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Liz Craven: Hello, and thank you for
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We have a great episode for you today, and whether you're joining
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us on, uh, your favorite podcast app or on YouTube or through our
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website, we are so glad you're here.
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And I hope you have a pen and a piece of paper ready.
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And if you don't, that's okay.
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It'll all be capsulized in a blog post after this as well, but there's a lot of
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great information coming your way, and so I want you to be prepared for that.
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Today, our topic is Medicare, and most of you know that Medicare open enrollment
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is upon us, and if you didn't know that, and you are of that, Age where you are
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partaking in Medicare, then this is an episode you definitely need to listen to.
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I have the pleasure of having with me today, Karen Dean.
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Karen is a licensed agent with DFG and Associates llc, and basically
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what they do is they provide guidance and assistance with choosing the
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best Medicare option for you.
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And she is very well versed in the topic of Medicare and I'm so
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excited to have her here because,
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I don't know.
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I, I kind of view Medicare as, as like an alphabet soup.
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There's all these different letters and all of these different things
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that different plans cover and how do I know what's right for
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me and is what's right for me?
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The same thing that's right for my neighbor and they're talking about
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this plan that they love and someone on TV that I can get free groceries.
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So we're gonna kinda get through all of that, explain all of those things to
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you, and help you get to the path that will lead you to the right plan for you.
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We're also gonna lead you to some areas where you can find some
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assistance if you need that as well.
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So, um, buckle up.
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Here we go.
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Karen, thank you so much for joining me today.
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I can't tell you how much I appreciate the fact that the day
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before open enrollment begin.
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You're here, so thank you.
Karen Dean:
00:02:06
Well, I appreciate you giving me the opportunity, Liz, to, to speak to
Karen Dean:
00:02:10
an, an, an audience in the masses because Medicare is difficult to understand
Karen Dean:
00:02:15
and it's important to, um, be educated.
Karen Dean:
00:02:19
Whether you're at Medicare age or not, it's nice to get
Karen Dean:
00:02:22
a foundation of knowledge, uh, whether you're currently using it
Karen Dean:
00:02:26
or gonna be using it anytime soon.
Liz Craven:
00:02:28
Absolutely, because knowledge is key.
Liz Craven:
00:02:31
And I always say know it before you need it.
Liz Craven:
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So before you get to the point where you have to make a choice, now
Liz Craven:
00:02:38
it's a really good idea to research your options and stay up to date.
Liz Craven:
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And you know, there are always changes too happening.
Liz Craven:
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So it's good to keep up with all of those things.
Liz Craven:
00:02:47
And before we get started, you know, I wanted to mention a change.
Liz Craven:
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Recently, just a couple of days ago, the.
Liz Craven:
00:02:56
2023 Cost of Living adjustment number was released.
Liz Craven:
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Um, and it was really good.
Liz Craven:
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I wanna say it was 8.3% for social security.
Liz Craven:
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So if you are a beneficiary, someone who is receiving social security, the
Liz Craven:
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average person is gonna see an extra $146 monthly in their Social security check
Karen Dean:
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That is
Liz Craven:
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that, yes.
Liz Craven:
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Huge.
Liz Craven:
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And that is what, um, the Inflation Reduction Act has done.
Liz Craven:
00:03:28
In part, obviously that is a very, very big piece of legislation, but
Liz Craven:
00:03:33
one of the things it did was create the largest cost of living increase
Liz Craven:
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we've seen since I believe 1981.
Liz Craven:
00:03:41
Um, yeah.
Liz Craven:
00:03:42
It, it's a big deal.
Liz Craven:
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That's a big deal for people.
Liz Craven:
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And also, um, there are components of that that also reduce
Liz Craven:
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costs of things like insulin and certain medications that people are very
Liz Craven:
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reliant on because one in three people who are on Medicare also are diabetic.
Liz Craven:
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So some really important things that have happened, and I hope everybody's paying
Liz Craven:
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attention and this is not what this episode is about, but it kind of ties in.
Liz Craven:
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And so I thought it would be a good idea to mention that.
Liz Craven:
00:04:12
Um, but before we get started into our main topic, Karen,
Liz Craven:
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tell us a little bit about you.
Karen Dean:
00:04:20
Well, um, I've been in Lakeland since the early nineties.
Karen Dean:
00:04:25
Uh, been in Florida since 1981.
Karen Dean:
00:04:27
Um, grew up in Kentucky mostly.
Karen Dean:
00:04:30
Um, but I've worked in the healthcare profession in different
Karen Dean:
00:04:33
aspects, uh, most of my life.
Karen Dean:
00:04:35
Uh, started in high school working in doctor in, in a clinic, medical clinic.
Karen Dean:
00:04:40
So I've done a lot of billing office work, um, a lot of aspects of the medical side.
Karen Dean:
00:04:45
And then I'm also a licensed physical therapist assistant, um, so I've
Karen Dean:
00:04:49
worked in, in that area also.
Karen Dean:
00:04:52
And, um, I just really love the medical field.
Karen Dean:
00:04:55
I've always had a passion too, to help, um, the older population.
Karen Dean:
00:04:59
And as I get closer to that , I, I, it keeps getting higher and higher.
Karen Dean:
00:05:04
You know how
Liz Craven:
00:05:05
I know I can relate to that
Karen Dean:
00:05:08
But my husband and I actually own our, our agency and, and he's
Karen Dean:
00:05:12
been doing this much longer than me.
Karen Dean:
00:05:13
And when he's, when he suggested to me to get licensed, he said, I
Karen Dean:
00:05:17
think you'll be really good at this.
Karen Dean:
00:05:19
I was very reluctant because I only saw it as a being a salesman.
Karen Dean:
00:05:25
Um, but in reality, Everyone at one point's going to be
Karen Dean:
00:05:29
eligible and go on Medicare.
Karen Dean:
00:05:31
So I had to change my perspective of it, as in I'm helping people, um, offset a
Karen Dean:
00:05:39
financial risk because original Medicare only pays 80%, so we have a 20% risk.
Karen Dean:
00:05:44
So I had to look at it.
Karen Dean:
00:05:46
I had to change my mindset, as in I'm helping people to protect their
Karen Dean:
00:05:49
assets, which is extremely important when you're on a fixed income.
Liz Craven:
00:05:53
It sure is.
Liz Craven:
00:05:54
And I think that your big heart is one of the things that makes you so different and
Liz Craven:
00:05:59
probably one of the, Oh, you're welcome.
Liz Craven:
00:06:01
But one of the, the scariest things for people when they are approaching
Liz Craven:
00:06:06
Medicare is that it's really confusing and there are a lot of people who want
Liz Craven:
00:06:11
to tell you a lot of things and nobody knows who's telling them the right thing.
Liz Craven:
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So you have this company over here telling you one thing and that you really need.
Liz Craven:
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X, y, Z plan, and you have somebody else telling you, but no, you really need the
Liz Craven:
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extra funds for your groceries or you really need, um, you know, whatever the,
Liz Craven:
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the carrot it is that they're dangling and it's hard for people to really, um,
Liz Craven:
00:06:38
dig in and figure out for themselves,
Liz Craven:
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what the right plan is for them.
Liz Craven:
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And so people like you are a godsend because I have no problem sending
Liz Craven:
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someone your way and, and knowing that you will treat them with respect
Liz Craven:
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and dignity, and that they'll walk away with truly what's best for them.
Karen Dean:
00:06:57
I, I, that is what I do for my clients and I
Karen Dean:
00:07:00
very much take that to heart.
Liz Craven:
00:07:02
Well, thank you for all that you do.
Liz Craven:
00:07:04
Okay, so let's get into it.
Liz Craven:
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We're gonna start at the very base of this conversation just in case
Liz Craven:
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there are people who are watching or listening that don't understand the
Liz Craven:
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difference between Medicare, Medicaid.
Liz Craven:
00:07:20
Let's start with a definition.
Liz Craven:
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What is
Karen Dean:
00:07:23
Medicare?
Karen Dean:
00:07:24
Okay.
Karen Dean:
00:07:25
Medicare is a federal health insurance program for people 65 or older, but also
Karen Dean:
00:07:33
anyone that has been on disability for 24 straight months is eligible for Medicare.
Karen Dean:
00:07:38
And then also there are, um, chronic diseases such as renal, end-stage,
Karen Dean:
00:07:43
renal disease, and ALS that qualify people for Medicare prior to 65.
Karen Dean:
00:07:49
Um, Medicaid is a state program and those have criteria of financial,
Karen Dean:
00:07:55
um, that assets and liabilities that, uh, the state looks
Liz Craven:
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at.
Liz Craven:
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So if we were to put it in layman's terms, you have Medicaid, which
Liz Craven:
00:08:04
is like you said, the state red program, and instead of shopping for.
Liz Craven:
00:08:09
A different type of insurance plan when you reach that age, then Medicare is the
Liz Craven:
00:08:15
plan that you are basically shopping for.
Karen Dean:
00:08:18
Yes,
Liz Craven:
00:08:19
Okay, good.
Liz Craven:
00:08:20
That's very helpful.
Liz Craven:
00:08:21
Okay.
Liz Craven:
00:08:22
Now the biggest question, and this will probably take quite a long time
Liz Craven:
00:08:26
to get through, um, the alphabet soup, you know, a b, d supplemental medigap.
Liz Craven:
00:08:34
What do all of those things mean?
Liz Craven:
00:08:36
And I know that's a very broad question, so I'm gonna lean on
Liz Craven:
00:08:40
your expertise to kind of walk us through from the beginning.
Liz Craven:
00:08:44
What it, what the types of Medicare plans are.
Karen Dean:
00:08:48
Well let, let's just start at what are the, what is original Medicare?
Karen Dean:
00:08:51
So, original Medicare consists of two different pieces.
Karen Dean:
00:08:56
Um, part A is your medical side, uh, which.
Karen Dean:
00:09:01
Over the lifetime of working, either you or your spouse, most
Karen Dean:
00:09:05
people have paid in enough quarters where it's prepaid upfront.
Karen Dean:
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So when you up, uh, enroll in Medicare Part A, uh, you may receive that
Karen Dean:
00:09:14
at no cost, which most people do.
Karen Dean:
00:09:17
Part B um, pays for outpatient services and Part B comes with a monthly premium.
Karen Dean:
00:09:25
Um,
Karen Dean:
00:09:27
So A and B together are called original Medicare.
Karen Dean:
00:09:30
They pay 80% of uh, Medicare approved services.
Karen Dean:
00:09:35
So you have a 20% co-insurance, which is an unknown amount, which is a
Karen Dean:
00:09:39
risk, and it could be catastrophic.
Karen Dean:
00:09:42
If you had a year where you might have to be transported by a helicopter, you
Karen Dean:
00:09:46
might be in the hospital for a long length of time or go into skilled nursing.
Karen Dean:
00:09:52
Um, as an agent, what I do is I sit down with a client and educate
Karen Dean:
00:09:55
'em on what Medicare is and what that risk presents for them.
Karen Dean:
00:09:59
And then we look at the options of how to offset that risk.
Karen Dean:
00:10:03
So there's two different options.
Karen Dean:
00:10:05
Uh, the first option is you utilize your original Medicare, um, as
Karen Dean:
00:10:09
it is and you add a supplement behind it or a medigap plan.
Karen Dean:
00:10:13
They're, they are just interchangeable.
Karen Dean:
00:10:15
So those plans are standardized.
Karen Dean:
00:10:17
Uh, they are different letters as far as the benefits.
Karen Dean:
00:10:21
and, but those come with a monthly premium.
Karen Dean:
00:10:24
And then you would also need to put a, a prescription drug plan in place, and that
Karen Dean:
00:10:28
would have a monthly premium, so that route can cost you a little more money.
Karen Dean:
00:10:33
Um, but those, uh, Medicare supplements are not Medicare, or,
Karen Dean:
00:10:37
I'm sorry, are not network based.
Karen Dean:
00:10:40
Um, And the most comprehensive plan will basically pick up
Karen Dean:
00:10:44
everything after Medicare pays.
Karen Dean:
00:10:46
Uh, the most comprehensive plan now is Plan G and it picks up everything except
Karen Dean:
00:10:51
for the Part B deductible every year.
Karen Dean:
00:10:54
So the other option, um, is called a Medicare Advantage plan, or Part C.
Karen Dean:
00:11:00
So you still have original Medicare benefits.
Karen Dean:
00:11:03
They are required to, at least at a minimum, give you original Medicare
Karen Dean:
00:11:07
benefits, but then they can add every extra things on top of that.
Karen Dean:
00:11:12
Those extra things could be, um, an allowance for glasses or reimbursement
Karen Dean:
00:11:16
for glasses, hearing aids, uh, dental services, fitness over the counter.
Karen Dean:
00:11:22
Those things are not Medicare benefits.
Karen Dean:
00:11:24
Those are being provided by the private insurance companies that
Karen Dean:
00:11:27
sponsor those Medicare Advantage plans.
Liz Craven:
00:11:31
those are all of the carrots that they're dangling in front of people,
Liz Craven:
00:11:35
and those are what you're seeing on the commercials that are saying, you
Liz Craven:
00:11:40
know, call our one 800 number now so that you can take advantage of free
Liz Craven:
00:11:45
fitness classes, or whatever it is.
Karen Dean:
00:11:48
So, so what you have to remember is a Medicare Advantage plan.
Karen Dean:
00:11:51
They, they're network based.
Karen Dean:
00:11:53
Now, there's different types of advantage plans.
Karen Dean:
00:11:55
There's PPOs that give you flexibility to go in or out a network.
Karen Dean:
00:11:59
You don't have to have referrals from your primary care.
Karen Dean:
00:12:02
Um, there's HMOs and HMOs, um, are gonna have lower copays and, uh, They
Karen Dean:
00:12:10
may have plans that give you money back to offset part of that part B premium.
Karen Dean:
00:12:14
Um, but they, you would have to have referrals from your primary
Karen Dean:
00:12:18
care to, um, have services provided.
Karen Dean:
00:12:22
Um, but there's also other types of plans.
Karen Dean:
00:12:24
There's special need plans, uh, for different chronic conditions.
Karen Dean:
00:12:28
Um, there's also plans that accommodate, um, those people that qualify for
Karen Dean:
00:12:33
Medicare and Medicaid, and those are called dual special need plans.
Karen Dean:
00:12:37
So there's a whole gammut of plans available under the Medicare Advantage
Karen Dean:
00:12:43
topic, uh, that, that people can look at.
Karen Dean:
00:12:46
And it is very overwhelming and very confusing, um, because you have to
Karen Dean:
00:12:50
remember that they're network based.
Liz Craven:
00:12:53
Right.
Liz Craven:
00:12:54
Right.
Liz Craven:
00:12:54
And by network based you mean Those are private companies
Liz Craven:
00:12:58
that are sponsoring the plans?
Karen Dean:
00:13:00
yes.
Liz Craven:
00:13:02
Ooh, that's, I mean, that's a mouthful right there.
Liz Craven:
00:13:05
All that you just said.
Liz Craven:
00:13:06
That's a lot to take in.
Liz Craven:
00:13:08
And so who, um, well, before I ask that question, let me ask you this,
Liz Craven:
00:13:13
you mentioned before about what parts a and b original Medicare cover.
Liz Craven:
00:13:20
Do you have to, are you required to sign up for part B or can you just take part
Karen Dean:
00:13:26
A.
Karen Dean:
00:13:30
If you, you can take out just Part A, but you don't have, you would
Karen Dean:
00:13:33
only have coverage for what Part A encompasses, which would be, um,
Karen Dean:
00:13:39
your hospital, a hospital room and board, skilled nursing and hospice.
Karen Dean:
00:13:44
You would have no coverage for outpatient services.
Karen Dean:
00:13:47
Um, What's recommended is once you are eligible for Medicare, unless you have
Karen Dean:
00:13:53
a creditable medical and prescription drug coverage in place, like through
Karen Dean:
00:13:58
an employer, um, a lot of people, uh, are, you know, they work past 65
Karen Dean:
00:14:03
and they're on employer group plans.
Karen Dean:
00:14:04
That's most often those are all considered, uh, employer, you know,
Karen Dean:
00:14:09
credible drug coverage and credible.
Karen Dean:
00:14:12
Uh, medical coverage, at that point, you would not be required
Karen Dean:
00:14:16
to take out your Medicare a and b.
Karen Dean:
00:14:17
You could wait until you, um, decide to retire or, and come off that plan, because
Karen Dean:
00:14:24
if you don't have that other coverage in place, then you can be charged delayed
Karen Dean:
00:14:29
enrollment penalty on the Part B section.
Karen Dean:
00:14:31
And also, if you don't have a drug plan in place, you can
Karen Dean:
00:14:34
also receive a penalty on that.
Liz Craven:
00:14:37
that's exactly what I was getting at.
Liz Craven:
00:14:38
Cuz some people do have employer plans, but in essence, in the
Liz Craven:
00:14:43
absence of another plan, you do have to be enrolled in both of those
Karen Dean:
00:14:47
parts.
Karen Dean:
00:14:48
You would want to be?
Karen Dean:
00:14:49
Yes, Because at in, at any point later down the road, you decide
Karen Dean:
00:14:53
to join late, then you're gonna incur the penalty for that time
Karen Dean:
00:14:57
period that you did not start it.
Liz Craven:
00:14:59
Right.
Liz Craven:
00:15:00
Okay.
Liz Craven:
00:15:00
So now we've, we've defined the fact that there are a whole lot
Liz Craven:
00:15:04
of different plans, and you've got the basics of those, and certainly
Liz Craven:
00:15:08
you will probably need assistance in choosing what's right for you.
Liz Craven:
00:15:12
But when is the time people should consider enrollment?
Karen Dean:
00:15:17
Well, you know, there's a, there's a lot of
Karen Dean:
00:15:19
different types of enrollment.
Karen Dean:
00:15:21
You do have to have an enrollment period to get your Medicare started.
Karen Dean:
00:15:25
When you first turn 65 or your first eligible, um, those, that's called your
Karen Dean:
00:15:30
initial enrollment period, that period.
Karen Dean:
00:15:33
Um, you can actually sign up three months before your birth month,
Karen Dean:
00:15:36
and then you have that birth month period and three months after.
Karen Dean:
00:15:39
So really a total of a seven month.
Karen Dean:
00:15:41
Time period to initially enroll?
Liz Craven:
00:15:46
Okay.
Liz Craven:
00:15:46
And so once you enroll in that initial period, does it take effect your
Liz Craven:
00:15:50
birth month or does it take effect?
Karen Dean:
00:15:52
Text your birth month.
Karen Dean:
00:15:53
Now obviously if you waited till three months afterwards, it's gonna start three
Karen Dean:
00:15:57
months later, but you would not incur a penalty if you are within that timeframe.
Liz Craven:
00:16:03
Okay.
Liz Craven:
00:16:03
Very good.
Liz Craven:
00:16:04
So that's one type of enrollment.
Liz Craven:
00:16:05
Another type of enrollment is, um, in the case of a move or change
Liz Craven:
00:16:11
or loss of employment, tell, tell us a little bit about that.
Karen Dean:
00:16:15
Right?
Karen Dean:
00:16:15
Those are called special, um, enrollment periods, and they can
Karen Dean:
00:16:19
occur anytime throughout the year.
Karen Dean:
00:16:22
Um, so if you, if you move, uh, you would be required to, uh, you know, if you
Karen Dean:
00:16:27
move outside the service area of the plan you're on, for example, you would have to
Karen Dean:
00:16:31
look at changing either your prescription drug plan or your Medicare advantage plan.
Karen Dean:
00:16:35
Um, when someone has stayed on an employer group plan and decides to
Karen Dean:
00:16:40
enroll later, um, that's considered loss of an employer group plan.
Karen Dean:
00:16:44
That's a special enrollment period.
Karen Dean:
00:16:46
There's many others.
Karen Dean:
00:16:47
Um, a couple of other common ones would be maybe your financial status
Karen Dean:
00:16:51
changes and you may qualify for some assistance from the state.
Karen Dean:
00:16:56
That gives you a special enrollment period.
Karen Dean:
00:16:58
And then there's other enrollment, special enrollment periods for, um, five star
Karen Dean:
00:17:02
Medicare Advantage plans or chronic plans.
Karen Dean:
00:17:05
Those things can happen all year.
Liz Craven:
00:17:07
Okay, great.
Liz Craven:
00:17:08
Well that's something that is curious.
Liz Craven:
00:17:11
Tell me about that chronic plans and five star plans.
Liz Craven:
00:17:15
What are
Karen Dean:
00:17:15
those?
Karen Dean:
00:17:16
So Medicare, the Center for Medicare and Medicaid, cms, uh, star rates.
Karen Dean:
00:17:22
They give a star rating based on feedback and questions they ask current members.
Karen Dean:
00:17:26
Um, from the standalone prescription drug plans and also
Karen Dean:
00:17:29
the Medicare Advantage plans.
Karen Dean:
00:17:32
Um, they rank from a one star to a five star being the best.
Karen Dean:
00:17:36
The five star rating gives, um, that plan, the ability for
Karen Dean:
00:17:41
anyone to sign up on it one time.
Karen Dean:
00:17:43
You can't change from one five star to another.
Karen Dean:
00:17:47
Um, but you can use that enrollment period one time during the year.
Karen Dean:
00:17:51
Uh, the other plans, the chronic plans that we discussed, they are based on
Karen Dean:
00:17:55
chronic conditions such as congestive heart failure or um, diabetes.
Karen Dean:
00:18:02
There's several different, a lot of companies have those plans and if you're
Karen Dean:
00:18:06
diagnosed or um, or have those chronic plans, They tend to accommodate more
Karen Dean:
00:18:12
in their, um, formularies and their, their, you know, they'll accommodate
Karen Dean:
00:18:18
that particular type of a disease.
Karen Dean:
00:18:20
But though you are able to sign up on a chronic plan, um, once
Karen Dean:
00:18:25
during the year, and then the doctor has to verify on all that.
Liz Craven:
00:18:29
Right.
Liz Craven:
00:18:30
Okay.
Liz Craven:
00:18:31
So let's talk about the open enrollment period.
Liz Craven:
00:18:33
So this would be not only a time to sign up if that's the right window
Liz Craven:
00:18:38
for you as far as, um, turning 65.
Liz Craven:
00:18:41
But this is a time that anyone can make a change to the plan that they have.
Liz Craven:
00:18:46
Right?
Karen Dean:
00:18:47
Yes.
Karen Dean:
00:18:48
Um, so from October the 15th, so starting tomorrow till December 7th, it's, um,
Karen Dean:
00:18:54
annual enrollment, um, open enrollment.
Karen Dean:
00:18:56
It gets called open enrollment more often.
Karen Dean:
00:18:58
We call it annual enrollment.
Karen Dean:
00:19:00
Um, but anyone, whether you're on a Medicare supplement and a drug plan,
Karen Dean:
00:19:05
or if you are on a Medicare Advantage plan, anyone during this time can make a
Karen Dean:
00:19:10
change, and it will begin on January 1st.
Liz Craven:
00:19:14
Okay.
Liz Craven:
00:19:14
And how often do you recommend people review the plan that they're on?
Liz Craven:
00:19:19
Is that something you should do annual?
Karen Dean:
00:19:22
I mean, you know, I have, I ha do have a lot of clients that do
Karen Dean:
00:19:25
like to review things annually, but, but typically, unless something is
Karen Dean:
00:19:28
changing, like maybe you want different providers or your medications have,
Karen Dean:
00:19:34
have kind of changed over the course of the year and the cost of gone
Karen Dean:
00:19:37
up, you might wanna do a little plan comparison because, um, the formularies
Karen Dean:
00:19:41
can differ from company to company and, you know, the cost can differ.
Liz Craven:
00:19:47
I hear this often, um, a lot of times when people are talking
Liz Craven:
00:19:51
about which plan to choose, they say, Well, I'm diabetic and I take insulin,
Liz Craven:
00:19:55
or I have x, y, Z condition, and they take a specific medication and that
Liz Craven:
00:20:01
they should be shopping for a plan specifically for their medications.
Liz Craven:
00:20:04
Can you speak to.
Karen Dean:
00:20:06
Well, and that's one thing as an agent, you know, there's two
Karen Dean:
00:20:09
things that we look at when, when, uh, people are specifically looking at
Karen Dean:
00:20:13
Medicare Advantage plans, or even with a standalone drug plan, we wanna make
Karen Dean:
00:20:17
sure that the medications that that client is taking are in that formulary.
Karen Dean:
00:20:23
Um, There are ways, if someone is currently on a plan and they get put on a
Karen Dean:
00:20:28
medication that is not in the formulary, that the doctor can ask for an exception,
Karen Dean:
00:20:32
but we wouldn't wanna start a client out with a new plan knowing that that
Karen Dean:
00:20:38
medication is not in their formulary.
Liz Craven:
00:20:40
Right.
Liz Craven:
00:20:41
How many different formularies are there?
Liz Craven:
00:20:44
I mean, I know that's a loaded question.
Liz Craven:
00:20:46
I know, but I wanted the response because it's that many
Karen Dean:
00:20:51
I, I really don't know, but I can tell you.
Karen Dean:
00:20:53
You know, the formularies all have to be approved by Medicare.
Karen Dean:
00:20:58
Um, they all have to have at least two drugs in every classification.
Karen Dean:
00:21:01
So it's not like you would be without a medication that would fit your needs.
Karen Dean:
00:21:06
Um, but, but the formularies can differ not just company to company, but sometimes
Karen Dean:
00:21:12
within the different types of planning companies, they, they are different.
Karen Dean:
00:21:15
So it's, it's kind of an intricate process.
Liz Craven:
00:21:19
So we mentioned it before, but what if someone moves, um, from one state
Liz Craven:
00:21:24
to another or even one city to another?
Liz Craven:
00:21:26
Um, what if they retire?
Liz Craven:
00:21:29
What, how do they go about making the change and how long do they have to do it?
Karen Dean:
00:21:34
Good question.
Karen Dean:
00:21:35
So, and this is something that a lot of people don't think about
Karen Dean:
00:21:38
when they are looking to move.
Karen Dean:
00:21:41
Um, so when someone relocates outside of the service area of where their
Karen Dean:
00:21:45
plan is or even just moves in general, they need to contact social security
Karen Dean:
00:21:49
and, and that's the beginning basis of getting that address changed.
Karen Dean:
00:21:55
Once that is done, they have a 60 day window to make a
Karen Dean:
00:21:59
change, um, with their plan.
Karen Dean:
00:22:01
Because prescription drug plans and Medicare advantage plans are tied to
Karen Dean:
00:22:05
the zip code and area where you live.
Karen Dean:
00:22:08
So once you're outside of that service area, it's gonna need to be changed.
Liz Craven:
00:22:12
And what happens if they don't or if they do it late?
Karen Dean:
00:22:15
If, if they don't take advantage of that, that's a special
Karen Dean:
00:22:18
enrollment period, then they would have to wait until annual enrollment
Karen Dean:
00:22:22
and, and, and make a choice at that.
Liz Craven:
00:22:24
Right.
Liz Craven:
00:22:25
But there are no, there would be no fees associated.
Liz Craven:
00:22:27
They would just be stuck with a plan that might not suit their
Liz Craven:
00:22:30
needs in their new location.
Karen Dean:
00:22:32
Uh, no.
Karen Dean:
00:22:33
If they're in a plan that is not in their service area and they don't take advantage
Karen Dean:
00:22:37
of that enrollment period to change, um, they will not have drug coverage or they
Karen Dean:
00:22:42
would not have a Medicare Advantage plan.
Liz Craven:
00:22:44
Right.
Liz Craven:
00:22:45
Okay.
Liz Craven:
00:22:46
So they would still maintain their parts A and B.
Liz Craven:
00:22:49
They just wouldn't have all of the other things that, that take
Liz Craven:
00:22:53
care of so much of the cost.
Karen Dean:
00:22:54
Absolutely
Liz Craven:
00:22:55
Okay.
Liz Craven:
00:22:56
Uh, so much to think about in all of those scenarios.
Liz Craven:
00:23:00
Have I missed anything that you think, Wow, this is another thing that, um,
Liz Craven:
00:23:04
people come to me for assistance and.
Liz Craven:
00:23:08
I think, I wish I had met them three months earlier because
Liz Craven:
00:23:12
this change happened and they didn't do anything about it.
Liz Craven:
00:23:15
What would that kind of scenario look?
Karen Dean:
00:23:17
I think the thing about moving that's, you know, You know, when
Karen Dean:
00:23:21
you're thinking about moving, you're not really thinking about every aspect,
Karen Dean:
00:23:25
but every, you know, there's so many.
Karen Dean:
00:23:28
When you go from county to county, even in Florida, especially if you go outta
Karen Dean:
00:23:32
state, the um, plans available to you.
Karen Dean:
00:23:36
Um, the networks are, you know, they're all different and costs are different.
Karen Dean:
00:23:41
Copays are different.
Karen Dean:
00:23:42
So people don't think about how, what they're utilizing, where they're moving
Karen Dean:
00:23:47
from, how different that's gonna be.
Karen Dean:
00:23:49
And it's, I think it surprises people sometimes.
Liz Craven:
00:23:52
I think so too.
Liz Craven:
00:23:53
And I think the other part of the confusion is all, again, all of the
Liz Craven:
00:23:57
commercials that you see in the newspaper ads, how do people sift through those?
Liz Craven:
00:24:03
How can you tell whether or not a company is reputable?
Karen Dean:
00:24:08
I really wouldn't say that the companies themselves, the
Karen Dean:
00:24:11
insurance companies aren't reputable.
Karen Dean:
00:24:13
Um, because you have to remember a lot of these telemarketing companies,
Karen Dean:
00:24:17
especially the television ads, um, they're, you know, they're companies
Karen Dean:
00:24:21
that are owned by a big corporations.
Karen Dean:
00:24:25
Um, but as a licensed agent, we have a individual responsibility
Karen Dean:
00:24:29
to do things compli.
Karen Dean:
00:24:31
um, Medicare, uh, has a guide, had guys, has guidelines for marketing,
Karen Dean:
00:24:37
and we have to adhere to those.
Karen Dean:
00:24:39
So a lot of that responsibility in my mind is, is mine.
Karen Dean:
00:24:44
Um, and you know, it's not just the television ads, it's uh, people
Karen Dean:
00:24:49
coming and knocking on your door or um, people calling you unsolicited.
Karen Dean:
00:24:54
Those things are, are prohibit.
Liz Craven:
00:24:58
right?
Karen Dean:
00:24:58
so, uh, why would you even want to entertain the thought of engaging
Karen Dean:
00:25:03
someone to be your agent that's already demonstrating that kind of behavior?
Liz Craven:
00:25:09
Sure.
Liz Craven:
00:25:10
That makes an awful lot of sense.
Karen Dean:
00:25:12
And, and what I tell people, I, I do a lot of talks in, um, some of
Karen Dean:
00:25:16
the senior centers around the county and what I tell people, they have to remember,
Karen Dean:
00:25:20
you know, don't get all caught up in the shiny packages and the, you know, and
Karen Dean:
00:25:24
everything just looks so pretty because the, the core of whatever coverage you
Karen Dean:
00:25:29
put in place is that you are being allot.
Karen Dean:
00:25:33
The providers, the best providers for yourself, and that your medications
Karen Dean:
00:25:37
are covered and that the cost on your medications is, is reasonable.
Karen Dean:
00:25:43
Um, so those are things that are important above and beyond all the extras and
Karen Dean:
00:25:48
additional things that are being promoted.
Liz Craven:
00:25:52
Right.
Liz Craven:
00:25:52
And that's probably why having a good agent on your side, um, or
Liz Craven:
00:25:59
some of the other things that we'll talk about in a minute, other areas
Liz Craven:
00:26:02
and avenues of assistance, it's important to take advantage of those
Liz Craven:
00:26:06
and not try to wade through it on your own if it's not your wheelhouse.
Karen Dean:
00:26:11
Well, and think about all, you know, it's, I started something
Karen Dean:
00:26:14
a couple years ago with people that are turning 65 when I go out and I do
Karen Dean:
00:26:18
an educational presentation to them.
Karen Dean:
00:26:20
I started putting together, um, it's kind of like a, um, I don't wanna
Karen Dean:
00:26:24
call it a Medicare, um, mail or trash bag, but basically that's what it is.
Karen Dean:
00:26:30
I'll take people a, a brown paper bag and I'll tell them, Put all your mailers.
Karen Dean:
00:26:36
in this bag, and then when we get back together to do your app, you know, to
Karen Dean:
00:26:40
look at what the best plans are for you, we'll we'll go through it and I'll let
Karen Dean:
00:26:44
you know what is reasonable to keep.
Karen Dean:
00:26:46
Because most of those things you get in the mail, your doctors, if
Karen Dean:
00:26:50
it's a Medicare Advantage plan, your doctors may not even be in the network
Karen Dean:
00:26:53
with, So it's, it's just, you know, it's confusing to say the least.
Liz Craven:
00:26:59
So when you consult with a client, what are the top three
Liz Craven:
00:27:02
things that you look for when you're considering which plan is right for.
Karen Dean:
00:27:08
Well, primarily who, who is your primary care physician and what, what
Karen Dean:
00:27:12
specialist do you wanna continue to see?
Karen Dean:
00:27:16
Now this is on a Medicare Advantage plan, cuz remember on a Medicare supplement,
Karen Dean:
00:27:19
it's not network based, um, lifestyle.
Karen Dean:
00:27:23
You know, uh, certain Medicare Advantage plans allow people to
Karen Dean:
00:27:28
travel more across the United States.
Karen Dean:
00:27:30
Maybe go visit and stay places where they moved from for several months out
Karen Dean:
00:27:34
of the year and utilize those networks.
Karen Dean:
00:27:37
Um, and then the medications.
Karen Dean:
00:27:39
So those, but that's, you know, everyone is different.
Karen Dean:
00:27:43
And what your neighbor has or what your, you know, family member has, doesn't
Karen Dean:
00:27:47
necessarily mean it's a good fit for.
Liz Craven:
00:27:49
Right.
Liz Craven:
00:27:50
You mentioned travel, and that brings up a question.
Liz Craven:
00:27:53
You know, a lot of us plan in our retirement years to do a lot of traveling.
Liz Craven:
00:27:57
I know, I do.
Liz Craven:
00:27:58
And so are there plans that incorporate coverage outside of the United States?
Karen Dean:
00:28:06
Any Medicare advantage plan, um, gives you emergency coverage
Karen Dean:
00:28:11
anywhere in the world, urgent care or emergency coverage anywhere in the world.
Karen Dean:
00:28:15
Um, Yes.
Karen Dean:
00:28:17
Uh, Medicare supplements, um, will have a little more of a, uh, more of a benefit
Karen Dean:
00:28:24
coverage to travel outside the us.
Liz Craven:
00:28:30
Okay, so now I want to talk about available resources that people
Liz Craven:
00:28:35
can use to dig in a little bit deeper.
Liz Craven:
00:28:37
So why don't you go first and tell me the best places you believe
Liz Craven:
00:28:42
people can go to get additional assistance and information about.
Karen Dean:
00:28:48
Um, Medicare itself.
Karen Dean:
00:28:50
Uh, for example, they usually send out a book every year called Medicare and you,
Karen Dean:
00:28:55
um, it has a lot of information in it.
Karen Dean:
00:28:57
It, it can be confusing because it covers a lot of scenarios, um, but
Karen Dean:
00:29:02
it is chopped full of information, um, medicare.gov, um, online.
Karen Dean:
00:29:08
, uh, people can actually go in as a general public.
Karen Dean:
00:29:12
You can put in your zip code and you can actually run plan comparisons or look
Karen Dean:
00:29:18
up, um, estimates on your drug cost.
Karen Dean:
00:29:21
They can do that individually on their own or even even just
Karen Dean:
00:29:24
calling Medicare 1-800-MEDICARE and getting someone that can help you.
Karen Dean:
00:29:29
Um, but I also did put down the elder help.
Liz Craven:
00:29:33
Mm-hmm.
Karen Dean:
00:29:34
which would refer people to shine in our area.
Karen Dean:
00:29:36
I know it's called different things in different states, but in our state
Karen Dean:
00:29:40
it's called Shine, and they're a good, unbiased, um, resource, um, to educate.
Liz Craven:
00:29:47
That's a great one, and that's the one that I was going to
Liz Craven:
00:29:50
mention also specifically that is, Nationally, that program is referred
Liz Craven:
00:29:56
to as Ship with a p We, we watched a presentation the other day and, and
Liz Craven:
00:30:03
the person doing the presenting kept saying Ship with a P because, um, she,
Liz Craven:
00:30:09
she is often misunderstood about what she's saying and even said that Ohio.
Liz Craven:
00:30:15
Plan name is O Ship, which is hilarious.
Karen Dean:
00:30:19
It is.
Liz Craven:
00:30:20
you go.
Liz Craven:
00:30:21
There's your giggle in the middle of a Medicare discussion, . But, um,
Liz Craven:
00:30:26
SHIP stands for, um, State Health Insurance Assistance Program, and
Liz Craven:
00:30:32
it is, Really, really a great idea.
Liz Craven:
00:30:36
These are volunteers who will meet with you here in Florida anyway.
Liz Craven:
00:30:40
Um, I'm not sure how it works in every state, but every state program is there
Liz Craven:
00:30:46
to find the program closest to you.
Liz Craven:
00:30:48
You're gonna go to eldercare.acl.gov.
Liz Craven:
00:30:50
When you get there, you'll see a place to put your zip code in, and once you
Liz Craven:
00:30:57
put your zip code in, you can find the referral to your local ship office.
Liz Craven:
00:31:02
And I would highly encourage people who don't have an agent
Liz Craven:
00:31:06
that they're working with.
Liz Craven:
00:31:07
Um, for whatever reason, if you haven't found the agent that you're
Liz Craven:
00:31:10
happy with, um, definitely go and explore this because people will sit
Liz Craven:
00:31:15
down with you and help you to get to the plan that best suits your needs.
Liz Craven:
00:31:20
Um, so all of that to say, don't try to go it alone, unless this is your wheelhouse.
Liz Craven:
00:31:26
If you've been in insurance all your life, then I'm sure you could figure
Liz Craven:
00:31:30
out exactly what you need to do and exactly which plan is right for you.
Liz Craven:
00:31:34
Um, but I think a lot of times we get embarrassed about what we don't know and
Liz Craven:
00:31:40
we try to do things on our own or just jump at the very first thing that we see.
Liz Craven:
00:31:44
And I don't know that that's the best course of action to take here.
Karen Dean:
00:31:47
No.
Karen Dean:
00:31:48
No.
Liz Craven:
00:31:50
Well, good.
Liz Craven:
00:31:51
Well, Karen, thank you for enlightening us today.
Liz Craven:
00:31:55
There's so much to learn and I hope that we haven't confused all of you.
Liz Craven:
00:31:59
All of the things that we mentioned and websites to go to will be listed in
Liz Craven:
00:32:03
the show notes, um, and in the comments below, wherever you are looking at this.
Liz Craven:
00:32:09
Um, so I hope that you'll take advantage of those resources.
Liz Craven:
00:32:12
I hope that you'll just save this episode and replay it if you need
Liz Craven:
00:32:15
to, to go over the basics, because when you go to work with an agent,
Liz Craven:
00:32:19
the more educated you are on the front end, understanding the basics.
Liz Craven:
00:32:23
The more time your agent will have to spend with you to really
Liz Craven:
00:32:27
dig in and see which is the best appropriate plan for you.
Liz Craven:
00:32:30
So before we leave, and this can be related to Medicare or life or anything
Liz Craven:
00:32:36
you want, how about a little piece of sage advice for our listeners?
Karen Dean:
00:32:40
Well, I, I kind of wanted to just segue into the fact
Karen Dean:
00:32:43
of knowing who is representing you.
Karen Dean:
00:32:46
And, you know, you hear the term fiduciary in the financial world, but
Karen Dean:
00:32:51
as a, as a licensed agent, we should be working as fiduciaries for our clients.
Karen Dean:
00:32:55
We, we need to have their best interest in heart, in mind.
Karen Dean:
00:33:00
Um, Regardless.
Karen Dean:
00:33:04
Um, and, and you know, it's not uncommon.
Karen Dean:
00:33:06
I've met with people before that are not my clients and, and I help
Karen Dean:
00:33:10
to clarify things for them or even check on their plans and just to tell
Karen Dean:
00:33:16
them that they don't need to change.
Karen Dean:
00:33:18
They're good where they're at.
Karen Dean:
00:33:19
And I think sometimes that surprises people.
Karen Dean:
00:33:22
Um, but it's not, you know, first and foremost.
Karen Dean:
00:33:26
People need you.
Karen Dean:
00:33:28
You know, they deserve to be put on in the, in the best place possible, um,
Karen Dean:
00:33:32
because they're the one using that plan.
Karen Dean:
00:33:35
And so I would just say there's a lot of good agents out there, you know, and,
Karen Dean:
00:33:38
um, you just, just be, uh, mindful of who you're utilizing, uh, that to help you.
Liz Craven:
00:33:46
Absolutely.
Liz Craven:
00:33:47
That's great advice and I would agree with you.
Liz Craven:
00:33:48
There are so many good people out there who are ready and willing to help, and
Liz Craven:
00:33:54
it's like a crazy time of year for them.
Liz Craven:
00:33:56
So be patient when you're scheduling your appointments because with
Liz Craven:
00:33:59
open enrollment upon us, Medicare agents are going to be very busy
Liz Craven:
00:34:04
indeed until the middle of December.
Liz Craven:
00:34:06
Karen, thank you so much for joining me.
Liz Craven:
00:34:08
I
Karen Dean:
00:34:09
you for having me.
Liz Craven:
00:34:10
Oh, of
Karen Dean:
00:34:11
my first time doing a podcast,
Liz Craven:
00:34:12
Woo.
Liz Craven:
00:34:13
Well, you did
Karen Dean:
00:34:13
I've got one under my belt,
Liz Craven:
00:34:15
Yes, you do.
Liz Craven:
00:34:16
You'll have to come back.
Liz Craven:
00:34:17
We'll have you back soon.
Karen Dean:
00:34:18
Okay, Liz.
Karen Dean:
00:34:19
Thank you.
Liz Craven:
00:34:20
You bet.
Liz Craven:
00:34:20
And thank all of you for joining us today for the conversation.
Liz Craven:
00:34:24
I hope it was helpful for you.
Liz Craven:
00:34:25
Our aim here at the Sage Aging Podcast is to give you bits of
Liz Craven:
00:34:29
information that can make your caregiving and aging journey better.
Liz Craven:
00:34:33
It's a little bit easier when you know what's happening, so as I always
Liz Craven:
00:34:37
say, know it before you need it.
Liz Craven:
00:34:40
I hope you'll join us on Facebook, Instagram, and any social
Liz Craven:
00:34:44
media platform that you enjoy.
Liz Craven:
00:34:45
We're present in most places, and also you can find us at eldercareguide.com.
Liz Craven:
00:34:51
We've got so much information available for you on that website, so go take
Liz Craven:
00:34:55
a look if there's something that isn't there that you'd like to see.
Liz Craven:
00:34:59
Let us know.
Liz Craven:
00:35:00
You can always reach out to us via our social media or
Liz Craven:
00:35:02
right there on our website.
Liz Craven:
00:35:04
You can use the contact form.
Liz Craven:
00:35:06
Um, so thanks for joining us.
Liz Craven:
00:35:07
We'll have a new episode for you up in two weeks, and we'll talk to you then.
00:00:05
Liz Craven: Hello, and thank you for
Speaker:
00:00:10
We have a great episode for you today, and whether you're joining
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00:00:13
us on, uh, your favorite podcast app or on YouTube or through our
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00:00:18
website, we are so glad you're here.
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00:00:21
And I hope you have a pen and a piece of paper ready.
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00:00:25
And if you don't, that's okay.
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00:00:26
It'll all be capsulized in a blog post after this as well, but there's a lot of
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00:00:31
great information coming your way, and so I want you to be prepared for that.
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00:00:36
Today, our topic is Medicare, and most of you know that Medicare open enrollment
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00:00:42
is upon us, and if you didn't know that, and you are of that, Age where you are
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00:00:48
partaking in Medicare, then this is an episode you definitely need to listen to.
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00:00:52
I have the pleasure of having with me today, Karen Dean.
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00:00:56
Karen is a licensed agent with DFG and Associates llc, and basically
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00:01:02
what they do is they provide guidance and assistance with choosing the
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00:01:06
best Medicare option for you.
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00:01:08
And she is very well versed in the topic of Medicare and I'm so
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00:01:13
excited to have her here because,
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00:01:15
I don't know.
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00:01:15
I, I kind of view Medicare as, as like an alphabet soup.
Speaker:
00:01:19
There's all these different letters and all of these different things
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00:01:22
that different plans cover and how do I know what's right for
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00:01:25
me and is what's right for me?
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00:01:28
The same thing that's right for my neighbor and they're talking about
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00:01:31
this plan that they love and someone on TV that I can get free groceries.
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00:01:35
So we're gonna kinda get through all of that, explain all of those things to
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00:01:41
you, and help you get to the path that will lead you to the right plan for you.
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00:01:46
We're also gonna lead you to some areas where you can find some
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00:01:49
assistance if you need that as well.
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00:01:51
So, um, buckle up.
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00:01:52
Here we go.
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00:01:53
Karen, thank you so much for joining me today.
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00:01:56
I can't tell you how much I appreciate the fact that the day
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00:02:00
before open enrollment begin.
Speaker:
00:02:03
You're here, so thank you.
Karen Dean:
00:02:06
Well, I appreciate you giving me the opportunity, Liz, to, to speak to
Karen Dean:
00:02:10
an, an, an audience in the masses because Medicare is difficult to understand
Karen Dean:
00:02:15
and it's important to, um, be educated.
Karen Dean:
00:02:19
Whether you're at Medicare age or not, it's nice to get
Karen Dean:
00:02:22
a foundation of knowledge, uh, whether you're currently using it
Karen Dean:
00:02:26
or gonna be using it anytime soon.
Liz Craven:
00:02:28
Absolutely, because knowledge is key.
Liz Craven:
00:02:31
And I always say know it before you need it.
Liz Craven:
00:02:34
So before you get to the point where you have to make a choice, now
Liz Craven:
00:02:38
it's a really good idea to research your options and stay up to date.
Liz Craven:
00:02:42
And you know, there are always changes too happening.
Liz Craven:
00:02:45
So it's good to keep up with all of those things.
Liz Craven:
00:02:47
And before we get started, you know, I wanted to mention a change.
Liz Craven:
00:02:51
Recently, just a couple of days ago, the.
Liz Craven:
00:02:56
2023 Cost of Living adjustment number was released.
Liz Craven:
00:03:01
Um, and it was really good.
Liz Craven:
00:03:04
I wanna say it was 8.3% for social security.
Liz Craven:
00:03:09
So if you are a beneficiary, someone who is receiving social security, the
Liz Craven:
00:03:13
average person is gonna see an extra $146 monthly in their Social security check
Karen Dean:
00:03:21
That is
Liz Craven:
00:03:21
that, yes.
Liz Craven:
00:03:23
Huge.
Liz Craven:
00:03:23
And that is what, um, the Inflation Reduction Act has done.
Liz Craven:
00:03:28
In part, obviously that is a very, very big piece of legislation, but
Liz Craven:
00:03:33
one of the things it did was create the largest cost of living increase
Liz Craven:
00:03:37
we've seen since I believe 1981.
Liz Craven:
00:03:41
Um, yeah.
Liz Craven:
00:03:42
It, it's a big deal.
Liz Craven:
00:03:43
That's a big deal for people.
Liz Craven:
00:03:45
And also, um, there are components of that that also reduce
Liz Craven:
00:03:49
costs of things like insulin and certain medications that people are very
Liz Craven:
00:03:53
reliant on because one in three people who are on Medicare also are diabetic.
Liz Craven:
00:03:59
So some really important things that have happened, and I hope everybody's paying
Liz Craven:
00:04:04
attention and this is not what this episode is about, but it kind of ties in.
Liz Craven:
00:04:08
And so I thought it would be a good idea to mention that.
Liz Craven:
00:04:12
Um, but before we get started into our main topic, Karen,
Liz Craven:
00:04:17
tell us a little bit about you.
Karen Dean:
00:04:20
Well, um, I've been in Lakeland since the early nineties.
Karen Dean:
00:04:25
Uh, been in Florida since 1981.
Karen Dean:
00:04:27
Um, grew up in Kentucky mostly.
Karen Dean:
00:04:30
Um, but I've worked in the healthcare profession in different
Karen Dean:
00:04:33
aspects, uh, most of my life.
Karen Dean:
00:04:35
Uh, started in high school working in doctor in, in a clinic, medical clinic.
Karen Dean:
00:04:40
So I've done a lot of billing office work, um, a lot of aspects of the medical side.
Karen Dean:
00:04:45
And then I'm also a licensed physical therapist assistant, um, so I've
Karen Dean:
00:04:49
worked in, in that area also.
Karen Dean:
00:04:52
And, um, I just really love the medical field.
Karen Dean:
00:04:55
I've always had a passion too, to help, um, the older population.
Karen Dean:
00:04:59
And as I get closer to that , I, I, it keeps getting higher and higher.
Karen Dean:
00:05:04
You know how
Liz Craven:
00:05:05
I know I can relate to that
Karen Dean:
00:05:08
But my husband and I actually own our, our agency and, and he's
Karen Dean:
00:05:12
been doing this much longer than me.
Karen Dean:
00:05:13
And when he's, when he suggested to me to get licensed, he said, I
Karen Dean:
00:05:17
think you'll be really good at this.
Karen Dean:
00:05:19
I was very reluctant because I only saw it as a being a salesman.
Karen Dean:
00:05:25
Um, but in reality, Everyone at one point's going to be
Karen Dean:
00:05:29
eligible and go on Medicare.
Karen Dean:
00:05:31
So I had to change my perspective of it, as in I'm helping people, um, offset a
Karen Dean:
00:05:39
financial risk because original Medicare only pays 80%, so we have a 20% risk.
Karen Dean:
00:05:44
So I had to look at it.
Karen Dean:
00:05:46
I had to change my mindset, as in I'm helping people to protect their
Karen Dean:
00:05:49
assets, which is extremely important when you're on a fixed income.
Liz Craven:
00:05:53
It sure is.
Liz Craven:
00:05:54
And I think that your big heart is one of the things that makes you so different and
Liz Craven:
00:05:59
probably one of the, Oh, you're welcome.
Liz Craven:
00:06:01
But one of the, the scariest things for people when they are approaching
Liz Craven:
00:06:06
Medicare is that it's really confusing and there are a lot of people who want
Liz Craven:
00:06:11
to tell you a lot of things and nobody knows who's telling them the right thing.
Liz Craven:
00:06:17
So you have this company over here telling you one thing and that you really need.
Liz Craven:
00:06:22
X, y, Z plan, and you have somebody else telling you, but no, you really need the
Liz Craven:
00:06:27
extra funds for your groceries or you really need, um, you know, whatever the,
Liz Craven:
00:06:32
the carrot it is that they're dangling and it's hard for people to really, um,
Liz Craven:
00:06:38
dig in and figure out for themselves,
Liz Craven:
00:06:41
what the right plan is for them.
Liz Craven:
00:06:42
And so people like you are a godsend because I have no problem sending
Liz Craven:
00:06:48
someone your way and, and knowing that you will treat them with respect
Liz Craven:
00:06:53
and dignity, and that they'll walk away with truly what's best for them.
Karen Dean:
00:06:57
I, I, that is what I do for my clients and I
Karen Dean:
00:07:00
very much take that to heart.
Liz Craven:
00:07:02
Well, thank you for all that you do.
Liz Craven:
00:07:04
Okay, so let's get into it.
Liz Craven:
00:07:07
We're gonna start at the very base of this conversation just in case
Liz Craven:
00:07:12
there are people who are watching or listening that don't understand the
Liz Craven:
00:07:18
difference between Medicare, Medicaid.
Liz Craven:
00:07:20
Let's start with a definition.
Liz Craven:
00:07:22
What is
Karen Dean:
00:07:23
Medicare?
Karen Dean:
00:07:24
Okay.
Karen Dean:
00:07:25
Medicare is a federal health insurance program for people 65 or older, but also
Karen Dean:
00:07:33
anyone that has been on disability for 24 straight months is eligible for Medicare.
Karen Dean:
00:07:38
And then also there are, um, chronic diseases such as renal, end-stage,
Karen Dean:
00:07:43
renal disease, and ALS that qualify people for Medicare prior to 65.
Karen Dean:
00:07:49
Um, Medicaid is a state program and those have criteria of financial,
Karen Dean:
00:07:55
um, that assets and liabilities that, uh, the state looks
Liz Craven:
00:07:58
at.
Liz Craven:
00:08:00
So if we were to put it in layman's terms, you have Medicaid, which
Liz Craven:
00:08:04
is like you said, the state red program, and instead of shopping for.
Liz Craven:
00:08:09
A different type of insurance plan when you reach that age, then Medicare is the
Liz Craven:
00:08:15
plan that you are basically shopping for.
Karen Dean:
00:08:18
Yes,
Liz Craven:
00:08:19
Okay, good.
Liz Craven:
00:08:20
That's very helpful.
Liz Craven:
00:08:21
Okay.
Liz Craven:
00:08:22
Now the biggest question, and this will probably take quite a long time
Liz Craven:
00:08:26
to get through, um, the alphabet soup, you know, a b, d supplemental medigap.
Liz Craven:
00:08:34
What do all of those things mean?
Liz Craven:
00:08:36
And I know that's a very broad question, so I'm gonna lean on
Liz Craven:
00:08:40
your expertise to kind of walk us through from the beginning.
Liz Craven:
00:08:44
What it, what the types of Medicare plans are.
Karen Dean:
00:08:48
Well let, let's just start at what are the, what is original Medicare?
Karen Dean:
00:08:51
So, original Medicare consists of two different pieces.
Karen Dean:
00:08:56
Um, part A is your medical side, uh, which.
Karen Dean:
00:09:01
Over the lifetime of working, either you or your spouse, most
Karen Dean:
00:09:05
people have paid in enough quarters where it's prepaid upfront.
Karen Dean:
00:09:09
So when you up, uh, enroll in Medicare Part A, uh, you may receive that
Karen Dean:
00:09:14
at no cost, which most people do.
Karen Dean:
00:09:17
Part B um, pays for outpatient services and Part B comes with a monthly premium.
Karen Dean:
00:09:25
Um,
Karen Dean:
00:09:27
So A and B together are called original Medicare.
Karen Dean:
00:09:30
They pay 80% of uh, Medicare approved services.
Karen Dean:
00:09:35
So you have a 20% co-insurance, which is an unknown amount, which is a
Karen Dean:
00:09:39
risk, and it could be catastrophic.
Karen Dean:
00:09:42
If you had a year where you might have to be transported by a helicopter, you
Karen Dean:
00:09:46
might be in the hospital for a long length of time or go into skilled nursing.
Karen Dean:
00:09:52
Um, as an agent, what I do is I sit down with a client and educate
Karen Dean:
00:09:55
'em on what Medicare is and what that risk presents for them.
Karen Dean:
00:09:59
And then we look at the options of how to offset that risk.
Karen Dean:
00:10:03
So there's two different options.
Karen Dean:
00:10:05
Uh, the first option is you utilize your original Medicare, um, as
Karen Dean:
00:10:09
it is and you add a supplement behind it or a medigap plan.
Karen Dean:
00:10:13
They're, they are just interchangeable.
Karen Dean:
00:10:15
So those plans are standardized.
Karen Dean:
00:10:17
Uh, they are different letters as far as the benefits.
Karen Dean:
00:10:21
and, but those come with a monthly premium.
Karen Dean:
00:10:24
And then you would also need to put a, a prescription drug plan in place, and that
Karen Dean:
00:10:28
would have a monthly premium, so that route can cost you a little more money.
Karen Dean:
00:10:33
Um, but those, uh, Medicare supplements are not Medicare, or,
Karen Dean:
00:10:37
I'm sorry, are not network based.
Karen Dean:
00:10:40
Um, And the most comprehensive plan will basically pick up
Karen Dean:
00:10:44
everything after Medicare pays.
Karen Dean:
00:10:46
Uh, the most comprehensive plan now is Plan G and it picks up everything except
Karen Dean:
00:10:51
for the Part B deductible every year.
Karen Dean:
00:10:54
So the other option, um, is called a Medicare Advantage plan, or Part C.
Karen Dean:
00:11:00
So you still have original Medicare benefits.
Karen Dean:
00:11:03
They are required to, at least at a minimum, give you original Medicare
Karen Dean:
00:11:07
benefits, but then they can add every extra things on top of that.
Karen Dean:
00:11:12
Those extra things could be, um, an allowance for glasses or reimbursement
Karen Dean:
00:11:16
for glasses, hearing aids, uh, dental services, fitness over the counter.
Karen Dean:
00:11:22
Those things are not Medicare benefits.
Karen Dean:
00:11:24
Those are being provided by the private insurance companies that
Karen Dean:
00:11:27
sponsor those Medicare Advantage plans.
Liz Craven:
00:11:31
those are all of the carrots that they're dangling in front of people,
Liz Craven:
00:11:35
and those are what you're seeing on the commercials that are saying, you
Liz Craven:
00:11:40
know, call our one 800 number now so that you can take advantage of free
Liz Craven:
00:11:45
fitness classes, or whatever it is.
Karen Dean:
00:11:48
So, so what you have to remember is a Medicare Advantage plan.
Karen Dean:
00:11:51
They, they're network based.
Karen Dean:
00:11:53
Now, there's different types of advantage plans.
Karen Dean:
00:11:55
There's PPOs that give you flexibility to go in or out a network.
Karen Dean:
00:11:59
You don't have to have referrals from your primary care.
Karen Dean:
00:12:02
Um, there's HMOs and HMOs, um, are gonna have lower copays and, uh, They
Karen Dean:
00:12:10
may have plans that give you money back to offset part of that part B premium.
Karen Dean:
00:12:14
Um, but they, you would have to have referrals from your primary
Karen Dean:
00:12:18
care to, um, have services provided.
Karen Dean:
00:12:22
Um, but there's also other types of plans.
Karen Dean:
00:12:24
There's special need plans, uh, for different chronic conditions.
Karen Dean:
00:12:28
Um, there's also plans that accommodate, um, those people that qualify for
Karen Dean:
00:12:33
Medicare and Medicaid, and those are called dual special need plans.
Karen Dean:
00:12:37
So there's a whole gammut of plans available under the Medicare Advantage
Karen Dean:
00:12:43
topic, uh, that, that people can look at.
Karen Dean:
00:12:46
And it is very overwhelming and very confusing, um, because you have to
Karen Dean:
00:12:50
remember that they're network based.
Liz Craven:
00:12:53
Right.
Liz Craven:
00:12:54
Right.
Liz Craven:
00:12:54
And by network based you mean Those are private companies
Liz Craven:
00:12:58
that are sponsoring the plans?
Karen Dean:
00:13:00
yes.
Liz Craven:
00:13:02
Ooh, that's, I mean, that's a mouthful right there.
Liz Craven:
00:13:05
All that you just said.
Liz Craven:
00:13:06
That's a lot to take in.
Liz Craven:
00:13:08
And so who, um, well, before I ask that question, let me ask you this,
Liz Craven:
00:13:13
you mentioned before about what parts a and b original Medicare cover.
Liz Craven:
00:13:20
Do you have to, are you required to sign up for part B or can you just take part
Karen Dean:
00:13:26
A.
Karen Dean:
00:13:30
If you, you can take out just Part A, but you don't have, you would
Karen Dean:
00:13:33
only have coverage for what Part A encompasses, which would be, um,
Karen Dean:
00:13:39
your hospital, a hospital room and board, skilled nursing and hospice.
Karen Dean:
00:13:44
You would have no coverage for outpatient services.
Karen Dean:
00:13:47
Um, What's recommended is once you are eligible for Medicare, unless you have
Karen Dean:
00:13:53
a creditable medical and prescription drug coverage in place, like through
Karen Dean:
00:13:58
an employer, um, a lot of people, uh, are, you know, they work past 65
Karen Dean:
00:14:03
and they're on employer group plans.
Karen Dean:
00:14:04
That's most often those are all considered, uh, employer, you know,
Karen Dean:
00:14:09
credible drug coverage and credible.
Karen Dean:
00:14:12
Uh, medical coverage, at that point, you would not be required
Karen Dean:
00:14:16
to take out your Medicare a and b.
Karen Dean:
00:14:17
You could wait until you, um, decide to retire or, and come off that plan, because
Karen Dean:
00:14:24
if you don't have that other coverage in place, then you can be charged delayed
Karen Dean:
00:14:29
enrollment penalty on the Part B section.
Karen Dean:
00:14:31
And also, if you don't have a drug plan in place, you can
Karen Dean:
00:14:34
also receive a penalty on that.
Liz Craven:
00:14:37
that's exactly what I was getting at.
Liz Craven:
00:14:38
Cuz some people do have employer plans, but in essence, in the
Liz Craven:
00:14:43
absence of another plan, you do have to be enrolled in both of those
Karen Dean:
00:14:47
parts.
Karen Dean:
00:14:48
You would want to be?
Karen Dean:
00:14:49
Yes, Because at in, at any point later down the road, you decide
Karen Dean:
00:14:53
to join late, then you're gonna incur the penalty for that time
Karen Dean:
00:14:57
period that you did not start it.
Liz Craven:
00:14:59
Right.
Liz Craven:
00:15:00
Okay.
Liz Craven:
00:15:00
So now we've, we've defined the fact that there are a whole lot
Liz Craven:
00:15:04
of different plans, and you've got the basics of those, and certainly
Liz Craven:
00:15:08
you will probably need assistance in choosing what's right for you.
Liz Craven:
00:15:12
But when is the time people should consider enrollment?
Karen Dean:
00:15:17
Well, you know, there's a, there's a lot of
Karen Dean:
00:15:19
different types of enrollment.
Karen Dean:
00:15:21
You do have to have an enrollment period to get your Medicare started.
Karen Dean:
00:15:25
When you first turn 65 or your first eligible, um, those, that's called your
Karen Dean:
00:15:30
initial enrollment period, that period.
Karen Dean:
00:15:33
Um, you can actually sign up three months before your birth month,
Karen Dean:
00:15:36
and then you have that birth month period and three months after.
Karen Dean:
00:15:39
So really a total of a seven month.
Karen Dean:
00:15:41
Time period to initially enroll?
Liz Craven:
00:15:46
Okay.
Liz Craven:
00:15:46
And so once you enroll in that initial period, does it take effect your
Liz Craven:
00:15:50
birth month or does it take effect?
Karen Dean:
00:15:52
Text your birth month.
Karen Dean:
00:15:53
Now obviously if you waited till three months afterwards, it's gonna start three
Karen Dean:
00:15:57
months later, but you would not incur a penalty if you are within that timeframe.
Liz Craven:
00:16:03
Okay.
Liz Craven:
00:16:03
Very good.
Liz Craven:
00:16:04
So that's one type of enrollment.
Liz Craven:
00:16:05
Another type of enrollment is, um, in the case of a move or change
Liz Craven:
00:16:11
or loss of employment, tell, tell us a little bit about that.
Karen Dean:
00:16:15
Right?
Karen Dean:
00:16:15
Those are called special, um, enrollment periods, and they can
Karen Dean:
00:16:19
occur anytime throughout the year.
Karen Dean:
00:16:22
Um, so if you, if you move, uh, you would be required to, uh, you know, if you
Karen Dean:
00:16:27
move outside the service area of the plan you're on, for example, you would have to
Karen Dean:
00:16:31
look at changing either your prescription drug plan or your Medicare advantage plan.
Karen Dean:
00:16:35
Um, when someone has stayed on an employer group plan and decides to
Karen Dean:
00:16:40
enroll later, um, that's considered loss of an employer group plan.
Karen Dean:
00:16:44
That's a special enrollment period.
Karen Dean:
00:16:46
There's many others.
Karen Dean:
00:16:47
Um, a couple of other common ones would be maybe your financial status
Karen Dean:
00:16:51
changes and you may qualify for some assistance from the state.
Karen Dean:
00:16:56
That gives you a special enrollment period.
Karen Dean:
00:16:58
And then there's other enrollment, special enrollment periods for, um, five star
Karen Dean:
00:17:02
Medicare Advantage plans or chronic plans.
Karen Dean:
00:17:05
Those things can happen all year.
Liz Craven:
00:17:07
Okay, great.
Liz Craven:
00:17:08
Well that's something that is curious.
Liz Craven:
00:17:11
Tell me about that chronic plans and five star plans.
Liz Craven:
00:17:15
What are
Karen Dean:
00:17:15
those?
Karen Dean:
00:17:16
So Medicare, the Center for Medicare and Medicaid, cms, uh, star rates.
Karen Dean:
00:17:22
They give a star rating based on feedback and questions they ask current members.
Karen Dean:
00:17:26
Um, from the standalone prescription drug plans and also
Karen Dean:
00:17:29
the Medicare Advantage plans.
Karen Dean:
00:17:32
Um, they rank from a one star to a five star being the best.
Karen Dean:
00:17:36
The five star rating gives, um, that plan, the ability for
Karen Dean:
00:17:41
anyone to sign up on it one time.
Karen Dean:
00:17:43
You can't change from one five star to another.
Karen Dean:
00:17:47
Um, but you can use that enrollment period one time during the year.
Karen Dean:
00:17:51
Uh, the other plans, the chronic plans that we discussed, they are based on
Karen Dean:
00:17:55
chronic conditions such as congestive heart failure or um, diabetes.
Karen Dean:
00:18:02
There's several different, a lot of companies have those plans and if you're
Karen Dean:
00:18:06
diagnosed or um, or have those chronic plans, They tend to accommodate more
Karen Dean:
00:18:12
in their, um, formularies and their, their, you know, they'll accommodate
Karen Dean:
00:18:18
that particular type of a disease.
Karen Dean:
00:18:20
But though you are able to sign up on a chronic plan, um, once
Karen Dean:
00:18:25
during the year, and then the doctor has to verify on all that.
Liz Craven:
00:18:29
Right.
Liz Craven:
00:18:30
Okay.
Liz Craven:
00:18:31
So let's talk about the open enrollment period.
Liz Craven:
00:18:33
So this would be not only a time to sign up if that's the right window
Liz Craven:
00:18:38
for you as far as, um, turning 65.
Liz Craven:
00:18:41
But this is a time that anyone can make a change to the plan that they have.
Liz Craven:
00:18:46
Right?
Karen Dean:
00:18:47
Yes.
Karen Dean:
00:18:48
Um, so from October the 15th, so starting tomorrow till December 7th, it's, um,
Karen Dean:
00:18:54
annual enrollment, um, open enrollment.
Karen Dean:
00:18:56
It gets called open enrollment more often.
Karen Dean:
00:18:58
We call it annual enrollment.
Karen Dean:
00:19:00
Um, but anyone, whether you're on a Medicare supplement and a drug plan,
Karen Dean:
00:19:05
or if you are on a Medicare Advantage plan, anyone during this time can make a
Karen Dean:
00:19:10
change, and it will begin on January 1st.
Liz Craven:
00:19:14
Okay.
Liz Craven:
00:19:14
And how often do you recommend people review the plan that they're on?
Liz Craven:
00:19:19
Is that something you should do annual?
Karen Dean:
00:19:22
I mean, you know, I have, I ha do have a lot of clients that do
Karen Dean:
00:19:25
like to review things annually, but, but typically, unless something is
Karen Dean:
00:19:28
changing, like maybe you want different providers or your medications have,
Karen Dean:
00:19:34
have kind of changed over the course of the year and the cost of gone
Karen Dean:
00:19:37
up, you might wanna do a little plan comparison because, um, the formularies
Karen Dean:
00:19:41
can differ from company to company and, you know, the cost can differ.
Liz Craven:
00:19:47
I hear this often, um, a lot of times when people are talking
Liz Craven:
00:19:51
about which plan to choose, they say, Well, I'm diabetic and I take insulin,
Liz Craven:
00:19:55
or I have x, y, Z condition, and they take a specific medication and that
Liz Craven:
00:20:01
they should be shopping for a plan specifically for their medications.
Liz Craven:
00:20:04
Can you speak to.
Karen Dean:
00:20:06
Well, and that's one thing as an agent, you know, there's two
Karen Dean:
00:20:09
things that we look at when, when, uh, people are specifically looking at
Karen Dean:
00:20:13
Medicare Advantage plans, or even with a standalone drug plan, we wanna make
Karen Dean:
00:20:17
sure that the medications that that client is taking are in that formulary.
Karen Dean:
00:20:23
Um, There are ways, if someone is currently on a plan and they get put on a
Karen Dean:
00:20:28
medication that is not in the formulary, that the doctor can ask for an exception,
Karen Dean:
00:20:32
but we wouldn't wanna start a client out with a new plan knowing that that
Karen Dean:
00:20:38
medication is not in their formulary.
Liz Craven:
00:20:40
Right.
Liz Craven:
00:20:41
How many different formularies are there?
Liz Craven:
00:20:44
I mean, I know that's a loaded question.
Liz Craven:
00:20:46
I know, but I wanted the response because it's that many
Karen Dean:
00:20:51
I, I really don't know, but I can tell you.
Karen Dean:
00:20:53
You know, the formularies all have to be approved by Medicare.
Karen Dean:
00:20:58
Um, they all have to have at least two drugs in every classification.
Karen Dean:
00:21:01
So it's not like you would be without a medication that would fit your needs.
Karen Dean:
00:21:06
Um, but, but the formularies can differ not just company to company, but sometimes
Karen Dean:
00:21:12
within the different types of planning companies, they, they are different.
Karen Dean:
00:21:15
So it's, it's kind of an intricate process.
Liz Craven:
00:21:19
So we mentioned it before, but what if someone moves, um, from one state
Liz Craven:
00:21:24
to another or even one city to another?
Liz Craven:
00:21:26
Um, what if they retire?
Liz Craven:
00:21:29
What, how do they go about making the change and how long do they have to do it?
Karen Dean:
00:21:34
Good question.
Karen Dean:
00:21:35
So, and this is something that a lot of people don't think about
Karen Dean:
00:21:38
when they are looking to move.
Karen Dean:
00:21:41
Um, so when someone relocates outside of the service area of where their
Karen Dean:
00:21:45
plan is or even just moves in general, they need to contact social security
Karen Dean:
00:21:49
and, and that's the beginning basis of getting that address changed.
Karen Dean:
00:21:55
Once that is done, they have a 60 day window to make a
Karen Dean:
00:21:59
change, um, with their plan.
Karen Dean:
00:22:01
Because prescription drug plans and Medicare advantage plans are tied to
Karen Dean:
00:22:05
the zip code and area where you live.
Karen Dean:
00:22:08
So once you're outside of that service area, it's gonna need to be changed.
Liz Craven:
00:22:12
And what happens if they don't or if they do it late?
Karen Dean:
00:22:15
If, if they don't take advantage of that, that's a special
Karen Dean:
00:22:18
enrollment period, then they would have to wait until annual enrollment
Karen Dean:
00:22:22
and, and, and make a choice at that.
Liz Craven:
00:22:24
Right.
Liz Craven:
00:22:25
But there are no, there would be no fees associated.
Liz Craven:
00:22:27
They would just be stuck with a plan that might not suit their
Liz Craven:
00:22:30
needs in their new location.
Karen Dean:
00:22:32
Uh, no.
Karen Dean:
00:22:33
If they're in a plan that is not in their service area and they don't take advantage
Karen Dean:
00:22:37
of that enrollment period to change, um, they will not have drug coverage or they
Karen Dean:
00:22:42
would not have a Medicare Advantage plan.
Liz Craven:
00:22:44
Right.
Liz Craven:
00:22:45
Okay.
Liz Craven:
00:22:46
So they would still maintain their parts A and B.
Liz Craven:
00:22:49
They just wouldn't have all of the other things that, that take
Liz Craven:
00:22:53
care of so much of the cost.
Karen Dean:
00:22:54
Absolutely
Liz Craven:
00:22:55
Okay.
Liz Craven:
00:22:56
Uh, so much to think about in all of those scenarios.
Liz Craven:
00:23:00
Have I missed anything that you think, Wow, this is another thing that, um,
Liz Craven:
00:23:04
people come to me for assistance and.
Liz Craven:
00:23:08
I think, I wish I had met them three months earlier because
Liz Craven:
00:23:12
this change happened and they didn't do anything about it.
Liz Craven:
00:23:15
What would that kind of scenario look?
Karen Dean:
00:23:17
I think the thing about moving that's, you know, You know, when
Karen Dean:
00:23:21
you're thinking about moving, you're not really thinking about every aspect,
Karen Dean:
00:23:25
but every, you know, there's so many.
Karen Dean:
00:23:28
When you go from county to county, even in Florida, especially if you go outta
Karen Dean:
00:23:32
state, the um, plans available to you.
Karen Dean:
00:23:36
Um, the networks are, you know, they're all different and costs are different.
Karen Dean:
00:23:41
Copays are different.
Karen Dean:
00:23:42
So people don't think about how, what they're utilizing, where they're moving
Karen Dean:
00:23:47
from, how different that's gonna be.
Karen Dean:
00:23:49
And it's, I think it surprises people sometimes.
Liz Craven:
00:23:52
I think so too.
Liz Craven:
00:23:53
And I think the other part of the confusion is all, again, all of the
Liz Craven:
00:23:57
commercials that you see in the newspaper ads, how do people sift through those?
Liz Craven:
00:24:03
How can you tell whether or not a company is reputable?
Karen Dean:
00:24:08
I really wouldn't say that the companies themselves, the
Karen Dean:
00:24:11
insurance companies aren't reputable.
Karen Dean:
00:24:13
Um, because you have to remember a lot of these telemarketing companies,
Karen Dean:
00:24:17
especially the television ads, um, they're, you know, they're companies
Karen Dean:
00:24:21
that are owned by a big corporations.
Karen Dean:
00:24:25
Um, but as a licensed agent, we have a individual responsibility
Karen Dean:
00:24:29
to do things compli.
Karen Dean:
00:24:31
um, Medicare, uh, has a guide, had guys, has guidelines for marketing,
Karen Dean:
00:24:37
and we have to adhere to those.
Karen Dean:
00:24:39
So a lot of that responsibility in my mind is, is mine.
Karen Dean:
00:24:44
Um, and you know, it's not just the television ads, it's uh, people
Karen Dean:
00:24:49
coming and knocking on your door or um, people calling you unsolicited.
Karen Dean:
00:24:54
Those things are, are prohibit.
Liz Craven:
00:24:58
right?
Karen Dean:
00:24:58
so, uh, why would you even want to entertain the thought of engaging
Karen Dean:
00:25:03
someone to be your agent that's already demonstrating that kind of behavior?
Liz Craven:
00:25:09
Sure.
Liz Craven:
00:25:10
That makes an awful lot of sense.
Karen Dean:
00:25:12
And, and what I tell people, I, I do a lot of talks in, um, some of
Karen Dean:
00:25:16
the senior centers around the county and what I tell people, they have to remember,
Karen Dean:
00:25:20
you know, don't get all caught up in the shiny packages and the, you know, and
Karen Dean:
00:25:24
everything just looks so pretty because the, the core of whatever coverage you
Karen Dean:
00:25:29
put in place is that you are being allot.
Karen Dean:
00:25:33
The providers, the best providers for yourself, and that your medications
Karen Dean:
00:25:37
are covered and that the cost on your medications is, is reasonable.
Karen Dean:
00:25:43
Um, so those are things that are important above and beyond all the extras and
Karen Dean:
00:25:48
additional things that are being promoted.
Liz Craven:
00:25:52
Right.
Liz Craven:
00:25:52
And that's probably why having a good agent on your side, um, or
Liz Craven:
00:25:59
some of the other things that we'll talk about in a minute, other areas
Liz Craven:
00:26:02
and avenues of assistance, it's important to take advantage of those
Liz Craven:
00:26:06
and not try to wade through it on your own if it's not your wheelhouse.
Karen Dean:
00:26:11
Well, and think about all, you know, it's, I started something
Karen Dean:
00:26:14
a couple years ago with people that are turning 65 when I go out and I do
Karen Dean:
00:26:18
an educational presentation to them.
Karen Dean:
00:26:20
I started putting together, um, it's kind of like a, um, I don't wanna
Karen Dean:
00:26:24
call it a Medicare, um, mail or trash bag, but basically that's what it is.
Karen Dean:
00:26:30
I'll take people a, a brown paper bag and I'll tell them, Put all your mailers.
Karen Dean:
00:26:36
in this bag, and then when we get back together to do your app, you know, to
Karen Dean:
00:26:40
look at what the best plans are for you, we'll we'll go through it and I'll let
Karen Dean:
00:26:44
you know what is reasonable to keep.
Karen Dean:
00:26:46
Because most of those things you get in the mail, your doctors, if
Karen Dean:
00:26:50
it's a Medicare Advantage plan, your doctors may not even be in the network
Karen Dean:
00:26:53
with, So it's, it's just, you know, it's confusing to say the least.
Liz Craven:
00:26:59
So when you consult with a client, what are the top three
Liz Craven:
00:27:02
things that you look for when you're considering which plan is right for.
Karen Dean:
00:27:08
Well, primarily who, who is your primary care physician and what, what
Karen Dean:
00:27:12
specialist do you wanna continue to see?
Karen Dean:
00:27:16
Now this is on a Medicare Advantage plan, cuz remember on a Medicare supplement,
Karen Dean:
00:27:19
it's not network based, um, lifestyle.
Karen Dean:
00:27:23
You know, uh, certain Medicare Advantage plans allow people to
Karen Dean:
00:27:28
travel more across the United States.
Karen Dean:
00:27:30
Maybe go visit and stay places where they moved from for several months out
Karen Dean:
00:27:34
of the year and utilize those networks.
Karen Dean:
00:27:37
Um, and then the medications.
Karen Dean:
00:27:39
So those, but that's, you know, everyone is different.
Karen Dean:
00:27:43
And what your neighbor has or what your, you know, family member has, doesn't
Karen Dean:
00:27:47
necessarily mean it's a good fit for.
Liz Craven:
00:27:49
Right.
Liz Craven:
00:27:50
You mentioned travel, and that brings up a question.
Liz Craven:
00:27:53
You know, a lot of us plan in our retirement years to do a lot of traveling.
Liz Craven:
00:27:57
I know, I do.
Liz Craven:
00:27:58
And so are there plans that incorporate coverage outside of the United States?
Karen Dean:
00:28:06
Any Medicare advantage plan, um, gives you emergency coverage
Karen Dean:
00:28:11
anywhere in the world, urgent care or emergency coverage anywhere in the world.
Karen Dean:
00:28:15
Um, Yes.
Karen Dean:
00:28:17
Uh, Medicare supplements, um, will have a little more of a, uh, more of a benefit
Karen Dean:
00:28:24
coverage to travel outside the us.
Liz Craven:
00:28:30
Okay, so now I want to talk about available resources that people
Liz Craven:
00:28:35
can use to dig in a little bit deeper.
Liz Craven:
00:28:37
So why don't you go first and tell me the best places you believe
Liz Craven:
00:28:42
people can go to get additional assistance and information about.
Karen Dean:
00:28:48
Um, Medicare itself.
Karen Dean:
00:28:50
Uh, for example, they usually send out a book every year called Medicare and you,
Karen Dean:
00:28:55
um, it has a lot of information in it.
Karen Dean:
00:28:57
It, it can be confusing because it covers a lot of scenarios, um, but
Karen Dean:
00:29:02
it is chopped full of information, um, medicare.gov, um, online.
Karen Dean:
00:29:08
, uh, people can actually go in as a general public.
Karen Dean:
00:29:12
You can put in your zip code and you can actually run plan comparisons or look
Karen Dean:
00:29:18
up, um, estimates on your drug cost.
Karen Dean:
00:29:21
They can do that individually on their own or even even just
Karen Dean:
00:29:24
calling Medicare 1-800-MEDICARE and getting someone that can help you.
Karen Dean:
00:29:29
Um, but I also did put down the elder help.
Liz Craven:
00:29:33
Mm-hmm.
Karen Dean:
00:29:34
which would refer people to shine in our area.
Karen Dean:
00:29:36
I know it's called different things in different states, but in our state
Karen Dean:
00:29:40
it's called Shine, and they're a good, unbiased, um, resource, um, to educate.
Liz Craven:
00:29:47
That's a great one, and that's the one that I was going to
Liz Craven:
00:29:50
mention also specifically that is, Nationally, that program is referred
Liz Craven:
00:29:56
to as Ship with a p We, we watched a presentation the other day and, and
Liz Craven:
00:30:03
the person doing the presenting kept saying Ship with a P because, um, she,
Liz Craven:
00:30:09
she is often misunderstood about what she's saying and even said that Ohio.
Liz Craven:
00:30:15
Plan name is O Ship, which is hilarious.
Karen Dean:
00:30:19
It is.
Liz Craven:
00:30:20
you go.
Liz Craven:
00:30:21
There's your giggle in the middle of a Medicare discussion, . But, um,
Liz Craven:
00:30:26
SHIP stands for, um, State Health Insurance Assistance Program, and
Liz Craven:
00:30:32
it is, Really, really a great idea.
Liz Craven:
00:30:36
These are volunteers who will meet with you here in Florida anyway.
Liz Craven:
00:30:40
Um, I'm not sure how it works in every state, but every state program is there
Liz Craven:
00:30:46
to find the program closest to you.
Liz Craven:
00:30:48
You're gonna go to eldercare.acl.gov.
Liz Craven:
00:30:50
When you get there, you'll see a place to put your zip code in, and once you
Liz Craven:
00:30:57
put your zip code in, you can find the referral to your local ship office.
Liz Craven:
00:31:02
And I would highly encourage people who don't have an agent
Liz Craven:
00:31:06
that they're working with.
Liz Craven:
00:31:07
Um, for whatever reason, if you haven't found the agent that you're
Liz Craven:
00:31:10
happy with, um, definitely go and explore this because people will sit
Liz Craven:
00:31:15
down with you and help you to get to the plan that best suits your needs.
Liz Craven:
00:31:20
Um, so all of that to say, don't try to go it alone, unless this is your wheelhouse.
Liz Craven:
00:31:26
If you've been in insurance all your life, then I'm sure you could figure
Liz Craven:
00:31:30
out exactly what you need to do and exactly which plan is right for you.
Liz Craven:
00:31:34
Um, but I think a lot of times we get embarrassed about what we don't know and
Liz Craven:
00:31:40
we try to do things on our own or just jump at the very first thing that we see.
Liz Craven:
00:31:44
And I don't know that that's the best course of action to take here.
Karen Dean:
00:31:47
No.
Karen Dean:
00:31:48
No.
Liz Craven:
00:31:50
Well, good.
Liz Craven:
00:31:51
Well, Karen, thank you for enlightening us today.
Liz Craven:
00:31:55
There's so much to learn and I hope that we haven't confused all of you.
Liz Craven:
00:31:59
All of the things that we mentioned and websites to go to will be listed in
Liz Craven:
00:32:03
the show notes, um, and in the comments below, wherever you are looking at this.
Liz Craven:
00:32:09
Um, so I hope that you'll take advantage of those resources.
Liz Craven:
00:32:12
I hope that you'll just save this episode and replay it if you need
Liz Craven:
00:32:15
to, to go over the basics, because when you go to work with an agent,
Liz Craven:
00:32:19
the more educated you are on the front end, understanding the basics.
Liz Craven:
00:32:23
The more time your agent will have to spend with you to really
Liz Craven:
00:32:27
dig in and see which is the best appropriate plan for you.
Liz Craven:
00:32:30
So before we leave, and this can be related to Medicare or life or anything
Liz Craven:
00:32:36
you want, how about a little piece of sage advice for our listeners?
Karen Dean:
00:32:40
Well, I, I kind of wanted to just segue into the fact
Karen Dean:
00:32:43
of knowing who is representing you.
Karen Dean:
00:32:46
And, you know, you hear the term fiduciary in the financial world, but
Karen Dean:
00:32:51
as a, as a licensed agent, we should be working as fiduciaries for our clients.
Karen Dean:
00:32:55
We, we need to have their best interest in heart, in mind.
Karen Dean:
00:33:00
Um, Regardless.
Karen Dean:
00:33:04
Um, and, and you know, it's not uncommon.
Karen Dean:
00:33:06
I've met with people before that are not my clients and, and I help
Karen Dean:
00:33:10
to clarify things for them or even check on their plans and just to tell
Karen Dean:
00:33:16
them that they don't need to change.
Karen Dean:
00:33:18
They're good where they're at.
Karen Dean:
00:33:19
And I think sometimes that surprises people.
Karen Dean:
00:33:22
Um, but it's not, you know, first and foremost.
Karen Dean:
00:33:26
People need you.
Karen Dean:
00:33:28
You know, they deserve to be put on in the, in the best place possible, um,
Karen Dean:
00:33:32
because they're the one using that plan.
Karen Dean:
00:33:35
And so I would just say there's a lot of good agents out there, you know, and,
Karen Dean:
00:33:38
um, you just, just be, uh, mindful of who you're utilizing, uh, that to help you.
Liz Craven:
00:33:46
Absolutely.
Liz Craven:
00:33:47
That's great advice and I would agree with you.
Liz Craven:
00:33:48
There are so many good people out there who are ready and willing to help, and
Liz Craven:
00:33:54
it's like a crazy time of year for them.
Liz Craven:
00:33:56
So be patient when you're scheduling your appointments because with
Liz Craven:
00:33:59
open enrollment upon us, Medicare agents are going to be very busy
Liz Craven:
00:34:04
indeed until the middle of December.
Liz Craven:
00:34:06
Karen, thank you so much for joining me.
Liz Craven:
00:34:08
I
Karen Dean:
00:34:09
you for having me.
Liz Craven:
00:34:10
Oh, of
Karen Dean:
00:34:11
my first time doing a podcast,
Liz Craven:
00:34:12
Woo.
Liz Craven:
00:34:13
Well, you did
Karen Dean:
00:34:13
I've got one under my belt,
Liz Craven:
00:34:15
Yes, you do.
Liz Craven:
00:34:16
You'll have to come back.
Liz Craven:
00:34:17
We'll have you back soon.
Karen Dean:
00:34:18
Okay, Liz.
Karen Dean:
00:34:19
Thank you.
Liz Craven:
00:34:20
You bet.
Liz Craven:
00:34:20
And thank all of you for joining us today for the conversation.
Liz Craven:
00:34:24
I hope it was helpful for you.
Liz Craven:
00:34:25
Our aim here at the Sage Aging Podcast is to give you bits of
Liz Craven:
00:34:29
information that can make your caregiving and aging journey better.
Liz Craven:
00:34:33
It's a little bit easier when you know what's happening, so as I always
Liz Craven:
00:34:37
say, know it before you need it.
Liz Craven:
00:34:40
I hope you'll join us on Facebook, Instagram, and any social
Liz Craven:
00:34:44
media platform that you enjoy.
Liz Craven:
00:34:45
We're present in most places, and also you can find us at eldercareguide.com.
Liz Craven:
00:34:51
We've got so much information available for you on that website, so go take
Liz Craven:
00:34:55
a look if there's something that isn't there that you'd like to see.
Liz Craven:
00:34:59
Let us know.
Liz Craven:
00:35:00
You can always reach out to us via our social media or
Liz Craven:
00:35:02
right there on our website.
Liz Craven:
00:35:04
You can use the contact form.
Liz Craven:
00:35:06
Um, so thanks for joining us.
Liz Craven:
00:35:07
We'll have a new episode for you up in two weeks, and we'll talk to you then.
