|
Residents who gathered in a conference room at CenterPlace at Mirabeau Point
recently were quickly introduced to a theme of wellness.
Beginning with
a presentation by Mary Ann Wilson, host of the "Sit and Be Fit" television
program, attendees learned the importance of staying informed and active in the
quest for good health.
"You have to make exercise a priority in
your life because it's going to pay dividends," said Wilson.
While
Paul Weeks, a sales representative for Spokane Community Care, didn't follow Wilson
in leading the audience through balance and stretching drills, he did provide
a valuable lesson in maintaining flexible and reliable healthcare.
Spokane
Community Care was one of a number of companies to emerge after the Medicare Modernization
Act of 2003. Known as "Medicare Advantage" programs, such companies
contract with Medicare to administer people's healthcare benefits.
Weeks
was quick to point out the benefits of a program that has planted roots in the
Inland Northwest.
"We're right here in Spokane and we're going
to continue to be here," he said. "We've made an investment in Spokane."
A
look at the company's history over the past few years appears to prove Weeks correct.
Since originating in 2004, Spokane Community Care has now contracted with every
area hospital as well as over 450 of the leading healthcare providers in the region.
Recognized names like the Rockwood Clinic, Northwest Orthopedic and the Spokane
Eye Clinic have come on board in recent years.
Mike Thompson, sales
manager for Spokane Community Care, points out the emphasis the program places
on catching illness before it spreads. There is no cost for immunizations, pap
smears, prostate exams, blood work, colonoscopies and other preventative procedures.
Another
trademark of the program's proactive pursuit of wellness includes free memberships
to a variety of local health clubs. Thompson pointed out that doctors should be
consulted before beginning any exercise program.
The annual enrollment
period for Medicare Advantage plans and Medicare's Part D Prescription Drug plan
ended Dec. 31, 2006. Now, there is one more opportunity to switch to a like plan
until March 31, 2007. The annual enrollment period will begin again on Nov. 15,
2007.
Spokane Valley resident JoAnn Howard attended one of the first
informational meetings sponsored by Spokane Community Care in 2004 and soon found
those who administered the program were able to bring the Medicare picture into
sharp focus.
"They were very generous to answer all our questions,"
she said. "It made being on Medicare and being older less stressful."
Cataract
surgery last year cost Howard only $150 in out of pocket expenses. Earlier this
year, she went in for blood tests on her kidney and liver after experiencing pain
in her abdomen. The co-pay for the visit was $10, while the tests amounted to
just under $7.
All those who qualify for Medicare are eligible for Spokane
Community Care coverage. There are three levels of membership, starting with the
basic plan, which carries no charge for the premium and includes copays.
The
"doughnut hole" phase of Medicare Part D speaks of a gap in prescription
drug coverage after a spending limit is reached with coverage resuming after the
beneficiary covers another amount in out-of-pocket expenses. Spokane Community
Care and some other Medicare Advantage programs help during that time by offering
discounts on medications. Spokane Community Care provides its generic drugs for
$18 throughout the uncovered period.
Thompson points out that there
are other options for people when picking a Medicare Advantage plan, noting that
Spokane Community Care "may not work for everyone." Other companies
that offer similar plans include Asuris, Sterling and Secure Horizons.
Earlier
this year, John Austin, a physician who helped launch Spokane Community Care,
visited Spokane Valley to describe the benefits of Medicare Advantage plans. Austin
talked to residents about the mission of providing reliable, affordable and efficient
healthcare.
"Our goal is to provide a product that will help people
with costs and make sure they receive top-notch care," Austin said.
With
nine people working out of Spokane Community Care's local office in the Rockpointe
Center, Thompson said program members can be assured of a quick response to problems
or concerns. A grievance system is in place to consider coverage of any procedure
or medication not currently covered by Medicare.
Program staff members
call pharmacists or doctors to straighten out issues, streamlining the process
and taking the headaches out of healthcare. In the end, Thompson said, organizations
like Spokane Community Care reduce fraud and provide more money to put back into
the program. For patients like Howard, the approach has meant cost savings and
a healthier outlook.
"It's a program that people who aren't rich
can afford," she said. "They take care of you." Want to
find out more? Spokane Community Care can be reached at the Spokane
office by calling 509-325-8004 or 800-573-8609. To learn more, visit www.spokanecommunitycare.com.
Aging and Long Term Care of Eastern Washington, 1222 N. Post, also is available
to answer questions about Medicare and healthcare in general. They can be reached
by calling 509-458-2509. For more information on Medicare, call 800-633-4227.
Click
here to...
Subscribe to the Spokane Valley News Herald
| 
By
Craig Howard
