because I like talking to people,” Morton said. He didn’t get to know clients on a very personal level, but he got satisfaction from being able to help them, answering questions and referring them to sources for more information. It is rewarding to know you have given someone the tools they need to make good decisions for themselves, he said. And his clients greatly appreciated his efforts, said Thompson. “He has given generously of his time and expertise. We will certainly miss his calm demeanor and gentle way with our seniors.”
“I’m happy to talk to anyone interested in the job,” said Morton, to help them understand what’s involved, and also to stay on to mentor someone who fills the position. He iterated that the job is fulfilling because people really appreciate knowing more, and it feels good to help them realize that “Medicare is not so scary once you understand it.”
A new training session for counselors begins in April. For more information, call the Harvard COA at 978-456-4120.
