Pressure in Poverty: How One HiCAP Saved $1.4 Million for Seniors

Medicare’s Open Enrollment from Oct 15 – Dec 7 is the busiest time of year for our partners, the Health Insurance Counseling and Advocacy Program (HICAP). During Open Enrollment also known as the Annual Election Period (AEP), Medicare beneficiaries can review their coverage and make a change. They have many choices and a lot of advertising and information to sort through. This task can be challenging at best, and extremely stressful and overwhelming at worst. For beneficiaries living in or at the edge of poverty, their health plan choice can make the difference between affording both food and health care, or only one or the other. HICAP provides free, individual one-on-one counseling on Medicare related questions to all beneficiaries, and helps thousands to navigate the maze of Medicare options to choose health care coverage that is best for them. As Medicare and coverage options have become increasingly complex, HICAP offices statewide have become busier and are in greater demand each year.

So how do HICAPs keep up with the growing demand and complexities? They are innovative, creative and extremely dedicated. Each HICAP office also recruits and trains a passionate team of volunteer counselors and together they create a system to meet these demands. Highlighted below is a successful AEP strategy from Orange County HICAP who conducted 36 enrollment events last fall and helped clients save over $1.4 million, one of many success stories among the HICAPs statewide.

Linda Walton, Orange County HICAP Program Manager, and Mary Ozurovich, OC HICAP Volunteer Coordinator, headed up the effort, along with their “right hand” volunteer Linda Cardoza and team of HICAP counselors. They started their planning early. They set up initial meetings at surrounding senior centers in January through March 2014 to establish enrollment clinics for the fall; these are the usual sites for their HICAP counseling sessions. In addition, they planned a clinic at their own site following a scheduled Medicare orientation workshop. They followed up with their initial site visits in early summer to finalize the schedule and added a few more enrollment clinic sites later in the fall. When meeting with the Senior Center Directors, Ms. Walton and Ms. Ozurovich also arranged for them to schedule the client appointments, thus reducing the workload in the office.

To man the clinics, Ms. Ozurovich formed teams of HICAP Volunteer Counselors, each team equipped with information packets and a designated leader to work directly with her. For centers without computers or internet access, the teams took laptop computers, a printer and a hotspot connection to get online. In addition, during the last 2 weeks of Open Enrollment, a reporter came out to do a story on their outreach events, and published it in the Orange County Register. The extra publicity made a big difference and immediately helped fill all the appointments for those last 2 weeks.

Another part of the strategic planning was having their Community Education & Outreach Specialist book and conduct presentations on Medicare’s AEP 2 weeks before the date of an enrollment clinic at each senior center with historically less outreach success. To better serve their Spanish and Vietnamese speaking clients, they also arranged for Spanish and Vietnamese speaking students from Western University School of Pharmacy to help these clients enter their lists of medications in’s Plan Finder for the counseling sessions.

The plan was a great success. In 2014 Orange County HICAP held 36 enrollment clinics, versus 25 in 2012; helped 825 clients, versus 519 in 2012; and helped clients save $1,409,801, versus $203,624 in 2012. This is a lot of people and a lot of money saved.

To calculate this saved money, they looked at what a client would’ve paid in drug costs if they stayed in their current plan, versus moving to the plan they enrolled in. Individual client stories are impressive. For example, one Vietnamese client saved $74,000 in prescription costs; another saved over $90,000, and one client actually avoided $200,000 in medication costs by changing to a different plan that had the drug on it’s formulary. The Medicare maze can be complicated, but getting good navigation advise both saves money and gives peace of mind to many beneficiaries.

One of the HICAP Counselor AEP team leaders, Donna R., gave this report upon completion of an enrollment clinic day. This short snippet gives the flavor of the great work done, the wellbeing created both for the client and counselor and of the contribution of this good service:

“We were packing up around 4 pm from our day of helping people at our annual enrollment clinic at the senior center when a disabled client using a walker came into the clinic. She was in a panic, time wise to change her PDP. I processed her drug plan (did a drug comparison on the comparison tool), which was quite expensive because of her chronic health issue, and was able to save her $7000. Our total savings was $25,000 for the day and we made a great impact – spending tons of time with new Medicare recipients. We saw 17 clients and I used my limited Spanish skills and my New York smarts dealing with a client needing a pharmacy that would fulfill his needs since he lacks transportation. Very good vibe the whole day.” ~ Donna R.

In talking with Ms. Walton about their 2014 AEP strategy and successes, she passionately stressed that their success “can only be attributed to a total team effort by more than 40 volunteers, staff and community facilities.” She shared of her experience assisting as a counselor at one of their enrollment clinics at the OASIS Community Center. Numerous facility staff and volunteers greeted the clients as they arrived, handled their registration and coordinated their access to the team of 8 HICAP counselors. Having made all the appointments ahead of time, they also called beneficiaries beforehand to remind them of their appointment. Ms. Walton exclaimed, “Without that assistance, we would not have been able to see 90 clients in 8 hours!”

Ms. Ozurovich sums up well the work of our statewide network of HICAPs stating how their services “promote community independence, health and dignity and strengthens everyone in community.” HICAP’s work also, she notes, brings a feeling of well-being to the counselors and staff through the gratification of a good deed well done and working together – many hands working together to produce a good outcome. “The Annual Election Period was a time for our HICAP Counselors to work as a team to make a concrete and positive difference in the lives of the people they served,” said Ms. Ozurovich. “It was an amazing time for us and at the end of the day—our HICAP Counselors had a feeling of ‘tired but exhilarated’.”

Thanks to the Health Insurance Counseling and Advocacy Programs, Medicare beneficiaries have an honest, reliable source of assistance, information and advocacy to turn to. Please join us in extending our appreciation to our stellar HICAPs, their teams of hundreds of dedicated volunteers across California and to the deeper meaning of their work of contributing to the well-being of the whole community through helping seniors make good, informed health care choices and enjoy a better quality of life.

Karen Joy Fletcher

Our blogger Karen Joy Fletcher is CHA’s Communications Director. With a Masters in Public Health from UC Berkeley, she is the online “public face” of the organization, provides technical expertise, writing and research on Medicare and other health care issues. She is responsible for digital content creation, management of CHA’s editorial calendar, and managing all aspects of CHA’s social media presence. She loves being a “communicator” and enjoys networking and collaborating with the passionate people and agencies in the health advocacy field. See her current articles.