Free service APPRISE helps older adults understand insurance options

Understanding Medicare, Medicaid, Medigap and other supplemental insurance options for older adults can be a confusing and frustrating process.

There’s a lot of information to sift through, and it’s not always easy to find answers to questions that arise.

What few people are aware of, however, is that Pennsylvanians don’t have to go through the process alone. There’s a free program in Westmoreland County called APPRISE that offers unbiased insurance counseling services and helps people find what’s right for them without pushing any one plan or company.

“We always say we’re the best-kept secret because no one knows about us,” said program coordinator Amy Halula. “We can analyze and look over everybody’s individual situation, their health care needs, how often are they going to the doctor, do they have a history of, say, diabetes or asthma or osteoporosis, are they thinking they’re going to have broken bones or need surgery at some point. All those things come into play when you’re looking at health insurance.”

APPRISE is the State Health Insurance Assistance Program that started in the 1990s as a no-cost, no-pressure way to help people navigate the Medicare system. It is sponsored by the Westmoreland County Community College Retired and Senior Volunteer Program, or RSVP, and funded in part under a contract with the Westmoreland County Board of Commissioners, Area Agency on Aging, the Pennsylvania Department of Aging and the Administration for Community Living.

The two most common questions people have, Halula said, are whether or not they have to sign up for Medicare and what to do about other health insurance to go with it.

“That’s really the key thing, because Medicare is one small part of your health care once you’re Medicare eligible,” she said. “There are so many questions, and people just don’t know what to do.”

At APPRISE they are not brokers, Halula said, but rather specially trained volunteers there to help. For example, they can explain which services are covered under Parts A and B and other Original Medicare benefits, discuss Medicare coverage options and Medigap insurance policy benefits and help determine eligibility for prescription drug programs and programs that pay Medicare deductible payments and Part B premiums.

“We’re looking at the whole picture, not just one or two plans,” Halula said. “And we’re looking not just at the type of plan, but what else is out there. We look at all the plans and sit down with the person, but we never pick for the person. We help them narrow down their choices and try to break things down to the basics and explain it to them step-by-step so they understand. We try to help educate them.”

They can also provide a list of companies that sell plans, help people make informed choices and understand the Medicare appeals process, and even help with paperwork. If someone has run afoul of regulations, they can help with that, too.

In addition, at locations throughout Westmoreland County, APPRISE offers programs such as Medicare 101, to answer basic questions for those new to Medicare, and the AARP Smart Driver Course.

The program is free to anyone who is eligible for Medicare, and no referrals are needed. For more information on APPRISE, visit westmoreland.edu/about/community/apprise.html or call 724-925-4213 or 800-262-2103, ext. 4213, for more information.