Seniors grapple with Medicare
Staff writer
Gene Winkler received a letter Dec. 4 from Clearspring informing him his prescription drug insurance no longer would be offered.
The letter was dated Nov. 22, two weeks before Winkler received it. The deadline for switching Medicare providers was Dec. 7.
That meant Winkler had three days to find a new insurance plan or he would not be covered for 2025.
No reason was offered as to why his coverage was dropped.
“I’ve never received any notice from them before this,” he said.
Winkler acted fast.
“I went down to the pharmacy, and they ran my drugs to see what would work best, and it came back BlueCross BlueShield,” he said.
Lu Turk, director of the Marion County department on aging, then helped Winkler enroll into a BlueCross BlueShield plan before the deadline expired.
Medicare has since extended its deadline for those affected by Clearspring denials.
But Winkler’s case is one example of various insurance issues seniors are grappling with, and which may worsen in the future with proposed cuts to social programs.
Insurance costs have risen under both Republicans and Democrats in the past decade.
In 2024, seniors say, things got out of hand.
Bill Goentzel and his wife, Kathy, were notified that they would each have to start paying a monthly $38.30 premium under their SilverScript insurance. Previously, the company was not charging a premium.
“We got a letter in the mail and saw SilverScript was gonna go up,” Goentzel said. “It was ridiculous. They keep raising it all the time. You don’t know what to do.”
Turk helped the Goentzels switch their insurance provider before deadline so they could avoid paying the premium.
While Goentzel said he and Kathy could have afforded the premium, he is grateful to have switched. He pays for three prescription medications, while Kathy pays for even more.
“We’re on a fixed income,” he said. “She’s got her eye drops she’s got to take. Glaucoma.”
Turk helps dozens of seniors sort out insurance plans this time of year.
“I’ve had people come to me this year that… had never checked their plans in the past,” Turk said.
She recalled a couple paying an $85 premium for Humana insurance.
“It’s crazy,” she said. “It doesn’t go into their drugs. They’re just making that company richer.”
According to Turk, switching providers, and even finding out what a provider is charging, can be difficult for seniors.
“I’ve had people that have tried to do it themselves,” she said. “And they get hosed up.”
Many seniors have had their Medicare numbers compromised by hackers, who use the numbers to purchase medical equipment or drugs in other states.
Winkler, while trying to find a new insurance provider, discovered his number had been hacked and shut off.
“I’ve heard of some problems with Medicare, that they would get a notice, and for some reason, [hackers] bought 1,000 syringes or something,” he said. “Well, that’s what happened with my Medicare number. Somebody got a hold of it, and they ordered a big bunch of stuff.”
The number was shut down Dec. 1, Winkler said. He was not informed.
Bud Kelsey’s Medicare number was also rejected because of a hack. He, too, was not informed.
“We were a little bit upset that we didn’t get any kind of notice about it,” Bud’s wife, Tressie, said.
Kelsey and Winkler have received new numbers and not been charged for fraudulent purchases. But lack of communication from Medicare was frustrating, they say.
Turk said she had called Medicare four separate times about hacked numbers and not once did Medicare notify anybody.
Issues with Medicare and rising premiums may worsen.
Mehmet Oz, President-elect Donald Trump’s pick to run Centers for Medicare and Medicaid Services, advocated in 2020 for putting all seniors into Medicare Advantage plans.
“Medicare Advantage does not work well in Marion, in rural America,” Turk said.
Winkler is hopeful that things will improve.
“Hopefully, when Trump gets in here, all this stuff’s going to get straightened out a little bit, and it’ll be better for the person that’s out there on a very low income,” he said. “Maybe he’s going to get that back in shape.”
Turk is less certain.
“I’m hoping and praying that it’s going to be better,” she said. “I hope I don’t regret voting for him.”