WEBVTT
00:00:00.880 --> 00:00:03.040
Welcome back to Senior Prime Time.
00:00:03.040 --> 00:00:09.439
I'm Bonnie Keith, and I'm here again with George Robertson, Elka Saddam, and Doris Ford.
00:00:09.439 --> 00:00:15.359
We are going to continue with part two of Medicare 2027.
00:00:15.359 --> 00:00:22.000
We'll explore the guide program enrollment options and what Medicare does and does not cover.
00:00:22.000 --> 00:00:25.440
Now, if you missed part one, go back and listen to that first.
00:00:25.440 --> 00:00:29.120
But right now, let's get started.
00:00:29.120 --> 00:00:36.240
Well, hello, and welcome back to Medicare 2027 part two.
00:00:36.240 --> 00:00:43.039
And once again, Joyce and I welcome our specialist, Elka Susana and Doris Ford.
00:00:43.039 --> 00:00:44.320
How are you doing today?
00:00:44.320 --> 00:00:45.679
Doing great, Bonnie.
00:00:45.679 --> 00:00:46.479
Thank you for having me.
00:00:46.479 --> 00:00:47.920
Doing fantastic.
00:00:48.079 --> 00:00:49.439
Thank you so much for having me.
00:00:49.840 --> 00:00:56.799
One program that I've gotten a lot of questions about, and I think it's relatively new, and I'm sure both of you can address it.
00:00:56.799 --> 00:01:02.000
The guide program when we look at dementia and aging in place at home.
00:01:02.000 --> 00:01:07.040
Can you help us understand the guide program relative to Medicare eligibility?
00:01:07.359 --> 00:01:19.040
What I understand is that it's a federal program that has allocated some funds for a specific agencies to provide home care for individuals that have Alzheimer's and dementia.
00:01:19.040 --> 00:01:26.959
And they do provide respite care of $2,500 for somebody that has already been diagnosed.
00:01:26.959 --> 00:01:34.959
And those $2,500 cannot be used to pay somebody to just come and take care of your grandmother or their aunt.
00:01:34.959 --> 00:01:37.760
It's not like the IHSS program.
00:01:37.760 --> 00:01:46.560
So it's a little bit different, and there is a specific agencies that can provide those services to these individuals.
00:01:46.560 --> 00:01:51.040
There's some Medicare Advantage plans that provide respite care, but it's very limited.
00:01:51.040 --> 00:01:53.519
Some do 20 to 40 hours maximum.
00:01:54.000 --> 00:02:02.480
I know that one of the pieces of the guide program, from what I understand, is you don't have eligibility if you're if you have Medicare Advantage or pay.
00:02:02.480 --> 00:02:03.359
Correct.
00:02:03.359 --> 00:02:04.159
That's correct.
00:02:04.159 --> 00:02:16.879
Is interesting because some of the people that were calling, they really wanted to look at that additional $2,500 annually, but they had a family member that was on Medicare Advantage.
00:02:17.199 --> 00:02:23.199
Yeah, they have to have they have to be on a Medicare supplement plan with original Medicare A and B.
00:02:23.199 --> 00:02:26.879
If they have a Medicare Advantage plan, that's disqualification.
00:02:27.199 --> 00:02:27.520
Okay.
00:02:27.520 --> 00:02:30.319
That that's really helpful, I think, for a lot of people to know.
00:02:30.319 --> 00:02:30.719
Thank you.
00:02:31.039 --> 00:02:39.599
And this is something new for 2027, I'm understanding, because there was nothing for dementia or Alzheimer's before through Medicare.
00:02:39.599 --> 00:02:40.159
Is that right?
00:02:40.159 --> 00:02:43.360
Are they trying to now do something, quote unquote?
00:02:43.360 --> 00:02:45.360
They're recognizing it's a disease.
00:02:45.759 --> 00:02:47.759
I think it's more about the custodial care.
00:02:47.759 --> 00:02:51.280
Like custodial care has not generally been covered by Medicare.
00:02:51.280 --> 00:03:03.120
In general, you have to have a long-term care plan or life insurance, or you need to be able to offset it through your assets, or if you have Medicaid, Medical in California, then they would offer that support.
00:03:03.120 --> 00:03:06.240
But Medicare in general did not offer that support.
00:03:06.240 --> 00:03:08.159
And so you're right, Doris.
00:03:08.159 --> 00:03:10.240
I think it's something very neat.
00:03:10.240 --> 00:03:11.599
There's a need for it.
00:03:11.599 --> 00:03:16.240
The other thing too that Medicare recently added was patient advocacy.
00:03:16.240 --> 00:03:20.240
So we do have through the foundation patient advocates that support members.
00:03:20.240 --> 00:03:30.159
Medicare will cover, I think it's up to six or eight hours of Medicare of patient advocacy support, but again, that will only be on original Medicare.
00:03:30.159 --> 00:03:34.800
So when you have an advantage plan, it takes over your Medicare.
00:03:34.800 --> 00:03:36.960
It determines what it will cover you for.
00:03:36.960 --> 00:03:39.520
Medicare is no longer in first position.
00:03:39.520 --> 00:03:41.039
It is more affordable.
00:03:41.039 --> 00:03:43.840
They throw in a lot of extra benefits.
00:03:43.840 --> 00:03:50.240
And like Dora said, some might cover some respite care, some custodial care, maybe after hospitalization.
00:03:50.240 --> 00:03:52.000
But it's very limited.
00:03:52.000 --> 00:04:03.120
So sometimes you do have to weigh out is it worth it to pay the monthly premium to have a supplement plan if I'm getting all of these other benefits, if you have a need for it.
00:04:03.120 --> 00:04:09.599
But unfortunately, sometimes if you wait until your health takes a turn, you can't qualify for a Medicare supplement.
00:04:09.599 --> 00:04:11.439
And so that's something to consider as well.
00:04:11.759 --> 00:04:12.479
Medigap?
00:04:12.479 --> 00:04:13.199
What does that mean?
00:04:13.199 --> 00:04:14.240
Medigap.
00:04:14.240 --> 00:04:16.240
Medigap.
00:04:16.240 --> 00:04:17.519
You hear about car stuff.
00:04:17.519 --> 00:04:24.160
You buy a car and then there's a gap something or other between leaving the car dealership and when I don't know.
00:04:24.160 --> 00:04:25.680
Is that like is that what Medigap?
00:04:25.680 --> 00:04:26.720
What's Medigap?
00:04:27.199 --> 00:04:30.240
That's another term for Medicare supplement plants.
00:04:30.240 --> 00:04:36.639
It it just covers the gaps that are original Medicare that's not covered.
00:04:36.959 --> 00:04:38.399
Oh, thank you.
00:04:38.399 --> 00:04:40.639
Great.
00:04:40.639 --> 00:04:51.600
See, in plain English, we're we're getting to understand what these terms mean because you hear them, and sometimes it's hard to put them together, though you hear them a million, a million times.
00:04:51.759 --> 00:04:53.839
So it's hard for us too, Bonnie.
00:04:53.839 --> 00:04:54.240
Let me tell you.
00:04:54.240 --> 00:05:00.959
I'm like we get thrown acronyms left and right, and we we have to try to decipher them for sure.
00:05:00.959 --> 00:05:09.439
But when you talk about Medicare, you have parts of Medicare, part A, Part B, Part C, which is uh Medicare Advantage, and you have part D.
00:05:09.439 --> 00:05:12.720
Those are parts, and that's Medicare or parts.
00:05:12.720 --> 00:05:17.279
When you talk about Medigap or Medicare supplement, it'll be plans.
00:05:17.279 --> 00:05:19.360
Plan N, plan F.
00:05:19.360 --> 00:05:21.759
I wish they didn't use letters, but that's what they do.
00:05:21.759 --> 00:05:23.759
Plan F, plan N, plan G.
00:05:23.759 --> 00:05:26.800
The plans are going to be the Medicare secondary, the Medigap.
00:05:26.800 --> 00:05:28.560
Did I make you more confused?
00:05:30.079 --> 00:05:32.240
The alphabet soup of Medicare.
00:05:32.240 --> 00:05:42.480
I'm so glad we have you experts to clarify all of this wonderful information, which makes me think about the 800 toll-free lines.
00:05:42.480 --> 00:05:45.279
We often get calls about that as well.
00:05:45.279 --> 00:05:46.560
What do we do with that?
00:05:46.560 --> 00:05:49.600
I call, and it seems like they don't understand what I'm asking.
00:05:49.600 --> 00:05:52.480
And of course, we have wonderful experts to refer them to.
00:05:52.480 --> 00:05:56.399
But what are those, what should we take from those toll free lines?
00:05:56.639 --> 00:05:59.759
Well, it all depends where which toll free line they're calling.
00:05:59.759 --> 00:06:05.759
If they are calling Medicare, they should have a little bit more knowledge of how Medicare works.
00:06:05.759 --> 00:06:15.600
But that my experience is from my clients that tell me they call Medicare, they usually end up being more confused when calling that number.
00:06:15.600 --> 00:06:21.759
But if they're calling the insurance company, they should be able to explain what their benefits are, right?
00:06:21.759 --> 00:06:35.519
Sometimes when individuals are calling an 800 number that they see on TV, they are calling a national company that may be a broker, maybe another insurance company advertising their plans.
00:06:35.519 --> 00:06:41.199
So it's always good to talk to somebody local in their local area that knows their own market.
00:06:41.199 --> 00:06:42.879
I strongly recommend that.
00:06:43.199 --> 00:06:45.920
I think there's a lot of fraud out there as well.
00:06:45.920 --> 00:06:54.399
So the one thing that I always tell seniors is if you did not initiate that call, then do not ever give your information.
00:06:54.399 --> 00:07:03.680
We have had clients who've had their insurance switched without their knowledge because they thought they were enrolling in a dental plan because that's what they really wanted.
00:07:03.680 --> 00:07:09.199
When they ended up getting enrolled into an advantage plan and that changed their coverage entirely.
00:07:09.199 --> 00:07:16.399
Very important advice is that if you get a call, you did not initiate it, you do not give them your information.
00:07:16.399 --> 00:07:20.160
They are not allowed to call you unsolicited.
00:07:20.160 --> 00:07:27.120
So unless you requested a call or you initiated that call, do not give your personal information to anybody.
00:07:27.120 --> 00:07:42.800
And if you're unsure, that is why you have experts at the Foundation for Senior Services, whether it has to do with Medicare or any other part of your life, you know, being able to have a resource that vets professionals, you know that you can call someone to just say, Hey, is this legitimate?
00:07:42.800 --> 00:07:44.240
Do I take this seriously?
00:07:44.240 --> 00:07:45.439
Or is this a scam?
00:07:45.439 --> 00:07:46.720
Just be very hesitant.
00:07:46.720 --> 00:07:47.600
Thank you, Elkin.
00:07:47.600 --> 00:07:49.600
When can you make a change?
00:07:49.920 --> 00:08:01.439
You can make a change to your Medicare Advantage plan or your prescription drug plan during the annual enrollment period, which is sure for AEP, another acronym you can learn.
00:08:01.439 --> 00:08:05.439
It is October 15th through December 7th.
00:08:05.439 --> 00:08:14.879
Okay, so that's the time frame where you should be reviewing your plan, sitting down with your broker, analyzing what has changed for 2027.
00:08:14.879 --> 00:08:18.720
Or if your plan is ending, what options do you have?
00:08:18.720 --> 00:08:24.639
Especially now that some Medicare Advantage plans will be terminating this year.
00:08:24.639 --> 00:08:28.560
So, or plans that are being discontinued.
00:08:28.560 --> 00:08:35.360
Members may have an option to either stay on that plan or be cross-walked.
00:08:35.360 --> 00:08:37.600
That's another term you might want to hear.
00:08:37.600 --> 00:08:51.919
You're cross-walked when you are moved from one plan that is close to another like plan within the same company, or you can simply shop around for another plan.
00:08:51.919 --> 00:08:57.759
So always, always plan reviews are strongly recommended during this period.
00:08:58.080 --> 00:09:00.720
And I'm going to add to that two things.
00:09:00.720 --> 00:09:06.879
Number one, the annual enrollment period is not when you shop around your Medicare supplement plan.
00:09:06.879 --> 00:09:09.519
A Medicare supplement doesn't have an annual enrollment.
00:09:09.519 --> 00:09:12.399
Once you're enrolled, your plan, you're in your plan.
00:09:12.399 --> 00:09:14.399
It doesn't really change year over year.
00:09:14.399 --> 00:09:20.000
So during the annual enrollment, like Dora said, it's just for your Medicare Advantage or your prescription drug plan.
00:09:20.000 --> 00:09:27.679
If you want to review your Medicare supplement plan in California and in, I think, nine other states, you have something called the birthday rule.
00:09:27.679 --> 00:09:31.440
So as you're aging, you know, we all get a little older.
00:09:31.440 --> 00:09:34.159
If you figure out a way to reverse it, let me know.
00:09:34.159 --> 00:09:37.440
But as you get older, your your rates go up every year.
00:09:37.440 --> 00:09:40.320
So at your birthday, you have a chance to shop around.
00:09:40.320 --> 00:09:45.600
So if your birthday happens to coincide with the annual enrollment, you're lucky because you can do them all at the same time.
00:09:45.600 --> 00:09:53.440
But if you're born in March or in April, that's really the time to shop your Medicare supplement to see if maybe there's a cheaper option available to you.
00:09:53.440 --> 00:09:54.320
That's the first thing.
00:09:54.320 --> 00:10:06.639
The second thing is, as I mentioned at the start of this podcast, there one in every five Medicare Advantage recipient will have a change this year, whether they want it or not.
00:10:06.639 --> 00:10:10.159
Please show grace to your Medicare broker.
00:10:10.159 --> 00:10:18.399
We have a very short window of time to be able to give everybody their personal attention that they deserve.
00:10:18.399 --> 00:10:24.240
So my ask would just be if they don't respond to your first email, send them another one.
00:10:24.240 --> 00:10:26.960
If they're not responding to your text, send them another one.
00:10:26.960 --> 00:10:37.440
But just have a little bit of grace, understanding that every single client we treat like family, and every client is important to us, but we have to make time for every single client as well.
00:10:37.440 --> 00:10:46.879
And I know brokers that work 18-hour days during the annual enrollment period to make sure that they can review and give that uh one-on-one attention.
00:10:46.879 --> 00:10:49.200
So that would be my only suggestion.
00:10:49.200 --> 00:10:50.399
But be patient.
00:10:51.039 --> 00:10:53.200
Although you mentioned the birthday rule.
00:10:53.200 --> 00:10:59.519
What is the time period from your birthday date and how long do you have?
00:11:00.159 --> 00:11:08.399
You usually have within a 60 days of your birthday month to apply for a Medicare supplement plan.
00:11:08.879 --> 00:11:09.519
60 days?
00:11:09.519 --> 00:11:10.240
60 days.
00:11:10.240 --> 00:11:11.679
Okay.
00:11:11.679 --> 00:11:13.200
So there's the birthday rule.
00:11:13.200 --> 00:11:16.080
Is there something called the 15% rule?
00:11:16.320 --> 00:11:16.960
Yes.
00:11:18.240 --> 00:11:18.879
So many rules.
00:11:18.879 --> 00:11:21.519
Bonnie, we're gonna get you licensed by the end of this podcast.
00:11:21.519 --> 00:11:22.720
No, no, no, I don't want it.
00:11:22.720 --> 00:11:23.120
No.
00:11:23.120 --> 00:11:24.240
No, thank you.
00:11:24.240 --> 00:11:25.679
That's your job.
00:11:25.840 --> 00:11:28.159
You can, you know, I will come to the experts.
00:11:28.399 --> 00:11:28.720
Yep.
00:11:28.720 --> 00:11:32.080
So the 15% rule is actually pretty unique to California.
00:11:32.080 --> 00:11:35.279
They're not there's a few other states that offer that.
00:11:35.279 --> 00:11:40.080
But what it says, and which is why the annual notice of change is so important.
00:11:40.080 --> 00:11:54.799
If your plan, your Medicare Advantage now, if your Medicare Advantage plan reduces its benefits by at least 15%, means it's gonna cost you more on let's say a copay or deductible.
00:11:54.799 --> 00:12:03.360
So if you added no deductible last year and next year they're adding a $200 deductible, then that's more than a 15% reduction of benefits.
00:12:03.360 --> 00:12:08.480
That gives you an opportunity to move into a Medicare supplement guaranteed.
00:12:08.480 --> 00:12:10.000
No underwriting.
00:12:10.000 --> 00:12:21.679
So even if you're going through the worst possible chronic condition and normally you would be declined on a Medicare supplement, that's where the 15% rule can come and help you.
00:12:21.679 --> 00:12:26.639
Generally, you know, years, years ago, we didn't really see much of a 15% reduction.
00:12:26.639 --> 00:12:29.919
It would just be, nope, sorry, you gotta go through underwriting.
00:12:29.919 --> 00:12:42.639
But now as the plans have been terminating and plans have been changing and plans are trying to recover money elsewhere, we are seeing it's very rare to not have that 15% guarantee, especially here in California.
00:12:42.639 --> 00:12:45.840
But it has to be done during the annual enrollment.
00:12:45.840 --> 00:12:48.720
After that, there is no longer that 15% rule.
00:12:48.720 --> 00:12:51.360
It can only be done during October 15th to December 7th.
00:12:51.360 --> 00:12:53.279
And that's the AEP.
00:12:53.600 --> 00:13:01.840
Yes, very Medigap or the supplemental, right?
00:13:01.840 --> 00:13:03.679
Without medical underwriting.
00:13:03.679 --> 00:13:05.200
You've already explained some of them.
00:13:05.200 --> 00:13:07.600
Are there any other ways that you can do that, Doris?
00:13:08.080 --> 00:13:08.320
Yes.
00:13:08.320 --> 00:13:20.879
So when you first become eligible for Medicare, when you first turn 65, you also have the eligibility window to enroll within the first eight months after your 65th birthday.
00:13:20.879 --> 00:13:23.519
That's a guarantee issue enrollment.
00:13:23.519 --> 00:13:33.840
Also, when you are leaving a group or employer group plan, you have 63 days to enroll in a Medicare supplement plan.
00:13:33.840 --> 00:13:46.960
So I know those so many numbers and so many rules, but it's critical, especially if people do want to have that flexibility to be able to drive their own car and not have to take detours.
00:13:46.960 --> 00:13:50.240
That's the Medicare supplement, that's what it offers you.
00:13:50.559 --> 00:13:53.840
And there's one other one that I think is not as well known.
00:13:53.840 --> 00:13:56.879
It's called the Medicare Advantage Trial Right.
00:13:56.879 --> 00:13:59.519
So think of it as a test drive.
00:13:59.519 --> 00:14:03.120
Since we're on the car topic of cars, think of it as a test drive.
00:14:03.120 --> 00:14:13.039
So if you are eligible for Medicare, the first time you are eligible and you go with an advantage plan, you have 12 months to try it out, test drive it.
00:14:13.039 --> 00:14:20.960
Anytime between those 12 months, if you change your mind, you can move to a Medicare supplement guarantee.
00:14:20.960 --> 00:14:25.759
But it can only be done during that first 12 months of being on a Medicare Advantage.
00:14:25.759 --> 00:14:44.000
And I think that's the importance of having the role of the agent, is that Doris spends hours and hours every year, hundreds of hours, studying, getting certified, getting light relicensed, continuing education so that we can learn all of these different rules and periods.
00:14:44.000 --> 00:14:48.799
So when we talk to a senior, everybody's situation is different.
00:14:48.799 --> 00:14:51.519
A husband and a wife can have a different situation.
00:14:51.519 --> 00:15:00.399
I don't know about you, Doris, but my pet peeve is when someone says, Well, my neighbor told me or my cousin told me, because everybody's situation is different.
00:15:00.399 --> 00:15:11.200
And that's why I think dealing with an agent who knows, like Doris said, works in the community, knows your situation, knows what how we can help you on a personal level is really vital.
00:15:11.519 --> 00:15:21.840
And the new one that I've heard is, well, my friend on Facebook has this Medicare plan, and I want to know, I want that plan.
00:15:21.840 --> 00:15:23.919
Or what about ChatGPT?
00:15:24.080 --> 00:15:26.240
Chat chat chatty G told me.
00:15:27.919 --> 00:15:30.720
We're talking to real people and real professionals.
00:15:30.720 --> 00:15:34.399
So uh Medicare is awesome for us older people.
00:15:34.399 --> 00:15:36.399
What what doesn't it help us with?
00:15:36.399 --> 00:15:37.679
What does it not cover?
00:15:37.679 --> 00:15:40.399
And give us the the highs and the lows, the ups and the downs.
00:15:40.639 --> 00:15:45.919
So well, I think one of the biggest misconceptions is that Medicare is going to cover you for things like long-term care, which we mentioned.
00:15:45.919 --> 00:15:52.240
We get a lot of calls from people who say, Hey, my mom needs a nurse, or my dad or my husband or my wife needs needs nursing care.
00:15:52.240 --> 00:15:55.919
And Medicare doesn't cover custodial nursing care.
00:15:55.919 --> 00:16:04.559
So unl they will cover home care, which is if you need an IV change, if you need wound care in your home, they will cover that.
00:16:04.559 --> 00:16:08.879
But they're not gonna stay there to help uh bathe you or cook for you or clean for you.
00:16:08.879 --> 00:16:12.960
So for that, you do need a long-term care plan, and that can be really pricey.
00:16:12.960 --> 00:16:15.679
So the younger you get it, the better it is.
00:16:15.679 --> 00:16:18.399
But it also doesn't cover final expense.
00:16:18.399 --> 00:16:24.320
So if you need a burial plan, that if you need to get that on your own, Medicare will not cover that.
00:16:24.320 --> 00:16:28.799
Those are the biggest gaps that I see that people come to us with.
00:16:28.799 --> 00:16:37.360
There are plans that you can get to help offset other expenses that you might have called critical illness plans in California.
00:16:37.360 --> 00:16:39.840
You have to purchase those before you turn 65.
00:16:39.840 --> 00:16:43.600
Once you turn 65, you can't even get it.
00:16:43.600 --> 00:16:44.399
It has nothing to do.
00:16:44.399 --> 00:16:49.200
You could be in the best of health, you could never have seen a doctor in your life, and you still wouldn't qualify.
00:16:49.200 --> 00:16:52.480
It's just not a real crazy, never never even heard of it.
00:16:52.480 --> 00:16:55.759
Yeah, how would I know to get it or to ask about it?
00:16:55.759 --> 00:16:57.279
You you don't know what you don't know.
00:16:57.519 --> 00:17:02.720
I'd like to add on on that critical illness, what Elka just mentioned.
00:17:02.720 --> 00:17:07.759
Since we cannot buy it in California if you're over 65.
00:17:07.759 --> 00:17:21.599
Bunny, you are in a very fortunate situation because you are in a state where you can actually purchase a critical illness, which includes a cancer protection insurance program, an accidental plan.
00:17:21.599 --> 00:17:25.200
Accidental plans are available here in California by one company.
00:17:25.200 --> 00:17:26.799
It's called Manhattan Life.
00:17:26.799 --> 00:17:33.680
I offer that to my clients, which I think every senior should have an accidental policy.
00:17:33.680 --> 00:17:36.799
I had a lady that she kept falling and falling and falling.
00:17:36.799 --> 00:17:41.119
When I met her, she was already in her 80s, so I couldn't sell her a policy.
00:17:41.119 --> 00:17:49.680
Unfortunately, she passed away, but she was falling in the bathroom, and every fall was in the bathroom.
00:17:49.680 --> 00:17:53.759
Then I have another example of a client of mine.
00:17:53.759 --> 00:17:55.839
She's on Cover, California.
00:17:55.839 --> 00:17:59.839
She purchased an accidental plan for her mother.
00:17:59.839 --> 00:18:05.920
Her mother was walking across the street, she fell, hit her head, ends up in the hospital.
00:18:05.920 --> 00:18:16.240
The accidental policy had reimbursement, which those critical illness policies pay you money, kind of like an AFLAC plan, if you're familiar with AFLAC.
00:18:16.240 --> 00:18:22.880
So she got reimbursed, $22,000 for all the surgery, emergency room.
00:18:22.880 --> 00:18:25.519
Plus, unfortunately, she passed away.
00:18:25.519 --> 00:18:38.160
The mother, that policy had a $50,000 death benefit, which the daughter ended up receiving after the she submitted a claim for the mom.
00:18:38.160 --> 00:18:43.519
So that's those are policies that are amazing, but again, you have to buy it before you're 65.
00:18:43.519 --> 00:18:50.240
This accidental policy can be sold up until or purchased up until you're 79 years old.
00:18:50.240 --> 00:19:00.880
But if you need a cancer protection insurance where reimburses you a monthly amount for cancer treatments, those cannot be purchased after 65.
00:19:00.880 --> 00:19:02.000
So that's huge.
00:19:02.000 --> 00:19:04.160
So if you need one of those, let us know.
00:19:04.160 --> 00:19:06.000
Reach out to Elko and myself.
00:19:06.319 --> 00:19:11.519
And then also Medicare won't cover dental, it doesn't cover vision.
00:19:11.519 --> 00:19:17.920
So it'll cover ophthalmologist, but it won't cover if you need a new prescription lens, like optometry.
00:19:17.920 --> 00:19:20.079
It doesn't cover hearing either.
00:19:20.079 --> 00:19:24.559
So if you need hearing aids, it's very minimal uh coverage.
00:19:24.559 --> 00:19:32.079
So generally that's why people like the Medicare Advantage because they throw in a lot of those extras that Medicare doesn't generally cover.
00:19:32.079 --> 00:19:34.319
Things like transportation benefits, too.
00:19:34.319 --> 00:19:38.319
If you need a ride to the doctor, you gotta pay for your own Uber.
00:19:38.319 --> 00:19:42.000
But some Medicare Advantage plans will offer you that coverage as well.
00:19:42.000 --> 00:19:53.119
So I think that sometimes people have the assumption that, well, if Medigap covers the gaps of Medicare, it must cover me for the gap, which is dental or vision or final expense or long-term care.
00:19:53.119 --> 00:20:05.759
But no, it only covers the gaps of what Medicare covers, which now sounds a little strange, but Medicare covers 80% of your doctor's and medically necessary coverage.
00:20:05.759 --> 00:20:12.160
So your Medigap will cover generally the other 20%, but it won't cover things that Medicare just will not cover.
00:20:12.160 --> 00:20:14.559
For that, you do need secondary insurance.
00:20:14.960 --> 00:20:17.279
What happens in an annual review?
00:20:17.279 --> 00:20:25.519
And what four things should every listener who's out there check and hopefully check with somebody like you guys, Doris?
00:20:25.759 --> 00:20:32.480
So at annual review, we make sure that the member has access to their primary doctor.
00:20:32.480 --> 00:20:46.880
We ask them what medications, if any, any new ones have changed, and what hospitals in the area they want to or must have, including their doctors, right?
00:20:46.880 --> 00:20:52.400
So the medical group drives the doctor and the doctors, the hospitals, right?
00:20:52.400 --> 00:21:02.240
And a lot of people get confused when this, instead of saying I have the insurance company name, they think they they have a medical group as their plan.
00:21:02.240 --> 00:21:06.319
So that's the most confusing part for some seniors.
00:21:06.319 --> 00:21:10.000
In my area, we have a big medical group called Opdom.
00:21:10.000 --> 00:21:15.359
And many of these they tell me, I have optimum, but that's not changing.
00:21:15.359 --> 00:21:30.000
So what's changing is their plan with their health insurance company, whether that could be Aetna, United, Anthem Blue Cross, Humana, Pichiel, all these are insurance companies that offer major advantage plans.
00:21:30.000 --> 00:21:34.480
So before they I meet with them, I ask them all these questions.
00:21:34.480 --> 00:21:44.319
We book the appointment and we make sure that we find them a plan that fits their needs and their budget and that their medications are covered as well.
00:21:44.640 --> 00:21:51.279
And I think the biggest thing during the annual review is the peace of mind because sometimes we'll say, you know what?
00:21:51.279 --> 00:21:56.000
You're the four out of five person who can just stay just float.
00:21:56.000 --> 00:21:56.880
You're good to go.
00:21:56.880 --> 00:22:00.880
You don't need to make a change because we don't, as humans, Like change.
00:22:00.880 --> 00:22:02.319
We like things to stay the same.
00:22:02.319 --> 00:22:08.400
So when you get that call from your agent who says, Hey, you can ignore what you're getting in the mail, you are good.
00:22:08.400 --> 00:22:12.160
You will get a new card towards the end of the year for the January 1st.
00:22:12.160 --> 00:22:16.400
And get having that peace of mind, I think, is is really something special.
00:22:16.400 --> 00:22:21.200
We see that relief from our clients when we tell them you don't need to make a change, you're fine.
00:22:21.200 --> 00:22:25.119
It's not always about making a change, it's just sometimes the change comes unexpected.
00:22:25.440 --> 00:22:27.200
I think I want to just highlight a couple things.
00:22:27.200 --> 00:22:33.359
First of all, I am so honored to see the expertise of our Vedic certified specialists in Medicare.
00:22:33.359 --> 00:22:41.759
And I think this month we have done seven educational programs in various regions with all of our Medicare specialists.
00:22:41.759 --> 00:22:45.599
And you're seeing two of the finest when you take RS and Elka.
00:22:45.599 --> 00:22:48.400
And I've learned so much myself today.
00:22:48.400 --> 00:22:54.799
I I just have so many more questions, but I certainly know I need to have my plan reviewed.
00:22:54.799 --> 00:22:58.799
And please, everyone listening, don't throw that mail away.
00:22:58.799 --> 00:23:06.880
Read what's coming and what's changing, but go to your specialist and find out what you need uniquely for you.
00:23:06.880 --> 00:23:13.759
And please be aware of the fraud out there because it is getting more, and we've got to combat that.
00:23:13.759 --> 00:23:23.759
And I also would want to ask Doris and Elke, what should we be advocating for as an advocate for our senior community?
00:23:23.759 --> 00:23:31.200
What are the key points we should be advocating with all these changes and complications to help our seniors?
00:23:31.680 --> 00:23:38.240
For us personally as agents, as I mentioned before, we treat everyone like family and we put our heart and soul.
00:23:38.240 --> 00:23:54.000
And some of these changes that have affected us, I hate to say it, have also affected us on our compensation, where carriers are cutting budgets or they're saying, you know what, we are gonna offer this plan, but we are not gonna pay brokers a commission.
00:23:54.000 --> 00:24:00.880
Or something brand new that is happening in 2027 is carriers are capping their enrollments.
00:24:00.880 --> 00:24:08.720
So they are saying once we hit a certain number of enrollments, we are no longer gonna be offering this plan at all to anybody on any platform.
00:24:08.720 --> 00:24:12.720
And so the role of the broker has never been more vital.
00:24:12.720 --> 00:24:26.319
And what I would ask is it's one thing when it comes from us as brokers, when we say, listen, we will talk to our local assembly person, representative, senator, and we will speak to the role of the broker.
00:24:26.319 --> 00:24:35.599
But when we can collect surveys and responses from actual seniors who have had their lives changed by their agent, that goes a lot farther.
00:24:35.599 --> 00:24:53.200
And so I would just say if you have had an interaction with an insurance professional who has supported you in a way that it was meaningful, that wasn't through some random call center and you don't know who you're talking to, but you have somebody's cell phone who actually cares for you.
00:24:53.200 --> 00:25:03.440
If you do have a connection with your local representative and if you wouldn't mind letting them know the role that that person played to advocate for you, that would really go far.
00:25:03.440 --> 00:25:06.720
And that's what I would that would be my push uh today.
00:25:06.720 --> 00:25:10.079
So that we can continue to do this job way into the future.
00:25:10.319 --> 00:25:16.319
I was just going to say that one of my clients asked me when I gave her the bad news about her plan ending.
00:25:16.319 --> 00:25:19.680
She says, Why can't you advocate for me?
00:25:19.680 --> 00:25:22.000
And I I put it back on her.
00:25:22.000 --> 00:25:25.839
Why don't you talk to your representative, your local representative?
00:25:25.839 --> 00:25:35.599
IS ELKA is I am also a member of uh NABIP, the National Association for Benefits Professionals and in California is called KHIP.
00:25:35.839 --> 00:25:37.920
California Health Insurance Professionals, yeah.
00:25:38.160 --> 00:25:51.440
So we are members of that organization that does work very strongly for the role of the agent to make sure that we have a seat at the table with helping all of our members, being able to help them.
00:25:51.440 --> 00:25:53.359
But we also have to make a living.
00:25:53.359 --> 00:26:02.799
If insurance companies keep cutting our commissions and they are expecting seniors to do this on their own, it's very difficult for them.
00:26:02.799 --> 00:26:11.519
And I am, I myself, I'm not sending my clients or telling them go enroll yourself on a Medicare.gov plan to buy your health plan.
00:26:11.519 --> 00:26:15.359
I am helping them, but I'm also spending a lot of time with them.
00:26:15.359 --> 00:26:28.559
So if you are listening, talk to your legislators about how we can help insurance agents continue to be compensated for helping seniors with their Medicare plans and prescription drug plans.
00:26:28.880 --> 00:26:34.480
So, Bonnie, I want to also bring up another topic that we get asked a lot because there are a lot of myths about using an agent.
00:26:34.480 --> 00:26:43.440
We've been obviously you've been advocating for us and Joyce advocates for us, but I want to demystify a couple myths about using an agent.
00:26:43.440 --> 00:26:49.039
I'm gonna actually ask Doris, Doris, is there anything that you charge your clients when they call you?
00:26:49.359 --> 00:26:50.640
Absolutely not.
00:26:50.640 --> 00:26:57.359
That's the biggest misconception people have that I'm going to charge them for my services.
00:26:57.359 --> 00:26:58.400
And guess what?
00:26:58.400 --> 00:27:00.079
How much do I charge?
00:27:00.079 --> 00:27:00.960
Zero.
00:27:00.960 --> 00:27:03.759
Zero for any questions you ask.
00:27:03.759 --> 00:27:05.839
I don't charge for questions.
00:27:06.240 --> 00:27:15.920
So then the other that brings up the other myth, which is well, if you don't charge anything, you must be charging more when I have to pay a premium.
00:27:15.920 --> 00:27:22.240
Like if I'm paying, you know, if you're on a Medicare supplement, maybe it costs them more to use you versus if they went directly to the carrier.
00:27:22.559 --> 00:27:24.960
That's another big misconception.
00:27:24.960 --> 00:27:37.759
The way we earn a living is by helping members enroll on a plan through the insurance company, whether it is a Medicare supplement plan or a Medicare Advantage plan.
00:27:37.759 --> 00:27:42.640
The insurance companies pay us a premium, and that's how we brokers make a living.
00:27:42.640 --> 00:27:44.400
We don't charge the members.
00:27:44.400 --> 00:27:48.799
And we are not allowed to charge anybody costs for our services.
00:27:49.039 --> 00:27:57.200
And so then that brings up the last question that we sometimes get, which is well, then you must have an incentive to push one plan over another.
00:27:57.200 --> 00:27:59.599
Maybe one plan pays you more than another.
00:27:59.599 --> 00:28:01.680
So how do you usually answer that, Doris?
00:28:02.079 --> 00:28:02.799
Great question.
00:28:02.799 --> 00:28:10.559
So the government sets the rates, how much they are going to pay insurance brokers, and that's a standard.
00:28:10.559 --> 00:28:29.440
So I am not incentivized to steer one person to a one insurance company versus another, except when they are forcing us to do so, like a prescription drug plan, or if a plan is going away, we have to put them in a different med Medicare plan.
00:28:29.440 --> 00:28:30.319
It all depends.
00:28:30.559 --> 00:28:38.400
If we can get the government to get involved with standardizing our pay, I think that's really important because we're not allowed to steer and we don't steer.
00:28:38.400 --> 00:28:45.680
But when a carrier decides that they don't want to offer compensation on a certain product, it forces brokers to steer.
00:28:45.680 --> 00:28:47.599
And that's not what we want to do either.
00:28:47.599 --> 00:28:54.880
The main reason why so many top insurance agents will still do the work even when we have no compensation.
00:28:54.880 --> 00:28:58.160
Because it's just a service and a commitment that we made to that member.
00:28:58.559 --> 00:29:00.240
Clients help you, you help the clients.
00:29:00.240 --> 00:29:01.599
It's a win-win situation.
00:29:01.599 --> 00:29:07.119
What one thing this month, what one thing can listeners do to help themselves?
00:29:07.440 --> 00:29:08.400
Prepare your questions.
00:29:08.400 --> 00:29:14.480
Prepare your list of doctors, your list of specialists, like Doris was saying, all your prescriptions.
00:29:14.480 --> 00:29:19.599
Have that ready and open your mail, like Joyce was also saying.
00:29:19.599 --> 00:29:25.359
Like read your mail, take a look at what you have, and and be prepared with your questions.
00:29:25.359 --> 00:29:26.960
I think that's the most important thing.
00:29:26.960 --> 00:29:33.759
We would love to hear about your grandkids and about your new dog and and all those amazing milestones in your life.
00:29:33.759 --> 00:29:34.960
We love to hear that.
00:29:34.960 --> 00:29:39.839
But with a limited time we have with each client, if you can have your questions prepared, that would be great.
00:29:40.079 --> 00:29:40.240
Yes.
00:29:40.240 --> 00:29:48.720
So opening your mail is looking for your annual notice of changes, which I'm going to give you another acronym, Bonnie, to remember.
00:29:49.519 --> 00:29:49.680
No.
00:29:50.000 --> 00:29:51.039
The ANOC.
00:29:52.000 --> 00:29:53.039
ANOC, yes.
00:29:53.279 --> 00:30:02.240
Remember to open and read your ANOC, please, and then schedule your annual review with your broker or contact any of us.
00:30:02.640 --> 00:30:06.319
Work with a vetted professional and be your best self-advocate.
00:30:06.559 --> 00:30:07.279
Absolutely.
00:30:07.279 --> 00:30:10.559
Great advice from all three of you.
00:30:10.559 --> 00:30:13.359
I concur with everything everybody said so there.
00:30:13.359 --> 00:30:16.720
And Elk and Daris, thank you so much.
00:30:16.720 --> 00:30:26.799
Obviously, I know you both personally, as friends, and as professionals, but uh the information that you have shared and the way that you shared it, you just made it real relatable.
00:30:26.799 --> 00:30:29.839
People will understand what they need to do.
00:30:29.839 --> 00:30:36.559
You just cut through a lot of the questionable, murky waters and clarified for us.
00:30:36.559 --> 00:30:37.519
So thank you.
00:30:37.519 --> 00:30:41.200
Thank you for being here, for being part of Senior Primetime.
00:30:41.200 --> 00:31:00.559
If anyone who is listening wants to reach out to the Foundation for Senior Services, to Doris Ford of Ford Benefits Group, or Elka Susana of Simpler Horizons, all of their contact information is in every description and show notes of the audio podcast and any of the videos that you will see based on this podcast.
00:31:00.559 --> 00:31:06.880
This is Senior Primetime Medicare 2027, what every senior must know.
00:31:06.880 --> 00:31:08.640
And thank you all for listening.
00:31:08.640 --> 00:31:11.599
Doris, Elka, Joyce, thank you.
00:31:11.599 --> 00:31:16.079
Have a good one, and we'll see you next time on Senior Primetime.
00:31:16.079 --> 00:31:24.000
Thank you for joining us for part two of our 2027 Medicare conversation on Senior Primetime.
00:31:24.000 --> 00:31:29.039
A heartfelt thank you to our guests, Elka Susanna and Doris Ford.
00:31:29.039 --> 00:31:33.039
Their contact information is in the episode description and show notes.
00:31:33.039 --> 00:31:37.119
Doris, Elka, thank you for sharing your expertise.
00:31:37.119 --> 00:31:43.759
And thank you to the Foundation for Senior Services and Joyce Robertson for making this conversation possible.
00:31:43.759 --> 00:31:53.119
In today's episode, we offered practical guidance to help you feel more informed as you review your Medicare coverage for 2027.
00:31:53.119 --> 00:32:02.559
If you found this episode helpful, please like, subscribe, and follow Senior Primetime, and share it with someone who may find it helpful.
00:32:02.559 --> 00:32:04.960
This is Senior Primetime.
00:32:04.960 --> 00:32:08.160
Real people, real conversations.
00:32:08.160 --> 00:32:10.079
See you next time.
00:00:00.880 --> 00:00:03.040
Welcome back to Senior Prime Time.
00:00:03.040 --> 00:00:09.439
I'm Bonnie Keith, and I'm here again with George Robertson, Elka Saddam, and Doris Ford.
00:00:09.439 --> 00:00:15.359
We are going to continue with part two of Medicare 2027.
00:00:15.359 --> 00:00:22.000
We'll explore the guide program enrollment options and what Medicare does and does not cover.
00:00:22.000 --> 00:00:25.440
Now, if you missed part one, go back and listen to that first.
00:00:25.440 --> 00:00:29.120
But right now, let's get started.
00:00:29.120 --> 00:00:36.240
Well, hello, and welcome back to Medicare 2027 part two.
00:00:36.240 --> 00:00:43.039
And once again, Joyce and I welcome our specialist, Elka Susana and Doris Ford.
00:00:43.039 --> 00:00:44.320
How are you doing today?
00:00:44.320 --> 00:00:45.679
Doing great, Bonnie.
00:00:45.679 --> 00:00:46.479
Thank you for having me.
00:00:46.479 --> 00:00:47.920
Doing fantastic.
00:00:48.079 --> 00:00:49.439
Thank you so much for having me.
00:00:49.840 --> 00:00:56.799
One program that I've gotten a lot of questions about, and I think it's relatively new, and I'm sure both of you can address it.
00:00:56.799 --> 00:01:02.000
The guide program when we look at dementia and aging in place at home.
00:01:02.000 --> 00:01:07.040
Can you help us understand the guide program relative to Medicare eligibility?
00:01:07.359 --> 00:01:19.040
What I understand is that it's a federal program that has allocated some funds for a specific agencies to provide home care for individuals that have Alzheimer's and dementia.
00:01:19.040 --> 00:01:26.959
And they do provide respite care of $2,500 for somebody that has already been diagnosed.
00:01:26.959 --> 00:01:34.959
And those $2,500 cannot be used to pay somebody to just come and take care of your grandmother or their aunt.
00:01:34.959 --> 00:01:37.760
It's not like the IHSS program.
00:01:37.760 --> 00:01:46.560
So it's a little bit different, and there is a specific agencies that can provide those services to these individuals.
00:01:46.560 --> 00:01:51.040
There's some Medicare Advantage plans that provide respite care, but it's very limited.
00:01:51.040 --> 00:01:53.519
Some do 20 to 40 hours maximum.
00:01:54.000 --> 00:02:02.480
I know that one of the pieces of the guide program, from what I understand, is you don't have eligibility if you're if you have Medicare Advantage or pay.
00:02:02.480 --> 00:02:03.359
Correct.
00:02:03.359 --> 00:02:04.159
That's correct.
00:02:04.159 --> 00:02:16.879
Is interesting because some of the people that were calling, they really wanted to look at that additional $2,500 annually, but they had a family member that was on Medicare Advantage.
00:02:17.199 --> 00:02:23.199
Yeah, they have to have they have to be on a Medicare supplement plan with original Medicare A and B.
00:02:23.199 --> 00:02:26.879
If they have a Medicare Advantage plan, that's disqualification.
00:02:27.199 --> 00:02:27.520
Okay.
00:02:27.520 --> 00:02:30.319
That that's really helpful, I think, for a lot of people to know.
00:02:30.319 --> 00:02:30.719
Thank you.
00:02:31.039 --> 00:02:39.599
And this is something new for 2027, I'm understanding, because there was nothing for dementia or Alzheimer's before through Medicare.
00:02:39.599 --> 00:02:40.159
Is that right?
00:02:40.159 --> 00:02:43.360
Are they trying to now do something, quote unquote?
00:02:43.360 --> 00:02:45.360
They're recognizing it's a disease.
00:02:45.759 --> 00:02:47.759
I think it's more about the custodial care.
00:02:47.759 --> 00:02:51.280
Like custodial care has not generally been covered by Medicare.
00:02:51.280 --> 00:03:03.120
In general, you have to have a long-term care plan or life insurance, or you need to be able to offset it through your assets, or if you have Medicaid, Medical in California, then they would offer that support.
00:03:03.120 --> 00:03:06.240
But Medicare in general did not offer that support.
00:03:06.240 --> 00:03:08.159
And so you're right, Doris.
00:03:08.159 --> 00:03:10.240
I think it's something very neat.
00:03:10.240 --> 00:03:11.599
There's a need for it.
00:03:11.599 --> 00:03:16.240
The other thing too that Medicare recently added was patient advocacy.
00:03:16.240 --> 00:03:20.240
So we do have through the foundation patient advocates that support members.
00:03:20.240 --> 00:03:30.159
Medicare will cover, I think it's up to six or eight hours of Medicare of patient advocacy support, but again, that will only be on original Medicare.
00:03:30.159 --> 00:03:34.800
So when you have an advantage plan, it takes over your Medicare.
00:03:34.800 --> 00:03:36.960
It determines what it will cover you for.
00:03:36.960 --> 00:03:39.520
Medicare is no longer in first position.
00:03:39.520 --> 00:03:41.039
It is more affordable.
00:03:41.039 --> 00:03:43.840
They throw in a lot of extra benefits.
00:03:43.840 --> 00:03:50.240
And like Dora said, some might cover some respite care, some custodial care, maybe after hospitalization.
00:03:50.240 --> 00:03:52.000
But it's very limited.
00:03:52.000 --> 00:04:03.120
So sometimes you do have to weigh out is it worth it to pay the monthly premium to have a supplement plan if I'm getting all of these other benefits, if you have a need for it.
00:04:03.120 --> 00:04:09.599
But unfortunately, sometimes if you wait until your health takes a turn, you can't qualify for a Medicare supplement.
00:04:09.599 --> 00:04:11.439
And so that's something to consider as well.
00:04:11.759 --> 00:04:12.479
Medigap?
00:04:12.479 --> 00:04:13.199
What does that mean?
00:04:13.199 --> 00:04:14.240
Medigap.
00:04:14.240 --> 00:04:16.240
Medigap.
00:04:16.240 --> 00:04:17.519
You hear about car stuff.
00:04:17.519 --> 00:04:24.160
You buy a car and then there's a gap something or other between leaving the car dealership and when I don't know.
00:04:24.160 --> 00:04:25.680
Is that like is that what Medigap?
00:04:25.680 --> 00:04:26.720
What's Medigap?
00:04:27.199 --> 00:04:30.240
That's another term for Medicare supplement plants.
00:04:30.240 --> 00:04:36.639
It it just covers the gaps that are original Medicare that's not covered.
00:04:36.959 --> 00:04:38.399
Oh, thank you.
00:04:38.399 --> 00:04:40.639
Great.
00:04:40.639 --> 00:04:51.600
See, in plain English, we're we're getting to understand what these terms mean because you hear them, and sometimes it's hard to put them together, though you hear them a million, a million times.
00:04:51.759 --> 00:04:53.839
So it's hard for us too, Bonnie.
00:04:53.839 --> 00:04:54.240
Let me tell you.
00:04:54.240 --> 00:05:00.959
I'm like we get thrown acronyms left and right, and we we have to try to decipher them for sure.
00:05:00.959 --> 00:05:09.439
But when you talk about Medicare, you have parts of Medicare, part A, Part B, Part C, which is uh Medicare Advantage, and you have part D.
00:05:09.439 --> 00:05:12.720
Those are parts, and that's Medicare or parts.
00:05:12.720 --> 00:05:17.279
When you talk about Medigap or Medicare supplement, it'll be plans.
00:05:17.279 --> 00:05:19.360
Plan N, plan F.
00:05:19.360 --> 00:05:21.759
I wish they didn't use letters, but that's what they do.
00:05:21.759 --> 00:05:23.759
Plan F, plan N, plan G.
00:05:23.759 --> 00:05:26.800
The plans are going to be the Medicare secondary, the Medigap.
00:05:26.800 --> 00:05:28.560
Did I make you more confused?
00:05:30.079 --> 00:05:32.240
The alphabet soup of Medicare.
00:05:32.240 --> 00:05:42.480
I'm so glad we have you experts to clarify all of this wonderful information, which makes me think about the 800 toll-free lines.
00:05:42.480 --> 00:05:45.279
We often get calls about that as well.
00:05:45.279 --> 00:05:46.560
What do we do with that?
00:05:46.560 --> 00:05:49.600
I call, and it seems like they don't understand what I'm asking.
00:05:49.600 --> 00:05:52.480
And of course, we have wonderful experts to refer them to.
00:05:52.480 --> 00:05:56.399
But what are those, what should we take from those toll free lines?
00:05:56.639 --> 00:05:59.759
Well, it all depends where which toll free line they're calling.
00:05:59.759 --> 00:06:05.759
If they are calling Medicare, they should have a little bit more knowledge of how Medicare works.
00:06:05.759 --> 00:06:15.600
But that my experience is from my clients that tell me they call Medicare, they usually end up being more confused when calling that number.
00:06:15.600 --> 00:06:21.759
But if they're calling the insurance company, they should be able to explain what their benefits are, right?
00:06:21.759 --> 00:06:35.519
Sometimes when individuals are calling an 800 number that they see on TV, they are calling a national company that may be a broker, maybe another insurance company advertising their plans.
00:06:35.519 --> 00:06:41.199
So it's always good to talk to somebody local in their local area that knows their own market.
00:06:41.199 --> 00:06:42.879
I strongly recommend that.
00:06:43.199 --> 00:06:45.920
I think there's a lot of fraud out there as well.
00:06:45.920 --> 00:06:54.399
So the one thing that I always tell seniors is if you did not initiate that call, then do not ever give your information.
00:06:54.399 --> 00:07:03.680
We have had clients who've had their insurance switched without their knowledge because they thought they were enrolling in a dental plan because that's what they really wanted.
00:07:03.680 --> 00:07:09.199
When they ended up getting enrolled into an advantage plan and that changed their coverage entirely.
00:07:09.199 --> 00:07:16.399
Very important advice is that if you get a call, you did not initiate it, you do not give them your information.
00:07:16.399 --> 00:07:20.160
They are not allowed to call you unsolicited.
00:07:20.160 --> 00:07:27.120
So unless you requested a call or you initiated that call, do not give your personal information to anybody.
00:07:27.120 --> 00:07:42.800
And if you're unsure, that is why you have experts at the Foundation for Senior Services, whether it has to do with Medicare or any other part of your life, you know, being able to have a resource that vets professionals, you know that you can call someone to just say, Hey, is this legitimate?
00:07:42.800 --> 00:07:44.240
Do I take this seriously?
00:07:44.240 --> 00:07:45.439
Or is this a scam?
00:07:45.439 --> 00:07:46.720
Just be very hesitant.
00:07:46.720 --> 00:07:47.600
Thank you, Elkin.
00:07:47.600 --> 00:07:49.600
When can you make a change?
00:07:49.920 --> 00:08:01.439
You can make a change to your Medicare Advantage plan or your prescription drug plan during the annual enrollment period, which is sure for AEP, another acronym you can learn.
00:08:01.439 --> 00:08:05.439
It is October 15th through December 7th.
00:08:05.439 --> 00:08:14.879
Okay, so that's the time frame where you should be reviewing your plan, sitting down with your broker, analyzing what has changed for 2027.
00:08:14.879 --> 00:08:18.720
Or if your plan is ending, what options do you have?
00:08:18.720 --> 00:08:24.639
Especially now that some Medicare Advantage plans will be terminating this year.
00:08:24.639 --> 00:08:28.560
So, or plans that are being discontinued.
00:08:28.560 --> 00:08:35.360
Members may have an option to either stay on that plan or be cross-walked.
00:08:35.360 --> 00:08:37.600
That's another term you might want to hear.
00:08:37.600 --> 00:08:51.919
You're cross-walked when you are moved from one plan that is close to another like plan within the same company, or you can simply shop around for another plan.
00:08:51.919 --> 00:08:57.759
So always, always plan reviews are strongly recommended during this period.
00:08:58.080 --> 00:09:00.720
And I'm going to add to that two things.
00:09:00.720 --> 00:09:06.879
Number one, the annual enrollment period is not when you shop around your Medicare supplement plan.
00:09:06.879 --> 00:09:09.519
A Medicare supplement doesn't have an annual enrollment.
00:09:09.519 --> 00:09:12.399
Once you're enrolled, your plan, you're in your plan.
00:09:12.399 --> 00:09:14.399
It doesn't really change year over year.
00:09:14.399 --> 00:09:20.000
So during the annual enrollment, like Dora said, it's just for your Medicare Advantage or your prescription drug plan.
00:09:20.000 --> 00:09:27.679
If you want to review your Medicare supplement plan in California and in, I think, nine other states, you have something called the birthday rule.
00:09:27.679 --> 00:09:31.440
So as you're aging, you know, we all get a little older.
00:09:31.440 --> 00:09:34.159
If you figure out a way to reverse it, let me know.
00:09:34.159 --> 00:09:37.440
But as you get older, your your rates go up every year.
00:09:37.440 --> 00:09:40.320
So at your birthday, you have a chance to shop around.
00:09:40.320 --> 00:09:45.600
So if your birthday happens to coincide with the annual enrollment, you're lucky because you can do them all at the same time.
00:09:45.600 --> 00:09:53.440
But if you're born in March or in April, that's really the time to shop your Medicare supplement to see if maybe there's a cheaper option available to you.
00:09:53.440 --> 00:09:54.320
That's the first thing.
00:09:54.320 --> 00:10:06.639
The second thing is, as I mentioned at the start of this podcast, there one in every five Medicare Advantage recipient will have a change this year, whether they want it or not.
00:10:06.639 --> 00:10:10.159
Please show grace to your Medicare broker.
00:10:10.159 --> 00:10:18.399
We have a very short window of time to be able to give everybody their personal attention that they deserve.
00:10:18.399 --> 00:10:24.240
So my ask would just be if they don't respond to your first email, send them another one.
00:10:24.240 --> 00:10:26.960
If they're not responding to your text, send them another one.
00:10:26.960 --> 00:10:37.440
But just have a little bit of grace, understanding that every single client we treat like family, and every client is important to us, but we have to make time for every single client as well.
00:10:37.440 --> 00:10:46.879
And I know brokers that work 18-hour days during the annual enrollment period to make sure that they can review and give that uh one-on-one attention.
00:10:46.879 --> 00:10:49.200
So that would be my only suggestion.
00:10:49.200 --> 00:10:50.399
But be patient.
00:10:51.039 --> 00:10:53.200
Although you mentioned the birthday rule.
00:10:53.200 --> 00:10:59.519
What is the time period from your birthday date and how long do you have?
00:11:00.159 --> 00:11:08.399
You usually have within a 60 days of your birthday month to apply for a Medicare supplement plan.
00:11:08.879 --> 00:11:09.519
60 days?
00:11:09.519 --> 00:11:10.240
60 days.
00:11:10.240 --> 00:11:11.679
Okay.
00:11:11.679 --> 00:11:13.200
So there's the birthday rule.
00:11:13.200 --> 00:11:16.080
Is there something called the 15% rule?
00:11:16.320 --> 00:11:16.960
Yes.
00:11:18.240 --> 00:11:18.879
So many rules.
00:11:18.879 --> 00:11:21.519
Bonnie, we're gonna get you licensed by the end of this podcast.
00:11:21.519 --> 00:11:22.720
No, no, no, I don't want it.
00:11:22.720 --> 00:11:23.120
No.
00:11:23.120 --> 00:11:24.240
No, thank you.
00:11:24.240 --> 00:11:25.679
That's your job.
00:11:25.840 --> 00:11:28.159
You can, you know, I will come to the experts.
00:11:28.399 --> 00:11:28.720
Yep.
00:11:28.720 --> 00:11:32.080
So the 15% rule is actually pretty unique to California.
00:11:32.080 --> 00:11:35.279
They're not there's a few other states that offer that.
00:11:35.279 --> 00:11:40.080
But what it says, and which is why the annual notice of change is so important.
00:11:40.080 --> 00:11:54.799
If your plan, your Medicare Advantage now, if your Medicare Advantage plan reduces its benefits by at least 15%, means it's gonna cost you more on let's say a copay or deductible.
00:11:54.799 --> 00:12:03.360
So if you added no deductible last year and next year they're adding a $200 deductible, then that's more than a 15% reduction of benefits.
00:12:03.360 --> 00:12:08.480
That gives you an opportunity to move into a Medicare supplement guaranteed.
00:12:08.480 --> 00:12:10.000
No underwriting.
00:12:10.000 --> 00:12:21.679
So even if you're going through the worst possible chronic condition and normally you would be declined on a Medicare supplement, that's where the 15% rule can come and help you.
00:12:21.679 --> 00:12:26.639
Generally, you know, years, years ago, we didn't really see much of a 15% reduction.
00:12:26.639 --> 00:12:29.919
It would just be, nope, sorry, you gotta go through underwriting.
00:12:29.919 --> 00:12:42.639
But now as the plans have been terminating and plans have been changing and plans are trying to recover money elsewhere, we are seeing it's very rare to not have that 15% guarantee, especially here in California.
00:12:42.639 --> 00:12:45.840
But it has to be done during the annual enrollment.
00:12:45.840 --> 00:12:48.720
After that, there is no longer that 15% rule.
00:12:48.720 --> 00:12:51.360
It can only be done during October 15th to December 7th.
00:12:51.360 --> 00:12:53.279
And that's the AEP.
00:12:53.600 --> 00:13:01.840
Yes, very Medigap or the supplemental, right?
00:13:01.840 --> 00:13:03.679
Without medical underwriting.
00:13:03.679 --> 00:13:05.200
You've already explained some of them.
00:13:05.200 --> 00:13:07.600
Are there any other ways that you can do that, Doris?
00:13:08.080 --> 00:13:08.320
Yes.
00:13:08.320 --> 00:13:20.879
So when you first become eligible for Medicare, when you first turn 65, you also have the eligibility window to enroll within the first eight months after your 65th birthday.
00:13:20.879 --> 00:13:23.519
That's a guarantee issue enrollment.
00:13:23.519 --> 00:13:33.840
Also, when you are leaving a group or employer group plan, you have 63 days to enroll in a Medicare supplement plan.
00:13:33.840 --> 00:13:46.960
So I know those so many numbers and so many rules, but it's critical, especially if people do want to have that flexibility to be able to drive their own car and not have to take detours.
00:13:46.960 --> 00:13:50.240
That's the Medicare supplement, that's what it offers you.
00:13:50.559 --> 00:13:53.840
And there's one other one that I think is not as well known.
00:13:53.840 --> 00:13:56.879
It's called the Medicare Advantage Trial Right.
00:13:56.879 --> 00:13:59.519
So think of it as a test drive.
00:13:59.519 --> 00:14:03.120
Since we're on the car topic of cars, think of it as a test drive.
00:14:03.120 --> 00:14:13.039
So if you are eligible for Medicare, the first time you are eligible and you go with an advantage plan, you have 12 months to try it out, test drive it.
00:14:13.039 --> 00:14:20.960
Anytime between those 12 months, if you change your mind, you can move to a Medicare supplement guarantee.
00:14:20.960 --> 00:14:25.759
But it can only be done during that first 12 months of being on a Medicare Advantage.
00:14:25.759 --> 00:14:44.000
And I think that's the importance of having the role of the agent, is that Doris spends hours and hours every year, hundreds of hours, studying, getting certified, getting light relicensed, continuing education so that we can learn all of these different rules and periods.
00:14:44.000 --> 00:14:48.799
So when we talk to a senior, everybody's situation is different.
00:14:48.799 --> 00:14:51.519
A husband and a wife can have a different situation.
00:14:51.519 --> 00:15:00.399
I don't know about you, Doris, but my pet peeve is when someone says, Well, my neighbor told me or my cousin told me, because everybody's situation is different.
00:15:00.399 --> 00:15:11.200
And that's why I think dealing with an agent who knows, like Doris said, works in the community, knows your situation, knows what how we can help you on a personal level is really vital.
00:15:11.519 --> 00:15:21.840
And the new one that I've heard is, well, my friend on Facebook has this Medicare plan, and I want to know, I want that plan.
00:15:21.840 --> 00:15:23.919
Or what about ChatGPT?
00:15:24.080 --> 00:15:26.240
Chat chat chatty G told me.
00:15:27.919 --> 00:15:30.720
We're talking to real people and real professionals.
00:15:30.720 --> 00:15:34.399
So uh Medicare is awesome for us older people.
00:15:34.399 --> 00:15:36.399
What what doesn't it help us with?
00:15:36.399 --> 00:15:37.679
What does it not cover?
00:15:37.679 --> 00:15:40.399
And give us the the highs and the lows, the ups and the downs.
00:15:40.639 --> 00:15:45.919
So well, I think one of the biggest misconceptions is that Medicare is going to cover you for things like long-term care, which we mentioned.
00:15:45.919 --> 00:15:52.240
We get a lot of calls from people who say, Hey, my mom needs a nurse, or my dad or my husband or my wife needs needs nursing care.
00:15:52.240 --> 00:15:55.919
And Medicare doesn't cover custodial nursing care.
00:15:55.919 --> 00:16:04.559
So unl they will cover home care, which is if you need an IV change, if you need wound care in your home, they will cover that.
00:16:04.559 --> 00:16:08.879
But they're not gonna stay there to help uh bathe you or cook for you or clean for you.
00:16:08.879 --> 00:16:12.960
So for that, you do need a long-term care plan, and that can be really pricey.
00:16:12.960 --> 00:16:15.679
So the younger you get it, the better it is.
00:16:15.679 --> 00:16:18.399
But it also doesn't cover final expense.
00:16:18.399 --> 00:16:24.320
So if you need a burial plan, that if you need to get that on your own, Medicare will not cover that.
00:16:24.320 --> 00:16:28.799
Those are the biggest gaps that I see that people come to us with.
00:16:28.799 --> 00:16:37.360
There are plans that you can get to help offset other expenses that you might have called critical illness plans in California.
00:16:37.360 --> 00:16:39.840
You have to purchase those before you turn 65.
00:16:39.840 --> 00:16:43.600
Once you turn 65, you can't even get it.
00:16:43.600 --> 00:16:44.399
It has nothing to do.
00:16:44.399 --> 00:16:49.200
You could be in the best of health, you could never have seen a doctor in your life, and you still wouldn't qualify.
00:16:49.200 --> 00:16:52.480
It's just not a real crazy, never never even heard of it.
00:16:52.480 --> 00:16:55.759
Yeah, how would I know to get it or to ask about it?
00:16:55.759 --> 00:16:57.279
You you don't know what you don't know.
00:16:57.519 --> 00:17:02.720
I'd like to add on on that critical illness, what Elka just mentioned.
00:17:02.720 --> 00:17:07.759
Since we cannot buy it in California if you're over 65.
00:17:07.759 --> 00:17:21.599
Bunny, you are in a very fortunate situation because you are in a state where you can actually purchase a critical illness, which includes a cancer protection insurance program, an accidental plan.
00:17:21.599 --> 00:17:25.200
Accidental plans are available here in California by one company.
00:17:25.200 --> 00:17:26.799
It's called Manhattan Life.
00:17:26.799 --> 00:17:33.680
I offer that to my clients, which I think every senior should have an accidental policy.
00:17:33.680 --> 00:17:36.799
I had a lady that she kept falling and falling and falling.
00:17:36.799 --> 00:17:41.119
When I met her, she was already in her 80s, so I couldn't sell her a policy.
00:17:41.119 --> 00:17:49.680
Unfortunately, she passed away, but she was falling in the bathroom, and every fall was in the bathroom.
00:17:49.680 --> 00:17:53.759
Then I have another example of a client of mine.
00:17:53.759 --> 00:17:55.839
She's on Cover, California.
00:17:55.839 --> 00:17:59.839
She purchased an accidental plan for her mother.
00:17:59.839 --> 00:18:05.920
Her mother was walking across the street, she fell, hit her head, ends up in the hospital.
00:18:05.920 --> 00:18:16.240
The accidental policy had reimbursement, which those critical illness policies pay you money, kind of like an AFLAC plan, if you're familiar with AFLAC.
00:18:16.240 --> 00:18:22.880
So she got reimbursed, $22,000 for all the surgery, emergency room.
00:18:22.880 --> 00:18:25.519
Plus, unfortunately, she passed away.
00:18:25.519 --> 00:18:38.160
The mother, that policy had a $50,000 death benefit, which the daughter ended up receiving after the she submitted a claim for the mom.
00:18:38.160 --> 00:18:43.519
So that's those are policies that are amazing, but again, you have to buy it before you're 65.
00:18:43.519 --> 00:18:50.240
This accidental policy can be sold up until or purchased up until you're 79 years old.
00:18:50.240 --> 00:19:00.880
But if you need a cancer protection insurance where reimburses you a monthly amount for cancer treatments, those cannot be purchased after 65.
00:19:00.880 --> 00:19:02.000
So that's huge.
00:19:02.000 --> 00:19:04.160
So if you need one of those, let us know.
00:19:04.160 --> 00:19:06.000
Reach out to Elko and myself.
00:19:06.319 --> 00:19:11.519
And then also Medicare won't cover dental, it doesn't cover vision.
00:19:11.519 --> 00:19:17.920
So it'll cover ophthalmologist, but it won't cover if you need a new prescription lens, like optometry.
00:19:17.920 --> 00:19:20.079
It doesn't cover hearing either.
00:19:20.079 --> 00:19:24.559
So if you need hearing aids, it's very minimal uh coverage.
00:19:24.559 --> 00:19:32.079
So generally that's why people like the Medicare Advantage because they throw in a lot of those extras that Medicare doesn't generally cover.
00:19:32.079 --> 00:19:34.319
Things like transportation benefits, too.
00:19:34.319 --> 00:19:38.319
If you need a ride to the doctor, you gotta pay for your own Uber.
00:19:38.319 --> 00:19:42.000
But some Medicare Advantage plans will offer you that coverage as well.
00:19:42.000 --> 00:19:53.119
So I think that sometimes people have the assumption that, well, if Medigap covers the gaps of Medicare, it must cover me for the gap, which is dental or vision or final expense or long-term care.
00:19:53.119 --> 00:20:05.759
But no, it only covers the gaps of what Medicare covers, which now sounds a little strange, but Medicare covers 80% of your doctor's and medically necessary coverage.
00:20:05.759 --> 00:20:12.160
So your Medigap will cover generally the other 20%, but it won't cover things that Medicare just will not cover.
00:20:12.160 --> 00:20:14.559
For that, you do need secondary insurance.
00:20:14.960 --> 00:20:17.279
What happens in an annual review?
00:20:17.279 --> 00:20:25.519
And what four things should every listener who's out there check and hopefully check with somebody like you guys, Doris?
00:20:25.759 --> 00:20:32.480
So at annual review, we make sure that the member has access to their primary doctor.
00:20:32.480 --> 00:20:46.880
We ask them what medications, if any, any new ones have changed, and what hospitals in the area they want to or must have, including their doctors, right?
00:20:46.880 --> 00:20:52.400
So the medical group drives the doctor and the doctors, the hospitals, right?
00:20:52.400 --> 00:21:02.240
And a lot of people get confused when this, instead of saying I have the insurance company name, they think they they have a medical group as their plan.
00:21:02.240 --> 00:21:06.319
So that's the most confusing part for some seniors.
00:21:06.319 --> 00:21:10.000
In my area, we have a big medical group called Opdom.
00:21:10.000 --> 00:21:15.359
And many of these they tell me, I have optimum, but that's not changing.
00:21:15.359 --> 00:21:30.000
So what's changing is their plan with their health insurance company, whether that could be Aetna, United, Anthem Blue Cross, Humana, Pichiel, all these are insurance companies that offer major advantage plans.
00:21:30.000 --> 00:21:34.480
So before they I meet with them, I ask them all these questions.
00:21:34.480 --> 00:21:44.319
We book the appointment and we make sure that we find them a plan that fits their needs and their budget and that their medications are covered as well.
00:21:44.640 --> 00:21:51.279
And I think the biggest thing during the annual review is the peace of mind because sometimes we'll say, you know what?
00:21:51.279 --> 00:21:56.000
You're the four out of five person who can just stay just float.
00:21:56.000 --> 00:21:56.880
You're good to go.
00:21:56.880 --> 00:22:00.880
You don't need to make a change because we don't, as humans, Like change.
00:22:00.880 --> 00:22:02.319
We like things to stay the same.
00:22:02.319 --> 00:22:08.400
So when you get that call from your agent who says, Hey, you can ignore what you're getting in the mail, you are good.
00:22:08.400 --> 00:22:12.160
You will get a new card towards the end of the year for the January 1st.
00:22:12.160 --> 00:22:16.400
And get having that peace of mind, I think, is is really something special.
00:22:16.400 --> 00:22:21.200
We see that relief from our clients when we tell them you don't need to make a change, you're fine.
00:22:21.200 --> 00:22:25.119
It's not always about making a change, it's just sometimes the change comes unexpected.
00:22:25.440 --> 00:22:27.200
I think I want to just highlight a couple things.
00:22:27.200 --> 00:22:33.359
First of all, I am so honored to see the expertise of our Vedic certified specialists in Medicare.
00:22:33.359 --> 00:22:41.759
And I think this month we have done seven educational programs in various regions with all of our Medicare specialists.
00:22:41.759 --> 00:22:45.599
And you're seeing two of the finest when you take RS and Elka.
00:22:45.599 --> 00:22:48.400
And I've learned so much myself today.
00:22:48.400 --> 00:22:54.799
I I just have so many more questions, but I certainly know I need to have my plan reviewed.
00:22:54.799 --> 00:22:58.799
And please, everyone listening, don't throw that mail away.
00:22:58.799 --> 00:23:06.880
Read what's coming and what's changing, but go to your specialist and find out what you need uniquely for you.
00:23:06.880 --> 00:23:13.759
And please be aware of the fraud out there because it is getting more, and we've got to combat that.
00:23:13.759 --> 00:23:23.759
And I also would want to ask Doris and Elke, what should we be advocating for as an advocate for our senior community?
00:23:23.759 --> 00:23:31.200
What are the key points we should be advocating with all these changes and complications to help our seniors?
00:23:31.680 --> 00:23:38.240
For us personally as agents, as I mentioned before, we treat everyone like family and we put our heart and soul.
00:23:38.240 --> 00:23:54.000
And some of these changes that have affected us, I hate to say it, have also affected us on our compensation, where carriers are cutting budgets or they're saying, you know what, we are gonna offer this plan, but we are not gonna pay brokers a commission.
00:23:54.000 --> 00:24:00.880
Or something brand new that is happening in 2027 is carriers are capping their enrollments.
00:24:00.880 --> 00:24:08.720
So they are saying once we hit a certain number of enrollments, we are no longer gonna be offering this plan at all to anybody on any platform.
00:24:08.720 --> 00:24:12.720
And so the role of the broker has never been more vital.
00:24:12.720 --> 00:24:26.319
And what I would ask is it's one thing when it comes from us as brokers, when we say, listen, we will talk to our local assembly person, representative, senator, and we will speak to the role of the broker.
00:24:26.319 --> 00:24:35.599
But when we can collect surveys and responses from actual seniors who have had their lives changed by their agent, that goes a lot farther.
00:24:35.599 --> 00:24:53.200
And so I would just say if you have had an interaction with an insurance professional who has supported you in a way that it was meaningful, that wasn't through some random call center and you don't know who you're talking to, but you have somebody's cell phone who actually cares for you.
00:24:53.200 --> 00:25:03.440
If you do have a connection with your local representative and if you wouldn't mind letting them know the role that that person played to advocate for you, that would really go far.
00:25:03.440 --> 00:25:06.720
And that's what I would that would be my push uh today.
00:25:06.720 --> 00:25:10.079
So that we can continue to do this job way into the future.
00:25:10.319 --> 00:25:16.319
I was just going to say that one of my clients asked me when I gave her the bad news about her plan ending.
00:25:16.319 --> 00:25:19.680
She says, Why can't you advocate for me?
00:25:19.680 --> 00:25:22.000
And I I put it back on her.
00:25:22.000 --> 00:25:25.839
Why don't you talk to your representative, your local representative?
00:25:25.839 --> 00:25:35.599
IS ELKA is I am also a member of uh NABIP, the National Association for Benefits Professionals and in California is called KHIP.
00:25:35.839 --> 00:25:37.920
California Health Insurance Professionals, yeah.
00:25:38.160 --> 00:25:51.440
So we are members of that organization that does work very strongly for the role of the agent to make sure that we have a seat at the table with helping all of our members, being able to help them.
00:25:51.440 --> 00:25:53.359
But we also have to make a living.
00:25:53.359 --> 00:26:02.799
If insurance companies keep cutting our commissions and they are expecting seniors to do this on their own, it's very difficult for them.
00:26:02.799 --> 00:26:11.519
And I am, I myself, I'm not sending my clients or telling them go enroll yourself on a Medicare.gov plan to buy your health plan.
00:26:11.519 --> 00:26:15.359
I am helping them, but I'm also spending a lot of time with them.
00:26:15.359 --> 00:26:28.559
So if you are listening, talk to your legislators about how we can help insurance agents continue to be compensated for helping seniors with their Medicare plans and prescription drug plans.
00:26:28.880 --> 00:26:34.480
So, Bonnie, I want to also bring up another topic that we get asked a lot because there are a lot of myths about using an agent.
00:26:34.480 --> 00:26:43.440
We've been obviously you've been advocating for us and Joyce advocates for us, but I want to demystify a couple myths about using an agent.
00:26:43.440 --> 00:26:49.039
I'm gonna actually ask Doris, Doris, is there anything that you charge your clients when they call you?
00:26:49.359 --> 00:26:50.640
Absolutely not.
00:26:50.640 --> 00:26:57.359
That's the biggest misconception people have that I'm going to charge them for my services.
00:26:57.359 --> 00:26:58.400
And guess what?
00:26:58.400 --> 00:27:00.079
How much do I charge?
00:27:00.079 --> 00:27:00.960
Zero.
00:27:00.960 --> 00:27:03.759
Zero for any questions you ask.
00:27:03.759 --> 00:27:05.839
I don't charge for questions.
00:27:06.240 --> 00:27:15.920
So then the other that brings up the other myth, which is well, if you don't charge anything, you must be charging more when I have to pay a premium.
00:27:15.920 --> 00:27:22.240
Like if I'm paying, you know, if you're on a Medicare supplement, maybe it costs them more to use you versus if they went directly to the carrier.
00:27:22.559 --> 00:27:24.960
That's another big misconception.
00:27:24.960 --> 00:27:37.759
The way we earn a living is by helping members enroll on a plan through the insurance company, whether it is a Medicare supplement plan or a Medicare Advantage plan.
00:27:37.759 --> 00:27:42.640
The insurance companies pay us a premium, and that's how we brokers make a living.
00:27:42.640 --> 00:27:44.400
We don't charge the members.
00:27:44.400 --> 00:27:48.799
And we are not allowed to charge anybody costs for our services.
00:27:49.039 --> 00:27:57.200
And so then that brings up the last question that we sometimes get, which is well, then you must have an incentive to push one plan over another.
00:27:57.200 --> 00:27:59.599
Maybe one plan pays you more than another.
00:27:59.599 --> 00:28:01.680
So how do you usually answer that, Doris?
00:28:02.079 --> 00:28:02.799
Great question.
00:28:02.799 --> 00:28:10.559
So the government sets the rates, how much they are going to pay insurance brokers, and that's a standard.
00:28:10.559 --> 00:28:29.440
So I am not incentivized to steer one person to a one insurance company versus another, except when they are forcing us to do so, like a prescription drug plan, or if a plan is going away, we have to put them in a different med Medicare plan.
00:28:29.440 --> 00:28:30.319
It all depends.
00:28:30.559 --> 00:28:38.400
If we can get the government to get involved with standardizing our pay, I think that's really important because we're not allowed to steer and we don't steer.
00:28:38.400 --> 00:28:45.680
But when a carrier decides that they don't want to offer compensation on a certain product, it forces brokers to steer.
00:28:45.680 --> 00:28:47.599
And that's not what we want to do either.
00:28:47.599 --> 00:28:54.880
The main reason why so many top insurance agents will still do the work even when we have no compensation.
00:28:54.880 --> 00:28:58.160
Because it's just a service and a commitment that we made to that member.
00:28:58.559 --> 00:29:00.240
Clients help you, you help the clients.
00:29:00.240 --> 00:29:01.599
It's a win-win situation.
00:29:01.599 --> 00:29:07.119
What one thing this month, what one thing can listeners do to help themselves?
00:29:07.440 --> 00:29:08.400
Prepare your questions.
00:29:08.400 --> 00:29:14.480
Prepare your list of doctors, your list of specialists, like Doris was saying, all your prescriptions.
00:29:14.480 --> 00:29:19.599
Have that ready and open your mail, like Joyce was also saying.
00:29:19.599 --> 00:29:25.359
Like read your mail, take a look at what you have, and and be prepared with your questions.
00:29:25.359 --> 00:29:26.960
I think that's the most important thing.
00:29:26.960 --> 00:29:33.759
We would love to hear about your grandkids and about your new dog and and all those amazing milestones in your life.
00:29:33.759 --> 00:29:34.960
We love to hear that.
00:29:34.960 --> 00:29:39.839
But with a limited time we have with each client, if you can have your questions prepared, that would be great.
00:29:40.079 --> 00:29:40.240
Yes.
00:29:40.240 --> 00:29:48.720
So opening your mail is looking for your annual notice of changes, which I'm going to give you another acronym, Bonnie, to remember.
00:29:49.519 --> 00:29:49.680
No.
00:29:50.000 --> 00:29:51.039
The ANOC.
00:29:52.000 --> 00:29:53.039
ANOC, yes.
00:29:53.279 --> 00:30:02.240
Remember to open and read your ANOC, please, and then schedule your annual review with your broker or contact any of us.
00:30:02.640 --> 00:30:06.319
Work with a vetted professional and be your best self-advocate.
00:30:06.559 --> 00:30:07.279
Absolutely.
00:30:07.279 --> 00:30:10.559
Great advice from all three of you.
00:30:10.559 --> 00:30:13.359
I concur with everything everybody said so there.
00:30:13.359 --> 00:30:16.720
And Elk and Daris, thank you so much.
00:30:16.720 --> 00:30:26.799
Obviously, I know you both personally, as friends, and as professionals, but uh the information that you have shared and the way that you shared it, you just made it real relatable.
00:30:26.799 --> 00:30:29.839
People will understand what they need to do.
00:30:29.839 --> 00:30:36.559
You just cut through a lot of the questionable, murky waters and clarified for us.
00:30:36.559 --> 00:30:37.519
So thank you.
00:30:37.519 --> 00:30:41.200
Thank you for being here, for being part of Senior Primetime.
00:30:41.200 --> 00:31:00.559
If anyone who is listening wants to reach out to the Foundation for Senior Services, to Doris Ford of Ford Benefits Group, or Elka Susana of Simpler Horizons, all of their contact information is in every description and show notes of the audio podcast and any of the videos that you will see based on this podcast.
00:31:00.559 --> 00:31:06.880
This is Senior Primetime Medicare 2027, what every senior must know.
00:31:06.880 --> 00:31:08.640
And thank you all for listening.
00:31:08.640 --> 00:31:11.599
Doris, Elka, Joyce, thank you.
00:31:11.599 --> 00:31:16.079
Have a good one, and we'll see you next time on Senior Primetime.
00:31:16.079 --> 00:31:24.000
Thank you for joining us for part two of our 2027 Medicare conversation on Senior Primetime.
00:31:24.000 --> 00:31:29.039
A heartfelt thank you to our guests, Elka Susanna and Doris Ford.
00:31:29.039 --> 00:31:33.039
Their contact information is in the episode description and show notes.
00:31:33.039 --> 00:31:37.119
Doris, Elka, thank you for sharing your expertise.
00:31:37.119 --> 00:31:43.759
And thank you to the Foundation for Senior Services and Joyce Robertson for making this conversation possible.
00:31:43.759 --> 00:31:53.119
In today's episode, we offered practical guidance to help you feel more informed as you review your Medicare coverage for 2027.
00:31:53.119 --> 00:32:02.559
If you found this episode helpful, please like, subscribe, and follow Senior Primetime, and share it with someone who may find it helpful.
00:32:02.559 --> 00:32:04.960
This is Senior Primetime.
00:32:04.960 --> 00:32:08.160
Real people, real conversations.
00:32:08.160 --> 00:32:10.079
See you next time.
