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>> As the days get shorter and the nights get cooler, we're all hearing and seeing more about Medicare every year from October 15th through December 7th, the Medicare Open enrollment period takes place.

>> As you know, this is the time to review your health care coverage and see if you need to make any changes or if you're happy with the plan you have now you may also be navigating the sometimes complex world of Medicare for the first time.

>> The good news is that for everyone currently enrolled or completely new with Medicare you could say that your ship has come in.

Ship is the acronym for State Health Insurance Assistance Program that provides free unbiased health insurance information which includes our conversation on this edition of Prime Time.

>> Good evening.

I'm Bruce Haines can with this week are Paul Theory of an Art Jackson.

They are two of more than 400 volunteer ship counselors in Indiana ready to help you evaluate which Medicare supplement program is right for you.

Our guests are here to help so the doctors are in the office call and you can share your questions or comments with the number you see right there on the screen as we widen out and have you get a chance to indeed see that Paul is here and there is art and gentlemen, thank you very much for being here.

>> Thanks you.

Thank you both.

You know, I was seeing the other day a statistic from an organization called KfW which apparently monitors Medicare across the country in a variety of levels but they said in twenty twenty just three out of ten Medicare beneficiaries surveyed actually reported that they took the time to compare their coverage three out of ten.

>> So I'm wondering is an opening question why should we not ignore the open enrollment period?

>> Let me start with you.

Well, if you're not worried about your money, your budget, then you know you can ignore however most people at a certain point in life or start to look at things like that and for example, in your drug if you're taking any prescription drugs at all, the choice between the best plan for you and the worst plan can be considerable in terms of cost.

Also if you're in the Medicare Advantage arena of picking a plan that has better benefits for you that will perhaps be of value to you if let's say your dental needs are such that you need that coverage, there are plans out there that offer that so it's a good time for a checkup all the way around for both health and drug needs.

>> All right.

How about you?

I would encourage everyone to check their plan because changes are being made every year.

Maybe not to your plan but you might have had a plan that is better than you currently have.

So for peace of mind, everyone should check their plan then check out what's available out there because Medicare is a program we want everybody to be healthy and and to that end that this is how SCHIP came to be.

It seems that it is the bridge between the abundance of information outside my front door and the policy that I'm working with on the other side of my front door and I have just a few sheets of paper.

There are a lot of sheets of paper on the other side.

Tell me a little bit about SCHIP and how it indeed works with folks who are being encouraged now to pull those papers out and give them a once over?

>> Well, SCHIP is an organization that we are in all states in different states call different names but the concept is identical and the purpose for our being here is that we will help individuals who are either new to Medicare or enrolling in or are needing to go through the annual open enrollment this we were we are volunteers.

We don't sell anything our service services solely information.

If someone comes in and says which plan should I choose normally we don't give them we give them two or three good choices.

We let them choose so we we've try to stay out of the selling concept altogether and instead we're just the information well and it's important information are to think about the idea of people saying, you know, I would I would go walking more around my block if I had someone to go with or I would be able to go jogging if I had someone to run with I would probably review my Medicare coverage if I had someone to review it with.

>> And there you are.

Yes, Some plan of you know, Jim Jim and people can go to the gym and and go on to the gym.

You might find someone that you like to walk with because believe it or not, walking is really healthy for all individuals.

There's less stress on your body.

All you need is a good pair of shoes and you can walk you know some people walk two miles some well less than that per day.

But whatever it is, try to get out and walk and help the doctors because oftentimes you have you know the problem before you go to the doctor.

>> Yeah.

And in fact you want that peace of mind if you're leaving the doctor's office as well as if you are then leaving this open enrollment window.

There are some aspects of contact information.

Let's show that now and we'll also bring this back as we move through the time together.

But how folks can reach out and how is that process for individuals who say I should get in touch with these gentlemen, I just need to know how to type setting up appointment or dropping by and that kind thing.

How does that work?

We encourage appointments.

All an individual has to do is call it number of those on the screen and we will set you up the date and time and we will spend as much time as needed assuming we're not busy that day and we will go through your options with you and hopefully give you enough information that you can make the choice that you came into to come in for and some of those choices I think it's still true, isn't it in L.A. County alone there and it's north of thirty Medicare Advantage plans to look through.

So if you're doing your walking, you're wandering through a whole forest of paper related to all that and we will be talking more about some of the key things that have shifted or key considerations for you so that you can be rock solid and knowing what kind of plans you have.

We'll go to the phones and welcome Jeff to the program.

>> Jeff, go ahead with your question, sir.

Oh, I would like to know what would it be if you don't sign up for Medicare when you when you become when you first become eligible?

>> OK, and Paul for Medicare Part B the penalty is a 10 percent per year for every full year that you're that you should have had Medicare but you don't have four for the drug plan.

It's one percent per month for every month that you were eligible but but did not choose a Medicare drug plan.

No, the exception to that is if you have creditable coverage through let's say the employer plan, then then you're not subject to that penalty.

So that's why we encourage people to enroll when the time when their time is up for them and when normally when you lose coverage through an employer is that's the point in time assuming you're over sixty five when you would sign up something that would be worth sharing.

Let's bring up there are two graphics related to enrollment to share.

Let's look at number four if we could for a moment because while there is this little subtle reminder that came to every mailbox Medicare and you that's the annual tome from the government and out of that indeed there is an initial sign up for Medicare and then of course the annual window that we're going through art to talk about.

And Paul, the initial idea if I knew in Medicare it build somewhat, right?

>> Well, I say we encourage and also Medicare encourage you.

You have a window for your initial coverage and it can begin three months before your birthday then your birthday more than three months after that initial you know, also for open enrollment that's every year from October the 15th to December seven.

And if you miss those you can go to a general enrollment and that is from January 1st to March 1st.

>> Yeah, let's share that information as well.

That's that's number five up there because it does seem that even though there is plenty of time sometimes it doesn't seem like plenty of time is ever enough time and the question comes up so if I missed this bus, is there another one coming there?

Kind of is yeah.

The general open period that art mentioned is that that other bus that you referred to that that allows someone who just should have enrolled but didn't?

There are certain exceptions to that is in the world of Medicare that's built on exceptions if for some reason that out of your control that you're unable to enroll sometimes we can there are special enrollment periods allow you to come into Medicare without penalty and when we get into this open enrollment eriod may be a good straightforward type of question on this matter would be what is it that we can change and what is it that we can't?

>> All right.

OK, oftentimes people think they have to make a change first if the program plan you have and you like it, you don't have to do anything but you want to go out and look at the plans to be an awful see whether a change had been made to your current plan.

See whether or not benefits are better then you know with plans out there then one that you currently have.

So that's what the individual do on is open enrollment and it seems the other key decision point or among other key decision points but it's got to be in the top three is whether one stays with traditional Medicare or part A and B or they go to something that's sometimes called part C the much talked about these days Medicare Advantage plan break that one down for me.

Well, this time of the year during the open enrollment we're looking at being able to change your Medicare Advantage plan if you already have one or two Medicare prescription drug plan now if you have a Medicare supplement, those don't have an annual open enrollment period.

>> They you have an initial period where you can purchase a supplement plan with no questions asked.

You don't have any health issues that that get in your way.

However, that's a one time six month window when you turn sixty five and enroll in Medicare Part B for the first time and then after that six months is up and you may be able to change Medicar supplement plans but there's no guarantee what are the places where I understand folks have wandered into some predicament is the notion of leaving your traditional Medicare going to a Medicare Advantage plan and then deciding it's time to switch back that the experience wasn't beneficial and they want to switch back sometimes Art, you can't necessarily go home again, right?

>> That's true.

Oftentimes individuals had tradition A and B and they want to change to a Medicare Advantage plan where they can do that.

But to have a trial period that they can go back and get that supplement that they had but for 12 months within 12 months they have to go ahead and switch back but often people look at Medicare Advantage plan because there are advantages compared to traditional A&E and I'm hearing about the idea of Medigap coverage as well as Medicare Advantage.

>> So you're both hearing one Paul talk to me about Medigap coverage Medigap and Medicare supplement are the same oftentimes they're used interchangeably and probably to the point of confusion to many people who hear both terms and saying well that's that's a new term for me.

Well, not really.

It's it's just the same Medicare supplement plans.

These are plans that are sold by a variety of insurance companies.

They cover the deductibles and co-pays that Medicare A and B have and that's that's pretty much all they do.

They they offer some additional benefits but the majority of why they're there is to cover the hospitalization deductible and part a and the 20 percent copay and Part B in the Medicare Advantage you were saying has some extra things you hear it is shared in every quarter about vision and dental and so on.

But there are some cautions as there are in all things.

>> But elaborate on that.

Well, in the Medicare Advantage plan they do offer dental vision and here most of time is just primary.

But there are some companies that would give you a comprehensive plan and most of the time those plans run about 25 to 35 hours premium but they're still good.

>> And when you are then at the place of deciding this is where information becomes your friend because you're using that then as a filter to determine how much of this lines up with where I am in life right now, do I need to see a doctor a lot?

Do I need to see a doctor?

Not so much.

Do I travel from state to state?

I pretty much generally in one location and there are probably other questions you all receive if you're ever think that you may need a specialty clinic meaning we need to go to that one hospital that treats a specific disease probably be best to look at Medicare and be traditional Medicare as your source of insurance along with the supplement if that's not in your future, if you didn't Medicare Advantage is a possibility for you or you can choose a good advantage plan but you have to be cautious of you know, do your health care providers do they accept that plan as well as looking at the drug costs that that plan offers the extra benefits that aren't talked about of whether it's PPO or an HMO does affect whether they'll that plan will pay if you go outside of network or not and for the way we are all looking at wrapping up twenty three and going into twenty four , let me be sure we take a moment on this going into the New Year Art what's changed if anything in coverages I understand it's deductible movements going up the changes you make on open enrollment become effect January 1st OK if you don't make any change you're going to continue with the plan that you can't have and those are some of the things that we would caution people to make sure they are completely satisfied with the plan to have.

But there is one exception if you have a plan especially in Medicare Advantage by and you found out in the middle of January that you don't like it, you can change to another Medicare Advantage plan when people are going through these comparisons and they come to you with all of this, you do those reviews that you have with individuals get into the cost part to be able to say here's the rate or here's the you know, this is where you would be.

>> Do you pull out a calculator at some point in that conversation?

No.

But one good thing many of Medicare Advantage plans to see your primary care physician is zero so a person can see that primary care physician every week if they want to see a specialist, most of them twenty five to forty four dollars per per visit.

>> And on that point a question has come up and let's go to towline four and bring out our next caller in and I think it might be George you go ahead, sir, please.

I was wondering well yeah I signed up for Medicare.

We've got A&E and then we signed up for advantage and the plan that we picked was United Health that cover drugs also well, the answer is I don't know because UnitedHealth sells plans with drug coverage and without drug coverage next year in Allen County there are total of I believe thirty eight Medicare Advantage plans and thirty one of those do include drugs.

If you're not sure, George, give us a call on Monday or just leave a message any time and just let us know what you plan you chose and I can tell you whether or not it includes drugs or not.

>> A related question to what George was asking if you have your Medicare drug plan, is it required to notify a person if the plan is changing its formulary?

They usually do and that's one of the things that we why we tell people to check your drug plan because if you take a certain prescription drug now they may not cover next year or they may put it in a different tier at a different price level so that so that can be a big factor in determining on the cost side or whether it's even included or not in their formulary and that's where the comparison shopping art I suppose really kicks in.

>> Yes, it does because plans you want to check your voice, you want to make sure your doctor is in the den that you check your medication, see whether or not all your medication is covered because one plan even for instance some players may not cover a particular drug and another one will.

So you just have to review everything as closely as possible.

>> We have one piece of information I want to be sure we cover before we run out of time and that relates to graphics six if we can share that this deals with low income assistance.

I think there are lots of folks that understanding fear of the unknown and maybe not knowing how much additional help there can be along the way.

Yes, this is a program that's is funded by Medicaid and what that does is to if your income and assets fall below those amounts then at a minimum you would be eligible for having Medicaid pay for your Medicare Part B premium which next year will be almost one hundred and seventy five dollars per month .

So if and then if your income is low enough then it may the plan may also pay for your Medicare deductibles and your Medicare co-pays.

But first and then we always encourage individuals to either come into our office to we can help you fill out an application or there's benefit enrollment center on S Anthony it's called the league the league slide number two and that that will allow individuals to they will set up a programs for the individuals to not only apply for one of those programs but other things that they may be entitled to other benefits so that that's one thought but that is is definitely a worthwhile program and it also also buys us entry into the extra health program for prescription drugs which will greatly reduce your drug cost.

>> We had an off line question from Rick wondering too if you are able to schedule a time for someone to come to a person's home and help them sort through information and compare plans to do does that part does that were virtual meetings perhaps in this we do I don't visit homes we have is a site you know where you got maybe 10, 15, 20 people say at a church I had to why something like that.

But normally we don't visit home but we have you in a way we can just call us and let snow and we'll be able to work with you and anything further that you should be kept in mind.

I mean I think a lot of the journey of course is how to take the first step and it seems to me you're saying just get yourself a nice cup of coffee or herbal tea and sit down, take a deep breath and start laying it out there, look at costs or look those bullet& points and all the information and see how they stack up and then be in touch with you and if you're in the market for Medicare Advantage plans, I would encourage you to visit our Web website Fort Wayne ship dot com on their will in that website it will show the I mentioned earlier the thirty eight Medicar Advantage plans for next year in L.A. County and there are several other surrounding counties also listed in that same site and you can look at the Medicare Advantage costs and benefits side by side basis and the mere fact that there are thirty eight of these it makes me so glad there are at least two of you two to help us move through it and we are deeply grateful Paul thier often heart checks and are two of your friends in the State Health Insurance Assistance Program the SCHIP program.

Gentlemen, thank you very, very much.

Thank you for having us and thank you for allowing us to be a part of your evening as well for all of us with Prime Time Ambersons take care and we'll see you next week.

>> Good night