Mary M. Nagle had an issue with the health insurance coverage she receives through the Medicare program, so she sought the advice of Darrell Lietz, a volunteer with Iowa’s Senior Health Insurance Information Program, or SHIIP.

It’s Medicare insurance open-enrollment time for senior citizens, and Nagle is among the many thousands who must choose new plans for both health and prescription drug coverage. She and Lietz met during an informational one-on-one session this week at the Bettendorf Public Library.

“Darrell’s helped me out of jams before,” Nagle, of Bettendorf, said.

There are 7,700 Iowans — including Nagle — who were in a plan that pulled out of the state, according to Kris Gross, the SHIIP program director in Des Moines. In Scott County, 800 beneficiaries lost coverage via Coventry Health Care, WellCare Health Plans or Aetna.

The open-enrollment period began this week and continues through Dec. 31. Scott County senior citizens can choose from 46 prescription drug plans for 2010, and there are 15 health plans that go beyond the basic Medicare coverage. Senior citizens in Rock Island County have 46 choices among the drug plans and 12 health plan selections.

“If a person is now in the Medicare Advantage program and does not make a new choice before Jan. 1, they will then revert to their original Medicare coverage,” said Julie Brookhart, a public affairs specialist with Iowa’s regional Medicare office in Kansas City.

In some cases, those who lost coverage and don’t get signed up before Dec. 31 will have until Jan. 31 to do so, but they will have to pay for costs incurred during January. It’s still advisable to sign up earlier, she said. “We want to minimize any lapse in coverage, if possible,” she added.

Web use recommended

There are 500,000 Medicare beneficiaries in Iowa, and some 89 percent have prescription drug coverage. There are 52,336 senior citizens around the state in Medicare Advantage plans.

The best way to investigate coverage choices is through the Internet, but many seniors are not comfortable using computers. A corps of volunteers is available to help, including those with SHIIP.

The primary national Web site is www.medicare.gov. A second choice is one established for Iowa residents and run by the state at www.therightcalliowa.gov. In Illinois, the Web site address is: www.insurance.illinois.gov/Ship.

Available online is a full list of programs to compare, ranked from the least costly to the most expensive. The program takes into account all prescription drugs a person uses, preferred pharmacies and information about any extra help that is available.

Typical case

Nagle lives with her husband in a Bettendorf retirement community. Coverage she had signed up for last year was dropped, so she knew that new choices had to be made.

“This happened to us before, too,” she said. She brought a list of prescription drugs to the session as well as top choices for a new plan.

Lietz — who noted that Nagle was more prepared than many of the individuals he sees every week — plans to plug her information into the Medicare Web site and discuss various options at a follow-up appointment.

Nagle considered the use of an HMO, which she has spurned before because a family member had a bad experience with one. She also has some fee-for-service options in mind. Nagle added that she probably will stay in some type of Medicare Advantage plan.

But one of the couple’s doctors no longer accepts Medicare patients, so they will have to determine costs that may result. Nagle further intends to ask her favorite pharmacist whether he will accept the new program she is considering.

“It’s a rare situation if a pharmacy won’t accept a plan,” Lietz said.

Four less program choices

Nagle was one of eight appointments that Lietz had Wednesday. He and seven other counselors meet weekly with seniors from around the Iowa Quad-Cities.

Individuals generally want to know what options they have because: they have lost coverage, they are trying to find the most cost-effective plans or they want to make comparisons on prescriptions, said Lietz, who is 81 and retired from an administrative job in the Davenport School District.

Iowa has four fewer programs to offer enrollees this year, Brookhart said. They were Medicare Advantage plans with prescription drug benefits and Medicare Advantage stand-alone plans.

Premiums basically went up, on a national basis, but some are down in Iowa. In other plans, deductibles went up or were added, Gross said.

Lietz has volunteered with SHIIP for years because he likes helping others. “It’s tremendously rewarding work,” he said.