Sage Insurance Advisors LLC, specializes in Medicare plans and represents insurance companies offering Medicare supplements, Medicare Advantage Plans, and Part D prescription drug plans.

Serving Northeast Indiana from 4233 East State Boulevard in Fort Wayne and online at SageInsuranceAdvisors.com.

I'm so happy you're joining us here on PBS Fort Wayne tonight.

I'm saying they Jomsom the host of The LIFE Ahead Show but the star is sitting over here beside me and I'll introduce you to him in just a moment.

I mentioned last week that we were doing a two part series if you want to call it that two part show on Medicare.

We're talking about the changes things you need to know as you have a time period here between October 15th and December 7th to make any changes decisions about that.

So if you have questions and I know last week many of you did please call us (969) 27 twenty .

>> Here's the guy who is going to answer those questions for you, an expert in the field, an insurance agent for how many years now?

Twenty two.

Wow.

Twenty two.

You know a lot about Medicare and how we've had changes every year.

>> Yes.

That happens.

Yes.

It's Greg McDonald.

If you watch us regularly here on LIFE Ahead, you see him a couple of times every year at this point as people are beginning to make some choices.

>> I mentioned the time frame so we have until December 7th to make any changes started October 15th.

>> OK, it goes to December 7th and that's for Medicare Advantage plans and Medicare drug plans now actually have another enrollment period that begins at the first of the year January 1st through March 31st just for people on Medicare Advantage plans and during that time they can make one change.

They can make change from one advantage plan to another or they can leave the advantage plan altogether and go back to Medicare and a drug plan.

>> Can they even change companies?

Insurance companies?

Yes.

During OK then you could count that one change.

>> Yes.

Or they could stay with the same insurance company a different do a different plan right.

Yeah I did that one year.

>> Yeah I did several years ago just my needs in life changed and you know I had been paying for things I didn't need money you didn't even use and you know found another plan in the same company that supplied whatever I need.

>> Well and things happen even for those of Medicare supplements.

I had a client come in today who had a Medicare supplement and he's had it for quite a while and we were talking about drug plans and he had mentioned something about his cost of a supplement and he was paying over six thousand dollars a year for his supplement.

Wow.

And so I said do you realize that we could do an advantage plan where the maximum out of pocket even if you had a terrible year is much, much lower than that?

Yeah.

And so that's what he ended up doing because he could save money on his drugs.

He could save money on expenses now with an advantage plan he has to do it as I told him, he has to adjust to the idea he's going to have to pay for services now rather than paying a premium.

>> Oh it's quarterly not monthly his it was quarterly or monthly but I said you're going to it's going to be at least two thousand dollars a year less even half a terrible year .

>> And so he thought that was a pretty good idea.

So yeah we made a change good good for you guys.

>> Now that may not be the case for everybody know I know everybody's unique situation and so you have to look at what your scenario is and how these different plans play out.

>> So you know one of the things Greg is understanding the difference between an advantage plan and a supplement.

>> Can you go over that again real quickly?

It's the idea that if you have a Medicare supplement the claim goes to Medicare itself and then the Medicare will tell the supplement company in that supplement company would pay what you normally would have to OK advantage plan the claims, go to the insurance company.

They're going to pay but you're going to pay a copay for most services too.

>> Yeah.

So you're not paying much of anything for the plan itself and it's combined so you have medical and dental and excuse me medical drugs all in one package not dental and vision.

>> Well unless you buy a separate you know, dental vision and hearing are all combined and most advantage plans so those are additional services that are yes.

>> But you have to have a specific plan that has those are advantage plans most all of them have them have that include oh all right it may be more minimal though it may be like maybe to dental preventative visits a year.

>> Well they have that but they've gotten much better there including major services now so you can have it crowns, crowns, even some have a few of them have implants.

Wow.

But they cap out on how much you're going the plan will pay per year.

Yeah.

For it so it's not if you're going to have a dental implant it's not going to pay for it all OK but it can help.

>> Is it still the case that if I recall correctly with Medicare and vision you can get one visit a year with an optometrist or oh no my trust is just a special so you can go as many times as you want and it covers medical such as if you have cataracts or macular degeneration or glaucoma it's all going to cover that under the medical portion of it.

But one the advantage plan will do.

>> In addition it will give you a routine eye exam which Medicare does not.

That's what I guess I'm thinking about and they will help pay for glasses.

>> Don't they allow Medicare to allow two hundred dollars a year for glasses and decanted?

>> It's the plan itself.

The advantage plans itself now Medicare, Medicare itself doesn't they'll give the glasses after cataract surgery.

>> Right?

I knew that and that was new last year I think wasn't it now it's been there for a while has it.

>> Yeah because a lot of people don't know that.

In fact I spoke with two different people this year that we're having cataract surgery and they didn't know that they were entitled to get yeah they're not going to and not going to tell they're not going to tell you you're supposed to know that that's why we're glad you're watching because you're going to hear some things that maybe some people don't know.

Greg, we do have a phone call already.

I knew we would and thank you, Jason for watching us here tonight.

Here's his question.

He said Can you be on Medicare if you are on Social Security disability also can I stay on my wife's insurance if I if I receive Medicare?

Two questions.

Yes, yes, yes and yeah.

>> Yeah.

Pretty simple, Jason.

So yes.

Now normally and that normally always you have to be on Social Security disability for two years before you qualify for Medicare.

>> But once that's OK you automatically get your card then you can enroll now you can be on Medicare and still be in your wife's group plan so you could do whatever you want on that.

OK, yeah.

>> OK Jason I'm so glad that Greg was able to help you out and thank you again for watching your LIFE Ahead.

I have a question, Greg, that came up last week after the show from someone you know we're talking about Medicare and Social Security and all of that if if a person is 64 years old and they know that within a year or whatever they're going to turn 65 should they be doing anything now to prepare or make any current with Social Security?

>> Well, it depends.

It's always good to investigate what your options are.

Yeah.

Going in.

But if you're sixty four and what I told the gentleman was he was on a he was working he had no intention of retiring he was going to stay on his group plan.

He liked it.

I told him he doesn't need to do anything.

He can continue to work as long as he wants to work.

Yeah and then when he decides he's going to retire, contact Social Security and sign up for Medicare at that point and then he could go on now if you're not on a group health plan and you're planning on on going on Medicare, start doing some investigation.

You if you're collecting Social Security, the Medicare card will be automatically mailed to you.

>> If you're not, you're going to have to contact Social Security about three months out to be able to three months prior to sixty five to your sixty fifth birthday month birthday month to tell them that you want to enroll and they will get you set up now I think as I recall you also told that gentleman that they don't take appointments anymore in person at the Social Security building covid has been good for keeping people out of buildings I guess and they just didn't change it.

>> They they they've been still I think you can get in depending on a certain locations but they like to do things on online on the phone over the phone.

>> Oh all right.

>> You can sign up for Medicare online as well at Social Security website OK ss a dot gov I think OK or if you don't remember that just Google Social Security and right and I'm sure I'll go to Medicare dot gov and they can show you where to go.

>> Sure.

And there are amazing things on Medicare dot gov a lot of things out there ok I'm going to talk about the relationship between you health and Parkview.

I understand there's a change right.

>> That's one of two changes in to a couple of Medicare Advantage plan companies.

>> Parkview has ended their contractual agreement with our new health plans and so at the end of Noveber they're no longer going to take IU health although they said that they would go ahead and continue actually providing services for members until the end of the year but next year they're not and so are you.

Health primarily your HMO plans?

Oh OK. Well if you have an HMO plan and you go to Parkview you're going to have to change plans because that's going to be out of network and you're not going to get any help from your insurance are you does have a plan called Flex which flex OK which does have our network benefits and it's a slight step up.

It isn't a big deal except when you come to diagnostic tests chemotherapy and that the in that case the price doubles.

So be aware I'm not saying if you have flex plan to abandon it, just be aware that the co-pays are going to be a little different.

You're going to have to work things a little differently.

>> You're going to stay on the plan.

Are people receiving this information themselves from you?

Yes, I've received the letter they should have received a letter to that alerted them to that.

>> OK, so is this something that they should be taking action on then by by this deadline of December 7th or not?

>> They should they should if that's going to be a thing that you if you go to Parkview and you're on are you healthy?

>> You should be talking to your agent or are we looking at other plans just to get options to see which is going to be a better fit for you?

>> Desilu Health Honor Lutheran.

Yes.

The New are you how are you does are you very well yeah.

>> Yeah but it does Lutheran as well so that's it now OK so you have two other options.

>> It's not like you can't do anything OK hey we have Ruth on the line tonight Ruth thank you for watching us here tonight and Ruth says Can you tell me more about the extra help program?

>> There you go.

So extra help is a state program for those that have lower income, OK?

And they're not they don't qualify for Medicaid but they could get some additional help for prescription drugs with that.

And so to see if you qualify you really do need to contact the Medicaid offices in Fort Fort Wayne or around the area just to let them know see what you let them do an assessment on you to see if you qualify for it or you can.

There's some forms that go out in the mail to that you can return and they can see if you qualify for that.

>> OK, one thing I'm curious about and by the way thank you so much, Ruth.

The book that we've been showing here, Medicare and you which many of you have probably already received if you're 65 or over and you're getting Medicare if you haven't and you are in that age category, you probably want to go online or call Medicare and say hey, I didn't get my book yet.

The book is very important because it lists any changes for twenty twenty four and it's not as difficult as it looks.

>> It looks like a big thick book but you don't have to read all if you only have to maybe look up things that apply to you.

Now here's a question someone has Greg does this book Medicare and you talk about advantage plans and supplements or where do you get information?

>> They have they have information on Medicare Advantage plans and supplements and in fact in the book they'll give you a line item on all the different Medicare Advantage plans and it's kind of like just a real quick summary so you could just do a quick look through could you can read the book.

>> I know exactly what Greg's talking about and and I did want to point this out well in the back of a book I even have it.

>> What do you call that your earmark dog dog whatever you want.

Yeah, whatever or dog eat dog eat dog you OK?

There are a number of pages and I just kind of give you a general view here and there are line items for every possible plan just Indiana or any plan they make it specific for the area that that book is destroyed.

>> OK, all right.

And they will tell you on each line all of these things about that plan.

They'll tell you what the monthly premium is the out of pocket limits the primary care visit if there's a copay specialist visit copay chemo drugs, other B drugs, home health care DMAE what is that durable medical equipment?

>> Oh, durable metal medical.

I will tell you do not pick a plan based on that.

>> Do not pick a plan based on that.

OK, so we can because because there's many more factors involved in picking plan than just that I see because what you have to determine are how are your prescription drugs covered by each one because they are all different.

of these plans so that'snetwork- important.

different so don't just go eeny meeny miny mo when that's the one that's I wouldn't do that.

>> You know, I think maybe what's important is let finish these categories here annual part D deductible Part D drugs and what offers extra benefits and then underneath that particular plan it answers all of those categories or questions so you can start doing some comparison yourself.

But as Greg mentioned, make sure you understand what's important to you some people really panic if they see a change here and find out that their doctor is no longer in their network, some people don't care.

>> That's fine.

I'll go to a different doctor but maybe other people have been to the same doctor for 40 years and they maybe are willing to pay a little more or whatever for their plan so they can stay with that same physician.

I remember once when I changed I had to get a new dentist that was traumatic.

>> You know.

But you know again things can change.

Hey George, you're on the line with us tonight here.

George wants to know are there any extra fees or penalties if I enroll late?

Yeah, we had that question last week I think and it's an important question depends George.

>> It depends if you are in a group health plan there's no fees as long as you enroll within 60 days after you leave your group plan.

>> Now if you do not have any other insurance and you go to enroll in Medicare Part B, yes, there's a 10 percent per year penalty that's added on to your part B premium.

Part A is as long as you have forty working hours there's no late enrollment period for that but if you don't there is a late enrollment period for part as well.

>> So it just depends so many of these things we're talking about it just it just it just depends on which drugs you're taking, you know.

>> Do you want to stay with this doctor?

Do you want to to change hospitals?

>> And that's what makes it difficult for the average person to navigate this insurance really the the value of an agent comes in because we deal with this.

>> What would you take what kind of information would you take to a meeting with an insurance?

What I always ask is first off I'd like to listen to prescription drugs, OK?

>> They're taking I'd like a list of their doctors.

OK, so you can go to those and you can find out what's covered and so on.

>> So we're able to see that and yeah, if they like to share with me any lifestyle things do they split time between here in Florida or Arizona?

>> I mean OK, let's take that into account.

Right because they want to make sure they can be medically covered in Florida as well.

>> Things like that, huh?

That's OK. OK.

Anything else on that?

>> Well it's just we because we have the well for for example I have computer programs to be able to plug all these things in and be able to spit out information that we can analyze pretty quickly.

Sure.

And so it just makes things easier for the for the consumer.

>> Right.

If you go equipped with the information it does I'm looking here at the book and just the very first it is on the inside cover by the way it'll say what's new and important, what's new for twenty twenty four so it'll give a quick overview and then there's a table of contents where you can look at any of these categories whether you want to talk about of the parts of Medicare finding the right coverage for you as Greg's been talking about how do you sign up the difference between Medicare Advantage plans?

So there's a lot of information again you can find what page or what category you need to find information.

I'll let you put that back over there.

OK, well I talk to you for just a minute.

Greg's been with this here for two sessions now talking about Medicare and again we want to remind you if you want to make any changes you have until December 7th to make some of those changes.

>> So what happens the first of the year?

Will you have an open enrollment period for advance plans?

But there's one thing that plan that is actually exiting the market.

Oh, OK.

I want to mention that because it's LASO Health LASO lassos it's a medical savings account plan and we did not have a lot of those people have these plans.

>> They were interesting because it was a high deductible plan that had a savings account the government funded do we call those MDAs?

>> Is that right now MSA OK so now do some that with companies where you work provide them.

>> No, no, no this was not don't confuse this with the health savings account OK medical savings account but anyway this plan is going to exit the market at the end of this year so all of our area all across the country oh OK.

So two things to for those people have this plan to to No one the money in your savings account will not go away.

>> Good will continue to be there and you can continue to use that account until you exhaust it for health expenses .

The other thing is you have to choose either another type of Medicare Advantage plan or if you want to go to a Medicare supplement, this is a great opportunity to do that because you can secure one without having to answer health questions.

>> OK, so if you want to make that change you can and this is the time to do that.

>> OK, all right.

So but you said that the money doesn't go away.

You can still use it even after the end of the year it technically goes away with applo away.

>> Right.

So you wouldn't be like re enrolling for that next year.

>> No, you can't I won't be there.

It will not be there.

OK, got it.

OK Francis has called this as well this evening.

Francis, thank you so much for watching.

Francis says Am I able to terminate my plan at any time if I'm not happy with it or am I stuck with yeah we've had other people ask that question.

>> That's a good one.

Well, the question OK, Medicare Advantage and prescription drug plans are technically one year contracts.

OK, so with a drug plan you got once you sign up for it it's yours for the year you're not going to make a change their advantage plans you have that three month enrollment period at the beginning of the year.

>> You can make a change at that time.

After that you're stuck with it.

Medicare supplements have no enrollment periods.

>> You can always change those at any time.

OK, all right.

That's important to know.

OK, how about the number of part B plans give back plans.

>> Is there something significant we should know when there's a handful of what they call Part B get back they help pay part of it Part B premium that you have.

>> So that's one thing for twenty twenty for the part B premium is going to be one hundred and seventy four dollars and seventy cents now that's about a ten dollar per month increase over this year and the part B deduct is going to increase from two hundred twenty six dollars to two hundred and forty so there's some changes there now the give back programs that are there on some advantage plans will pay part of that premium and it just comes right out your Social Security.

>> So if it's hundred dollar give back instead of paying one hundred seventy four you pay seventy four dollars.

>> OK got it.

OK and also part D deductible increases speak to that part B D D D r D is D as in drugs is in drugs yeah five forty five is the deductible this year ok some plans have lower deductibles, some plans have no deductibles ok but that five forty five is the maximum ok and if that's important to you again that's something that you should ask your agent about.

Consider when you're choosing a plan or if you want to change anything.

Greg we have about a minute and a half left here and we've talked about a lot of important things last week in this week.

But I want to give you the opportunity to go over what you think is the most important thing that our viewers should know about Medicare.

Well, just keep in mind you have an opportunity right now to review your plans and I understand insurance is not the most exciting thing that you want to do right here.

>> It's right up there with us.

>> Yeah, it's like chewing razor blades but really if you have prescription drugs, take a few minutes and have it evaluated.

>> That's the most important thing I can tell you because it seriously can save you hundreds of dollars now it might not your plan might be great but take the time to check it out because it really can save you some money.

>> Yeah, we talked a little bit about prescription drugs last week and again one of the things that you mentioned I think it was when we were finished when we were off the air is the same drug can be very different from one drug control the pharmacy to another one has that same plan.

I mean different plans, tier priced drugs, different different plans have different pharmacy networks and just like advantage plans have in network and out of network pharmacies have preferred pharmacy and standard pharmacies in their advantage plan and drug plan network.

So yeah, check it out.& Some can be out of network if you happen to have I'll take Silver Scrip for example.

It's owned by Aetna.

If you go take your Greens with that plan you're not going to get any help at all.

So be aware of those things and you know it's easy to overlook if you don't pay attention to your policy.

So make sure you look and see if they're connected with any particular pharmacy.

Once again, Medicare and you twenty twenty four.

We appreciate all the information.

Oh things new things that Greg MacDonald has shared with us.

Meanwhile, we're going to see you all back here next Wednesday night at seven thirty right here we have different topics and different guess but Wednesday at seven thirty.

>> Meanwhile, stay safe and stay healthy.

Good night Sage Insurance Advisors LLC, specializes in Medicare plans and represents insurance companies offering Medicare supplements, Medicare Advantage Plans, and Part D prescription drug plans.

Serving Northeast Indiana from 4233 East State Boulevard in Fort Wayne and online at SageInsuranceAdvisors.com.