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

Episode · 3 months ago

059. Everything you always wanted to know about Medicare

ABOUT THIS EPISODE

“Does Medicare cover assisted living?” is a common question Lori Williams gets as a senior living professional. Since Medicare functions as health insurance and doesn’t cover senior living, she welcomes an expert back to the show to share what it does cover.

You’ll get a simple overview of the Medicare puzzle from June Kim, a community relations specialist with BlueCross BlueShield of Texas. With Medicare enrollment October 15 through December 7, it’s a great time to learn - though it’s always helpful to understand what you’re getting into! She’ll answer common questions like:

·What is Medicare Part A, B, C and D?

· What’s a Medicare supplement? What about Medicare Advantage?

· I’m still employed - should I enroll in Medicare?

· How much does it cost?

· Where do I enroll?

If you need to learn the basics of Medicare or just need a refresher, this is a great place to start. Plus, you’ll also be aware of what changes are coming.

 

Takeaways from this episode:

-Enroll for Medicare Part A (hospital insurance) once you turn 65 - even if you’re still employed. You’ve already paid into it, so it’s free.

-Only enroll in Part B when you’re fully retired because your employer may already offer health insurance coverage.

-You can’t be on Medicare Part A and B (traditional Medicare) without a drug plan - Part D.

-Medicare covers 80% of the costs, and you’ll have to pay the last 20% out of pocket unless you have Medicare Supplement insurance.

-Medicare Part C is an “all in one” plan run by private insurance companies. You wouldn’t get Part A, B or D if you already have Medicare Advantage, nor could you get a supplement.

-You must be reasonably healthy to qualify for a Medicare supplement, and costs vary according to lifestyle. The older you get, the more expensive it is.

-Medicare Part C is like an HMO health insurance plan; whereas Medicare A and B are like a PPO.

- If you have Medicare Part A, B and D, and supplement insurance, you can use your Medicare in all 50 states - any doctor and any hospital that takes Medicare, with little to no out-of-pocket expenses.

-Choosing the plan for you comes down to many factors including network and resources. What’s most important is that you understand the plan you choose.

Resources mentioned in this episode:

12. Medicare 101

https://www.loriwilliams-seniorservices.com/aging-in-style-podcast/episode/794eb1c8/012-medicare-101

For more information about plans and the brochure mentioned in this episode, please visit: 

www.Thinkbluetx.com

https://static.wixstatic.com/media/2c62c2_5fdf7b18b96d45639040f7972bf54fc8~mv2.jpeg

https://static.wixstatic.com/media/2c62c2_ea7e019a7a9a4becae1d3bbbe025e9a2~mv2.jpeg

To contact June Kim:

June_kim@bcbstx.com

214-783- 7901

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

www.medicare.gov  

Or call at 1-800-633-4227; available 24/7

And for social security:

www.ssa.gov

Enroll for Medicare with Social Security: 1-800-772-1213, Monday through Friday 7 a.m. - 7 p.m.

To suggest a topic, be a guest or to support the podcast please email Lori@Loriwilliams-seniorservices.com 

For more senior resources and to sign up to the newsletter please visit:

https://www.facebook.com/LoriWilliamsSeniorServices/

https://www.instagram.com/theloriwilliams/

https://www.linkedin.com/in/theloriwilliams/

https://loriwilliams-seniorservices.com/aging-in-style-podcast/

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Topics discussed:

-Navigating Medicare

-Medicare Advantage

-Medicare supplement insurance

-Choosing the right Medicare plan

-Medicare FAQs

-Medicare enrollment

So if I retire at sixty five, because I'm completely retired, I'm not getting insurance in any other way.So I want to do part a and part be right away. Correct,and then if I am still working, I'm just going to do part a, but because I'm going to get insurance to my employer. But say it'sseventy, I retire and I have six months from that point next much I'mgetting part B to be guaranteed issue, to get a medicare supplement. Okay, but if I just say oats on, I didn't get part B, thenI'm going to be hit with this penalty. Correct. Okay. Thecontent available in this podcast and on Malory William Senior Servicescom has been produced foreducational purposes only. The contents of any episodes do not constitute medical, legalor professional advice, do not reflect the opinions of this company, any ofits parent companies or affiliates and do not create any type of professional relationship betweenthe audience, guest and the host. No person listening to this podcast shouldact or refrain from acting on the basis of the content of a podcast withoutfirst seeking appropriate professional advice and or counseling. Nor shall the information be used asa substitute for professional advice and or canceling. Marie William Senior Services LLCexpressly denies any and all liability relating to any actions taken or not taken basedon any or all contents of this podcast. Welcome to aging in style with me, Larie Williams. I'm an optimist by nature and I believe you canfollow your dreams at the age my grandmother's journey with dementia ignited a passion andneed 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 today's episode of aging in style with Laurie Williams.Today we are talking about Medicare, and if you've been following us for awhile, you know that this time last year we talked about Medicare and I'vejust felt it was important to go ahead and do another podcast about Medicare withJune Kim, who was with us last time. But open enrollment period forMedicare is coming up October fifteen and it runs through December seventh, and peopleneed to know what their options are. They need to know about the enrollmentperiod and Medicare just kind of it's confusing and even after I've learned a lotabout it, but still when I have to explain it back to someone,I'm confused. So that's why we have the expert on today and we're havingJune Kim is going to speak with us and she is a community relations specialistwith Blue Cross Blue Shield of Texas. She's been in the Dallas area forabout twenty years and she's been building relationships and various capacities throughout her career.She enjoys educating the community about insurance options and she is amazing at it.Her Passion is to help individuals become educated to make the best informed choices whenit comes to their healthcare. June has her bea and psychology from the Universityof Maryland and her MBA from Twu and she's very involved in church and inher time off she enjoys traveling and reading. So welcome, June. I'm soglad you came back to talk to is this year. Oh It's mypleasure, Laurie, you have been awesome and this podcast has been really greatfor the Community of educating about Medicare, because it is complicated, it isit's very confusing, so I'm glad you're here to straighten it out for us. Okay, I would definitely try my best. Yeah, I know you'lldo a great job. So let's just kind of start off with the basics. So what is Medicare? Okay, so many care is medical health insurancefor those that are sixty five or older...

...or those that have been on disabilityfor two years or more or those that have like certain diseases, as andstage renal disease or Lou GARRIG's disease. But it is strictly medical health insurance. This is not and will not pay for any senior living expenses if youwant to live in like assisted living or any one of those beautiful buildings thatare popping up everywhere in the metroplex right and he senior living apartments or anysenior living situations. Medicare is strictly health insurance. Great, and thank youfor clarifying that because, like I was saying earlier, I get that questionall the time. Yes, yes, and they expect Medicare, oh it'sgoing to pay for this, it's going to pay for that. No,it will not. It will only pay for your medical major medical health insurance. Okay, Great. So let's kind of break it down, because medicure, like we've been saying, it is confusing. There's all different parts.Part A, part be, you know, D I don't know. There's awhole bunch of different ones. So why don't you break it down forus? Okay, so I have this little cheat sheet and I think youuploaded it. It's called how does Medicare work? And it's this puzzle pieceit. Medicare is like a huge puzzle, right, with all these different pieces. So let me break it down for you. Part A is whatthey call hospital insurance. So with Part A, anytime you are in inpatient and hospital, it will cover those hospital costs. Okay, so that'spart A. Part A is free for most people because if you have enoughwork credits, you know I say free loosely because they actually took it outof your paycheck while you were working. Right, so you are entitled tothat Part Art a if you have enough work credits without anything, no moreextra premiums added to it. And that, like I said, covers anything that'sinside the hospital, if you've been admitted into the hospital. Okay,part be, as in boy, is everything outside the hospital. It's yourmedical insurance. So that basically covers like your doctor's services, any sort ofmedical services and supplies, like your lab, your x Ray, any sort ofDM like your canes, walkers, wheelchairs, and then any sort ofpreventive care like your flu shots and pneumonia shots. Those are all covered underpart be. So obviously it's really important that you have both parts, right, the part a and part be, because you're not going to be hospitalizedall the time. No, that's hope, not right, and so you'll you'llneed both parts a and B. B is not free be. Youwill pay a monthly premium and for this year, two thousand and twenty one. It's a hundred forty eight dollars and fifty cents for the average person.Okay, so permit a hundred forty eight. That's correct. Okay, for partbe. Okay, it obviously will change every year. It'll most likelygo up, but that is the average payment for a person for part be. Now just know that that will depend on your situation and depend on yourincome. So obviously the more money you make, the higher your part bepremiums will be too. Okay, so that's based on your income. Yes, all right. The other important part about part B is you may havea penalty if you did not sign up for part B. When you shouldhave. Okay, when should you sign up for part be? So youturn sixty five? Not necessarily so. You should obviously get part a whenyou turn sixty five because it will not cost you anything. Part be,you're going to hold off until you're fully retired because if you are still working, your employer is paying for your part be because you will have employer insuranceright and employer insurance has that part a...

...and part be. So you don'twant to be double pay and especially in Texas, if you get part bthey have what they call six months of guaranteed issue from getting part B.That means when we discuss further about the Medicare supplement plan, you cannot bedenied right, and that's going to be really important, especially if you haveany sort of pre existing conditions or what have you, because you want tocontinue on your insurance right. You want to be Makeure, making sure thatyou are covered. So part be you want to get when you're fully retired. You do not want to get it when you are working because your employeris paying for it and you do not want to get double paid for it. Nor do you want to be disqualified from that guaranteed the issue period,right, Gotcha. Okay, so part be. There's a lot into partbe. member. There's going to be a penalty if you did not signup for it when you should have. It's actually going to be ten percentfor every year you should have signed up and you didn't. And so okay. So just to be clear, you should sign up. So if you'resixty five and you're retired and you don't sign you have six months to signup for B is that correct? No, if within six months, we'll discussit more when we get to the Medicare supplement. Okay, bet,but that is the reason why not to sign up for part be until you'refully be tied okay, okay. If you are fully retired, you wantto sign up. For want to sign up. Is there a penalty ifyou don't sign up? That's what you're talking about, the penalty right.Correct. So when does the penalty kick in? Like how long do youhave? What's the time period? So you will have basically within that timeperiod, for every year that you did not get that part be, youwill be charged the penalty. Okay, okay, okay, and that penaltywill go with you for as long as you have Medicare. That is reallyimportant. So if I retire at sixty five, I look, I'm completelyretired. I'm not getting insurance in any other way. So I want todo part a and part be right away. Correct, and then if I amstill working, I'm just going to do part a, but because I'mgoing to get insurance to my employer. But say it's seventy, I retireand I have six months from that point. Is that what you're you said somethingabout six months. But yes, six smart from getting part B tobe guaranteed issue, to get a medicare supplement. Okay, but if Ijust say OOP, some I didn't get part B, then I'm going tobe hit with this penalty. Correct? Okay, Gotcha, correct. Yes, okay, parts see of the puzzle piece is what we call a Medicareadvantage plan, and this is very confusing to people because Medicare advantage plans arerun by private insurance companies. Okay, so our Medicare supplements, so theyget them confused, intertwine. But Medicare advantage plans is a whole new ballof wax. It's actually what we call an all in one plan, okay, and so it will have your part a, it will have your partbe most often. It even has a drug plan included your part D okay. So that's why they call it an all in one plan and it isrun by private insurance companies. So okay, and we'll discuss that other too,because advantage plans can be a little less expensive. That's why people tendto go with them. Is that correct? It depends. It depends on howoften you go to the hospital, how often you go see your doctor, because those costs could add up to MMM. Okay. So with anadvantage plan you are subject to what they call copays. So anytime you goto a doctor, anytime you go to a hospital, anytime you get alab you may be subject to Copays, and if you do that quite often, that could very well add up right, definitely fast. The other puzzle piecewill talk about is the part D, which is D for drugs, andthat's easy to remember. You will have to get a drug plan whenyou get on Medicare. If you do not, you will also have apenalty. Okay, so you will have...

...a penalty with your part be,B for Boy and part D, D for drugs, if you do notget a plan when you should have and you didn't. Okay, okay,and it runs like part B does. If you are fully retired, getit right away. If you Yes for part D, is as long asyou have credible coverage. MMM, just like with part be. As longas you have credible coverage, if it's through your employer or through va orwhatever, it's considered credible coverage. Then you will not have a penalty.Okay, but you cannot be on medicare part a and be and not havea drug plan, okay, or else you will have a penalty. Thepenalty for part D is for every month that you should have had a drugplan and you didn't. There will be a penalty for that, heiks,that could at one yes, that could add up very, very fast toand you will have that penalty. Penalties for Medicare will last for as longas you have Medicare, for the rest of your life. Yeah, basically. Okay. So those are two parts to remember. That to have penalties. We will talk about Medicare supplementasurance. Now this, like I said,is also run by private insurance companies and they get it mixed up between theMedicare advantage plan and the Medicare supplement plan. Medicare supplement plan is often, Ithink in the olden days, called a medicap plan, m but itis what it is. Its supplements your Medicare. Okay. So when wego into original Medicare, which is part a and part B, we callit original or traditional. Some people may refer it to Medicare only covers eightypercent of the costs. Okay, with that part a and part B ifyou're in traditional Medicare. So the other twenty percent you will have to payout of pocket or hopefully you have a medicare supple maniasurance to help supplement thatother twenty percent. That Medicare will not cover. Okay. So supplement insuranceis covered by private insurance companies like boot Coss Boushield, and it will helpcover your supplemental costs. Okay, that Medicare covers. So the thing withsupplements is the older you get, the more expensive it will be, andalso you need to be what they call somewhat healthy to get a medicare supplementinsurance. And this is why I say in Texas they give you six monthsfrom getting part B to have what you call guaranteed issue, and guaranteed issuemade. It's basically no questions asked, you can get that plan. Sothat's why I said it's important to hold off on part B unless you're fullyretired, because then it would preclude you from that guaranteed issue. The sixmonths Right, oh, I got you. Okay, that was supplemental. Yeah, exactly. And so that day at sixty five, you're still workingand you're going to work until you're seventy. Okay. So at sixty five goahead and get that part A. Right, if it's not going tohurt you, part be hold off on until you're seventy, until you're fullyretired, then you can go ahead and when you get part B, thenyou have within six months. Well, obviously you want to get it soonerbecause then you won't have that part of the medical insurance. As soon asyou get part B, you can get a medicare supplement within six months,no questions asked. That's what they call guaranteed issue, right, and thatsupplemental plan. It will not go up as you age. Or will theprice go up as you age? Oh, okay, so it still will.Okay, but you won't have any questions ask. So you can getit okasily. Yeah, once you get on the supplement, we cannot basicallyboot you off unless unless you do not pay. Right, you don't payyour premiums and obviously you know your plan will not be in existence. Sonow if you can answer this, but on the supplement, what are theaverage premiums for that? or I guess...

...there's probably a lot of variables withthat yet. So the variables with the supplement, it is whether you ifyou're male or female, and if you're smoker or non smoker. Okay,and then obviously it goes up, you know, depending on what what aideyou are and what plan you choose. Okay, it's a there's a lotof variables in them. If people want to get a quote, be morethan happy to get rid of quote for that. Great, okay, sothey can contact me. All right. So we talked about all the differentparts of Medicare. Now we're going to talk about how does that all worktogether? Right, what we call in this I'm going to describe it asa flow chart. So there's two paths to take on Medicare, and thisis for individual not if you are in the large group, because if youwork for a large company and you get retired, they may have different plansfor you. Right. So this is for just for individual people that aretrying to choose a medicare on their own and it's it's not tied to anysort of union or large company. Okay, okay. So what we have isoriginal Medicare. That is your part a and part be. On thisroute you will have to get a separate drug plan because, remember, ifyou don't have a drug plan you have a penalty. And on this routeyou can get a medicare supplement insurance. So on this route original Medicare,you have your part a and part B. that's your eighty percent. You haveyour part D, your drug plan and then you can choose to getyour Medicare supplement insurance. Okay, so on this route you have three cards, basically your red, white and Blue Medicare card, you're going to havea part D, a drug plan card, and you're going to have a supplementcard. That's a lot of cards. That there's a lot of cards.But the upside to this, taking this Medicare, original Medicare route,is that you can use your Medicare anywhere in America, all fifty states,any doctor, any hospital that takes original Medicare, you can get service andthey're not going to have a lot of out of pocket because you have thesupplemental. So basically correct. Maybe on some drugs, I guess. Iknow. I hear people talk about that. A lots of medications your expensive.Yeah, because that's different plan. Yeah, on this route you canget a separate drug plan, but that is correct. On this side youcan go any like I said, any doctor, any hospital on the fiftyUnited States that takes original Medicare and you are covered. So it's a prettygood plan. I call it PPO on steroids, PPO plan on steroids,because your service, your network is huge, yeah, all right. So theother route is what we call the Medicare advantage plan. Okay, andthis plan, remember I said, it has part a part B. Mostoften it has a drug plan included to right. So it's an all inone plan. On this plan you cannot get a supplement. Okay, it'sbecause supplements, supplements, the original Medicare supplement, is not intended for Medicareadvantage plant. That would be too much insurance. MM. And actually it'sillegal for for agents to sell you both plans. Okay, that is justway too much. So, yeah, don't fall into that trap. Okay, good. So now, so on this side, that's Medicare advantage plan. Is that all in one plan? This is very localized and you willnot be using your red, white and Blue Card, although you will haveit because you have your part a part b. You would be using thecard that you chose the company to have your Medicare advantage plan with. Soit would may be a blue cross blue shirt card, hopefully, or itcould be any one of the competitive insurance plan card. That's what you're goingto use to get your services at a doctor's and a doctor's office or hospital. Okay, it's kind of like an HMO is, yes, okay,yeah, and we'll discuss more about that too in detail to the difference betweenhim and the PPO. Right. So in the Medicare advantage plant, alot of companies they have hmos and they have PPOs on this plant. Butthe biggest difference between this and the original...

Medicare is that the care that youget instead of all fifty states, it's very localized. So you can onlygo to the doctors and the hospitals that take your Medicare advantage plan. Solet me repeat that, you can only go to the doctors and the hospitalsthat take your Medicare advantage plan. It's very, very different than original Medicare. Okay. So normally this is very localized and it is within counties.So if you're in a big METROPLEX, so obviously you know Dallas Fort Worth, the FW, you choose a Medicare advantage plan and that's the service area. It's within the Dallas Fort Worth area and there's only certain hospitals and maybecertain doctors that will take that plan. Okay, if you move to Austin, you will have to get a different Medicare advantage plan because what works inDallas Fort Worth will not work in Austin. Okay. So also, if youmove out of state, if you move out of that country or thatMetroalplex County, you may have to change your Medicare advantage plan June. Whatwould happen if you are on a Medicare advantage planning live in Dallas, butyou go visit your daughter in Austin and something happened, you had to goto a hospital? What would happen? I get that question a lot.In a true emergency, and you has to be an emergency, okay,like several attackers, you know, however, hearttack exactly. You go obviously tothe closest hospital there is, okay, and they're supposed to cover it inthe true emergency. Now, if they find out that, well,that we really goes in the emergency, you may be subject to out ofnetwork costs. So, okay, just be careful. That's that is acaveat to the advantage plan. Okay. Now there are some companies that thatif you call ahead of time, like for us with Boocross Blue Shield,if you call ahead of time and you are an advantage plan and saying hey, you know I'm going to be in Florida visiting my grandkids for two months, will be like, Oh, okay, let's find out who around that areacan give you care if you do happen to get sick. Okay,so it's kind of like a prior authorization or prior permission, yeah, tofind somebody that's in your network. But yes, in a true emergency,you go to the closest hospital and you just you're going to have to makesure that it is true emergency. Okay, okay, good anyway. And soyou won't have that with an original Medicare remember, because you go,we don't basically anywhere. Right. So that brings up the point on networkof HMO and PPO. We hear those acronyms a lot. So the differencebetween the HMO and PPO is in the HMO network is very, very limited. And then Hmo you have to go through your primary care doctor for everything. So basically, if you want to go see a specialist, you haveto go to your primary care doctor first and then say hey, you knowwhat, I have this mole growing, I think I need to see adermatologist, and your PCP will go to hmm, you know what, you'reright. Let me get your referral. So there's an extra added step andyou have to follow the rules. And then HMO. Okay, and youthat specialist needs to be in that HMO network. HMM. Now if youdon't follow the rules and you go out of network and you're like well,I don't like that dermatologist that I got a referral from, just going togo to the one that I like, you may be responsible for one hundredpercent of the costs because you have gone out of network and an HMO.Okay, you have to follow the rules really, really closely. When thenHMO. Now on a PPO, it's a larger network. Let's just saythat in the PPO you don't have to go to your primary care doctor fora referral. You can go to any primary care doctor or general doctor that'swithin that PPO network. Okay, and specialist, so you can go toyou don't have to go to your primary care doctor first and say hey,I'm want to go see this temorcologist, you just go through the dermatologist that'sin your network. Now, in the...

PPO, if you go out ofnetwork, you pay out of network costs. Okay, obviously it's going to saveyou money if you stay in network, to stay in that PPO network.But with a PPO it has an option. They have in network costsand out of network costs. So if you go out of network, you'llstill be cover but you're going to have to pay out of network costs.So it's very, very different with an HMO because it n Hmo, outof network you're responsible for a hundred percent of the costs. Okay, sowe kind of recap that original medicure. You go wherever you want. Anadvantage plan is through an insurance company and could be an HMO or a PPO. That's correct. Okay, Gotcha. I'M gonna really get this this timearound. Yeah, you're getting better. I think the more that people hearit, get have that Light Bulb Aha moment like Ah, okay, youhave to hear it over and over, I think. Yes, so Iwe really appreciate you, Lori, in the community, to just kind ofjust you know, I ironed things out for us and just kind of helpus explain better, because it is very complicated and seniors. This is whyI got into the business because, you know, when my mom aged intomedicare she was so confused and I was like, well, you know what, I have a college degree, I even have an MBA. Let melook at this. It was so confusing and I was like, if Iam confused, how our older seniors able to, you know, work throughthis or even understand what's going on? Yeah, absolutely, and and Idon't even know all the INS and outs of it. And you know,and I've been with Lacrosse Fu Shiol for eight years now, but it's allthese little different nuances and and different scenarios, because everybody has a different scenario right. So it's not a medicare one size fit all kind of although there'stwo basic paths to follow, but it really depends on what your situation is. Yeah, and I know, like I was telling you earlier, Imean probably weakly. I get a call where people just have a question aboutmedicure or they think medicure covers something it doesn't, like senior living, which, as June said, it does not cover, or they're moving from outof state and wondering how that's going to work if they're on an an advantageplan or, just like you said, moving city to city. You knowyou need to read, you know, change that advantage plan or maybe to. So yeah, so I'm really glad to have you in the community andI know I send people your way all the time because I just have verybasic knowledge, although it's growing each time we get a podcast. So we'regoing to you're going to be a professional. Yes, sorry, will be anexpert one day. We'll see. So what changes are you seeing forgoing into two thousand and twenty two, because another open enrollment period, likeI said, this coming up October fifteen, which is why we're doing this podcastnow, and then going through December seven. Well, actually, whatdoes that mean? The open enrollment? What does that mean to people?Oh, yeah, that's a really good question. During open enrollment, whichhappens every year October five hundred fifty, December seven, like you said,people that are on Medicare have that onetime opportunity within that time period, Octoberfifteen to December seven, to make any changes to Medicare. So if youare on the Medicare plan and you're happy with it, like the old sayinggoes, if the wheel ain't broke, don't fix it, you have everyright to stay on the plan that you're already on. You have no obligationto change whatsoever. If you're happy with your plan, you stay with it. That will continue on for the upcoming year. Now, if you're nothappy with your plan and you want to make changes, you have that opportunityto do so during Medicare open enrollment. Okay, and when you make changesduring Medicare open enrollment, your new plan will become effective January first of theupcoming year. So make changes during this...

...open enrollment coming up, it'll beyour new plan will be effective January one of two thousand and twenty two.Okay, and I believe last time we talked about this. So say someoneis on original Medicare, they switch to an advantage plan and then get cancer, M and then they're like, okay, I want to switch back to original. That's they can't do it right. That is the million dollar question.Okay, is really important. Yeah, so people think that they can changeback and forth, switch back and forth, and the answer is yes, you can, as long as you are healthy. So you can switchback from original Medicare to advantage plan. Advantage plan has no restrictions in termsof preexisting conditions or health. Okay, but if you are an advantage planand, like you said, two. Three years later down the line,you get cancer and you're like, wow, none of my specialist or our doctorsor hospitals are in my network. I want to change back to originalMedicare. It will be too late for you. You cannot do that because, remember, medicare supplement insurance. You got to be healthy. HMM,you have to be healthy unless you are within that six month of getting partB. Okay, try, so badgeties now, Jane. All right.So this is really, really important. This is what I tell people.A lot of people think, oh, sixty five, I'm going to getpart A, I'm going to get part beat, and then they find outtwo years later to get cancer and they didn't get a supplement, and thenthey want to get us something. I'm like sorry, too late, okay, too late, okay. So there is time on the essence of this, and nobody has a crystal ball because you do not know when you're gonnaget, you know, acute disease right or else, you know, youwould be getting a supplement right before, right right. And another thing toremember was with this supplement, you know, the older you get, the moreexpensive it is. So I have these people that are in their sand they're wanting to change and I'm like, you know, I I would welcomeyour business, but I cannot in my good right conscious to tell youto change that, because the older you get, the more risk you haveof, I'm coming you know, injuries or diseases. Right. So Iwould recommend, if you are on the supplement, to keep that supplement foras long as you can now. But, like I said, that's just me. I can't tell you to choose one way or another. But ifyou have an advantage plan, and you know so. Let's go back tomy story of my mom. She's on original Medicare and she has a supplement. Okay, and then, further into it, a couple years later shegot cancer. She's in remission now, but she would call me up everyyear because every year her supplement gets more expensive. Right. She's like,it's open enrollment time June. Can I change her own? I was like, mom, no, you want to keep it because I'm like, becauseit's getting so expensive. I'm like, but okay, when you go toa doctor, how much do you have to pay? She has the Fplan, which covers basically everything. There's different plans on the supplement, butshe has a comprehensive plan, so anytime she goes to doctor, anytime shegoes to hospital, she doesn't pay anything more because it's covered with her premiumthat she pays every month. That she's complaining that it's okay now, onthe other hand, and so it works for her. Okay. On theother hand, my inlaws are on a Medicare advantage plan and they love theirdoctor and they love their hospital that they can go to and, you know, they have minor surgeries and overall their health is really good. So theylike the network and they like the plan that they're on. So they're happywith that. Right. So it really depends. They had a supplement butthey said it was too expensive for them.

Okay. So so, you know, there's a lot of factors that go into choosing. You know,what plan is right for you, but only that person knows and it reallydepends on, like I said, their resources and and another big thing isthe network, because a lot of seniors are, what I say, quoteunquote, married to their doctor. They don't want to change right. That'sa really important question I asked them because I'm like, if you don't wantto change, then there's not many choices you have, then you need tofind a plan that your doctor will take right m and that fits, thatfits what you are wanting. Yeah, you can't choose Willy Nilly, youknow, like throwing dart. No, and I think I know a lotof seniors and I get confused to you see these beautiful commercials where they makeadvantage plans look. I mean just that's what you need to be on.And I've had families call me were they had. You know, dad wasin Rehab and saw a commercial and called and switched his plan while in Rehab. So you know, that's that's concerning. But, like you said, advantageplans can be less expensive in some cases, but they could end upbeing more if you have a lot of copays, right. So it reallythere's a lot of factors that come into play. You can't just say acrossthe board an advantagement it's going to be cheaper, because that's kind of whatI thought. But what you're saying, that's not necessarily true. So,like I said, with the supplement right, because you're paying it up front,with those monthly premiums, you're not subject to any copays, right,or you may be subject to you know some little incidentals that is not coverright, that you would have to pay a pocket within advantage plan, everythingis copay. So anytime you go to a doctor, anytime you go toa specialist, any time you go get maybe lab work done or to goto the hospital, their subject to Copas. M Now, if you don't visitthose providers very often, like my inlaws, you know that it ischeaper than it is cheaper. But if you go a lot and you havean acute disease or you a lot of ailments, you have to go toa doctor like every two weeks or something, it does add up. HMM.So you got to have to you have to take the whole situation intothe picture. They are when you're thinking, oh well, advantage plan is cheaper, it may not be, hmm. You know, and that's why peopleneed to talk to you June before they make a decision. Well,I can, I can definitely give them the tools, but they have todecide on their own what's right for them and I would tell them, youknow, just because your neighbor or your friend or somebody has a certain plandoes not necessarily mean that it's going to work for you. It may workfor them right, perfectly and that's why they chose it and maybe they're,you know, advocating it for you, but you really have to make thatdecision. I don't know. Okay, and just a question because it hascome up before. So if someone like you, know, we had thisgentleman who was in a rehab and it was during open enrollment. He calledand changed his insurance, can he change it back if you don't like thekids discovered, oh my gosh, you shouldn't have changed it, can theychange it back if it hasn't started the first of the New Year, ifit's still within the open enrollment period? Yeah, so that's a really goodquestion to so normally you can change as many times as you want during openenrollment. The last change that you made on or before December seventh is whatwill take place on January first. Okay, okay, that's good to know.It is something happens. You find out this is not the right plan. You know, your kids say you know, you can always switch itback. Right. And to add to that, this was just recently anda couple years now, CMS, which is center for Medicare Medicaid Services.They make all the rules they actually extended open enrollment for Medicare advantage plan,so January first to March thirty one.

If you have an advantage plan andyou find out that, wow, this is not the advantage plan for me, you can change to another advantage plan from January first to March thirty one. So it's only for people that have an advantage plan. So say theyan open enrollment in October. They said, okay, first the year, I'mgoing on advantage. They get on the advantage plan January and then theyhave till March and they're like this is not the right plan. They canswitch to another advantage plan. Yet they have a plan time. Okay,but they can't switch back to original. They have to stay in an advantageplan. Actually they can, but remember, you can't get the supplement. Oh, that's right, so that's not good. Yeah, okay, beforeit used to be I used to kind of call it like a lemon law, like wow, I didn't like that advantage plan. Let me turn somethingelse. So before it used to be till Valentine's Day, but now they'veextended it. So you have that one time from January first to March thirtyone. If you chose an advantage plan during open enrollment and you find out, wow, this is not what I wanted. You can choose another advantageplan or you can go back to original Medicare, but obviously if you're nothealthy, you might not be able to get that supplement plant. Right,exactly, basically, I mean just choose wisely and pretty much study the pathwith your decision, right, I mean because, yeah, can't. Youdon't want to lose the supplement plan by going off original and I'll exact vantageexactly if you're if you're on that route. Yeah, like I said, everyyear advantage plans you can change and you can go on the new onestarting the new year. And then if you honor an advantage plan, thenyou're like wow, I didn't mean to choose that one, that one,that choose another one. You can do so from January first to March thirtyone one time change and it will become effective April first. Okay, yeah, there's a lot of rules and regulations regarding that too. So just likeyou said, choose wisely, choose wisely and stay the course. Yeah,don't be trying to switch around. I can trouble right, I do wantto say, though, for those that are aging in, because we havea lot of people that are aging in. I want to say we're still inthe baby baby boomers. Yeah, are all right, like over tenzeroturnings and sixty five every day. So for those that are aging into whatwe call Medicare, you actually have seven month period during your aging in ofturning sixty five, which happens only once in a lifetime, right, sothey're going to give you a once in a lifetime those seven months to actuallyenroll in Medicare. Okay, but the earlier the better. Early bird getsthe worm, because if you start three months prior to okay, you areMedicare benefits will start the first day of your birthday month. Okay, okay. So, like I'm the I'm the last year of the baby boomers.I'm one thousand nine hundred and sixty four. So I wanted to do my birthday'sApril, so like April one, April six, okay, in thebeginning, so three months prior to aprior. Okay, I want to go aheadand figure out what I want to do and get enrolled. That's right, April first, right. Then it would start. I'm on medicure absolutely. I think original is what I'm choosing. Okay, yeah, well, mybirthday is in July, as the end of the month, July twentysix. Okay. So if I start my Medicare and apply through social security, because social security is actually the administrator for Medicare, a lot of peopledo not know that. Okay, okay, at Social Security is the administrator forMedicare because we've been paying into social security for medicure as work. Right, okay, got it right. So...

...three months prior to my sixty birthdayI am hopefully going to be fully retired. So I'M gonna get part A,man a, sign up for part A and I'm going to sign upfor part B. Okay, and because I did it three months prior tomy benefits per Medicare, I would get my red, white and Blue Cardsaying that the benefits are effective July first, even though my birthday is July twentysix. MMM, okay, Gotcha. All right, so early bird getsto warm. If you start on your birthday month or start any timeafter your birthday month, it will be the month after, okay, ortwo months after. Okay. So they maybe without coverage there. Okay,exactly. All right, exactly. Okay, that makes sense. Yes, andtoday send you just out of curiosity now, because I mean that's stillhave several years until in sixty five. Will Not that many, I guess, but you know it's getting close. Sor. But do they send yousomething in the mail, like you know, way prior? Do you needn't justknow that that three months before you turn sixty five you can go aheadand do this? That I'm not sure, because I haven't been in that position, but I do hear that. A lot of my senior say,Oh, I'm being getting bombarded with Medicare information. So I'm pretty sure thatthey know when you're coming up, back up, coming up. But yeah, it's your responsibility to make sure you sign up for a part A andfor part B, or delay part B if you're still working. Okay,all right, and then you can do all this on your own. Dothe A and the B, and then when you add the supplemental and thedrug, that's when you need to choose going through an insurance company like wouldcorrectly shield. Okay, correct, yes, so your a ANDB. Obviously you'regoing to sign up to social security, which is SSA DOT Gov, SSAdot Gov. Okay, those are one of the resources. And thenMedicare dot Geov. That's Medicare. Okay. They're wonderful website to reference to.So when you're ready, yes, you want to go to SESSA DOTGOV and sign up for part a or for part be, depending if you'regoing to be fully retired or not. And then they're the ones that say, okay, we're going to send Medicare your information and dispense your Medicare card. Okay, and Medicare will cant have that. And then you go toBluecross, Blue Shield or whatever other insurance provider, and that's when you workout right, so her to the other. So Blue Cross bushield can help youwith all parts of Medicare, just like any other health insurance. Wecan help with your part D R drug plan, your Medicare supplement plan anda Medicare advantage plan. So we have all the parts of Medicare. Gotcha. Okay. And then how can they contact you for more information? Sothey can contact me by my phone number two, one hundred and four,seven eight, three, seven nine are one, or they can email meat June underscore Kim so, Jun me underscore Kim at BCBS txcom. Okay, and we will put this on the website or we have all the informationafter the podcast. So will have all that connection so that they can findyou. You are the best at explaining this. June, I really feellike I've got it now. Okay, great, so confusing. So isthere anything else you want to add? Or Yeah, so if you can, along with my personal resource and contact information. Just don't forget Medicare dotGov and the one eight hundred Medicare number. They are open twenty four seven.Yes, okay, Medicare is open twenty four seven, wow, okay. And then social security is SSA DOT GO v. The one eight hundrednumber for social securities one eight hundred seven, seven, two, one, two, one three. They are open...

Monday through Friday. Seven to seven. Okay. And what was the one eight hundred number for Medicare data?It's one eight hundred six three, three, four, two, two, seven. Okay, Great. We'll put all that to yeah, okay,Great. And then one last resource is my website, or are think blue. I'm part of the think blue team. We are internal agents for Bluecoss,Blue Shield. Our website is think blue, Thhi and K blue txcom. So think blue t xcom. Okay, and they can find methere and they can request a one appointment and they can find a lot ofresources at our think blue txcom website. Okay, excellent. Thank you somuch, June. Like I said, you're just such a great resource foreverything medicure. You're my goto person and I you do a great job ofexplaining it and that's why you are the specialist. I appreciate that and Ialways tell people, you know, I really don't care what kind of Medicarethey have. I should it's more important to me that they understand when theyhave. Yeah, okay, because you know, people call me up andthey're like, Oh, you know, I want I want this and Iwant that, and I'm like okay, but let me show you your trueoptions, all right, and let me make sure that you understand. Youknow, and are you okay with that? So it's really important that you havesomebody that can help you ask those right questions, because Medicare so confusingyou don't even know questions to ask right exactly. So find someone who can, you know, educate you, know your options and then choose wisely anddon't be switching back and forth. That's probably that's mostly what I got outof this. I think exactly. It's especially if you are, you know, under a rehab or under doctor's care or you know you that's not thetime to switch. Yeah, absolutely, you're under some sort of treatment.Absolutely, do notice. Absolutely not. So I will thank you so much, June. I appreciate you being on the podcast and I hope this isinformative to everyone. We will have all the information and you could always goto my website, which is Lori Williams senior Servicescom, and also please sharethis podcast with your friends and family. I just think it's so important toget this information out because, like June said, it is it's confusing.It's confusing to everyone. It's confusing especially if you're a senior. So pleasebe sure to share this information and, as always, thank you for listeningand we'll see you next week.

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