Video Transcription
Hello, everybody, and welcome into Senior Living Live. My name is Melissa. Thank you so much for joining us here today. Well, with our webinar this afternoon, we are discussing Medicare.
It's a great resource, but, unfortunately, if you've had anything to do with it, you know it can be a tough one to fully understand when it comes to enrollment, types of plans, their benefits, and, of course, the cost. Nikki Ferrett is here today to help you understand the system and tell you how you can maximize its benefits to the fullest extent. Our webinar, we expect, will last about an hour, so settle in, everybody. We encourage you, of course, to be a part of the conversation.
And in order to do that, all you have to do is scroll down to the bottom of your screen where it says Q and A. Feel free to type your questions out there, and I will be happy to read those to Nikki at the end of her presentation. Nikki, the webinar is all yours. Take it away.
Thanks so much Melissa. So I'm gonna go ahead and share my screen. What we're gonna be talking about today is going to help you, the viewer, prepare for Medicare. So to begin with, I'm just gonna tell you a little bit about myself.
Like Melissa said, my name is Nikki Ferrett. I'm an agency owner and a licensed insurance agent. I've been working with Medicare products for over eight years now, and, I currently reside in the Chicagoland suburbs with my family, my husband, and my three kids.
And I began my career as an independent career agent with the largest Medicare insurance carrier in the country. So that's where I started, got involved in Medicare, and I decided that's where I wanted to stay, that I wanted to focus on Medicare. So those are the only products that I offer.
A few years ago is when I decided to expand to an agency. I became contracted with additional carriers and now work with multiple carriers across the country. So my agency is called BrickHouse Agency, and we're licensed in thirty five states. We also do business as Chicagoland Medicare in the Chicagoland area of Illinois, Indiana, and Wisconsin. So you'll see my name associated with both agencies. So one of our missions at Chicagoland Medicare, and in fact, most agents' missions that are trying to, you know, help those Medicare eligibles, is to make sure people are enrolled in the plan that fits their health care lifestyle financial needs. So that's really important. That's how you kinda determine which Medicare plan is the best for you, and we're gonna talk about the different Medicare options out there and how to determine what's gonna be the best for your particular situation. And education and getting the right information is extremely important.
Education is really important because, as you know, Medicare is really complex. It's really confusing. In fact, you see some statistics on the screen. Eighty percent of Medicare eligibles are confused about original Medicare. Well, it's kinda hard to know what else you might need or what other coverage you might require if you don't even understand original Medicare. So we're gonna talk about that today, define original Medicare so you have the information you need. Sixty three percent of Medicare eligibles are overwhelmed by advertising. So particularly during certain parts of the year, you can just be inundated with ads on TV and, you know, you're getting all kinds of marketing material in your mailbox. It's important to know what you should pay attention to. And fifty eight percent of people do not yearly, annually review their coverage. So we're gonna talk about how not reviewing your coverage on an annual basis could end up costing you more money in the long run, which is nothing any of us want. So we're gonna figure out how to prevent that from happening. And sixty nine percent of people cannot easily find the information they need to make an effective plan decision. So, again, information is so important, having the right information.
So one of the things that we're gonna talk about today are enrollment periods. So enrolling at the right time is important as well because if you miss an enrollment period, sometimes you don't get another chance or you have to wait for your next chance, and that can lead to late time lifetime late enrollment penalties. So that's something we definitely want to avoid. Also, insurance plans change yearly. Every year, there are tweaks that are made to plans. So just making sure you understand where to find those changes, and I'm gonna tell you how to do that, is really important. And then lastly, enrolling in the wrong Medicare plans for your needs, like I said before, it can end up costing you additional money. So that's not something that we wanna happen. We wanna be protected financially as well, and that's what your Medicare insurance can do for you.
So let's start with the basics. What is Medicare? So you can see on your screen here, these are the parts of Medicare. On the left, you see the four parts of Medicare. We have original Medicare, which is part a and part b. That covers your hospital and outpatient care. Then there's part c, which are Medicare Advantage Plans. Then there's part d, which are prescription drug plans. And then not officially part of Medicare, but goes along with Medicare or Medicare supplements. So I wanna start with original Medicare and define what is original Medicare.
So first of all, when are you eligible to enroll in original Medicare? So eligibility starts for most people at age sixty five. You also must be a legal resident. You must live in the US or have including you have lived in the US for at least five years in a row as a legal resident, including the five years prior to applying for Medicare.
Now there are some people under the age of sixty five that do qualify due to disability, but the majority of the people first are eligible for original Medicare at the age of sixty five.
So I talked about original Medicare being Part a and Part b. Part a is your inpatient care coverage. So that's when you're an inpatient in a hospital setting. This also covers some skilled nursing. This covers, hospice care and some home health care. So those are some of the things that are under the umbrella of part a. Part a, for most people, does not include a premium. So, again, it's your hospital inpatient coverage, and for most people, no premium for part a. Part b helps pay for your outpatient care. So these are things like your primary care visits, your specialist visits, x rays, MRIs, durable medical equipment. Any outpatient care that you receive falls under part b of original Medicare. Most people pay one seventy four seventy per month in premium for their part b coverage. Now that can be different according to your income level. So you would be notified if you're gonna pay a different premium, than the typical premium of one seventy four seventy per month. Part b premium is something you will always pay. So we're gonna talk about other products that you can go with or instead of original Medicare, but just please remember, you will always pay that part b premium.
So those are the things that original Medicare covers, but there are some costs and gaps in addition to the premium for Part b. So the other cost that we have with original Medicare are your Part a inpatient hospital deductible, which covers your first sixty days of a hospital visit. That deductible is one thousand six hundred and thirty two dollars. So that's the largest portion of payment for your portion of cost for part a. There are some other cost. There are some co pay for hospital days above sixty days. There are some co pays for skilled nursing, but the biggest one is your inpatient hospital deductible. With Part b, we have a onetime yearly deductible. This year it's two hundred and forty dollars. After you fulfill your Part b outpatient care deductible of two hundred and forty dollars. We have a twenty eighty split. You pay twenty percent of your outpatient care, and Medicare covers the eight other eighty percent. Now important thing to remember is with original Medicare, there is no maximum out of pocket. So you will just keep continuing to pay for whatever services you receive. Medicare does not cover your prescription drug cost, so that's something we're gonna talk about on how you can get prescription drug coverage. It also does not cover routine dental, vision, and hearing. So that's something else we're gonna have to look at. You know, you have to have other options for your routine dental, vision, and hearing care. For your long term care insurance, you're gonna have to look outside of original Medicare as well. Original Medicare does not cover long term care. So those are the cost and gaps of original Medicare. We're gonna talk about ways that you can cover those costs.
But first, we have to figure out how do you get on to original Medicare to begin with. What are your original Medicare enrollment opportunities? So at age sixty five, you're first eligible, and that's the time when you need to start looking at enrollment. So if you are working and you have what we call credible employer coverage, you can possibly delay parts of Medicare. But we gotta make sure that coverage is credible first. So one clue, one tip is if your employer has a group plan that covers more than twenty employees. If that's the case, there's a good chance your coverage could be credible. I always recommend people speak to their employer. The HR department can typically help you with this, and they should be able to let you know if your coverage is credible. If it is credible, then you can consider delaying parts of original Medicare after the age of sixty five. So these are some of the enrollment periods, and we're gonna throughout the rest of this presentation, we're gonna hit on each one of these. First of all, some people are automatically enrolled into original Medicare. Some people need to use their initial enrollment period, also known as their IEP. There are special enrollment periods that allow you to enroll in Medicare. That's called your SEP, and there is a general enrollment period at the beginning of every year, January one through March thirty first, and that is called the GEP.
So let's hit on the first one first. Some people are automatically enrolled into Medicare at the age of sixty five. These are people that are already receiving Social Security benefits. So if you are receiving Social Security benefits at least four months prior to your sixty fifth birthday, you will be automatically enrolled into original Medicare. Couple months before your sixty fifth birthday month, you will receive that red, white, and blue card that we're all familiar with. You will receive that in the mail. So that is the automatic enrollment at the age of sixty five for people already receiving Social Security benefits. Now some people delay those Social Security benefits. If you are delaying your Social Security benefits and you are not receiving a Social Security check at that time, then you are going to need to go sign up for Medicare for whatever parts of Medicare you want. The easiest way to do that is to visit the Social Security website, which is s s a dot gov. That's the easiest, fastest, most efficient way to sign up. You can go to your local social security office. You can give them a call. I have heard that the wait times can be rather long. The easiest way is if you have access, go to their website, set up an account there, and then you can apply. It usually only takes ten minutes to thirty minutes. So it's a pretty easy process, and they'll guide you through it. If you're signing up this way, you need to utilize your initial enrollment period. That's that IEP we talked about. It's a seven month window surrounding your sixty fifth birthday. So the three months before your sixty fifth birthday, the month of your sixty fifth birthday, and the three months following your sixty fifth birthday. That makes up your initial enrollment period, and that's when you can go and sign up for parts a and b or just part a. And we're gonna talk about why you might want to only sign up for part a.
If you are continuing to work past the age of sixty five and you do confirm that the insurance you have through your employer with your group plan is credible coverage, then you can delay part b. Now we talked about how part a is premium free and part b has a premium associated with it. That's why you could go ahead and enroll in part a. It's premium free. It will be a secondary insurance to your group employer plan, and you can delay enrolling in part b until you need it later at your retirement. You do wanna compare cost, though. So I would recommend, you know, a few months before your sixty fifth birthday, sit down, talk to an agent that you trust, and kinda get some pricing just to see what is the best option for you. What is gonna be the best coverage for the best cost? And if that is remaining on your employer group plan, then you can do so. And like I said, you can just go ahead and sign up for part a and delay part b because you have that credible coverage. Now one key to that is that if you are contributing to an HSA, a health savings account, then you do not want to apply for either part a or part b. So if you have that credible coverage, you're also contributing to a health savings account, then you need to delay both parts of original Medicare. But if you're not, then you can go ahead, pick up part a, delay part b. Again, visiting s s a dot gov is the easiest, fastest way to sign up for part a.
Now when are you going to be able to pick up part b? Say you've done that route. You've you have credible insurance. You go ahead. You take Part a. You delay Part b. Now it's a few years later. It's time for retirement. Now you will be able to enroll in part b with your special enrollment period. That was that SEP we talked about. So your special enrollment period will allow you now to enroll in Part b of original Medicare because you are losing your credible health insurance policy that you received through your employer. This special enrollment period lasts eight months from your loss of coverage or when you quit your job. So that's when you wanna go ahead and pick up your Part b of original Medicare. So a few months before you retire, again, that's what I would recommend, meeting with a trusted agent, find out what you what you want to do, you know, what options you wanna take with your Medicare coverage. And then that's also when you go ahead, you log back into s s a dot gov, and you file and apply for that part b coverage. So if you do not get the different parts of Medicare when you're supposed to, that's when you can have a late enrollment penalty.
So one of the late enrollment penalties that you really wanna make sure you avoid is the Part b penalty. So with part b, if you missed your IEP and you were not able to enroll in Part b or if you retired and somehow you missed your SEP and you did not enroll in Part b at that time and you are without Part b coverage, if you go without Part b coverage for a twelve month period, you would then have to pay an extra ten percent in premium. That would be your late enrollment penalty for part b. Please remember that if you leave your employer plan and go on COBRA, COBRA is not considered a credible coverage. So you need to go ahead and make sure you get that part b within a proper enrollment penalty to avoid the late enrollment penalty. So say you did miss your IEP or you missed your SEP when you lost your employer coverage. The other time that you would have an opportunity to enroll in part b would be during the general enrollment period, which runs January one through March thirty first of every year. So if somehow you missed it, you could enroll in that time period. But, again, if it's been more than twelve months, now you have that ten percent surcharge in premium. So it's really important to make sure you get that Part b at the proper time.
For your Part d coverage, your prescription drug coverage, there is also a late enrollment penalty that can be applied. And that happens if at any time during your initial enrollment period, you have a sixty three day time period where you do not have prescription drug coverage. If you have no coverage, no credible coverage for sixty three days in a row, you would incur a Part d late enrollment penalty. And you would generally have to pay that penalty for as long as you have Medicare. So here's the situation that typically happens that that I've worked with people and this has occurred. Someone turns sixty five. They enroll in Medicare. They're not currently on any prescription drugs, and they think why should I pay a premium for this plan that I'm not even going to utilize? Well, the late enrollment penalty is the reason you wanna do that. Most of us are gonna end up on some kind of prescription medication at some point in our life. So you just wanna make sure that you have that coverage. So what I recommend to people if they're in that situation and I'm working with them, I say, let's just get you on the least expensive prescription drug plan in your area so you have some amount of coverage. And we can always change it later, and we're gonna talk about the options for changing that part d coverage in a minute. But you just wanna make sure you have that coverage. Because if you wait ten, fifteen years, which I've talked to people that that's happened to, now we're talking about a significant fee. So, basically, the penalty is one percent of the median average drug plan in the country times however many months you went without that coverage. So it can add up if you have a number of years of a lapse in coverage. So just keep that in mind. Again, Part d prescription drug is something that you're most likely gonna wanna enroll in because you're most likely gonna need it eventually, and you do not want to have to pay an additional cost through your premium because you have a late enrollment penalty.
So for most people, they get on original Medicare, and then they want to start thinking about additional options. So on the screen here, you're gonna see a chart of the options that you have. So the first option is you could remain on just original Medicare and pick up a drug plan to prevent that late enrollment penalty. I personally would not recommend just going bare with Medicare because of what I said in, an earlier slide about no maximum out of pocket for original Medicare. So I feel like you're putting yourself at financial risk if you do not have some kind of additional coverage. So you can do that. You can go original Medicare with a Part d plan. It's not something typically agents such as myself recommend. The other option is you could go with original Medicare, a part d plan, and add a supplement to your original Medicare, and we're gonna talk about that. Or you can do a Medicare Advantage Plan. So those are kind of your three options. I wanna dive a little bit more into that option two and option three. So option two is your Part d plan, which helps pay for your prescription drugs, and a supplement, which helps cover some of the cost that original Medicare does not cover. Those out of pocket costs that we talked about. Option three is the Medicare Advantage Plan. Medicare Advantage Plans are combination plans where they cover your Part a inpatient care benefits, your Part b outpatient care benefits, and most of these plans also offer a Part d coverage as well. They can offer additional benefits included with the plan too. So those are kind of the two options that when I sit down with someone, these are the two options we're talking about. And each person decides, you know, which of those two options is the best for them. Medicare is a very individualized, decision that you have to make for yourself. Even with couples, there might be, you know, one spouse that, one option is best for and another option might be better for the the other spouse. So it's just really important to look at the options, look at your particular situation, and figure out what's best for you.
So let's talk about, define what these two products are so you can kind of know which one might be the better option for you. So let's start with the Medicare Supplement. These are also sometimes referred to as Medigap policies. So with the Medicare supplement, some people like the Medicare supplement option because with med Medicare supplement, you are still actively using your original Medicare. What this means is when you go to the doctor or the hospital, you will give them both cards, your original Medicare card and then your supplement. And with billing, they'll run both of those cards through billing. So you're actively using original Medicare. What this means is that you can see any provider, any doctor, any hospital that accepts original Medicare. That's your network. Your network is any hospital or provider that accepts Medicare must also accept your supplement. I also like to think of Medicare supplements as a more predictable cost. So with Medicare supplements, and I'm gonna show you a chart in a minute that shows because there are a range of Medicare supplements available to you with varying levels of coverage. But the majority of Medicare supplements have, and especially the more popular Medicare supplements, they have fewer co pays associated with them or fewer coinsurance. So with these plans, you can kind of look at the cost of your premium for your Medicare supplement. And in a lot of cases, you're not gonna have a lot of other cost above and beyond that premium cost. So if you like to budget and you like to know, you know, more closely what you're gonna spend every month on your health insurance, a Medicare supplement policy might be a good option for you. Supplement policies work nationwide just like original Medicare works nationwide. So if you end up moving two or three years down the road, you wanna move to another state closer to family, relocate, your policy will move with you. Some of these plans offer some emergency foreign travel coverage for people who like to travel outside of the country. That could be a benefit to them. An important thing to remember with Medicare supplements is that everyone has their own personal Medigap open enrollment period. So this is the six month period after you've turned sixty five and you've enrolled in part b of original Medicare. During that six month window, you have a guaranteed issue status. What this means is you could apply for any supplement that's offered in your state and any insurance carrier, and you cannot be turned down. You don't even have to answer the health questions. So if you know that you want to take the Medicare supplement policy route as your additional coverage, the recommendation would be go ahead and get it during your Medigap open enrollment period because none of us know, you know, how our health might change in the future. And down the road, outside of that Medigap open enrollment period, most likely, you would have to answer health questions and go through health underwriting and possibly pay a higher premium for the plan that you would like to enroll in. So those are just some things to think about with Medicare supplement policies.
This is a chart of the Medicare supplement policies that are available. Now not every insurance carrier offers all of these plans, but these are the plans that you can find, in your state. You possibly could find any of these plans at some insurance carrier. So, I'm not gonna go through each plan. You can kinda see on the screen how it works and, you know, the the different varying amounts of coverage. The example I'm going to use is plan g because that's one of the more popular plans out there. And in fact, plan g is the most comprehensive coverage plan available to people that turn sixty five after the year twenty twenty. So anyone that turned sixty five after twenty twenty, plan g is the most comprehensive plan that you can apply for. As you can see, when you look down the column of plan g, there's only one x, and that's for the part b deductible. So with your plan g, you pay your premium every month. You have to fulfill that part b deductible, which this year is two hundred and forty dollars. And after that, you do not have any other costs that are yours. As long as you're getting a Medicare approved service, it will be covered by your supplement. So when I talked about, more predictable cost, that's what I was referring to. So as someone who has a plan g, they know they just need to pay that premium every month. They have to pay the two hundred and forty deductible, but then everything else is covered by their supplement. So it's just important to look at these plans and decide which one's the best fit for you. As you can imagine, the higher, the more comprehensive the coverage, the higher the premium. So just kind of look at them, find out which one's the best fit for you. Do know that these are standardized plans. So it does not matter what insurance carrier you go to. The plan letter must carry cover the same things. So, again, using plan g as an example, if you get a plan g at any insurance carrier, it has to cover the same things. So just be aware. And, again, you can, you know, work with someone to find out which one is the best option for you.
So let's now talk about how with the Medicare Advantage Plans, also referred to as Part c. Why might a Medicare Advantage Plan appeal to some people? So Medicare Advantage Plans are actually an alternative to original Medicare. They, like supplements, are offered by private insurance companies. But when you enroll in a Medicare Advantage Plan, you're getting all of your insurance through that Medicare Advantage Plan and through that private insurance company. So you still have all the same rights and protections you had with original Medicare, but you no longer are using that red, white, and blue Medicare card. You're gonna put it in a safe place. And when you go to the doctor or the hospital or probably even the pharmacy, you will use your Medicare Advantage card. Some people like these plans because they have typically lower premiums than you see with supplements. And in fact, there are even some zero dollar premium plans out there. So some people like to, you know, keep that money in their pocket, not spend it on premium, and then just know that they will be paying co pays for services that they receive. That's how Medicare Advantage Plans work. They are pay as you go plans. So you will have a co pay associated with any Medicare approved service that you receive. So it's really important to compare these plans, the ones that are offered in your area because premiums, co pays, maximum amount of pockets, those all can vary greatly even within the same insurance company. Because each insurance company puts out multiple Medicare Advantage Plans to choose from. So you just really wanna shop, do a lot of comparison, and make sure you get on the plan that's the right fit for you. These are also network driven plans. So researching and looking and making sure the doctors and hospitals you prefer are in network for these plans is very important. There are different kinds of Medicare Advantage Plans out there. There are HMOs. There are PPOs. There are POSs. There are, there are many different kinds. But the majority of people I work with like to look at the PPOs. I'm bringing that up because PPOs do have the availability to go out of network. So if you like the idea of a Medicare Advantage Plan and, first of all, I would always work with the client and make sure the doctors and hospitals they prefer are in network. But with a PPO, you would know if down the road, you picked a new physician, they happen to be out of network. You can still see them. You'll just pay a higher co pay when you visit them.
Most of the Medicare Advantage Plans do not have medical deductibles, so that's comparison, doing shopping, very important. Most of them offer prescription drug coverage. If you work with an agent, Most of them offer prescription drug coverage. If you work with an agent, they'll ask you to share your prescription drugs that you take, and then they can work with you and make sure those medications are covered, for your plan. You can always visit medicare dot gov as well. On medicare dot gov, they have a tool that allows you to do your own shopping. If you wanna DIY it, do it yourself, you can go to medicare dot gov, click on their find a plan tool, and you can put in your prescription medications and compare the Medicare Advantage Plans in your area. Now they do not have a tool in there to look up your physicians and your hospital. So that's something you'd have to do separately or work with an agent who could do that for you or work with the insurance company, but you can look on medicare dot gov and compare plans for yourself. Many of these Medicare Advantage Plans also offer additional benefits. So this can be very appealing to people. These additional benefits are nice. I would never encourage anyone to get distracted by the additional benefits. The first most important thing is to make sure that you understand, you know, the premiums, the co pays, the coinsurance for your plan. You make sure all your doctors are in network. You make sure your prescription drugs are at the right cost. That's the most important thing about these plans. But after you have honed in on the right plan for you, then exploring these additional benefits can be wonderful. Because like we have said before, original Medicare does not cover dental, vision, and hearing. It doesn't cover routine dental, vision, and hearing. You can get that with these plans, especially the dental coverage. A lot of people, that's important to a lot of people. So that comes with these plans. They also sometimes come with gym memberships. They can have a meal delivery service for after hospital visits, and they sometimes can offer free transportation to and from doctors' visits. So they can have some nice additional.So what do we need to do yearly to make sure that we're on the right plan for us? So you gotta do all that work ahead of time. You wanna get in the right plan. But like I said earlier in the presentation, the plans can change.
Medicare Advantage Plans and Part d plans can change yearly. So you really wanna make sure you do a review on a yearly basis to make sure that your plan is the right plan for you. Don't be one of those people that just never reviews and never changes plans because that could end up costing you additional money. So every September, your insurance company is going to mail out a booklet. It is called the annual notices notice of change booklet. I talk to my clients all the time and and, you know, I try to keep them aware of this. Sometimes it still slips through the cracks because, you're getting so much mail during that time of the year. So it's and the reason you're getting so much mail during that time of the year is the next thing we're gonna talk about, which is the annual election period, which starts which starts in October. But just remember in September, please look for that annual notice of change book booklet that comes from your insurance company. It applies to your Medicare Advantage Plan or your Part d plan, whichever those you're enrolled in. And it is gonna give you a side by side comparison of what your plan offers this year, what the premium is, what the co pays are, what the coinsurance is. And right next to it, it's gonna show you what your plan offers for the following year. The plan changes for the following year. So you're gonna be able to see that side by side. You need to look at that and make sure, is this still the best plan for me? If it's not, then we have the annual election period. Annual election period runs October fifteenth through December seventh. This is your opportunity to change. Medicare Advantage Plans are part d plans. So you really wanna review. You wanna make sure that you're in the right plan. Maybe you picked up a new doctor and they were out of network, and now you wanna look at a a new Medicare Advantage Plan where you can pay an in network cost for that doctor. Maybe you were prescribed to do medication during the year and it's at a higher cost for you. You need to review your plan and see if there is an option out there that would be a better fit for you. Again, you can go to medicare dot gov and do this. Or if you're working with an agent, they should be reaching out to you either a phone call or an email and letting you know, hey. It's the annual election time. Let's set aside a little bit of time for us to meet and make sure that you're still next year going to be in the plan that's the best fit for you. At the beginning of the year, January one to through March thirty first, there is also what is called the Medicare Advantage open enrollment period. You might remember that time frame. I mentioned that for the general enrollment period, they run together at the same time. So January one till March thirty first, there are several things that can be done during this period. If you are already as of January one of that year, you were enrolled in a Medicare Advantage Plan, you can make a one time switch. One Medicare Advantage Plan to another. One time, you can make that switch during the general enrollment period. So say, somehow the annual election period, got away from you. You didn't get a chance to change your plan or maybe you did. And come February or March, for whatever reason, you're not completely satisfied with it. You can go ahead and make a onetime switch to another Medicare Advantage Plan during that time. You can also, during that January one to March thirty one time frame, disenroll from a Medicare Advantage Plan, go back to original Medicare, and pick up a part d plan. So those are the things you can do during that January one through March thirty first time frame. Another thing to be aware of with Medicare supplements, they do increase in premium yearly. So pretty much every year, you're going to receive a notification from your insurance carrier that covers your supplement, and it'll make you aware of that premium increase. So that's something to look at as well. Now all the carriers come out at different times. Many of them do it around springtime. So just be aware that yearly, you're gonna receive that notification and, they're possibly and probably will be an increase in your supplement premium. So that's something else to be aware of. And that is the prepare for Medicare presentation. So, Melissa, I don't know if there are any questions out there that people have, but, I'm ready for questions if if there are some out there.
We do have a couple of questions. Excellent presentation. We can give you a minute to breathe. Great job. And, yes, this is an excellent time for those of you watching, to, get your questions in for Nikki. And the way to do that, as you saw in the chat that I sent earlier, is to use the q and a button at the bottom of your screen. You can type your questions out there that you have about Medicare.
Again, this was, pretty thorough. So, but I know we already have a couple of questions, and there's several coming in now as we speak. So let's get going with that. Guys, we've got about fifteen, little more than fifteen minutes to the top of the hour, about twenty minutes to go. Let's start with Amy's question, and let's make sure that was the first one, and it was. For original Medicare, you mentioned it may cover home health care. How do you find out what is covered? Does it cover in home care like a Home Instead agency?
Okay. So Medicare does cover a certain amount of in home health care. So if you do visit medicare dot gov, you can see the total breakdown. It does cover a certain amount, but it is for people that, it's not for custodial care. So it's not something where if you need to be in kind of a home where they take care of you for custodial care if you cannot, you know, do things like get dressed, bathe yourself. It's not for that, but there is some amount, a few hours of care per week that can be covered by original Medicare. So that's something that if you think that you're gonna if you want additional care, that's when sometimes long term care insurance can be important, because it's not gonna give you some it's not gonna give you that kind of daily care.
Yeah. And, you know, it seems when we get questions like that that it's almost like you need multiple avenues to sort of bridge the gap to get there. Right? Unless you're just independently wealthy and you've got all that money sitting in the bank, it's gonna take a couple of avenues, I think, to get there. Do you agree with that?
Yeah. Completely. Yeah. So, you know, original Medicare doesn't cover everything. And, again, even if you're on a supplement, it's it's only gonna cover what original Medicare covers. So, yeah, just making sure that you sit down with someone and get all of your, all those areas of coverage taken care of is really important. So I know long term care insurances specifically, you know, people need to look into that, because, again, a lot of people are surprised that there isn't any kind of coverage, that helps in that area with original Medicare.
Yeah. And we would love that to be the case, but, you know, we're trying to give you facts and trying to be realistic about what it does cover, what it doesn't cover, and Nikki has done a fabulous job with that today. So, Amy, I hope that that answers your question. The next one comes from anonymous. Does Medicare cover incontinence briefs, wipes, or bedpads?
I don't believe that it does. It might cover under durable medical equipment. That's not really durable, though. So I have not seen that being covered under original Medicare or under your supplement. Now with Medicare Advantage Plans, you do get I did not put this in the additional benefits. But with a lot of Medicare Advantage plans, they offer what is called over the counter credits. Now these over the counter credits can vary like everything else with Medicare Advantage Plans, can vary greatly from plan to plan. Some of them are, like, twenty five dollars a quarter. Some can be fifty dollars a quarter. Some can be even more. With those over the counter credits, you could purchase items such as that because they're really for purchasing things that you would find in your, in your, you know, pharmacy section of, like, a Walmart or in your Walgreens or something like that, and that's where you could take care of items of that nature. Original Medicare will cover durable medical equipment, but that as the name suggests, durable, it's medical equipment that you, like wheelchairs, walkers, things of that nature, that CPAP machines, things that you keep for an extended period of time.
Got it. And and thanks for defining that because that was going to be my next question, but you did a great job with it. So thank you. And and anonymous, I hope that that answers your question. Rebecca just wanted to say great job. So, and I think we all agree. The next question, another one from anonymous. Can you explain long term care insurance, please? And this question did come in just before we started talking about it, from just the previous question that we had. So can you go a little bit more in-depth about that?
So I actually do not offer long term care insurance. I offer the Medicare products. So I do Medicare Advantage, Medicare Supplement, Part d plans. The only other plans I offer, are plans that kinda go with Medicare, which include your dental, vision, and hearing, some cancer, some small cancer insurance policies, and things of that nature. I don't wanna speak on long term care insurance. That's not something that I personally work with. A lot of financial planners actually are a good resource for long term care insurance. I do work with a number of financial planners. When they get a Medicare client that they can't help, they pass them to me. When I get a long term care insurance client, I pass them along to them. It is a product that, you know, you would want to go with someone who kind of, like, specializes in that area. I wish I had more information on it, but like I said, it's not a product that I offer. But I do know with that product, the earlier you go, the better. So if we have some people on here that, you know, are that under sixty five agers would that are just sort of trying to start planning for things like that, you know, going and talking to someone who specializes with long term care insurance would be a good idea. You know, the sooner, the better.
Got it. Perfect. And and before we kind of bury the lead here, Nikki, can you, give us maybe some information, for the viewers as to maybe how they can contact you if they're interested in in, utilizing you to help them with this journey or, maybe utilize the contacts that you have that you just mentioned?
Sure. There you go. Oh, there we go. So I the websites that I have up here are my Chicagoland Medicare website, chicago land medicare dot com. If you're in Indiana, Illinois, or Wisconsin, that's a great place to go. And then if you're outside of that area and, really, you could utilize either of these websites, no matter where you live. But I also have brick house agency dot com for people in the remainder of the states, the thirty five states I'm in. We try to make it very simple on the website. There are opportunities there on almost every page of the website, to schedule an appointment. I do most of my appointments by phone and Zoom. That way, you know, we can schedule it at your convenience, and I can share just like I did today in this presentation. I can share all the pertinent information. And you also see on here my email. Please email me if you have any questions, or my phone number, and that is my direct line phone number on on the screen. So that's a good way to reach me. And my website, especially Chicagoland Medicare, does have a lot of good general information. So there's a lot of products to find on there. So if you just kinda wanna look something up or you wanna get some information on part a, part b, or something of that nature, you can visit chicago land medicare dot com, and it'll give you that. It's lots of good information on the website.
Fantastic. And we're gonna leave that up through the remainder of, the q and a segment here. Paula has a question. How does the automatic enrollment work if you have to select a plan?
So the automatic enrollment works for original Medicare. So that would be to get your part a and part b. So if you're already taking, the the Social Security benefit payments, like I said, four months prior to your sixty fifth birthday, you will be original Medicare. Now the other products we talked about, the Medicare supplement, the part d plan, the Medicare Advantage Plan, that you will always have to do either, like I said, on your own, that you will always have to do either, like I said, on your own by visiting medicare dot gov or by working with an agent such as myself who can guide you through the process. So you will not be automatically enrolled in a supplement, a part d plan, or a Medicare Advantage Plan. That's something that you're gonna have to decide on your own which of those products automatically enrolled to in if you're withdrawing those Social Security benefits.
Got it. Perfect. Paula, I hope that that answers your question. If you have any follow ups, feel free to put them into the q and a, just as you did with that question there, and we'll get it to Nikki to answer. Thank you. Another question from anonymous. If covered under I'm covered under state of Illinois retiree, Aetna Advantage Plan have to co pay co pay in premium, would plan g with zero premium be better for me?
So that really depends. We'd have to do a cost comparison with that. So what we would do is, you know, we'd look up plan g, like I said, is a different cost carrier to carrier. It also is a different cost based on your age, at least in the state of Illinois. They can be priced differently in different states. In the state of Illinois, it does go by your age and your gender. So we would have to find out your age, your gender, then we would, find out what the premium for the particular, plan g you want at the insurance company you want, then we'd find out the cost of that premium. Something to remember about these retirement plans. It's always good to kind of check it out and see see if you can get a a, you know, a lower cost. So I would always recommend doing that. Nothing wrong with shopping. Do remember with these retirement plans, though, typically, if you leave them, you cannot get back on them. So you do want to confirm and make sure that another type of coverage would be the better option before for you before you leave one of those retirement, plans. But, you know, you're in the state of Illinois. If you would like to chat with me, if you'd like to get a quote for a supplement, I can certainly do that for you. And then, you know, we can see you could then price compare side by side and see, okay, which one's going to save me money.
And this is why we have you on. It's like there are rules and then rules to the rules and side rules to those rules. So, yeah, this this is why we have you here. Thank you so much. I hope that that answers your question. We have a couple more minutes, guys, remaining in the webinar. I'm gonna get to Sabrina's question here in a second. If you have a question for Nikki, it's a great time to get it in. Sabrina asks, is there a fee for using agencies?
Oh, that's a great question. No. So any agent you use, there there's not a fee. What happens is, say, you call me, we work together, and I help you enroll in a plan. You will have no additional cost. So I won't charge you a fee, and the insurance company won't charge you a higher cost or higher premium for using me. But what will happen is I will then be your agent of record. I will be a resource for you, and the insurance company will pay me a commission, fo basically, for for being that resource for you and for being there for you and, you know, helping you answer any questions you might have. So no additional cost to the consumer. The insurance company is who will pay the commission to the insurance agent.
Well, we love that. That is that is best case scenario for sure. And then, as a follow-up to that, a question just came in from anonymous. Is there a cost for your services to assist with the annual open enrollment period? And I guess my assumption is no?
There is no cost. No. So yeah. And and what we do at, at my agency is we start sending out emails. We have some a series of emails that go they start in September to remind you to look for that annual notice of change and to remind you that the annual election period's coming up. And you will continue to receive emails, about five emails in the series throughout the annual election period to say, hey. You know, this is the time. Let's get together. Let's review. But there is no charge for that those reminders. And if we work together and we find out there's a better option out for out there for you, you enroll in a new plan, no charge for that as well. So it's just a service that, that we provide and, hopefully, any agent would provide just to kind of make sure that you still remain on that best plan for you.
Wonderful. Okay. So we've got one more question here. Oh, nope. We got another one that popped up too. Let's get to Lisa's. How do I find out what supplement plans are available to me?
Yeah. That's a tricky one. If you're working with an agent, well, first of all, not all agents work with all the companies. Like, I myself, I just work with the big national carriers. So when you, you know, reach out to an agent, find out who they're working with, make sure that you like the carriers and that you're satisfied with the carriers that they're contracted with, and then they can give you a quote. Other than that, you really kinda would have to do the research, you know, on your own. I know medicare dot gov has the tool for Medicare Advantage Plans and Part, d plans. I don't believe medicare dot gov has a tool for supplements. So, you know, that's something you kinda would need to look and see, you know, what supplements are you know, what carriers offer supplements in your state and then which particular supplements each carrier offers, to kinda do a comparison. But it's a little trickier and a little, you know, a little more research involved. Yeah.
Yeah. Lisa, I hope that answers your question. Marta has a good question here. It is If you are retired but have been on a part c plan via your employer, if you changed during IEP or SEP, will there be a penalty if you switch to original Medicare and supplement?
Okay. So in this scenario let me repeat it back to make sure I understand. So in this scenario, it sounds like someone has another one of those retirement, Medicare Advantage Plans. Is that what they said, Melissa? A retirement Medicare Advantage Plan.
Yeah. Okay. Part c via the employer.
Right. Change, change during IEP or SEP, will there be a penalty to switch to original Medicare? So you wouldn't change during IEP or SEP in this scenario as I understand what's going on. What what I'm understanding is you're on a Medicare Advantage Plan that's offered by your employer as a retirement plan. So you would have an option to change during the annual election period. During the annual election period, you could either go to another Medicare Advantage Plan or you could enroll in a prescription drug plan and apply for a supplement. So two things to think about. A is what I already mentioned. With those retirement plans, you do want to make sure that you don't want that plan because if you leave it, you most likely will not be able to get back on it. Once you leave those plans, you're typically then excluded from them. So that's a. B, if it's a supplement you're wanting to go to, like I said, outside of your Medigap open enrollment period, which is that six month window when you're sixty five and enrolled in part b, you would have to answer health underwriting questions. So we would also want to make sure that you can pass health underwriting if you're not guaranteed issue, if you're not in your Medigap enrollment period. We wanna make sure you can pass health underwriting and get that supplement. So that's something that's a situation that I would recommend. Again, you know, work with a an agent and, you know, get all of your questions answered, you know, before you make any decisions because we don't want you to lose coverage that you cannot go back to, or be left without the coverage that you need.
Yeah. And, Marta, I do hope that I was able to interpret and read that, question correctly to Nikki. If not and, there's something else you can add, feel free to add it to the q and a. But, we are winding down on our time I'll maybe give a couple of seconds here to, Marta, and, no, she just said you did. So thank you. Perfect. So that we've got it done.
Yay. Alright. So that will, wrap up the q and a session here, guys. A lot of great information, obviously. But wait. Someone's coming in here at the last minute. What is the difference between part c and, plan g?
Part c and Plan g the difference? Yes. Okay. So Part c is Medicare Advantage Plan. So Medicare makes it interesting because they have parts and plans. Yeah. So Part c is another name for Medicare Advantage Plans. So all those things we talked about Medicare Advantage Plans, how it is you're using it instead of original Medicare and, you know, they have varying co pays and premiums and things like that. That's part c Medicare Advantage. Now plan g is a one of the many Medicare supplements you can choose from. Plan g is a supplement. You pay a premium for it. You pay your, Part b deductible. This year is two hundred and forty dollars, and then you have no other Medicare approved services that you receive, no other Medicare approved services are you required to pay a portion of because your plan g takes care of that. But plan g is a supplement. Part c are Medicare Advantage Plans. So parts and plans are different, but it can be confusing if you're not, you know, overly familiar with the products. But those are two different products. It is the alphabet soup of Medicare. There's a lot going on there, which is why we have you here today. I hope that that answers your question, anonymous. Thanks for, getting that in there, before we wrap up.
Excellent breakdown of the Medicare system. There's, obviously, a lot of information out there, and I think you did a wonderful job really narrowing it down, to the black and white rules that, can certainly help our viewers understand the system a little bit better. Thank you so much, Nikki, for being here.
Yeah. No. Thank you, Melissa. I enjoyed it. Thank you.
Yeah. Thank you. And, again, all that information about Nikki up on the screen. You can contact her. You can contact any of the individuals there at Brick House Agency, again, licensed in thirty nine states. Hopefully, they'll be in one of yours. But, again, we just wanna offer up, as much information as we can here in this short hour that we have together and then hopefully guide you to places where you can get additional, answers to your questions. So, thank you, Nikki, for being here. Thank you all for being here. If you enjoy this webinar with Nikki, check out our website. It's w w w dot senior living live dot com. We've got all kinds of videos all about senior living. And the best part, they're available on demand twenty four hours a day, seven days a week. Thanks so much for being a part of senior living life. Have a great day, everybody.