Horne helps residents navigate health care

A veteran who was denied benefits years ago. A senior confused by Medicare coverage. A family member concerned about an unfamiliar medical bill or a suspicious telephone call.

Their circumstances may be different, but they share a common question: Where do I begin?

At Munising Memorial Hospital, Carol Horne is helping residents find the answer.

Horne became the hospital’s outreach education coordinator in May, stepping into a newly created position that extends beyond traditional hospital services. Her work includes Medicare education, fraud prevention, veterans outreach, insurance assistance and connecting residents with community resources.

“The main thing is information, assistance and navigation,” Horne said.

With Veterans Day approaching Wednesday, Nov. 11, and Medicare open enrollment underway through Dec. 7, her work is particularly timely.

At one Feeding America event in Sawyer, she spoke with a woman who had provided her Medicare number over the telephone the previous day.

Scams can involve unsolicited medical equipment, testing kits, social media advertisements and callers impersonating legitimate providers.

Horne’s advice is straightforward: Don’t trust an unexpected solicitation simply because it appears to come from a familiar organization.

“You initiate the call,” she said.

Residents should contact their medical provider or insurer directly using a verified telephone number rather than information supplied by an unsolicited caller.

Horne also encourages beneficiaries to review Medicare Summary Notices for services they do not recognize. Fraudulent claims can potentially affect future access to covered equipment or services.

For those uncomfortable using computers, she distributes paper health care trackers to record appointments, tests and equipment orders.

Family members can help, too.

“Help your loved ones identify and watch,” Horne said.

And she wants people to know there is no shame in asking questions.

“Don’t be embarrassed,” she said. “It’s just me, Carol, and I can help you decipher.”

Making sense of Medicare

Medicare’s annual open enrollment period runs from Oct. 15 through Dec. 7, allowing beneficiaries to review and make eligible changes to their health and prescription drug coverage for the following year.

Horne encourages residents to compare their current coverage with available options, particularly when medications, providers or health needs have changed.

Horne is currently pursuing certification through Michigan’s State Health Insurance Assistance Program, or SHIP, which provides free, unbiased Medicare counseling.

The program helps beneficiaries understand coverage options, medical bills, prescription drug costs and potential savings programs.

Horne also assists residents with navigating Michigan’s MI Bridges application system and identifying other community resources.

Those connections may involve food assistance, mental health services, insurance paperwork or simply finding the right person to call.

Helping veterans closer to home

Another major component of Horne’s position is connecting veterans and their families with benefits and health care services.

Through the I-REACH Rural Veterans program, Munising Memorial Hospital partners with the Michigan Center for Rural Health to improve access to care.

Program manager Jim Yates said rural veterans often face barriers to care, including distance, aging-related health needs and limited access to providers.

Yates said connecting veterans with available resources often requires repeated outreach and encouragement. Some are unaware of benefits they may qualify for, while others have been reluctant to seek assistance after previous denials.

“Every time we have an event, someone comes out,” Yates said, underscoring the importance of continued outreach to veterans who have yet to access available services.

Horne helps identify veterans who may qualify for services, connects them with community organizations and assists with referrals.

She also works with Alger County Veterans Affairs, where Becky Burns, accredited county veteran service officer, helps residents navigate VA benefits.

“Carol refers veterans to our office, and I refer them to her office,” Burns said.

Both noted that veterans previously denied benefits should consider having their eligibility reviewed again, particularly following expansions under the federal PACT Act.

Horne also wants veterans to understand VA Community Care, which can allow eligible veterans to receive authorized treatment from local providers, including Munising Memorial Hospital, rather than traveling farther for every appointment.

VA approval is generally required before receiving nonemergency community care.

Connecting the community

Horne’s outreach includes presentations, informational materials, community events and a confidential veteran intake form that allows residents to request follow-up assistance.

Her approach is individualized. Some people need help understanding an insurance notice. Others need transportation information, veterans benefits assistance or a connection to services outside the hospital.

The larger goal, Frush said, is to help people access resources before an unmet need becomes a greater problem.

For Horne, that means meeting residents where they are, listening to their concerns and helping them take the next step.

In a rural community where finding assistance can require navigating multiple agencies and unfamiliar systems, sometimes the most important resource is simply knowing someone who can help.