Medicare 101 and navigating Medicare


By Susan Wright  | San Juan Basin Area Agency on Aging

Medicare is complicated. It is important to learn about it. We can help. Not only does our State Health Insurance Assistance Program (SHIP) office have free counseling, we’re also having a free Medicare 101 class on Monday, April 24, at the Ruby M. Sisson Memorial Library. It’s through SHIP, not a private insurance company. 

Also, if you have specific question, certified Medicare counselors are available to guide you. Just call (970) 264-0502, ext. 4 for an appointment. You can leave a message 24 hours a day, and we’ll get back to you ASAP. 

One of the San Juan Basin Area Agency on Aging (SJBAAA) Medicare counselors, Susan Wright, will offer a free Medicare 101 class for an hour or so Monday, April 24, at 1:30 p.m. at the library. Enjoy some snacks and treats while Wright gives you an overview of Medicare and answers your questions afterward. Bring a pen and notepad. 

Medicare help has been offered in Archuleta County at the Pagosa Senior Center for more than 15 years. SJBAAA is the sponsoring agency for free Medicare counseling services at the Senior Center (the west end of the Ross Aragon Community Center) on Hot Springs Boulevard. On most Mondays, called Medicare Mondays, counselors are available by appointment. Counseling occurs on additional days during the annual Part C and D Open Enrollment Period, Oct. 15 through Dec. 7, and sometimes by phone or appointment on other days. Advantage Plans also have enrollments from Jan. 1 to March 30. You can compare prices and see what insurance companies offer plans in our area at 

SJBAAA counselors are also trained as Senior Medicare Patrol counselors (SMP). They can help with possible health care fraud, errors and abuse. There are even rewards available for reporting Medicare fraud. You can report it at, or call 1 (800) 633-4227. TTY users can call 1(877) 486-2048. You can also report abuse, like all those annoying phone calls from private insurance companies by calling (888) 382-1222 or visiting It’s estimated we lose $100 billion a year from Medicare and Medicaid fraud and abuse. Whether it’s overbilling, phony billing or spending health care money reaching out for new customers instead of using government money for care, we need to report it. 

Medicare eligibility begins at age 65 (unless you are younger and have been on disability for almost two years). Three months before (and until three months after) your birth month you can enroll in Medicare and start making decisions about your options. Some of the questions you need to consider follow: 

• Are you eligible for Medicare Part A and Part B? Do you need both?

• Do you have a retirement plan that will work with Medicare? 

• Do you want a Medicare supplement (also called Medigap)? 

• Would you prefer coverage through a Medicare Advantage plan from an insurance company? 

• Do you want a Part D drug plan to avoid a monthly penalty? If so, which plan would work best for you? This varies depending on which drugs you take. 

• Do you qualify for help with part B or D premiums? 

Generally, you can enroll in Medicare online at or by calling the Social Security Administration in Durango at (888) 472-6115. If you are already receiving a Social Security check, you will be automatically enrolled in Part A and Part B, but you will need to enroll in Part D and Part C or supplements yourself. The Social Security office probably won’t be able to sign you up for Medicare without an appointment. Appointments can take months to get, according to state coordinators, so don’t delay. 

After you are enrolled in Medicare, you can compare and enroll in Medigap plans, drug plans or Advantage Plans at Private insurance companies have the most detailed information about what Medicare Advantage plans in our area offer, so it’s best to get information from them directly. 

If you are already on Medicare and have a Part D drug plan, Medigap or a Part C supplement, it’s prudent to review each plan every year during the open enrollment period. Plan premiums and coverage of drugs change each year. Medicare counselors can help you during that time, or you can go to to review your plan and compare it to others. 

Also, contact Medicare at (800) Medicare [(800) 633-4227] if you did not receive a Medicare card when you turned 65. You can sign into to see if your card was mailed and, if so, print out an official card. 

The above Medicare number can help with any questions you may have. They are available 24 hours a day, seven days a week (except for some federal holidays). 

If you are receiving Social Security disability, you will probably be eligible for Medicare starting 23 months after your disability begins. You will have a limited period to enroll in a Part D drug plan. It is important to take advantage of opportunities to enroll so that you have the coverage and not the penalties. 

The state trains people to provide you with the information and tools to navigate Medicare with as little stress as possible. Wright would enjoy helping you understand your benefits, so join her Monday, April 24, at 1:30 p.m. at the library. RSVP to (970) 264-0502, ext 4. Leave a message 24/7 with your contact info so we know you’re coming, and we’ll see you there. We’ll have refreshments and door prizes, too.