Aging in Style with Lori Williams
Aging in Style with Lori Williams

Episode · 1 year ago

012. Medicare 101


Medicare is a topic that’s often discussed – and often misunderstood. June Kim is a community relations specialist with Blue Cross Blue Shield of Texas that specializes in Medicare, and she’s here this week to separate the fact from fiction. 

Though it can be confusing at times, she’s passionate about making healthcare a more approachable, understandable topic for seniors. This week Lori and June will discuss key differences between the original Medicare plan and Medicare Advantage, the limitations of each, and who might benefit from each of the plans. There are also opportunities to switch the plan and inherent risks of doing so. For instance, seniors must be healthy to enroll in a Medicare supplement program, but they couldn’t get coverage for preexisting conditions such as cancer. Based on knowledge like this, June offers insights and tips to help seniors navigate their healthcare.

Takeaways from this episode:

- Seniors aged 65+ are eligible for Medicare, and there are 2 types: Original Medicare and Medicare Advantage.

- Medicare is strictly for medical insurance and doesn’t cover senior living facilities (assisted or independent). 

- Everyone should take advantage of Medicare Part A, which is free and covers hospital costs

- Medicare Part B covers doctor visits, X-rays, outpatient care, and more – which requires a monthly premium and increases each year.

- Original Medicare (consisting of Parts A and B) and does not cover everything, just 80%, so patients must pay the remaining 20% in addition to the normal Original Medicare monthly premium.

- Those who choose Original Medicare can supplement with “Medigap” coverage, which can cover the remaining 20% – but to be eligible, patients can’t have preexisting conditions.

- Those who still have medical insurance through their employer don’t need to sign up for Part B healthcare plan because it’s essentially double-paying.

- Medicare Advantage is Part C, which is a local plan that often requires co-pays, making it an attractive option for those who seldom visit doctors or don’t have the resources to pay larger monthly premiums.

- Part D helps cover the cost of prescription drugs, so they’re more affordable.

- Medicare Advantage is an “all-in-one” plan that often bundles in add-ons like drugs, transportation, hearing aids, and even basic vision and dental.

- Medicare Advantage is also very localized, so if you move, you’d need to enroll in a different Medicare Advantage plan. 

- There’s a risk involved with switching from Medicare Original to Advantage – if you want the Original plan again because you’ve become ill with a disease, you wouldn’t qualify for the supplement plan.  

Topics discussed:

- Medicare plans and supplements
- Prescription drug coverage
- Home health / rehab
- Hospital visits
- Preexisting conditions
- Medicare enrollment
- Switching Medicare plans (life changes)

For more information about plans and the brochure mentioned in this episode, please visit:
To contact June Kim:
214-783- 7901

For more detailed and up to date information please go to:  

And for social security:

If you wish to suggest a topic, be a guest or want to support the podcast please email or reach out online:

Welcome to aging in style with me, Laurie Williams. I'm an optimist by nature and I believe you can followyour dreams at any age. My grandmother's journey with dementia ignited a passion inme to work with seniors. I've spent the past thirteen years learning about seniorsand aging. In my mid S, I followed my own dream and foundit my company, where I use my expertise to help seniors locate housing andresources. On this podcast, we cover all aspects of aging. Joanna's eachweek to meet senior living experts and inspirational seniors who are following their dreams.The fact is, we're all aging, so why not do it in style? Hi, welcome to another episode of aging and style. Today we aretalking about Medicare, and I've wanted to cover this topic for a while becauseit is one that comes up pretty frequently when people call me looking for seniorhousing. A lot of times they are under the misconception that Medicare covers seniorliving like independent living in assistant living, and that is not true. Sotoday we are going to talk all about Medicare, what it is, whatit covers. We're going to break down, you know, the difference between originalMedicare advantage plans, all these different terms that confuse people, and Iknow it's confusing. I mean I am confused on it. So we havebrought in an expert today and today's guest is June Kim and I've known Junefor I don't know how many years, several years. June is a communityrelations specialist with Blue Cross and Blue Shield of Texas. She has her beain psychology and NBA and June has extensive experience and knowledge and the insurance industry. She specializes in medicure from working with seniors and from previously marketing in thehome health industry and from the area agency on Aging of Terran County. Shebrings with her extensive knowledge of resources, enthusiasm and passion to educate and helpseniors make the best possible decisions in regards to their health care. And Iknow she does that because I've been to several of her talks and it makessense the way she explains it. So that's why I thought who better thanto have June come and explain it to all of us. So welcome June. Thank you so much, Lori for that introduction and I am so excitedto be on your podcast. I know that was a long waiting list,so I'm happy to be one of the people that you get to interview.Yeah, I'm so glad you're here too. So so why don't we just startoff? I always like to ask my guests this question. How didyou become interested and working with seniors and specifically with Medicare? I have togive all the credit to my mom. So when my mom was aging intoMedicare and she turned sixty five, she comes over to me and she's like, I don't understand anything about this, but I know I have to signup for many care why don't you look through this and help me? AndI was like, Oh, okay,...

...sure, I've got my, youknow, college degree, I even have an MBA, I can figure thisout. No, I could not for the life of me. I waslike, if I couldn't figure this out, how our seniors able to figure thisout, you know? So I had to do a lot of researchand basically that's how she kind of like thrust me into this business of justeducating seniors about Medicare. And my mom actually has an assisted living business.She started in the residential home and now she has a huge weight list.She's retired right now, but she had a huge weightless and so that justreally prompted me into my heart and my desire of just helping seniors. Yeah, so she had an assistant living and she still was confused about medicares andwhat to fit. That's totally as you know, when you first started outand you're saying there is that big misconception about Medicare will help you, youknow, pay for all these costs and assisted living in and independent living.No Medicare. I think people will get confused. Medicare is strictly medical insurancefor those that qualify. So you know, most people qualify when they turned sixtyfive because that's the age that you get Medicare. There are some otherstipulations to like if you are in disability and such, but it is strictlyjust basic health and medical insurance. It does not come for anything else interms of helping you live in in the facility or in the community. That'sa big myth. Will have absolutely and I you know, I feel terriblesometimes with people because they are just they'll call me and say, Oh,I'm ready for assistant living for my mom. She has medicure and then it's likeOh, I'm sorry to like burst your bubble and I feel terrible,but then they're just so confused or like well, I move. What ismedicure for? And, and I explained it that way, that's your it'syour health insurance. It's going to cover your doctor visits, hospitalizations, Rehabif needed. You know, it's those type of things. So let's kindof like just jump into what what Medicare like. There's original Medicare, there'sadvantage plans and people get so confused. So why don't you just take usthrough like medicure one hundred and one. Okay. So basically, when youwhat we call aging into Medicare as for most people, like I said,when you turn sixty five, so three months prior to your sixty five birthday, you will want to sign up for Medicare and you can do it viasocial security because social security is actually the administrator for Medicare. So when yougo on to that website and you sign up for social security, it's notnecessarily saying you're going to take that social security check, but if you definitelywant to sign up for Medicare Part A, which is your hospital, and thatshould be free from most people because why you are working or your spousewas working, they take it out of your paycheck. So you've already paidinto that system. For Medicare Part A, which covers your hospital costs, okay, Medicare part be, that covers...

...anything outside the hospital, like yourdoctor's visits, your x rays, outpatient surgeries, anything that has to dowith your doctor or medical or lab. Is Medicare part be and part Bis not free. Part be you will have to pay a monthly premium,and so people get confused on that. They're like, Oh, okay,I'm Medicare age. I shouldn't be able to pay for anything right now.Part A. Part A is free for most people. Part B is not. Okay, the government still wants you to pay for your doctors and medicalservices. So Part A and part be, which is your hospital, your doctormedical that's what they call original Medicare, okay, and that is your red, white and Blue Card and that will cover you at any hospital ordoctor that takes that. June one question. So your medicure a. that's thefree part in most cases, and then be. How much does thattypically cost someone? Or does that? I guess there's probably a lot ofvariables. Yeah, so it increases every year. I want to say that. Don't quote me on this. Okay, that like a we're on that.Hundred and thirty five dollars. But, like I said, every year itwill increase and you will have to pay that, unless that's a mostlythanks for help much. That is your monthly premium for your part be.Now going down the line, I'm going to take you through original Medicare,or so on original Medicare, so you have your part a and you haveyour part be, your red, white and Blue Card. On original Medicareroute, you need to get a separate drug plan, because everybody needs adrug plan. On Medicare, you can get a separate drug plan from anyhealth insurance company that provides drug plants, and their thousands out there that youcan choose from. Just make sure that you choose a drug plan that obviouslycovers the most expensive cost of your drugs, because you wouldn't want a drug planthat doesn't cover your most expensive drugs, right, yeah, exactly. Andthen, following this route on original Medicare, along with the part aand part B and a separate drug plan. You can get a Medicare supplement planor sometimes referred as to medic gap plans. So these are private insuranceplans that cover extra or on the original Medicare side, Medicare will pay eightypercent of your cost. The other twenty percent either you're going to have topay out a pocket or hopefully you've got a medicare supplement plan that can helpcover that. Okay, that's the medic gap. Yes, medic gap orMedicare supplement there and they're used interchangeably. And the good thing about the Medicaresupplement and the original Medicare route is that you can use this Medicare in anyof the fifty United States. So any place that takes original Medicare and hedocked there, any hospital in the fifty United States, they'll be more thanhappy to help you. So that is what we call the original Medicare routeand one of their question, and I...

...mean you may just have to giveluck an average. I think a lot of people will say or come tome and they think medicure o good, I'm on Medicare. Don't have topay anything out of pocket, which is, you know, as you're saying isnot true because you have the bee and the drug part and the MEDAGAP. So with all those added can you say kind of like an average whatthat would cost someone those premiums per month? And I know this is I don'twant to hope not holding you to this number, but what's kind ofan average of people can kind of have that in mind when they're planning forretirement. So I would I can't give you a definite amount because it dependson what company even I wouldn't be able to give you an exact amount ofmy company because we'd have to sign that disclosure first before I tell you howthe prices uh. Because we are regulated by CMS, which is the Centerfor Medicare and medicate services. We can't basically give you that kind of informationuntil we have real prior consent to but I would say on average it wouldbe a couple hundred dollars because just right off the Bat, part B isgoing to be over a hundred dollars and changing every year. And then yourdrug plan anywhere depends from what company you choose from. That could go upinto another hundred and then your Medicare supplement, depending on what company you choose from. I would say the total would be a couple hundred dollars. Okay, that's good to know. Yeah, for those people that are on Cobraor those people that are on self employed insurance plans, it will be alot better for them when they age into Medicare. Yeah, I'm looking forwardto that. More cut. Yeah, looking forward to that myself, asI am self employed, but I have several years to go still chill andready for Medicare, but I'm looking forward to it. Yes, so forthose of you that are self employed, yes, you will get a breakin your healthcare costs. Now, those of you that are coming off ofemployee plans or that have like really great, you know, federal or state plans, yeah, it may be a sticker shock to some. So that'sbasically on the Medicare original side. Now the Medicare advantage side is also runby private insurance companies. So that's why people get confused between the both sides, with the Medicare supplement Medicare advantage. On the Medicare advantage you still dohave medicare part a and part be. You still have to pay your partB premiums, okay, no matter which side of Medicare you choose. Buton the Medicare advantage plan, what they tried to do is with these healthinsurance companies, they bundled a package together for you Medicare advantage side, youactually have a drug plan included in most of your advantage plans, so youdon't have to have a separate drug plan and you don't have to have separatecosts for that. And then on this Medicare advantage side you do not needa medicare supplement plan because basically it's kind of and all in one plan.And so on this side it's also very localized too, because of you're onlypaying a set fee. Or it may..., you know there's some Medicarevantage plans that have zero dollar premiums out there too, so it may notbe. You're only paying for your part B premium and you might not haveto pay any extra premiums on top of that monthly like you do on theoriginal Medicare side. But the one difference on this side is the Medicare Advanyour side, you can only go to the doctors and hospitals that contract andtake your plan. So, unlike original Medicare where you can go to anydoctor any hospital in the fifty United States that takes Medicare. On the Medicareadvantage plan, you can only go to the doctors and hospitals that take yourplan, and this is very localized. So usually, where we are inthe Dallas Fort Worth area, you can choose from certain amount that companies thatcontract and that work in the Dallas Fort Worth area. Now, if youchoose to move to Houston or to Austin, you will have to change your Medicareadvantage plan because that Medicare advantage plan only works in that local area.So it is sort of like, would you like an HMO? kind oflike that, because you have specific doctors you have to go to. Yes, so even within the Medicare advantage route they have hmos and then they alsohave p Pos to but you still have to follow the rules, even thoughif it's a Pepo PPO, just means that you have a wider range ofdoctors that you can choose from, you know, whereas in an HMO,a select one doctor and he is your primary caregiver and he will be yourgatekeeper to all your Medicare and healthcare needs. On the PPO. You get morechoices, but there's still some rules that you have to follow. Thebiggest difference between an HMO and Ppio, people get confused with that, isan Hmo you have to go through your primary care doctor first and you haveto get a referral if you want to go see a specialist, and ifyou go outside of your Hmo network you will be responsible for one hundred percentof the costs. Who on a p Po, you don't have to chooseyour primary care doctor, you don't have to get a referral, you canchoose your your family physician or doctor that you go to, as long asthey are in that PPO network. Now, if you go outside of the PPOnetwork, you are responsible for out of network costs. So there's adifference. You know, with an HMO, you go out of network, you'reresponsible for one hundred percent of the costs. In the PPO, yougo out of network, irresponsible for the out of network PPO costs. Iwas going to say, you know, having worked in your living for,you know, long time, I talked to a lot of people and Ihave heard several people say don't do an advantage plan, that they had abad experience and so in talking with you earlier, an advantage plan makes sensefor some people. It's going to make a lot of sense for them.So if it were just, you know, someone trying to decide between just doingoriginal Medicare or an advantage plan, what would be your advice on that? And when does an advantage plan make...

...more sense? Sure? Okay.So, obviously because of all the bells and whistles and less restrictions of originalMedicare. So more choices always equates to more money, right. So anoriginal Medicare, that sounds great if you have enough resources and you can choosethat route. And also, I forgot to mention within your six months ofgetting part be signing up for part B, you have what they call guaranteed issue, right. So in Texas we cannot turn you down for any sortof pre existing condition or any health conditions of getting a Medicare supplement. Now, any time outside of that we will have to do medical underwriting. Sobasically you will have to be healthy to get a medicare supplement. So youneed to do it in your first six months. Yes're saying okay, ofsigning that part part be. Yes, okay, and signing up for partbe as another kind of worms to it gets more complicated. If you're stillworking and you're still under an employee plan, don't sign up for part B becausethen you'll be double paying. At that time you are under your employerplan, your employer is still going to pay right for your insurance. Thenyou don't want to double pay. That part be part okay, and thenthat will also exclude you. If you do, you doub will pay onthat. That will also exclude you from your six months. You know,right of issue for that Medicare supplement plan and if you do have, youknow, previous condition as a cancer or any major health condition, you knowthat may prevent you from getting a Medicare supplement. If you were still working, would you just want to drop your insurance from your employer and go ahead, just get on original Medicare and your part be so you don't get excludedbecause of the six month thing? Or How would that work? You willnot be penalized if you have what they call a plan in place of whatthey call if you are already under an insurance plan and you're still working pastsixty five, you do not have to sign up for that Medicare part be. I would recommence go ahead and sign up for part a. It doesn'tcost you anything, right, it's free. But for that part be, that'sa very crucial component. You don't want to sign up for part beif you already have that part be coverage. And then once they stop working andthen they need part be, then they have sign up. So let'ssay you you work your sixty five, but then you've been to work foranother three more years. So at sixty eight you're going to fully retire.That's when you can sign up for part B and then your six months ofguaranteed issue, right, will start from then. Gotcha. Okay, thatmakes sense. Okay, good, good. Now. Yeah, so that's anotherthing that people just rush in, you know. They think, Oh, I'm six, I five, I'm going to sign up for everything.Well, it depends on your situation again, right. So be very clear.If you're going to fully retire, go ahead, you can sign upfor part a and part be, but if you're not and you are stillunder your employee plan or your spouse as...

...plan, you do not have tosign up for part be. Okay. So that is another thing about theMedicare supplement. Like I said, if you're outside up that guaranteed issue right, you will have to go through medical underwriting. You will basically have tobe healthy to pass and get that. And also with a Medicare supplement,the older you get, the more expensive it's going to be, because,you know, insurance is all about risk. So the older you get, themore risk we're putting on you, and obviously you're going to you havethe higher risk of getting more ailments and such. So, no matter whatcompany you choose, the older you get, the more expensive your Medicare supplement willbe. So then advantage plans. When is this a good idea tochoose advantage over the original? Okay, let's say that you didn't sign upfor a part B, and this is happens a lot with the self employedpeople, you know, because you're looking for your own insurance. But let'ssay that you didn't sign up for part B when you should have, andnow, knock on would, but you got cancer, okay, from yoursixty eight now okay, and so we will basically deny you, for mosthealth insurance companies would deny you at that point of getting a Medicare supplement.So the part be you're going to be denied. No part be, youwill open only one. Okay, so the supplement bland, you'll be denied. Okay, Gotcha. Okay, that's on the rich, like weren't?They're like, wait, whatever happened to you know, we can't be discriminatedagainst preexisting conditions. We're not discriminating you against Medicare. You can still getmedicare part aim, part be, but we are saying no to that extrainsurance and Medicare supplement. Okay. So if you can't qualify for that,and obviously, well, maybe you're in a situation where you're just living onsocial security, just pure social security, which a lot of seniors are sure, so they can't afford that extra, you know, Medicare supplement plan andthe extra drug plan. So then your next bet is to choose the bestadvantage plan that there's out there for you. So number one, you're going tostart with what companies provide that advantage plan in the area that you livein, because I remember it's very localized vocal, and then you want tochoose a plan that obviously that your doctor's going to take right. A lotof seniors are married to their doctors. Unfortunately. Sure, and then justknow that, you know, not all Medicare advantage land takes all the doctors. Right. We don't have control of the doctors who take our plans.It's all up to the doctors to choose what companies that they want to pairup. So that's another consideration. But yeah, an advantage plan these dayshave a lot of Bell, some wiles. They've added so many other membership perks. Like some companies even add transportation, which is huge for seniors. Theywill add like basic dental and vision hearing aids. I mean so there'sa lot of other fringe benefits that you...

...can get from Medicare advantage plan thatyou won't get from the original Medicare because on the original Medicare it does notcover any dental or vision either, or hearing. So on the on thepositive side, you can get more out of an advantage plan, but youjust need to do their research to make sure your doctors and hospitals you wantto go to are on that plan right. Absolutely. So, yeah, youdo have to do your due diligence in terms of and the providers thatyou want to see and the hospitals that are close by and but advantage planis is a great plan. It is also governed under cms laws too,so they have to provide the same services as original Medicare. It may notbe to the same extent. So what I mean is for Rehab, likewhat if you had hip surgery and you were going into a sniff or okay, I'm going to school nursing facility, nursing facility to get your rehab done? In original Medicare you have you have basically twenty days that you don't haveany co pays to fully, you know, utilize that on the original Medicare.Now with a Medicare advantage plan, you have to find that sniff thattake your plan number one and they might not calculate the full twenty days.Maybe they contracted only ten days with your Medicare advantage plan or seven days,you know. So it depends. So, like I said, you will receivethe required benefits but it may not be to, you know, thefull twenty days that original Medicare as. It depends on what kind of contractthat your Medicare advantage plan has with that sniff. So cut that's probably oneof the biggest examples that I can give you. What the major differences ofour original Medicare and the Medicare advantage plan. To what about like if someone hasthe example of the hip surgery. So they went, they did theirrehab, they return home and they're going to have home health and physical therapycoming in. Is there a difference with advantage plans over original medicure and howservices that you receive at home? No, but it's still follows the same roleas the sniff. So basically the home healthcare and any sort of Rehabcare that you're going to get received from your home, that company has tocontract with your Medicare advantage plan to make sure that they are going to getreimbursed for the services that they're giving you. So yes, you do have thesame opportunities as under original Medicare, but you do have to make surethat that company, as providing services to you, does take your plan.Okay, but would they do the same thing like, say, under originalyou got maybe twenty visits, but under advantage maybe they cut it to ten. Does that ever happen or is that's not my specialty, but I thinkthat would have to depend on that company itself and they would obviously have tofollow the CMS guidelines in terms of crime, health to so with an advantage plan, price wise, so it's is... a lot less expensive? Well, generally I can say that because you know when I said more choices willcost more money. Because an advantage plan is it is in the controlled environmentand you do have to follow the rules. It may be a lot more costeffective. But with an advantage plan you will have basically co pay.So every time you go to a doctor you will have to pay a copay, any time you go to the hospital co pays. So if youdo visit your providers quite a bit, that might add up. Yeah,so with the original there's no co pays. With an original and a medicare supplementthat covers that. Yes, there should not be any extra depending onwhat supplement you choose, there should not be any extra copays. But,like I said, that depends on what supplement you choose. But normally workto doctor and you go to hospital, that should be covered under your supplementplan. Okay, that's good to know that. You know, if withthe advantage planet may be less expensive upfront, but you are going to have tomake this cope pays. So you're right, every time you go differentto your provider. HMM, there's and so, if so, I'll kindof go to the story of people always ask me, June, if Iwas your mom or your dad and and uncle, which side of Medicare shouldI choose right now? I say, you know what, that depends.A Medicare is not a cookie cutter. My Mom, she is on medicoriginal Medicare, and she has that separate drug plan and she has a Medicaresupplement and every year she calls me up she's like, oh, June,can you put me on a cheaper plan? This is going up. I'm like, mom, we discussed this already. Every year it's going to go upbecause you're older every year, right. But my mom had answer and shecomplaints about the price. But when I ask her, how much didyou have to pay when you went to the doctor, I think, howmuch did you have to pay when you go to the hospital? Nothing.So, yeah, she's paying all that up front on the original Medicare.With the supplement, you are paying it up front. But if you wereto get some you know, ailment or disease or it may help you becauseyou've all paid that up front. Now My inlaws, they were on Medicaresuppleant, but it got too expensive for them. So they changed to Medicareadvantage plan and they love it because, number one, their doctor takes thatplan, number two, their hospital is like two miles away from their house, so then they're fine with that. And number three, they're very healthy, fairly healthy. They go like maybe once a year for their annual checkup, maybe once for, you know, just minor surgeries here and there.So they're very, very happy with their plan. So, as youcan tell, it really depends on your...

...situation, on your resources. Maybe, you know, like I said, your health too. Can you switch? Can? I guess it gets kind of complicated if you switch. Youcan't really switch back and forth, right. Can you explain that? A milliondollar question. So okay, so every year during Medicare open enrollment,which is going to come soon, it happens every year October fifteen to Decemberseven. If you on Medicare, you can make a change. If you'renot happy with your plan, you can change from that time, from Octoberfifteen to December seven. Your new Medicare plan will become effective January first ofthe coming year. So for this open enrollment, if you make any changes. It will be effective January first two thousand and twenty one. Wow.Now, if you're going to change from an advantage plan to an advantage plan, that's not a problem. If you're going to change from an advantage planto original Medicare and you're trying to get a supplement, you need to behealthy. Okay, okay, go to that underwriting. Now. Let's sayyou went from original Medicare with this supplement and went to an advantage plan andthen now you want to switch back, but now you've got cancer. Cannotget your supplement back. Okay, as you have that and you know condition. So that is the million dollar question. So yes, you can change andthink about as long as you're healthy. The day that you become unhealthy youcan no longer qualify for a medicare supplement. And there's another thing too. If you are already on the Medicare supplement and you get cancer or CEOPDor whatever, we cannot boot you off. So you you are already grandfathered intothat plan. As long as you keep on making your payments, nocompany can boot you off because basically you are already grandfather didn't, and theonly way that we can boot you off is if you don't make any payments. Okay, so your original Medicare and you have the supplement or Meta gap. That's the same thing, right. And you get sick, you getcancer or CEOPD or Parkinson's or whatever that, you just keep making that payment,don't miss your payment and you're on there forever. That's right. Okay, so let's get you there. Yeah, and so I always tell people,you know, the ones that are on supplement and thinking about changing,I always tell them, you know, be really, really careful, becauseonce you make that change, you really don't know what's going to happen.Yeah, and only we'd had a crystal ball, right of which, andactually had actually had this one lady who was crying, and I was cryingwith her because she wanted to change back to her original Medicare and she haddeveloped all these diseases, and I was kind with her and I was like, I'm sorry, you know, we can't. Was it because she couldn'tfind the doctors on the plan, or what was happening that she so shewas talking with her friends, she was...

...on a Medicare supplement, talking withher friends. They were all on the Medicare advantage plan. They're like,oh, it's great, you know, and I'll save you a lot ofmoney. And so she did and come to find out she had developed allthese diseases and all the specialist that she wanted to go to or taking thatplan. Like I said, she tried to contact me and she said nowwhen they go back, and I had to tell her I'm sorry, yeah, there's no going back. I've had a few cases where the families lookat an adult daughters called me and said, Oh, my dad was in,you know, in Rehab, and he was watching TV and they hadthese commercials for advantage plans and he switched. So what do we do now?And it's like, Oh gosh, that's that's not good, because theydo the commercials they do make it sound like it is the best thing,you know, ever to switch to advantage plans. So this is why weneed to educate ourselves and educate our senior so that we, you know,don't run into a situation like this. Lady, you were just telling thisabout right, and that just breaks my heart. I it really breaks myheart that seniors are not completely informed and those commercials they look great, youknow, they have all the bells and whistled, because advantage plans, theytoo, they do, offering you more in terms of the extra dental orvision or what have you, or chance. Some of them have transportation, likeI said, and it is very compelling. But if it doesn't fityour needs and then you come to find out that your doctors don't take itor the hospital that you want to, then you know, then you're reallyup a creek, and especially if you changed while you were deep within Medicareand you have these conditions now. Yeah, you can never ever get back toa medicare supplement. Yeah, because you might, you know, researchit as you're healthy. Oh this is my doctor, great, he's onthis plan, this is my hospital, but you don't know what's to come. And what if you develop some disease that you want to see a specialistand you know the specialist you want to see is not going to take yourplans. So then, like, you know, the same situation with theland. He was crying. So yeah, we really, really careful, andI tell the seniors out there when if you're going to make a decision, and ninety nine point nine percent of a time, if they're on thesupplement I sell them and they want to switch over at I'll be more thanhappy to have but I don't recommend it and I would not. I justnot in good conscience, knowing that if they can still stay that bath andkeep that plan, that is probably the best for them. But I doknow that, you know, not all seniors have that resource and they're juststuck on that one social security check. So you'll have to do what youhave to do and, yeah, and figure out the right choice for you. So, yeah, if we all have that crystal ball, it wouldmake the decision a lot easier, right. Yeah, it would. Another thingthat people don't realize and Medicare.

It's different state to state. Soif someone like here in the Dallas area, we have a lot of people whomove from, you know, other states of California or wherever, andthen your parents usually will come with them. They have to make that complete changeonce they get here to Texas. So that's outside. You know,we mentioned the open enrollment period, but if you have a life change moving, you can go ahead and change then correct sure, so you do havethat special enrollment time, what they call if you do move out of thearea, and this is more specifically for those that are are on the advantageplan. If you have a medicare supplement plan or that medic gap plan,remember that works anywhere in the fifty United States. Okay, so you donot have to change that plan. You will have to change your drug plan, though, because drug plans are very localized. If you have a separatedrug plan, you will have to change to US another separate drug plan that'swithin your local area that you're moving to. But for Medicare supplement you do nothave to change. That will work within the fifty nights states. Nowthe Medicare advantage plan. If you were on in a different state, yes, or in the different county, like I said, if you're moving fromDallas to Houston or to Houston to hear or even to Austin, they allhave different advantage plans. Okay, so they would have that special enrollment there. They could make that change. And then when we were talking earlier,you mentioned something that I think is really important about speaking to a live person, like how confusing it is for seniors trying to call and they are justgetting, you know, one recording after another where you know you're already confusedbecause this is a confusing topic. So the best thing is to be ableto speak with a live person. Yes, so, like I said, itwas confusing for me and the very beginning when my mom, when Ihad to tell my mom. So I can't imagine how much more confusing itis for a senior that don't have all the resources or the information, because, you know, medicare changes yearly to so that is my passion to helpthose seniors to make the best educated guests our decisions regarding their healthcare, becauseit is really important, you know, like I said, especially if youchoose a plan and then you wanted to go back. You know, there'ssome stipulations regarding that too. So I would love to help our seniors andour community. That's my passion. That's where I'm at too, and I'mvery fortunate to work for a any that lets me educate first. Yeah,more than anything else, because that's why I love my job so much.So, yes, feel free to reach out to me Lori will post itmy contact information, but have my direct line on there, and then youcan reach out to me via email at June underscore Kim at bcbs Txcom,and you can also visit our think blue txcom website where we have daily seminarsand I have some that are already pre...

...recorded just on Medicare drug plans,on Medicare supplements, on Medicare advantage plants. So it'll go further into detail andyou can just watch it and listen to it at your leisure. Oh, that's excellent. We will put all that information at the end of thepodcast where you can go and access it and find June, because she isa wealth of information and your passion shines through and that's why I always loveto to go here. You speak. Well, when we can go backout again and Covi it is open, will be great. And and hereyou speak. So you speak, but you also have a great like avisual that. I've seen it before, so if you have, if youwant to send that to me, I'll also post that on my facebook andI'm sure June can even email it to you. But it just kind ofbreaks down visually what we've talked about, and I know I'm very visual,so that I think it's very helpful tool. Yeah, so I call that mymedic a care cheat sheet and they will. It has the different puzzlepieces because Medicare is a big puzzle, right. And so the front pagewill talk about the different parts of Medicare, which I describe to you the parta, be the see is actually what we call Medicare advantage plan,and then D for prescription drug plan. And now on the back of thatCheat Sheet it tells you the two paths of taking Medicare the original Medicare routeand then there advantage route. So, yes, I'm a very visual personto it makes a lot more sense when I see it, you know,written down on paper. Yeah, and that's a really good flyer that youhave, so we'll make sure we share that as well. We'll thank youso much, June, for coming on and talking to us and explaining medicure. I think I know it helped me and and I'll just say I meanI've heard it over and over, but it's still kind of like my braindoesn't like compute it all together, and I think that's probably the case formost of us. So so I just think it's very valuable information and Ijust know that you've helped many of our listeners out there. And again,if you have questions or want to contact GM, will have all that informationand please go to our podcast and let us know what you think of asa review and if there's a topic you want to learn about, shoot mea message. So thanks for joining us, but by.

In-Stream Audio Search


Search across all episodes within this podcast

Episodes (69)