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July 7, 2023

Navigating Medicare as a Health Worker

Navigating Medicare as a Health Worker

Navigating Medicare- a Day in the Life of a Community Health Worker

 

At Mountain Hope Good Shepherd Clinic, we see people from all walks of life. They may be the person who waits on you at your local coffee shop, the person helping you at an amusement park, or the person who helps keep your yard mowed and bushes pruned. The need for services is also varied: The mother who is taking her child in for immunizations, a person with shortness of breath, and sometimes the patient has put off seeing a doctor for too long and has a variety of symptoms to work through. Life goes on, whether we have insurance or not.  These are the people we see each day at Mountain Hope Good Shepherd Clinic.

In many cases, the first-time screening process can reveal not only an initial diagnosis, but clear gaps in what resources a patient might need to develop a healthier lifestyle.  In one case, a 64-year-old patient had come into the clinic for medical care and was unclear on what direction he needed to go, because he had just become eligible for insurance through his employer. They offered a health benefits insurance plan that he would qualify for, but within a brief time, he would also qualify for Medicare.

One of the Community Health Workers (CHW) here at Mountain Hope Good Shepherd Clinic discussed the options with the patient, such as how much the employer plan might cost, both while he continued his employment, and how much it would cost to continue that plan, should he be unable to keep working due to health reasons. The patient also learned that there can be penalties associated with delayed enrollment of Medicare, and that they can go up the longer you wait to sign up. The information our Community Health Workers supplied helped clarify his choices, and once he had a better understanding of his options, he knew which plan would work best for him.

Sometimes, the Community Health Worker plays a vital role in aiding the patient in connecting the dots to other resources they may need. For example, if a patient is diagnosed with diabetes, a change in diet or medication may be needed, and that can create an unplanned expense that their budget cannot accommodate. Insulin and syringes are another such cost, and can often present a difficult choice, as a patient may have to decide between paying for medication or for their utility bill. In such cases, the CHW can connect them with resources to supply more nutritious foods, or medication assistance programs if costs are not within their budget.

In this case, our patient did opt to begin Medicare at age 65, and returned for his last visit, as he would continue care under this new plan, with a new provider. He stated he was fond of his provider at Mountain Hope Good Shepherd Clinic, a sentiment echoed by many over the years, who found they could receive quality health care while being treated kindly and with dignity. We are always happy to see a positive outcome, knowing we are being led to provide these vital services to those that need them, through the spirit of compassion and giving.

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