made possible in part by the KET Endowment for Kentucky productions.

>> Good evening.

Welcome to Medicare Enrollment 2025.

Call in a KET forum.

I'm Renee Shaw, and we thank you so much for joining us this evening.

For Americans aged 65 and older, enrolling in Medicare can be a complex undertaking.

Now is the open enrollment period that started October the 15th and goes until December 7th.

It's time for those eligible to review all their options and decide whether they want to keep the health care coverage they have or make a change.

And tonight we'll help you understand how it works.

The coverage options and the enrollment process.

Our guest tonight in our Lexington studio are Eryca Bowman, public benefits paralegal with Legal aid of the bluegrass.

Lindsey Medley, a social worker with the Lexington Senior Center.

Olivia Wilson, public benefits counselor with Legal aid of the Bluegrass Justin Aulds, health insurance specialist with True Cordia Insurance Services, formerly Kentucky Health Solutions.

And Angela Zieg, health and Government Benefits unit manager with Legal Aid of the bluegrass.

We'll also check in with Laura Rogers standing by in our studios with AARP Kentucky Communications Director Scott Wiggins, who will fill some important questions that you may have tonight.

And we have a phone bank of volunteers with AARP Kentucky ready to take your questions and pass as many as long possible for us to get to tonight to our expert panel to answer during this hour.

And there are a few ways for you to submit your questions.

You can give us a call at one 800 944 4664.

Send an email to Public Affairs at ket.org or even post a question on X at Public Affairs KET.

This program is part of Ket's ongoing Aging Initiative, the next chapter that explores the rewards and challenges of growing older.

Before we get started with your questions tonight, let's get down some basics first.

I spoke last week with Doctor Tricia Newman, senior vice president and executive director for program on Medicare Policy at the KFF, formerly known as the Kaiser Family Foundation.

Doctor Tricia Newman, thank you so much for a few minutes of your time today.

>> My pleasure.

Thank you for having me.

>> Medicare is so complicated.

First of all, if you can give us just a basic primer on what is Medicare?

Who is eligible and why is it so hard to enroll?

>> Okay, well, I'm sorry to say that Medicare is is fairly complicated.

It didn't used to be the case.

Medicare is the program for people who have paid into the program through all their working lives.

It's generally for people 65 and older, but there are certain people who are younger with disabilities or have end stage renal disease who also qualify.

Medicare is a very popular program because it's there for people once they qualify without regard to their medical history.

So it's it's an important source of health insurance for people.

And it's it has gotten more complicated over the years because there are more plans and more choices.

But it is a real bedrock of health coverage for people.

And many people in their early 60s count the days until they can get on Medicare.

>> Right.

And as you well know, many people in their 60s are still working and plan on working for several years.

So if you are age 65, the age of eligibility and you're still working and you have private insurance options, must you enroll in Medicare?

>> No.

You must.

There's you can delay enrollment in Medicare.

You sign up for part A, but part A is premium free.

So you go to Social Security, you say, yes, I'm signing up for part A, but I do not want part B, I do not want to pay the part B premium because I have employer sponsored coverage, either on my own or from a spouse.

>> Right.

And when you say part A and part B are real quick definition of both of those please.

That's okay.

Yeah.

>> Yeah.

So Medicare has parts and part A is the part that pays for in hospital care inpatient services.

Part B is the part of the program that pays for physician services, outpatient hospital services, diagnostic tests, things like that.

And so there are just different ways of signing up for the program.

There also is a part D of the program just to make things a little bit more complicated, which is the prescription drug portion of the program.

And when people come onto Medicare and they need prescription drug coverage, they also they sign up for part A, part B, and also part D.

>> And all of those parts are optional.

>> Not really in the sense that, for example, with part B, it is a voluntary program, but there is a penalty for delayed enrollment.

And the reason that the law was created that way is an insurance program can't really work if people wait until they get sick to sign up.

So when.

So the idea is that when you're first eligible and you no longer have employer sponsored coverage, that's the time to sign up rather than to go periods of being uninsured.

For services that are covered under part B like physician services, and then sign up later.

So it's it's kind of voluntary, but it's not voluntary.

And the same is true for the drug benefit.

It's the same principle.

So for people who no longer have employer sponsored drug coverage, the idea is people with Medicare need prescription drug coverage.

And the and there's it is voluntary, but there is a penalty for people who say, I'm going to skip a few years because I don't take expensive drugs and sign up when I really need it.

>> So let's talk about some changes that are happening with Medicare.

What should beneficiaries know about increases or decreases in their monthly insurance premiums?

>> Okay, this is the time.

We are now in the middle of the open enrollment period.

It started October 15th and it runs through December 7th.

This is the time for people to review all their options and decide whether they want to keep the coverage they have or make a change.

And I'm just going to say up front, it's not an easy decision, but it is an important decision.

And there are some some changes that you really can't affect.

For example, everybody on Medicare is responsible for the Medicare Part B premium, and for most people, that's deducted from their Social Security check, that will go up between 2025 and 2026.

And it kind of is what it is.

There's not much anyone can do about that.

But for people on Medicare who choose Medicare Advantage plans, and I can talk about what they are or Medicare drug plan, those plans change from year to year.

Premiums may go up, some premiums may go down.

But there are a number of things that change.

And so this is really the important time to look at what's changing, what's not, what really matters in making this decision.

So people aren't blindsided when they, you know, start the new year and they find out something in their plan has changed.

>> So let's go back to where you were, Tricia, what is a Medicare advantage plan and what should beneficiaries think about in choosing between traditional Medicare versus Medicare Advantage?

>> That is a great question.

And a lot of people struggle with this decision.

So when people think of Medicare, they may think of the national Medicare program that you go to the doctor, Medicare pays its share, you pay your share.

Same with the hospital and other services.

That's that has been what Medicare has looked like for many years.

But over time, there has been a growing segment of the Medicare program called Medicare Advantage, which are really HMOs and PPOs that receive a payment from the federal government from Medicare to provide Medicare services.

So if you're at home and it's during the open enrollment period, you're probably going to see a lot of ads for Medicare Advantage.

And this is an alternative to the traditional fee for service program.

>> Are there fewer options for 2026 because of changes, or does that stay the same there?

>> Has there been a number of news reports about insurers dropping out of the Medicare Advantage program?

We are seeing that by and large, insurers are still very much in the Medicare Advantage program.

Some are pulling out of some markets, but some are expanding into other markets.

Most people around the country will have a choice of dozens of plans available to them.

And while there may be some markets where there are few, if any, Medicare Advantage plans, the good news for people who are living in those areas is they're not going to risk being uninsured.

They always have regular Medicare there as a backstop.

And so that's a really important sort of safety net for people who may be concerned that the plans are pulling out.

But what we are, we are not seeing a mass exodus of Medicare Advantage insurers this year.

>> So our thanks to Doctor Patricia Newman with formerly the Kaiser Family Foundation, now known as KFF.

And so you're going to hear a lot of the same questions more than once tonight, because we know this is a complex issue to understand.

And we want to make sure that you have as much information as possible when you're making your choices on how to enroll and what to actually get under Medicare.

So I want to ask the question again, Angela.

Zeke, do I have to sign up for Medicare when I turn age 65?

Reiterate that for us.

>> You do not have to sign up for Medicare at age 65, as long as you have access to employer coverage.

If you are retiring, yes, you need to consider enrolling into Medicare, and depending on your employer coverage, you might want to delay even enrolling into Medicare Part A if your employer offers a health savings account, there are other stipulations you need to follow and you need to know so you're not penalized with a tax penalty later on.

>> Okay, so I do want to get to that because that was a question we got a lot last year was about health savings accounts and how to not trip over some of those Medicare rules, because they can be some substantial consequences.

Perhaps if you don't quite understand how that works, give us more information about that.

>> So when a person enrolls into Medicare Part A, if they have an HSA, they will need to stop contributing to the HSA.

If they delay their enrollment into Medicare beyond age 65, they need to delay or stop contributions to the HSA at least six months before, because Medicare will go back retroactively and enroll someone six months prior to the date that they have completed their application.

If they were eligible within that six month period.

So they need to work with their benefit administrator at their employer and find out what those rules are.

So they so they're not making falling in a pitfall.

>> Yeah.

And so, Olivia, just to ask you about even if you're 65 and this is the open enrollment period, you can enroll in Medicare at any time when you turn age 65.

It doesn't have to be from October the 15th until December 7th.

Is that correct?

>> That's perfectly correct.

So when you delay enrollment into Medicare because you have access to that employer coverage, you actually get an eight month, excuse me, special enrollment period to enroll in that coverage.

When you do lose your employer based coverage.

>> Yeah.

And so, Erica, when you talk to folks and they're really confused about where to start, what would what advice would you give them right now to like help them to get going on the process?

>> Simple advice I would definitely recommend looking at some great resources.

Medicare.gov is a great resource if you're just getting started and you need some general information about Medicare or what the plans look like this year, I would also give Medicare a call at one 800 Medicare.

They always have agents.

I think they're available 24 over seven.

And of course, your local Medicare ship has counselors that are available to answer any sort of questions.

>> And when you said Medicare ship, what does that mean?

>> Of course I have to plug.

Yeah.

State health insurance assistance program.

Of course we drop the A. So the acronym makes a little more sense.

Right.

But yeah, we are able to answer pretty much any questions about Medicare off offer Medicare counseling.

We also are able to speak to beneficiaries about things like supplements and things like that, all things Medicare.

>> And we'll have all those resources on our website at ket.org the next chapter.

So you don't have to jot that down right now.

You can go to our website and we'll have that available for you tomorrow.

We do want to include this side of the panel too.

We're getting some questions in and it takes a little bit.

But as you think about what is changing or the same for this year and we say we're calling it Medicare enrollment 2025, but it is for the 2026 year.

What are some things that people really need to keep in mind as they start the process?

>> Well, there's quite a few things that kind of depends what type of program you have.

Are you under the Medicare Advantage?

Are you under a Medicare supplement with a standalone drug plan?

The Medicare Advantage plans and the drug plans will always send out an annual notice of change document, and you need to make sure you're aware of that document.

If you don't receive it, you can call and request it from your company for your plan.

That's going to give you all the changes that are going into this next year.

And so you may see something in there that could be alarming, that is important to you, whether it be a medication max out of pocket on a plan, an extra benefit that you used to have that may not be there next year.

So make sure if you have an advantage plan, take a look at that annual notice of changes and then you can call your local agent.

Talk to your senior center.

They may have resources.

And of course Schip and Medicare.gov are great resources as well.

If you have a supplement, just keep in mind that those rates usually go up once a year.

Most companies it's the anniversary of when you started the policy.

Some reset at standard intervals depending on what they have and for the drug plans, it's the formularies.

The formularies can change on those medications.

And that formulary is basically a list of covered drugs.

And there are different tiers, usually one through five.

And there are different costs associated with each tier.

>> Okay.

And the tiers mean what what are they.

>> So basically they can have higher costs.

So usually it's tier one preferred generic standard generics preferred brand names in tier three.

That's where a lot of deductibles will kick in on drug plans.

Tier four is Non-preferred and tier five is specialty medications.

And so depending on where your provider puts those tiers within the drug plans, it can depend what that cost or what plan may be best for you.

So if your premium changes on your plan, there could be a reason for that.

It could be your formulary change.

So make sure you take a look at your list of medications.

>> Yeah Lindsay, if you have private insurance, not employer sponsored but perhaps Medicaid does that impact impact the enrollment in Medicare?

>> No, it shouldn't impact the enrollment whatsoever.

>> Yeah.

Yeah.

Well, right now we want to go over to Laura Rogers, who is standing by right next to us in the studio with AARP Kentucky Scott.

>> Yes, thank you, Renee and Scott, I've seen you nodding your head a lot upon hearing the information that we're getting from the panel and from Renee's conversation with Tricia Neuman.

But again, want to reiterate some things because we know it helps to hear it more than once to better comprehend some of this information.

Can you summarize for us some of the big changes that we're seeing going into 2026?

>> Laura, in a in a nutshell, what we're going to see in 2026 are lower drug prices on ten prescription drugs.

For the first time in history, the government was able to negotiate lower drug costs, and that's going to impact your overall donut hole and your your your overall Medicare costs.

Some of those prices are going to decrease.

They're going they're treating drugs like diabetes, cancer, arthritis, some of the most common.

And it's an important feature, I think, for Medicare to be able to negotiate these lower drug prices.

>> Absolutely.

And I would say that's welcome news for people to hear lower.

>> Prices, your cap in the donut hole.

And they're going to talk about that later.

Yes.

But that's going in 2026 will be limit will be capped out at $2,100.

And there's also a payment plan that you can apply for so that you spread that cost over the years, over your year so you can manage your budget, you can manage your income.

>> Anything else?

Any other big changes that stand out to you that you think is important to address?

>> I think some of the the most and this is where fortunately, we have the state health insurance assistance program.

We have Area Agency on Aging that have local counselors that can help you.

There's a lot of resources out there for consumers that you can go and get this kind of help.

And we have panelists like we have here.

But I think in in brief.

You have to make sure that you're you're getting the plan that is tailored for your needs.

That's the priority as far as I can tell.

>> Well, Scott, thank you much more.

We'll be chatting about throughout the hour.

And Renee, we'll head back to you and your panel.

>> Thank you Laura, and thank you, Scott.

So the donut hole, you just heard that.

And maybe if you hadn't heard it before, you're like, what are they talking about?

So who wants to take the question on what is the donut hole?

>> Anybody.

Well, I can just go ahead.

Yeah.

So the donut hole doesn't necessarily exist like it used to.

So previously there was a limit at which you reached with your medications.

Medicare was doing some math on the back end with the retail cost of your medications.

Once you hit a certain limit, you go into this donut hole and pay a percentage of your cost instead of your co-pays that you would normally get.

And so now, rather than figure all that out to where you then hit another limit, go into the catastrophic is.

Now there's just a max out of pocket on medications.

And so that was also one of the changes that went into effect, along with negotiating those drug prices down, is putting a cap on those really expensive medications.

And that's just been a great Boone for a lot of folks, especially on those really high cost drugs.

>> Yeah, that's good to hear.

Okay, so we're getting a lot of your good questions in.

And we're going to keep the ways you can connect with us at the bottom of the screen tonight.

So you can either give us a phone call or you can send us an email, or you can even post your question or comment on X. And we've got folks, the phone bank is there who are volunteers with AARP Kentucky.

They are answering your calls, as you see right there and sending some to us, and we've got several coming in that we'll get to from Steve.

If you're already enrolled, what do you need to do if you have a preexisting condition and it has changed?

Do you need to switch coverage?

>> I'll take that.

>> Okay.

>> During open enrollment, that is your time to compare all insurance policies.

And we highly recommend everyone to compare their insurance.

Like Justin said, they can change the deductible, they can change the formulary, the list of medicines that they cover.

They can move medications into different tiers, making it more expensive.

Regardless of your condition or any new condition that might be diagnosed, you need to compare your prescription drug coverage and or your Medicare Advantage plan coverage during Medicare open enrollment.

>> Good.

Anybody else want to add to that or does that cover it?

Okay.

So and once again let's explain Medicare versus Medicare Advantage and the benefits of each.

And we heard Doctor Patricia Newman there earlier explain that a little bit.

But like we said we need to hear it a couple of times for it to really sink in.

So Medicare versus Medicare Advantage I'll take okay.

Olivia.

>> So Medicare Advantage plans are required to base their coverage off of what Medicare offers.

They do often come with other extra benefits that you would not get with original Medicare coverage, just your part A and part B, so it's and they're very situational.

So you really need to look at those plans to see if they're going to work for you because there's a network that they're going to require you to seek your care within.

And depending on the type of plan, you may not have any coverage outside of that network.

Something else to keep in mind.

A lot of people come into this thinking that they're going to have lower out-of-pocket costs, and that's that's not necessarily the case.

If they go with an advantage plan, it could be, but it's not necessarily the case.

So it's really you have to look very closely at those plans.

It's very situational.

But they are definitely very different from the original Medicare coverage.

They do cover the same things, but they can offer they can charge their own rates for that.

>> One's not better.

One's not worse.

Right.

>> No.

>> Yeah.

And so once again, we want to remind people the differences between part A and B and d d. We think of d meaning drugs prescription drugs.

So that's an easy way to remember that.

But the A and the B who wants to sort through that.

Lindsay.

>> So part A I remember it by saying A for ambulance because that takes you to the hospital.

And then B when everything else fails, plan B is go to the doctor because that covers your doctors.

>> Perfect.

That's great.

I mean now I'm going to remember that I don't know if I remember it this time next year when we do this show, but I'm going to remember for the next 40 something minutes.

Okay.

So some other great questions here.

Can someone return to traditional coverage if they had add ons before but no longer need them?

Erica.

>> Yeah, when you say add ons, do you mean like a supplement?

>> I guess so, I mean, I'm not sure because I'm just interpreting what they're what they're reading, but yeah.

>> Or is it the dental vision and hearing.

>> So let's let's take a couple of different scenarios.

So you define add ons as perhaps at first registers to you.

And then we'll talk about maybe where Lindsay has some ideas.

>> Right.

So if their main question is just about switching back and forth, then yes, they are able to do that.

So if you have original Medicare plus a supplement, just for example, and they want to switch over into a Medicare advantage plan, you are able to do that during Medicare open enrollment.

However, you do need to really, really consider that because once you drop your supplement, it could be very, very difficult to get that back.

Right.

But if you have a Medicare advantage plan and you're deciding to transition over into original Medicare again during open enrollment, you are allowed to do that.

But again, it may be a little difficult to get a supplement just because the best time to get a supplement typically is during your initial enrollment period, right when you're first new to Medicare.

So if you're outside of that, there could be some issues.

So it's definitely worth looking into.

>> Yeah.

Good thing to keep in mind.

Anything else there Lindsay.

>> Well, and Kentucky is also now considered a birthday rule state, meaning that if you do want to change your supplemental plan, you have to change it within 60 days after your birthday.

>> Okay, good.

Justin.

>> Another caveat to that is it does have to be with the same plan letter that you currently have.

And on the advantage.

>> Plan letter okay.

>> So there's different plans.

There's a lot more letters.

But the main ones that we usually look at for supplements right now are those that had Medicare prior or before January 1st of 2020, are able to get a plan F, or they may have a plan C that's even a little bit older.

The more common plans now are the plan G and the plan N, and the main coverage differences between like F and G. Those were kind of your two Cadillac plans that people like to call them is G does not cover the part B deductible, which this year was 257.

They'll eventually release that I think later next month for 2026.

Right.

Okay.

But with those plans you have to stay in the same letter.

So if you have an F and you're trying to use that birthday rule, you have to go to an F. And with the switch from the advantage plans, the one thing I would add there is there is a trial, right?

If you start with a supplement, you decide to switch to an advantage plan during one of the annual enrollment periods.

There's no health questions to do that, but if you want to go back to your supplement within the first 12 months of having that advantage plan, you can roll back to the exact same supplement you had, as long as it's still offered, and pick up a drug plan within 60 days.

>> All right.

Yep.

Everybody got that.

That's a lot.

That's why we're so glad that you all are here.

I mean, these are the experts.

Okay, another question before we go back over to to Laura and to Scott, what might happen to telehealth services?

Will it be renewed or are advantage plans not wanting to participate due to high usage?

Will Congress renew?

>> It's my understanding that that telehealth will be covered by Medicare.

>> Okay, great.

>> So it looks like most services for the most part have done that.

And from what I've seen so far within the open enrollment or annual enrollment period, is that a lot of these plans are still covering that.

Okay.

So so make sure check your plan because it can vary from plan to plan county to county.

So just make sure you check it.

>> Yeah.

And county to county.

So coverage can depend on where you live.

>> Yes very much so.

So there are certain plans that are offered that may be from the exact same company and have very, very similar benefits, but they have different codes associated with them by Medicare.

And the way that they look at that is all actuary costs.

So they're looking at the cost of living in the area, the claims in the area, a bunch of other factors that go way over our heads usually.

But they can it can vary from county to county and especially state to state.

>> Okay.

Anything else you want to add there?

>> Angela I would just add that this that's mainly Medicare Advantage plans.

When we talk about the prescription drug plans, we have the same plans throughout the state.

>> Okay.

All right.

Very good.

Okay.

One more question before we go over to Scott and Laura.

My wife is older than I am.

I am retired from the city of Cincinnati and have medical insurance with my employer.

Does my wife need to sign up now or wait until I turn 65?

>> It depends on the cost.

So if it is cheaper for her to stay on your plan, make sure that she stays on your plan.

>> All right.

Anything else?

Anybody else want to add anything on that?

>> You say the wife was?

>> The wife is older than he is.

So we assume the wife is already Medicare eligible 65.

Yeah.

>> So as long as he's still actively working and it's not a retiree plan because like here we do have state retiree plans and teachers retiree which offer plans for those that are on Medicare.

And spouses can join those plans.

But if she is Medicare eligible and he's on the retiree version of the plan, you would want to check with that retiree coverage whether or not she needs to pick up Medicare.

Okay.

But if she's still actively working, she's okay.

>> All right.

Sounds good.

Some good advice there.

Okay.

Let's go back over to Laura and Scott.

>> All right.

Thank you.

And, Scott, I wanted you to explain something again.

You referenced it earlier and Justin also explained it very well.

But the donut hole for prescription medication, just in case someone wants to hear that again.

What that means.

>> So what's going to happen in 2026?

You're going to see that Medicare donut hole gap close.

I spoke with a couple just last week who's his cardiac medicines were through the roof.

They couldn't afford them.

And she is looking forward to some of these.

Some of the new drug prices that have been negotiated for Medicare.

And her concern is how last year they hit that donut hole and they were just paying out of pocket and looking forward to some relief under the new 2026 rules.

>> Good.

Yeah.

>> So that's all.

>> Okay.

Well good.

Deal with that.

And then getting assistance paying for Medicare premiums as well.

If somebody is needing some relief when it comes to those costs, what resources are out there and how do people find them?

>> Again, that's where your area agency on aging folks can help you in.

The state Health Insurance Assistance Program can help you, and we have aarp.org resources that are available that help you navigate some of those extra the Medicare savings plan and the extra help.

And you might be newly eligible for Medicaid in certain circumstances.

>> And that might be something that our panel will also address, and we'll send it back to you.

>> All right.

Thank you, Laura, and thank you, Scott.

So a couple of more questions here.

We're getting a lot of good questions.

And we hope that you're keeping your eye on the bottom of the screen.

At times you will see that there are ways to connect there.

It is just like magic the phone number there for you to call.

Or you can even send us an email or even post your question or comment on X, formerly known as Twitter.

And we'll get around to as many of those as we can.

Can you have Medicare and VA benefits at the same time?

Absolutely, yes.

So no worries there.

Quick and easy.

We like those quick and easy answers.

Okay, a caller needed a tetanus shot from their doctor.

Medicare didn't pay for the shot.

How can they resubmit if the doctor submitted it improperly?

>> Medicare should cover that.

>> Okay.

>> It is a covered expense.

Most vaccinations are now covered 100% through Medicare.

So I would call the doctor's office and ask them to resubmit it.

They can also call Medicare and find out what code the doctor's office should use, and then relay that information to the doctor's office.

But they can also call the doctor's office and tell them that it was denied, and ask them to resubmit the claim.

Okay.

And as long as they do that within 12 months, it should be covered.

>> So they've got 12 months to do that.

Okay.

From the time of the service.

Yeah.

Okay.

Good.

>> I would like to add on to that.

>> Sure.

>> That's okay.

There is also the ability to submit a claim yourself.

It's not the easiest thing to do.

It's some paperwork.

But I just wanted to relay.

That's also a possibility.

I think there's even an option on the form to fill out the reason why you are submitting the claim directly.

So if you're having trouble getting your doctor's office to resubmit it, you can submit a claim yourself.

>> And you can submit that claim where on medicare.gov.

>> It will be on the form.

So I would I would go to CMS or go to Medicare.gov and pull the form from there.

And I believe it goes somewhere in CMS.

Okay.

It'll have the instructions on there.

>> Okay.

Very good.

And CMS center for Medicare and Medicaid Services okay.

Very good.

Are there exceptions to avoid penalties for signing up late for supplemental assistance?

>> I'll take that question too.

Okay.

All right.

>> It's like jeopardy.

>> But I first wanted to say there's not actually a penalty for signing up for a supplement late supplement.

I think Erica mentioned earlier a supplemental policy is not the same as drug coverage.

There's no penalty if you don't get one at all.

It's optional.

There is a better time to enroll in a supplement, and that's a period in which you have a guaranteed issue, right?

Meaning the companies can't deny you based on preexisting conditions or your age or base your rates off of that.

So just to clear that up, if we're talking about a penalty for Medicare Part B, as in, boy, Medicare Part B, that you can file for an appeal at Social Security, there again forms online.

And if you contact your local ship counselor, they'd be more than happy to help you with that paperwork.

And then for part D you can also appeal that.

But if if you are eligible for a program called Extra Help, that will actually eliminate your part D penalty.

So just keep that in mind.

>> Good, good.

All right.

Great responses.

This from Patricia from Lexington.

If Medicare is paying $12,000 a year for my advantage plan, why do they still take $180 a month from my Medicare?

Why do I have to pay for part B when the advantage plan covers both?

>> So I will just say that, you know, the federal regulations require beneficiaries to pay the part B premium, which is $185.

It's projected to go to 206 next year.

Again, that's projected.

We don't have the.

>> When did they determine that?

>> Well, it can it can be released at any moment.

We've had it released as early as October in recent years but as late as December.

So it's really hard to say with the government shutdown, I'm assuming it's going to be later in the year.

But but they do deduct the part B premium unless you qualify for a program that Scott had referenced the Medicare savings programs.

And in Kentucky we have three of those.

They are income based and but they provide an enormous amount of of assistance.

And we encourage everyone to apply or at least to inquire to see if you're eligible.

But it is required for people to pay the part B unless they meet the qualifications for Medicare savings program.

>> Okay, great.

Yes.

>> If I could just add on to that the reason why you have to pay for the part B premium, even though you have an advantage plan, is because an advantage plan, they also call it like a replacement plan.

You have to have both A and B to have an advantage plan.

Advantage plans kind of combine those A and B benefits right.

So because they have to provide what Medicare would cover at least what Medicare would cover or more.

So it's you still have to have Medicare Part B even if you get an advantage plan, which is why that's still required.

Right?

That's why it's still coming out.

>> Okay.

>> The terminology would be more like it's it still is an add on.

You still have your original Medicare, you still have all your original Medicare rights.

So you have to pay for that because it is still paying for a portion of your care.

>> Yeah.

Understood.

Okay.

This question 60% of callers prescription drugs are imported.

What impact would that have on their insurance coverage cost, if any?

>> My assumption is they're referencing the tariffs.

And that would be hard for me to answer.

I don't know if anyone else.

>> Yeah, unfortunately.

So sorry caller.

That's what we get.

Zero points on jeopardy for that one.

But that's not up to us, right?

That's up for you all to determine.

Okay.

If you enroll in a Medicare Advantage plan, can you ever go back to traditional Medicare?

Yes yes.

Yes yes okay.

Any penalty?

No no no.

Good okay.

From Mister Rogers.

He is a state retiree and has insurance through that retirement.

Are there any benefits from adding on Medicare to that?

>> I mean, it can vary as far as the retiree plan.

If they don't require you to pick up Medicare, you may not need it.

So I would just look at the cost comparison, especially if you've delayed enrolling till now, because you may have a penalty for doing so.

But if your retiree plan requires you to pick up Medicare, you will still want that.

But most retiree plans have great medical benefits built into them, so there's not like a need for another advantage plan or a supplement plan.

Your retiree coverage may be enough.

Obviously, you can reach out to any of the resources to get a little more information or compare your options.

>> Great.

Anything additional there?

Okay, this caller does not take medicine at the moment and they use Humana.

Now why do they have to pay extra for medication costs in their monthly costs if they're not taking any.

>> Yeah, that's a good question.

I always relate Medicare Part D to auto insurance or homeowner's policy.

You're not always filing a claim with your homeowner's insurance, but if you need to, it's there to protect you.

And that's what part D is.

And I would I would recommend if someone is not taking medication that they go with the cheapest part D plan available, which this this coming year will have a zero premium.

And should that change and they have medication costs added sometime in 2026, then use open enrollment next year to find a plan that better suits their needs.

>> Yeah, good advice there okay.

From Carl.

He has hospital bills, is on a fixed income and has Medicare advantage.

Is there anything that can help supplement the cost on top of the Medicare Advantage?

>> I'd say unfortunately, no.

There's you can't add a supplement on to an advantage plan.

The supplements only work with original Medicare that part A and part B coverage.

So with the Medicare Advantage plans, you are going to be charged whatever the plan has laid out for you.

And there's not going to be an additional coverage you can purchase through the Medicare program.

>> Yeah, there there isn't anything through the Medicare program that you can do for the advantage.

But there are a couple of ways you may be able to get some assistance with that.

We referenced the Medicare savings program earlier, which that does have income limits, which you can contact your local PBS office or Medicaid office to see if you may qualify for that.

Medicare.gov also post the income and resource limits for that, but that can help pay for the part B premium as well as co-pays, co-insurance, deductibles, etc.

on those plans.

The other thing you could potentially look at with an advantage plan is there are indemnity style plans you may have heard of Aflac, or when you get injured.

It's kind of like that.

If you have a stay in the hospital, it may pay a set dollar amount out for that.

So there are some things you may be able to add, but some of those plans also require underwriting.

So which is asking health questions to see if you qualify checking your medical claims history.

So it just depends on when you're looking and if you're healthy enough to potentially qualify.

>> And I would add one other benefit.

There is a program called Medicaid spin down for people who have out-of-pocket medical expenses that they've incurred in the last 90 days.

So if it is a pre-arranged surgery, they should apply before the surgery, before they're sick and trying to recover.

But if they have incurred expenses, they may be able to get some assistance.

It's not going to be 100% coverage, but the state could pay a portion of the bill.

>> Okay.

Because that kind of ties into this one question about how do I get help with my Medicare premiums.

>> Yeah.

So that's the Medicare savings program.

>> Okay, okay.

A caller is currently on Medicare, a part A, but is retiring March 31st.

When do they need to enroll in parts B and D?

>> So ideally about three months prior to when they turn 65.

Or it sounds like they already are 65.

So about three months before the retirement date okay.

>> All right.

>> And the part D coverage does have to be picked up within 63 days.

If you go with a gap of more than 63 days, you'll be penalized 1% of the average premium for every month you don't have it.

And that gets tacked on for life.

>> So that's tacked on in in perpetuity.

>> Yes.

So that's why they say part D is optional because you don't have to have it.

But you do incur that penalty if you don't need it now but need it later.

And that is tacked on for life.

So if you wait 20 years, you're going to have a pretty large penalty and that again will be on there forever.

>> Oh wow.

Okay.

Good advice there.

This person says I just turned 65.

I signed up for Medicare A I'm still working in a public school and received my health benefits through them.

Do I need to do anything else?

>> Not at this time.

>> Nope, not at this time.

>> Okay, you're good to go, whoever.

Congrats on being 65.

You don't need to do anything else right now.

Okay?

From Virginia, she's had regular Medicare for 20 years and wants to know what the premiums would be if she were to add advantage.

Whenever she calls.

They want a lot of personal information such as birthday and social security number.

But she just wants to know what the premium would be.

Just give her the money.

Give her, give her the number.

Not all the other stuff.

Is that possible?

>> Well, Medicare.gov is a good tool for something like that.

They have what's called the plan finder tool.

And if she went on there, she could even enter in the list of medications she has so she can see exactly what the premium would be and how much she'd be paying in drug costs, approximately.

So that's always a good option.

>> And for those who may not have some of those digital resources at hand, what should they do as a backup?

>> Again, I would recommend the Medicare Schip program because we are able to look into that for them.

Yeah.

>> And I'll plug in for the Lexington Senior Center.

>> Call me.

Yeah.

Call Lindsay.

Right.

Call anybody at this table.

They can help you.

Okay.

Well, one more question before we go back over to to Scott and Laura, what is the easiest way to compare companies plans to see what is different about each?

That's a good question.

Is there a chart?

>> Not really.

And Medicare.gov is again probably going to be your best resource for comparing plans, because I'm not exactly sure on ship, but as far as agents are concerned, we do have rules around what we are allowed and not allowed to do and talk about before having a form called a scope of appointment, which lets Medicare know what we're allowed to talk about with you.

So some of those questions may come from that they shouldn't need your social for that.

Just as a heads up, if you call an agency, you should be able to just get a scope of point and talk about it.

But generally the you can just call in.

Sorry, I forgot the question.

>> That's okay, that's okay.

I think you've answered it plenty.

Okay.

Because I do want to go over to Scott and Laura because, you know, the whole thing about getting your Social Security number and giving that out, we know that this is a high time.

Laura and Scott, for fraudsters and scammers to really do some of their best work.

And so we're going to pass it over to you guys to talk about that for a minute.

>> Yeah.

This is something unfortunate that comes with the open enrollment period for Medicare.

Right?

Absolutely.

And seniors can be targeted at any time, unfortunately.

And they're often victimized.

But let's talk specifically about what our seniors need to look out for to make sure that they're not being defrauded.

>> Since the beginning of Medicare, scammers have taken advantage of this open enrollment season.

There's three things.

Three key things that we like to talk about.

One, Medicare is not going to call you, okay.

So you're not going to have a call from Medicare.

They're not going to text you two.

If you get a suspicious call.

Do not give out your personal data.

Three, you have to be aware of the sort of an emotional push that you know, your policy is going to be terminated, or you're going to be charged extra because you didn't do what x, y, or z. So the the most important thing to keep in mind is protect your personal data, talk to your family.

Because a lot of times folks will not talk to their family about that.

So what you want to do is just make sure that you always pause and and and reflect and and prevent yourself from becoming caught up in some Medicare scam because they're out there and they're going to come after you.

>> I get phone calls, people asking me about Medicare enrollment.

So just be cautious.

Again, like you said, they're not going to call.

>> You in Medicare.gov and some of the other resources that are mentioned tonight on the program, contact them.

They have contact points of contact where you can report a suspected scam.

And if you see something, you should say something, right.

So it's just like that.

But it's a it's a scourge.

And they will take advantage of folks when they try to get them into a panic mode.

>> Right?

So if it's that sort of sense of urgency, like you said, pressure, you need to do this right now or you're going to be owing all these penalties and a lot of the information or the advice you've given.

I mean, that could really apply to any situation, regardless if it's Medicare.

>> And again, we have a terrific panel tonight.

>> Yes.

>> And we also have a terrific resource with your area agency on aging and your state health insurance assistance program.

Great resources.

And one of the the best thing you can do is just talk with folks and let them know, hey, I got this call.

They said they're going to send me a free card.

They're going to send me a gift card if I pay them.

There's a lot of different approaches to these type of scams, right.

>> So follow up with somebody.

Get clarification on if something is legitimate before you advance it any further.

All right, Scott with AARP, thank you so much.

And Renee, we'll go back to you and your panel and some of our callers questions.

>> Yeah.

Thank you so much, Laura.

Thank you.

Great job.

And we just want to say Medicare is not going to call you and never give out your Social Security number or your Medicare number.

Right.

So just any other advice you all want to give about how to protect yourself from these unscrupulous scammers?

>> Don't give out your credit card number either.

>> Don't give out your credit card number either.

Yeah, yeah, that's a good one too, right?

They're not going to ask you for any of that.

Okay.

So we've got a lot of great questions.

And we with ten minutes left, unfortunately we won't get to everything.

But we are going to try and hopefully our phone bank that they also have a lot of knowledge that hopefully they're helping you as well.

They are busy and you kept those phone bank volunteers really going tonight.

So let's get a couple more of these in.

What is the requirement or penalty to switch from supplement plan G to G. High deductible okay.

And I don't even know what G is.

So let's start there.

>> So plan G is one of the Medicare supplements that is offered.

Or Medigap plans is another name that Medicare will use for them.

And that is the one that is the quote unquote Cadillac plan.

So the the part that's kind of missing from that is the part B deductible, because Medicare wants the beneficiary to pay first dollar and part plan G, the high deductible version is literally just that.

It has a high deductible, which I believe this year was set at about $2,700.

And so you have to pay that deductible before it starts picking up its portion of care.

>> Okay, good.

And kind of tangential or related is if you want to switch from plan G to an advantage plan, do you have to do that during open enrollment or in your birthday month?

>> Open enrollment.

>> Open enrollment.

So you don't have to worry about your birthday during open enrollment, which is until December the 7th?

Okay.

Will Eliquis, which is a prescription blood thinner, be one of the drugs that will cost less next year?

Yes yes yes yes.

And you all are ready for that question.

Yeah.

That must be a very common popular drug.

>> Jardiance.

Xarelto.

>> Okay.

>> Januvia.

All of those will be part of the price negotiations through the Inflation Reduction Act of 2022.

>> Okay.

Great.

I mean, a lot of information on that, which is good.

Okay.

What does the supplement plan that the advantage what is the supplement plan have that an advantage plan does not.

>> I would say one of the reasons why someone would go with a supplement plan is they don't want to go to the hospital and then have to walk to the mailbox later on and get a large bill and have sticker shock.

The supplement plan is basically going to cover almost 100% of all of the out-of-pocket costs after Medicare pays.

If you are a traveler, Medicare and a supplement is going to travel very well, unlike a Medicare Advantage plan.

So there are some things people should really look at, look at, look at their lifestyle, how they use their health insurance now before they make a decision.

But that is those are two reasons why someone would want a supplement.

>> Okay, great.

A caller wants telehealth like she had before, but no longer has one that is more affordable.

How can she get it?

>> I would say compare policies.

It sounds like something's happened either with the provider not doing telehealth, or the plan has decided to cut back.

So use open enrollment to find a plan that has telehealth.

>> Yeah.

Talk to ship right.

Or the area development area aging areas.

Okay.

I am currently enrolled in Tricare for my medical insurance.

I signed up for parts A and B, does Tricare for life kick in as my supplement automatically, or do I need to initiate the process?

>> It automatically.

>> Should be automatic.

Okay.

>> Should be automatic okay.

From Robert.

He would like to know.

He would like to change from UnitedHealth to Medicare, but he is worried he could be turned down for previous ailments or preexisting conditions.

>> Well, if you are trying to go back to a supplement where you do have to go through that underwriting your pasture trial, right, or anything else, what I always recommend doing is speak to either them, an agent, whatever you use for your resource there, and apply before you cancel your coverage and give yourself plenty of time during this annual enrollment.

December 7th is the cutoff, so you'll want to give yourself at least a few weeks because they are busy this time of year.

Make sure you apply.

Get that approval back.

Then you sign up for your drug coverage, and then that will automatically cancel your advantage plan for the end of the year.

>> Although we haven't had this question, some may be curious.

With the federal government shutdown, does that delay any of the enrollment process or come into play at all?

No no no no.

>> Not from.

>> It comes into play many ways.

>> Right.

>> Right, right.

It's not going to prevent people from getting insurance for next.

>> Year okay.

Excellent.

That's what we want to know.

A caller already carries Medicare A and B. Can they also have the advantage plan on top of that.

>> Yes.

>> Yes that's actually.

>> A required.

>> That's a requirement.

So you're doing it right already okay.

If you've had a Medicare Advantage plan for more than one year and have preexisting conditions, are you able to change to an original Medicare plan with a supplement?

Is an a supplement hard to get at that point?

>> It very well can be.

Underwriting guidelines will vary from company to company.

So what you can kind of do is maybe shop around a little bit, see what questions are being asked, because companies will have different lookback periods.

So one company for a cancer diagnosis, once you're clear, may only look back two years, while another will look back five.

So you can kind of shop around the company, see if that will work.

Other potential opportunities to make that switch is if your advantage plan leaves the market completely.

That gives you a guaranteed issue period to get into a supplement.

If you move to a new state and lose your advantage plan because of that, that will also give you a guaranteed issue to get into a supplement.

Just remember to get your drug coverage within 60 days of ending that advantage plan, because otherwise you'll get that penalty okay.

>> Yeah good advice there.

So a caller will turn 89 tomorrow.

Happy birthday.

They currently have parts A and B. They would like to know if they should add on more.

>> So it sounds like they don't have a drug plan if they only have part A and B. So my concern there would be that they might be penalized for not having that that drug plan.

So if they're not taking any drugs then by all means stay with part A and part B at this time.

>> Well, and if they're 89 tomorrow and they're not taking any drugs, I want to know who that is.

So we can understand that.

So we can get on the same plan there.

Okay.

We've got about four minutes remaining.

Let's see how many more we can get in is help through the State Health Insurance Assistance Program, or Schip, only for people with low income?

>> No, it's for anyone who's 60 years old or older and anyone on Medicare.

>> Okay, great.

From Vicki, she has United Health Care is thinking about switching to Medicaid.

Okay, I want to I'm just going to read this.

And maybe it's being conflated with Medicare but is undecided.

Medicaid says that she has to work nine hours to be eligible, but she's unable to do so.

What should she do or where should she go?

She's mainly concerned about the possibility of losing her prescription coverage.

>> It sounds like she's trying to go for what they call a key plan.

So qualified, disabled and working individual.

So that's under the Medicare savings plan, which you have to work so many hours a week in order to get onto that plan.

So I think that's what she's talking about.

>> Okay.

Okay, okay.

>> She is talking about Medicare.

If she hasn't paid enough quarters into Social Security, that might be something else.

And she would need to focus on on SSI Medicaid potentially.

I think that needs more information.

>> Yeah.

And perhaps the phone volunteer is helping her read through that.

And we certainly hope that's the case.

Okay, one final question before we do some takeaways.

A caller lives alone and doesn't know where to go or who to talk to, or to find out about what covers dental care.

Yeah, this is a big one.

>> Yeah.

>> That's something a Medicare ship counselor could help with.

Not only are we looking at the Medicare Advantage plans that do offer that type of coverage, we also have local resources for folks to to get what they need, because it's part of our mission is to make sure folks health care needs are being met.

And that's part of it.

>> Yeah, great.

Anything else to add there?

Well, with two minutes remaining, let's just kind of go around the horn and give some final takeaways.

It's been a great conversation.

Thank you all at home for some excellent questions.

We got to almost three dozen of those on air and I know they're still coming in.

So we thank you for watching and we hope that you'll go back and watch this program to hear the answers again.

Because sometimes if you're like me, you need to hear it more than one time.

Any final takeaway, Angela, that you'd like to share with the audience during this enrollment season?

>> Please compare.

Don't let this time pass you by.

You do not want to go to your pharmacy in January and find out your medicines are not covered.

So compare your insurance options now.

>> Okay?

Justin.

>> Yep, I would say the same thing.

Definitely be looking at those annual notice of changes.

You should definitely have received that by now.

If not, call your company and ask.

Call your local agent or ship program and we'd be happy to assist.

>> Okay, Erica.

>> In addition to what they said, I would also recommend looking into state assistance, like the Extra Help program and the Medicare savings program that we've mentioned so many times throughout this.

Even if you're worried about your eligibility, please look into it and please apply.

It's really helpful.

>> Lindsey.

>> Focus on what's going to give you the most peace of mind, whether that be something that covers more hospital coverage, whether you're looking more for dental and vision coverage.

When you're comparing plans, do what is going to give you the most peace of mind.

>> Okay, 15 seconds Olivia.

>> Just make sure you're getting your information from a good source.

Make sure you're looking at the government websites and not just what your neighbor says.

>> Yeah.

>> Good advice all the way around.

We're going to have some of those resources on our website hopefully tomorrow Ket.org the next chapter.

It's on your screen and you can see even past programs about this issue and so much more.

That's part of our aging series.

It's been a pleasure being with you tonight.

You've been good company.

Thanks for all your great questions.

And we'll be doing a financial planning program in December for seniors, so you don't want to miss that.

Keep your eyes on the tube and our visions magazine if you're a member to find out when that will air.

I'm Renee Shaw.

Thanks for your attention tonight.