ach day, about 10,000 Americans mark their 65th birthdays. As a present, those new senior citizens are entitled to government-backed health insurance through Medicare. With approximately 110,000 Medicare recipients, Alaska has the fewest of any state, yet reaching beneficiaries presents unique challenges. To overcome these challenges, the Alaska Medicare Information Office launched the Ambassador Program, a trusted resource for determining the best Medicare coverage for individual medical needs.

Established in 1965 as an expansion of the Social Security system, Medicare is a federal insurance program for citizens with the most expensive healthcare needs. In addition to people age 65 and older, Medicare also covers younger people who have been on Social Security disability for twenty-four months and those who have end-stage renal disease (permanent kidney failure).

While Medicare provides much-needed assistance to eligible participants, understanding the program’s varied plans can be daunting. Approval of covered services for Medicare benefits is usually based on what is medically necessary. Amounts paid for covered services are based on payment schedules set by Medicare.

Under Medicare Part A, which covers hospital and hospice charges, healthcare providers are not allowed to charge more than the amount Medicare approves. Under Medicare Part B, which covers general medical expenses, excess charges are allowed for some services, but there are limitations. Medicare pays most costs, but significant gaps can leave large bills to pay.

Medicare supplemental policies are used to cover excess medical costs not covered by Medicare A or B. Medicare supplemental policies are also referred to as Medigap, or Part C, coverage. Private insurance companies sell these policies.

In Alaska, companies selling Medigap coverage are limited to “Standardized Policies” identified by the letters A, B, C, D, F, G, K, L, M, and N. Identifying the policies needed to maximize insurance coverage can be overwhelming. Getting information to those eligible to receive Medicare is vital to helping them navigate the somewhat confusing labyrinth the numerous programs entail.

The Alaska Medicare Information Office (MIO), part of the state health department, provides unbiased, authoritative counseling and outreach to help Alaskans get more out of Medicare, supplement plans, and prescription drug plans (enacted in 2006 as Part D).

The state office is funded by three federal grants:

• State Health Insurance Counseling and Assistance Program grants pay for free, unbiased counseling to Medicare beneficiaries, families, and caregivers and offers community outreach and group education about Medicare.
• Senior Medicare Patrol focuses on empowering and assisting Medicare beneficiaries, their families, and caregivers on how to detect fraud and abuse.
• The Medicare Improvement for Patients and Providers Act funds outreach and assistance to limited-income Medicare beneficiaries to help them apply for programs that lower their Medicare costs.

Alaska MIO Program Coordinator Dana Norwood joined the office in the fall of 2017. “I didn’t know anything about Medicare at that time, but I had a director who served as my mentor and she brought me up to speed,” Norwood recalls.

The team at MIO comprises just four individuals. Norwood oversees the department and manages the grants that fund the office programs. Terri Crockett serves as volunteer coordinator and is responsible for recruiting and training volunteers from all over Alaska. Project assistant Jeanné Larson and office assistant Teresa Garfield complete the team.

The MIO relies on volunteers to help get information out to Alaskans currently eligible for Medicare and to those approaching age 65. Currently there are about 100 volunteers. “We have two types of volunteers,” says Norwood. “In-kind volunteers that need to know and understand Medicare for their jobs and true volunteers who just want to help. All our volunteers devote time and energy to this valuable program.”

In the volunteer counselor program, participants must complete fourteen hours of online training followed by two full days of in-person training to go over more specifics of Alaska’s Medicare program and the various insurance companies that work with Medicare. “Not everyone can devote the time required to do this amount of training,” says Norwood. “Also, not all agencies have a dedicated staff member that has the time to complete the training process, and in some instances there could be a conflict of interest.”

The program also lost some volunteers during COVID-19 lockdowns when most people were staying home to avoid illness.

The MIO launched an Ambassador Program in the spring of 2022, and it continues to grow. Organizations that have regular interactions with Medicare beneficiaries participate in the program and provide resources about Medicare benefits and contact information to reach Medicare counselors for patients who have additional questions.

“The Ambassador Program was a goal of mine for several years before we were able to launch it,” says Norwood. “Watching it grow and sharing information about the program is very exciting.”

The spark came alive for the Ambassador Program in 2018. “We wanted to provide an opportunity for agencies that deal with seniors—such as community health centers, senior centers, pharmacies, and even some tribal offices—to help spread information to help Alaskans understand Medicare and the benefits they are entitled to receive,” explains Norwood. “I reached out to everyone I could think of where our seniors might go, including libraries, the Elks Club, Moose Lodges, and more.”

Norwood says she believed Alaska needed another method of getting information out to seniors, beyond the MIO’s cadre of volunteers, in part due to the size of the state. “Our geography sets us up differently than states in the Lower 48,” she explains. “We’re so large that many folks don’t even know what’s available, and due to the number of small villages in the Interior of Alaska, there may not be a Medicare provider in the area.”

In contrast with volunteers, ambassadors can be fielded with less training. They represent the office through handout documents, acting as a point of contact at outreach events.

“The Ambassador Program is a really easy program to be involved in,” says Norwood. “Our main goal is to ensure we get all the necessary Medicare basics into the hands of a local ambassador who can then share that information with seniors within their community and, when necessary, connect individuals with a Medicare counselor for one-on-one assistance in selecting the Medicare program that is best for that individual.”

During the launch in spring 2022, Norwood visited several communities to introduce the Ambassador Program to the local population and organizations whom she felt could aid in sharing information with seniors. On a trip in Southeast, she connected with agencies in Juneau, Ketchikan, Petersburg, and Sitka. In the Interior, Norwood connected with Denakkanaaga, a Koyukon Athabascan nonprofit, to build relationships with people who can, in turn, be a trusted resource for seniors within their community.

“My goal is to strive to have at least one ambassador in every community,” says Norwood. “Ideally, I would love to have a Medicare counselor in every community too; however, having at least one ambassador in place to build community trust is vital.”

Norwood acknowledges that getting someone to return her call, especially in extremely remote communities, is challenging at times. Believing in-person visits are more effective in building trust and understanding, Norwood is planning another round of visits through the Interior to introduce the Ambassador Program.

Members of the Ambassador Program are supplied with tabletop signs to display, letting Alaskans know they are an information resource. The information they have at hand comes in the form of pamphlets.

“Agencies that would like to provide Medicare education and information display the table topper for customers and clients to see,” explains Norwood. “When folks request information, the ambassador provides the handouts, captures the dissemination efforts on the program reporting sheet, and submits the reporting sheet by fax to the MIO monthly.”

Through partnerships with volunteers and statewide organizations that can help provide accurate and authoritative Medicare information to their community, the MIO has a much greater reach, which results in Alaskans receiving the information and benefits they are entitled to through the Medicare program.