DEADLINE LOOMING FOR HEALTH CARE DECISIONS NEW CHOICES ON HMOS, DRUGS.

Byline: Eric Leach Staff Writer

SIMI VALLEY - Caught in an unprecedented year-end rush for enrollment, a Ventura County agency that helps Medicare recipients find HMOs and drug benefits has been swamped with hundreds of calls each day.

``Some of the people we are talking to are starting to panic because the end of the year is getting close,'' said Katharine Raley, program manager for the Health Insurance Counseling and Advocacy Program.

``They are confused, they don't understand it,'' she said. ``They are all trying to figure out what they are going to do.''

She said volunteers from her office will be working through Friday to help people make year-end decisions and will resume Jan. 3. People who make decisions in January can get drug benefits in February, but there are penalties for those who make their decisions after May 15.

Officials estimate there about 116,000 elderly Medicare beneficiaries in Ventura County, plus thousands more who receive Medicare benefits because they are disabled.

Most choose their own doctors on a fee-for-service basis, but a growing number have been choosing Medicare Advantage health maintenance organizations as the HMO options have increased in southeastern Ventura County in the past two years.

Two years ago, the seniors in southeastern Ventura County had a single choice, Kaiser Permanente, for HMO coverage under the Medicare Advantage program.

Now they have Kaiser, Universal Care, which started offering service to the area last year, and SCAN Health Plan, which began its service here this year. All three have built-in drug prescription plans.

Universal Care and SCAN have primary-care physicians in the Simi Valley and Thousand Oaks communities and they work with Simi Valley Hospital and Los Robles Hospital & Medical Center.

Kaiser has clinics in Simi Valley and Thousand Oaks and a main hospital in Woodland Hills to serve the area.

Jeremy Brewer, marketing director for Simi Valley Hospital, said his hospital is happy to see changes in the industry, providing greater options.

``The beneficiaries are the seniors living in our community,'' he said.

Officials from Kaiser, Universal Care and SCAN also said it's good the area's senior citizens to have options.

David Schmidt is chief executive officer of SCAN Health Plan in Long Beach, formerly known as the Senior Care Action Network.

His not-for-profit company began providing service in southeastern Ventura County this year and will start serving Thousand Oaks in 2006.

``Having more choices is better,'' he said. ``... We obviously hope people choose us, but we are also there as a resource for people trying to make a choice.''

Raley said volunteers working with her Ventura County agency, funded by the federal and state governments, are available at senior citizen centers in Simi Valley, Moorpark and Thousand Oaks to help people find the health care and drug plans that meet their specific needs.

``With all three (HMO) plans, people need to know the costs and ask whether they can use the system locally,'' she said. ``What hospitals they can use? They need to compare the whole package.''

The Health Insurance Counseling and Advocacy Program in Ventura County can be reached at [phone] to make appointments with HICAP volunteers at the the Simi Valley Senior Center, the Moorpark Active Adult Center or the Goebel Senior Center in Thousand Oaks.

Raley said Medicare recipients concerned about the drug benefit can also call (800) MEDICARE, [phone], seven days a week, 24 hours a day. They can also go online to www.medicare.gov.

Eric Leach, [phone]

eric.leach(at)dailynews.com