Support for Delta College.

Public Media comes from Midland County Senior Services, helping Midland County residents aged 60 plus remain independent in their homes and stay socially engaged.

Senior Services provides a variety of services, supports and programs, including meals, fitness classes, educational programs and more seasons.

Adult day services and volunteer opportunities are also available.

More information is at SeniorServicesMidland.org.

Embrace your age with senior services.

Hi, I'm Barb Zebley-Oldni from Senior Services in Midland.

What I am about to share with you today is on our health benefits assistance program.

the program that we offer in Midland County, but it's really, relevant to our older adults who our Medicare beneficiaries O ur staff and volunteers are not affiliated with any insurance company, nor do they sell insurance.

Their sole purpose is to provide unbiased, information to the Medicare beneficiary so that they may make an informed decision on their Medicare options.

Medicare actually has different parts to it.

Medicare Part A is for hospitalization.

Medicare Part B is for doctor visits and outpatient, medical appointments.

And then Medicare Part C is the advantage plans.

Medicare Part D is for prescriptions.

To put things into perspective When we are employed and we have health insurance options.

We are generally offered 2 or maybe 3 or 4 plans to choose from Medicare beneficies if they are choosing a prescription drug plan, There are 20 different plans that they can choose from for Midland County, and there are 40 Medicare Advantage plans for them to pick from.

So it's pretty complex, and they need to look at this information every year.

signing up for Medicare takes a few steps.

usually about three months prior to their birthday month, when a person is about to turn 65, they will receive their Medicare information from Social Security.

They need to read that information carefully and take the appropriate steps.

usually if a person is not working, they will enroll in Medicare Part A & Part B and part B through Social Security.

Usually, Medicare Part A is premium free.

Part B has a premium.

And then usually if they're not working and they're retired, it goes into effect the first day of the month.

They turn 65.

If their birthday is by chance May 1st... Their Medicare actually starts April 1st.

So one month prior.

So those first initial steps are through Social Security.

Once they do that initial enrollment with their Medicare Part A and B, then they can come to us at senior services and we can help them to choose their Medicare options.

if an individual is working at 65 or working beyond the age of 65, there is a, the possibility that they can delay their enrollment for Medicare Part B and D, usually it's because they are working or their spouse is working and they have health insurance through that employer.

So they don't need to enroll necessarily in Medicare Part B or D, but they should talk with their HR manager to make sure that their health insurance through their employer is what's called creditable coverage.

And that is as good or better than what Medicare offers.

So they can delay until they are retired.

Once they decide on their retirement date, then they would reach out to Social Security to enroll in part B, they would be set with that, get a new Medicare card, and then they can come to us to then decide on their health benefit options through Medicare, including prescription insurance.

So, once an individual has Medicare, there are a few things that they need to keep in mind.

If they have original Medicare and they have a supplement insurance or a medigap plan plus prescription.

Part D, they should review anything they receive in the mail from Medicare, their secondary insurance, or their part D throughout the year.

And then they need to look for their summary notice in the fall that they would receive from their prescription plan, their part D plan that will give them information on what their plan will look like for the next year.

So this fall, fall of 2024, they will get information on their plan and what that plan will look like for 2025.

They can use that information, meet with a volunteer for compare to, compare their current plan with two other plans that will be available in 2025.

They can then decide if they want to stay with what they have, or switch to something else where they may, save money or have better coverage, or have better customer service with a different type of plan.

Individuals with Medicare Advantage plans, they need to carefully review their plan information.

They offer extra benefits, such as, helping with the cost of over-the-counter medications or dental services.

So make sure that you review your plan so that you can take advantage of the different extra benefits that that plan is offering.

So Medicare has open enrollment each fall from October 15th through December 7th.

We assist about 250 individuals each fall.

We send them a worksheet that they fill out, giving us their medications, their current, plan information, their Medicare number.

We use the Medicare website Medicare.gov to enter their information into their website, to then compare their current plan with two other plans so they can see exactly what it is going to cost them to go to the doctors, what it's going to cost them for each of their different medications.

Plans change every year.

So while a plan this year may cover a medication very well, next year it may not be on their formulary.

So it's really important to to compare each fall to see how your current medications will be covered and what it's going to cost for you to go to see the doctors and things like that.

Yes, there are deadlines when you enroll, initial enrollment is around your 65th birthday or when you retire.

And then at certain times of the year, you can choose how you get your Medicare coverage.

If a person misses certain deadlines, there could be penalties.

individuals do not need to sign up for Medicare every year.

But again, keeping in mind that each fall open enrollment is a very important time to take a look at the different plans.

if a Medicare beneficiary has limited income and assets, they may be eligible for what's called extra help.

And that is extra help with prescription drug cost.

This is a program that individuals can apply for through the Social Security Administration.

It's fairly simple application online, although there is a paper application, the online application is very simple.

It would help with, Medicare prescription premiums, co-pays, cost... can really reduce what a person has to pay.

for a single individual.

The income guideline is $22,830 per year, and then they need to have at or below assets of 17,220.

For a married couple, their their income limit is $30,900 per year or having assets at or below $34,360.

This application is through the Social Security Administration.

There is no penalty for applying, so if your income or assets are close to the amounts, apply and let Social Security determine your eligibility.

If the person is eligible, they could have a zero premium and can pay as low as $4.10 for a generic medication, or $11.30 for a brand name medication.

Another assistance program is through the state of Michigan called Medicare Savings Program.

The application for Medicare Savings Program is through your local Department of Health and Human Services.

If an individual has limited income and assets, the state will help pay for Medicare costs.

For example, the state may pay Medicare Part A and or B premiums, and the Medicare beneficiary cannot be billed for deductibles, co-insurance, or co-payments.

There are several levels to this program, so depending on the level of the program that the person is eligible for will determine what the state will pay for or cover for them.

There are income and asset guidelines for this program.

For a single individual, the income guideline per year is $20,571.

And then a person's assets need to be at or below $9,430 for a married couple.

The income limit is $27,834, and their assets need to be at or below $14,130.

There are some assets that do not apply are not counted.

So if you feel like you're close to the income amount or the assets amounts, please apply and let Department of Health and Human Services determine your eligibility.

The final assistance program that I'd like to review is Medicaid.

Medicaid is state and federal program more of an assistance program, that helps folks with their medical cost.

Nursing home cost, in-home care cost, things like that.

that is another one that is lower income, lower assets.

That can be a huge, savings for the Medicare beneficiary.

An individual who has Medicare can have both Medicare and Medicaid.

There are a lot of bad actors out there acting as if they're from senior services, from Medicare, from Social Security Administration.

They're end-game is trying to persuade you into giving you giving them your personal information.

So, please, when you get those phone calls, don't engage.

Do not give your personal information.

Medicare cannot, can't talk to you unless you have requested that company to call you.

So you're not going to get random phone calls from Medicare or Social Security.

So watch out for scammers.

Final thoughts... please read your Medicare and you handbook.

Review your plan information.

A couple of really good, national websites to, get accurate and important information would be Medicare.gov and the Social Security Administration, website.

and your local Council on Aging.