In this episode of Senior Living LIVE!, Ben Green, President and COO of Insurance Advantage, sits down with Melissa once again, this time explaining everything related to Medicare—what it is, who is eligible, how to enroll, and where to find helpful resources.
Video Transcript
- Hello everyone and welcome into Senior Living Live. My name is Melissa. As always, thank you so much for watching and I hope you are having a wonderful day today. Now as we continue our commitment to provide you news you can use, information to arm you with the latest and greatest about Senior Living, I'd like you to meet Ben Green. He is the President and COO of Insurance Advantage. If you need help navigating life insurance, medicare, long-term care insurance, social security benefits, retirement, Ben is absolutely your man. Ben, I know you're a busy guy, how are you today?
- Great, great Melissa, thank you for having me. It's an honor to be with such a fantastic interviewer.
- Oh, well, I appreciate that. And you have a fantastic background. And you're gonna tell us a little bit about that as we kind of venture into the topic of Medicare today. Tell us a little bit about yourself.
- Yep, so I'm President and COO of Insurance Advantage. We're based in South Carolina, but we do work all over the country. And, we started out helping folks with the Affordable Care Act plans and kind of migrated over to Medicare in the last five years. And have from there, kind of built a practice around pre-retirement planning. So, Medicare, long-term care, life insurance annuities even helping folks with social security questions that they have, that's what we do. And, I'm also proud to say I'm a Regional Director of the Financial Education Partnership which is a nonprofit that really leads and provides financial literacy for free for folks. So it really helps, really makes me excited to be able to help educate folks on these topics.
- Yeah, and I do find it impressive too, your multi-lingual and in conversation so you can help out really a large number of people. And tell us a little bit about that too in case somebody is watching and there's a little help on that end.
- Yep, yep, so, yeah so, spent a little bit of time over in Japan and Spain and Brazil and so really, I appreciate the fact that I've been able to learn some different languages. But it's really applicable to what we're gonna talk about today because Medicare in particular is its own language. You know we're not taught it in high school or I didn't have to take a class in college or even when I got my MBA. And so, it makes me excited to be able to share a little bit of information there with folks.
- Yeah, fantastic. So you know, we've all heard the term Medicare. I think everybody, you've been living under a rock if you have not. But what exactly is it Ben and who is eligible to receive it?
- Yeah, so Medicare, it's health insurance for folks that are 65 and older typically. Or if you are under 65 and you have certain disabilities like ALS for example, Lou Gehrig's disease, or other types of disabilities, you can qualify for Medicare. And anyone that has end stage renal disease typically is gonna qualify for Medicare.
- Excellent, so quite a few different factions of individuals there. We have seen some options right out there, but what really is available if you're putting it on paper and how much does it cost?
- Yep, yep. So Medicare, it's kind of two parts basically. So part A is typically your hospital insurance. And the eligibility to that is typically you have to have 40 quarters of work if you will either for yourself or as a spouse or as a child. And you can file for part A and it's usually, we call it premium free or is a $0 premium if you have your 40 quarters of work basically. Part B is medical insurance, to go see doctors and so forth. And that is also a voluntary program, if you will. And the eligibility for it is that you have to apply for it and you have to pay a monthly premium for it. And that monthly premium, for most folks, if you're single under the age of, if you're single and under about $87,000 per year, that premium for part B is gonna be about $148 per month right now.
- Gotcha, and how has some of this changed? You consistently hear that everybody wants to help Medicare and to help people with Medicare or through Medicare, how has that kind of changed over the years since you started? I mean, what's the latest and greatest about Medicare so to speak?
- Yep, so the plans that you can choose, if you will are always changing, like the, kind of share a little bit with you about that. And so, Medicare itself covers and original Medicare covers 80% of your cost. So Part A covers, as I said the hospital, 80% of your hospital stays. Part B covers 80% of your doctrine outpatient stays, but, and that's the good news, it's 80%. The bad news or your responsibility if you will and this is what changes all the time. And this is where folks really kind of need some help is that you have to cover that additional 20% of the gap. And then you also have to be responsible for getting a part D drug plan or prescription drug plan. And so that is what is always changing. Those, the 20% sort of supplement policy is in the part D plans are always changing and what's always changing is the cost of part B. About four years ago, part B was around a hundred dollars per month per person and now it's $148. It's been going up a little bit every year. And then the part B deductible, which you're responsible for as an individual, that's going up every year, it's about $203 per year now. It used to be, you know, less than that. So every year there's some changes that happen that are always being made and so that's why it's really important to either, you know be an expert in this yourself, or reach out to someone like myself for like, you know, independent brokers and agents who would kind of walk you through this process for free.
- Yeah, reach out to the pro and what did I hear? Did I hear the word free?
- Yes, yes. Yeah, we do.
- Do people know this?
- A lot of folks do not know it and that's what, that I think is why they sort of brave the elements on their own and, you know deal with the phone calls and deal with some of the unsolicited mail that you may see, or you know, call into some of the things that folks see on TV with promotions about Medicare plans.
- Wow, so before we start to talk about enrollment, let's go back to, you mentioned that there's that gap there, that some people are needing a little bit of help to maybe fulfill, what can you give in terms of advice on that and to somebody who says, I don't know if I can afford that on my fixed income.
- Sure, sure. So our option to fill the gap you have two options, essentially especially when you're turning 65 years old. You have option number one, you're a left, as you can see which is called typically a Medicare supplement plan. You may also hear it called Medigap plan and that those plans are, they have the alphabet with them. So like a plan G or plan N for example. Those plans are available and they help to fill the gap in terms of co-pays, in terms of co-insurance for your plan, they fill that 20% gap and those plans can range in price and $70. for example per month, up to $120, $130 depending on your age, your state and even your county actually, we use zip code. The part D plans which are the drug plans those plans in a range in price from seven bucks up to $150 depending on what your prescriptions are. But essentially you have to, you need to dig in based on what your current prescriptions are, you know who your current doctors are, et cetera, to figure out whether or not you're gonna go with an option number one, particularly based on your budget. Option number two, which is called a Medicare advantage plan or also called a part C plan, those plans are becoming increasingly popular now based on budgeting sometimes. And what they do, is they essentially combine part A with part B and they're administered by private companies. And they also, a lot of times include the drug plan and additional benefits like dental and vision for example and hearing. And so really based on your network based on the doctors you need, your prescriptions and so fourth, we typically sit down with folks and figure out what best meets their needs.
- And as you're going through the alphabet, I mean you could really get into the weeds here. So this is something that, I mean, if you can get the help and as you mentioned Ben, it's free. You should probably take advantage of that. So on that end, if somebody is watching, they're listening how can somebody enroll? Is there a window of opportunity to enroll or can someone do it anytime?
- That's a great question. So you can all, so the general enrollment is on the initial enrollment period or for IEP, if you will. And that is typically, you know, when you're turning 65 you have about three months beforehand and three months afterhand to enroll. The other times to enroll or it's maybe change your plan for example are during the open enrollment period that's typically from October 15th to December 7th. Okay, and that's for Medicare not to be confused with the affordable care act, affordable care act open enrollment period which can confuse a lot of other folks. And then you have, you do have some other special enrollment period times based on your, like chronic conditions for example, if you do happen to qualify for Medicaid, for example, or for another special government program.
- Yeah, so if someone's dipping their toes into this for the first time you bring up Medicaid, what is the difference between Medicare and Medicaid? I don't think I could even tell you.
- Yeah, so Medicaid, obviously we've already explained what Medicare is. Medicaid is a, it is a jointly funded state and federal medical assistance program that is designed to help people but you have to have a certain level of income. And so it's means tested if you will. So, if you're for example, in South Carolina that level is $12,880 per year as an individual, you go over that, you will very likely not qualify for Medicaid in Illinois or in New Jersey for example, even in Florida, it's about $17,000 per year. So if you're, you know, you're getting more than that per year as a single individual you're not gonna qualify for Medicaid. And so what we tell folks, especially when it comes to things like long-term care that are not covered by Medicare and not covered by other government programs, you don't want to qualify and you do not want to count on Medicaid as something that really kind of, that's gonna take care of your long-term care, for example, and with Medicare joining into Medicaid you can get some special, basically some special provisions and some special plans. But once again it's all means tested and a lot of folks do not qualify for Medicaid.
- Yeah and you mentioned another topic that we will be touching on soon and that is long-term care insurance. So if you're wondering about that, stay tuned because we will have that video with Ben available as well. Now, if someone needs resources or they're just not ready to make that phone call yet, where can they go to find out maybe the slimmest version of this to just get the basic understanding of Medicare and how to help pay for it?
- Yep, so they're always, of course you can always go to medicare.gov actually. medicare.gov is a free resource provided by CMS which the center for Medicaid, Medicare and they you can search for plans there. If you wanna know how to apply for Medicare, you can literally Google apply for Medicare part a or part B. We help folks with that all the time to apply for their part a or their part B a lot of times. Particularly if you're gonna be taking social security or if you're turning 65 your part a will typically arrive kind of automatically if you qualify for Medicare based on your 40 corners. Part B you typically have to apply for and measure RA taking social security at age 62 or age 63 for example, but those are the free resources and then once again, you can always reach out to my team to help, to get help with, you know your Medicare questions, the basic questions and also the process of getting the supplements or Medicare advantage, for example.
- Yeah, Ben Green, you are an impressive man. This is obviously not an easy topic to navigate and we've really only scratched the surface here. So I would tell everybody who is watching now that if they have any questions whatsoever or just are not understanding the minutia of all of this, that is what someone like Ben is there for. And trust me, he knows what he's talking about when it comes to Medicare and everything that it entails. You are a pro and we certainly appreciate you sharing your knowledge with us today. Now Ben, if someone wants to get in contact with you we see the contact page here but if they're saying, oh, well he's in South Carolina, who can you help?
- Yeah, so we can essentially help anywhere in the country. So I was just on the phone with a guy who has been texting us this morning, you know helping somebody to enroll in Georgia tomorrow, tomorrow actually and we have clients in, Connecticut, Delaware, et cetera. So even if we can not officially enroll you we can point you in the right direction and be a resource for people and we're happy to do that. As I said, it's a personal passion of mine to provide this education. And I really want to thank you for your time and thank you for bringing me on. That's a great treat for me.
- Yeah and we will have quite a few more topics from you and we are so thankful that you have provided your time for us here today to share your knowledge. Excellent job, Ben. And we will see you soon.
- Thank you and welcome.
- Thank you So if you were looking for more information about senior living, you could head on over to www.seniorlivinglive.com. You can check out our video vault 24/7. Thank you so much for watching. Have a great day, everybody.
- Bye.
