DECATUR - Wole Adeoye, owner of Victory Pharmacy, recently was tending to a diabetic customer with Medicare and Medicaid when he rang up the customer's medication. Instead of the usual no cost, the customer was faced with a co-pay of $17.

"He said, 'But I've never paid before,' and I had to tell him, 'Well, you switched plans, and now this isn't covered,' " Adeoye said.

Extra awareness and education is needed when it comes to Medicare plans and their supplements, Adeoye said. Medicare Advantage plans are sold by private insurance companies and are "private fee for private plans"; the entire benefit is managed by a private company. Medicare Advantage plans are not traditional Medicare supplements.

Usually what occurs is that a private insurance representative will try to sell Medicare Advantage plans on commission to seniors who are already on Illinois Medicaid and do not need additional Medicare supplements, Adeoye said.

Premiums are at no cost, and many seniors figure there is no harm in signing up for the supplement. But, Adeoye said, taking on a Medicare Advantage plan eliminates a customer from the Medicare plan they previously were on and usually changes their benefits.

"We do see quite of bit of that, where our customers aren't even aware of the plan they have," said Andrea Liming, patient advocate at Dale's Southlake Pharmacy. "I see a lot more say they got switched, and now something isn't covered anymore. Company reps make their offers look very good, with no premiums, which is true, but then one major illness will get you, and you're not covered for that."

Leslie Stanberry, interim director for the Decatur-Macon Country Senior Center, said the senior center hasn't seen many seniors being sold Medicare Advantage plans, but has seen some computer glitches in which seniors won't be switched to a new plan when they think they are, and it takes time to get it figured out.

Switching plans or taking on a new plan can be very beneficial to some, Adeoye said, but only if the customer is aware of every outcome.

"The Medicare Advantage Plans can be a blessing to many that are now able to buy a plan to help with the financial responsibilities beyond Medicare, like those below 65 with disabilities," said Adeoye. "But for others, those on both Medicare and Medicaid, when they switch, they give up benefits they had before."

Liming urged Medicare customers to call their pharmacy, insurance provider, doctor and even hospital before changing plans to ensure the new plan is indeed a good choice.

Stanberry said the senior center has outreach counselors trained to provide assistance for seniors dealing with Medicare; for questions, call 429-1239, she said.

Courtney Klemm can be reached at cklemm@herald-review.com or 421-6968.