By Amanda Estes
Staff writer
    Many seniors find it difficult to navigate the maze of health insurance options available through Medicare. For seniors in Southern Maine, Carol Rancourt is there to help steer them in the right direction.
    Rancourt works out of the Southern Maine Agency on Aging (SMAA) as the state coordinator for the State Health Insurance Program (SHIP). SHIP is a statewide program that assists seniors with issues related to Medicare, health insurance and nursing homes.
    “I am in a revolving position,” Rancourt said, “Because the complexity of health insurance policies in the U.S. is quite daunting to the normal person.”
    A large part of Rancourt’s job is to educate seniors about their insurance options. She said there are a lot of misconceptions about Medicare not only among seniors, but also among the general public.
    “Medicare is not a complete insurance system,” she said. “Medicare does not offer dental or vision coverage and it would not cover a visit to a specialist, such as a podiatrist. A senior would have to seek out a private provider for these areas of coverage.”
    “Think of all the people out driving who need to have vision exams for everyone’s safety. The only items Medicare covers are cataract surgery and the first pair of glasses after surgery,” Rancourt said.
    The challenge facing the “younger group” of seniors, or people in their mid-60s, is that, as Rancourt said, “nobody does the homework for you” when it comes to choosing a plan. Most seniors in the group are retired and Rancourt said they “can’t count on an employer to do the research and select an acceptable plan.” 
    “There are close to 100 different choices as well as the option of staying with your retiree policy,” she said, “But we don’t know what our life will be like down the road.”
    Due to this reality, Rancourt said seniors should also consider long term care insurance, which, she said, helps them live a healthier life in a nursing home or their own home. Rancourt recommended that people in their late 70s to 80s revisit the “cost and utilization of their policies.” She said that seniors in this age bracket are visiting the doctor more frequently and most likely paying a co-pay every time.
    “Your health insurance health is just as important as your physical health,” she said. “Unless we get national health insurance, people are going to have to think about insurance for the rest of their lives.”
    Rancourt said the Medicare Prescription Drug Program or Medicare Part D forced many seniors to reconsider their future health insurance needs. The advent of Medicare in 1965 was a time when “the average life span was in the mid-60s.” Rancourt said, “At that time, you would need Medicare and you would go to the hospital, most likely to die, but since then there has been a burgeoning expansion of life spans.” She estimated that the average life span today is 75 with women having a longer life expectancy. 
    Medicare Part D was written into law as part of the Medicare Modernization Act of 2003.  When the prescription drug program went into effect on January 1, 2006, Rancourt said, “There were 72,000 eligible seniors living in Cumberland and York counties we had basically six months to get people enrolled. Many people settled for any coverage at all and chose what really wasn’t the best plan for them.”
    Now that the open enrollment period has passed, Rancourt said she and the agency are working with people who are just turning 65 years old. On the first Thursday of every month, SMAA sponsors “birthday clinics” for people who would like more information about their insurance options. The clinics are by appointment only and Rancourt said there are usually 20 to 30 people at every clinic.
    Rancourt also goes out and does speaking engagements for senior groups, church groups or any other group that wants more information. As she passes on her knowledge, Rancourt said, “A large part of her job is trying to protect people from fraud. You have to be ever vigilant against fraud.” She gave a recent example in which an insurance representative spoke to the York Senior Citizen Club and convinced about eight people to sign up for the plan. Later, the group discovered that neither York Hospital nor York physicians used the plan so the insurance was worthless.
    “As far as I’m concerned, that is questionable ethics,” Rancourt said. “A counselor will tell you if a plan is in your best interest. We don’t sell insurance here.”
    Rancourt said she has always “wanted to work with the elderly.”  After graduating with a degree in social work from the University of Southern Maine, she worked for an agency on aging and a senior citizens council for about ten years before adopting her daughter. In order to “be more of a mom” she taught social studies at Sanford High School and taught aging courses at Saint Joseph’s College in Windham. She also worked part-time as a paralegal and part-time as SMAA’s personnel director.  She said her decision to return to work full time was due to the fact that her daughter had grown up and she realized her “natural love of work.” When she is not working with seniors, Carol is fulfilling her duties as a member of the Scarborough Town Council.
    Through her work, she has realized that seniors in the Scarborough community face the same challenges that many communities face. Besides changes in housing design such as wider doorways for wheelchairs and grab bars for showers, the community as a whole needs to think about public transportation and more walkable streets.
    “Scarborough is attracting a number of retirees and these are little things that we need to think about for the future.”