On Oct. 1, while reading the legal section in the newspaper, Empire resident Barbara Rhodes found out her Medicare Advantage insurance plan was being canceled as of Dec. 31.

At age 73, Rhodes had come to depend on her ATRIO Health Plan, which acts as a supplement to her Medicare coverage. In 2006, she signed up for ATRIO’s $102-a-month policy. Five days after she signed up, ATRIO covered the portion of her bill not paid for by Medicare for a surgical procedure she had done.

Now she worries about her own health care, as well as the 1,285 others in Coos County who have come to rely on ATRIO. Of these members, about 250 are signed up for Medicare and ATRIO, and the others have Medicare, Medicaid and ATRIO. They have less than three months to choose a new insurer for supplemental health care.

“Some of these people who don’t have computers or are ill, three months is not enough,” Rhodes said.

At press time, no one at ATRIO’s main branch in Roseburg was available to say why the insurance company decided to pull out of Coos County.

Bill Murray, chief executive officer of the Doctors of the Oregon Coast South in Coos Bay, said insurance companies are only required to maintain Medicare Advantage plans in any certain area for one year, so ATRIO’s service reduction in Coos County was not unusual. His company, commonly known as DOCS, is owned by more than 90 percent of the area physicians and administers the Oregon Health Plan, which is Medicaid, and ATRIO.

ATRIO’s Oct. 2 letter outlines options for members once the insurance company’s coverage ends. Those include relying on Medigap or Medicare prescription drug plans. The letter was accompanied by a nine-page document that goes into more detail. The federal agency, Centers for Medicare & Medicaid Services, mandates that insurance companies ceasing service in certain areas send members the letter.

All this can be daunting, Rhodes said, as she stared at her thick stack of paperwork.

“There’s so many of them,” Rhodes said of the health care providers. “There’s co-pays. There’s no co-pays. There’s these deductibles. See here, they have an annual drug deductible on some of them,” she said.

Chere Kifer, the coordinator for RSVP-SHIBA, Retired Seniors & Volunteer Program’s senior health information benefits analyst, said ATRIO members have to be really careful about their next step. Members are only allowed one change per year, and they need to change their coverage to a different provider, not just cancel their enrollment with ATRIO.

“If they disenroll, that will be their one change. Then they’ll be left without coverage,” Kifer said.

Her next worry is that people will enroll in the wrong coverage. Area clinics don’t take all the insurance plans available. For example, North Bend Medical Clinic, which was only accepting ATRIO and the ODS health plan, starting Jan. 1, 2009, will only accept ODS and Regence Blue Cross Blue Shield, she said.

She explained that there are two types of supplemental insurance for patients on Medicare — Medigap and advantage plans.

“There are pros and cons for both,” Kifer said.

With three types of Medicare Advantage plans — HMOs (health maintenance organizations), PPOs (preferred provider organizations) and private-fee-for-service — and several choices of companies within these types, it is almost impossible for seniors to make a choice themselves.

She and other volunteers at RSVP-SHIBA, a nonprofit organization that’s not affiliated with any insurance company, are here to help. Kifer highly recommends that ATRIO Health Plan members schedule an appointment with the volunteers.

“These volunteers are very highly trained to provide free and unbiased advice,” Kifer said.

“Once they make that choice, they’ve made that choice for a year,” she said. “They won’t have an opportunity to enroll for another year.”

During open enrollment, from Nov. 15 through Dec. 31, volunteers will be at seven locations throughout Coos County, she said. She encourages people covered by ATRIO to call 888-7332 to schedule an appointment. She warns that they must sign up by Dec. 31 so there is no gap in coverage. If seniors are not able to make the Dec. 31 deadline, they will have 63 days from Jan. 1 to sign up for coverage, although they will have a gap in coverage, she said.

Beginning Jan. 1, Doctors of the Oregon Coast South in Coos Bay will begin offering new health care plans in ATRIO’s place, according to Murray.

“There is an upside,” he said. “The options that will be available in 2009 — there are more options and options that will cost them less and also provide greater benefits.”

DOCS representatives also are available to walk ATRIO members through their new choices step by step, he said.

“There’s choice, but choice is difficult if you have too many choices to choose from,” he said.