What you need to know about Medicare to help your aging parents.
Medicare Open Enrollment is October 15 – December 7. This is the time of year when people can make changes to Medicare health and prescription drug plans to better fit their needs.
Understanding what coverage your aging parent needs can be pretty confusing.
During this time your parents are likely getting phone calls trying to convince them to change their Medicare plan over the phone… or potentially have them give permission to change without them realizing it.
Kim & Mike Barnes talk with Independent Medicare Specialist Sherry Hoppmann to sort through Medicare.
They discuss why it’s important to do an annual review of your parent’s plan, why you might consider making a change, the difference between a Medicare Supplement Plan and a Medicare Advantage Plan, what your parents should never give out over the phone and free resources that can help you in this process.
Read the full transcript
Transcript of Interview: “Should you change a Medicare Plan?”
Mike Barnes:
Medicare can be so confusing. I thought I was getting better with it, but as we learned more about Medicare, Medicare Advantage, and all the fraud involved, it’s overwhelming.
Kim Barnes:
Absolutely. If you want your head to spin just a little bit, start investigating and trying to understand Medicare. That’s why we’re bringing in Sherry Hoppmann. She’s an independent Medicare specialist. Thanks so much for being with us because do you agree that the more you start talking about it, the more confusing it gets? We’re glad to try to streamline and simplify some of this as we help our aging parents. It is open enrollment in October, right?
Sherry Hoppmann:
Yes, thanks for having me. It is very confusing. Open enrollment started on October 15th and ends December 7th. During this time, those with a Medicare Advantage or prescription drug plan can change their plan, and it will take effect on January 1st.
Mike Barnes:
Why is it so important to know what Medicare plan your parents have and to review it?
Sherry Hoppmann:
It’s important for many reasons. If your parents’ medications have changed or the formulary of their prescription drug or Medicare Advantage plan has changed, you need to know if there will be a change in the cost of the medications in the coming year. Another plan might do a better job at covering an expensive drug or a type of insulin, potentially saving hundreds or thousands of dollars. A yearly review is extremely important.
Kim Barnes:
When you talk to your mom or dad and ask what Medicare plan they’re on, they might say, “I’m on Medicare.” Without looking at the card, you might not know for sure which supplement plan they have or if they’re on an Advantage plan.
Sherry Hoppmann:
First, get all the cards out of their wallet and review them. You can also create an account at www.medicare.gov. You’ll need their Medicare card and some information from it, like the correct address on file for Medicare. This account will show you their current plans and almost always the Medicare supplement company if they have a supplement. It’s extremely useful.
Kim Barnes:
When I asked my mom, she didn’t even remember who her agent was or is because it was so long ago when she made the decision at 65. The biggest confusion comes because Medicare sounds like it’s all the same, but it’s really not. What’s the simplest way to explain the difference between regular Medicare, Medicare with a supplement, and Medicare Advantage?
Sherry Hoppmann:
Original Medicare includes Medicare Parts A and B. Part A covers hospital or inpatient services, and Part B covers doctors or outpatient services. If you have original Medicare, there are several deductibles, including one for the first 60 days of hospitalization, which can be quite large. You could spend nearly ten thousand dollars after 90 days under original Medicare without a supplement. To cover these costs, you can add a Medicare Supplement Plan. Part A and B will pay first, and the remaining deductibles and co-payments will be paid by your Medicare supplement. You can get a Plan G where you’re only responsible for your Part B deductible, which is $226 next year, but you’ll need a separate drug plan. These can be pricey. Some clients choose a Medicare Advantage plan instead. Medicare pays a monthly amount to a private company to manage your Medicare, pay claims, and handle compliance issues. These plans often include drug plans, vision, dental, gym memberships, personal emergency response systems, and other useful services.
Kim Barnes:
If you’re trying to get a Supplement Plan, those are provided by private insurance companies, so they have criteria or can choose to insure you or not. Original Medicare Parts A and B are government-funded and everyone gets that, but whether you can get a Supplement Plan may depend on your health condition, right?
Sherry Hoppmann:
That’s correct. You have an open enrollment period for Medicare supplements when you first get on Medicare A and B or leave your employer plan. During that time, you can enroll in a Plan G regardless of your health. After that, to switch plans or return from a Medicare Advantage plan to original Medicare and a supplement, you have to answer underwriting questions, and your health becomes very important. They can decline you.
Mike Barnes:
When shopping for a Medicare Supplement Plan and a drug plan, do you shop around for the best prices? What if you can’t afford it? Is that when you consider Medicare Advantage or even Medicaid?
Sherry Hoppmann:
You do have to look at multiple options. If I’m talking to a client new to Medicare, I compare the cost of original Medicare with a supplement and drug plan to a Medicare Advantage plan, which might have a zero premium but include co-pays. We look at these side by side. If someone is already on a Medicare supplement, we shop for one that might be less expensive based on their health conditions and the correct standalone prescription drug plan. It’s important to work with an agent to explore these options.
Kim Barnes:
When dealing with an agent, it’s good to know it won’t cost you anything, right?
Sherry Hoppmann:
That’s correct. Agents are paid commissions by the insurance company they choose for you. You shouldn’t have to pay an agent for their services.
Mike Barnes:
That’s huge to know because we need the help since we’re all so confused about this. What should I do? What should I choose?
Kim Barnes:
Absolutely. If you don’t know, find an expert to help. It won’t cost you a thing.
Sherry Hoppmann:
We’re here to help.
Kim Barnes:
One thing we’ve heard a lot about is the phone calls that seniors are getting, trying to get them to switch to a different plan. I would imagine the best advice is to not make any important decisions over the phone. What else can we do to help our parents avoid making snap decisions that could put them in a bind?
Sherry Hoppmann:
There are several lead aggregators collecting phone data on Medicare members and making calls from different states. They may not have a good understanding of what is best for you and your area. Never give your Medicare number to someone who calls you because they can change your plan. If something piques your interest, jot it down and call the agent you know and trust. If you don’t have an agent, find one and deal with someone locally who you can meet face to face.
Mike Barnes:
What’s the best way to find an agent for people around the country?
Sherry Hoppmann:
One resource is the Area Agency on Aging. In Texas, it’s our SHIP (State Health Insurance Assistance Program) organization. Different states may have different SHIP organizations. You can find these resources online. Talk to your friends and see who they’re using. I get many referrals from people who tell their friends about me. The Medicare.gov website is also handy for quick questions.
Kim Barnes:
There might be reasons to change from one Supplement Plan to another or to a different type of plan depending on changing circumstances. It’s important to have a specialist who talks about this all day, every day, versus trying to figure it out on your own.
Mike Barnes:
It’s very confusing and time-consuming. It helps to know the advantages and disadvantages of each plan.
Kim Barnes:
Is there anything about Medicare we’ve missed?
Sherry Hoppmann:
One key point is to never give out your Medicare number over the phone to anyone, unless it’s the agent you’re working with. If someone calls offering a free back brace or something similar, it’s likely fraud. They’ll want your Medicare number and either send you the item and bill Medicare or not send it and still bill Medicare. These items should be prescribed by doctors.
Mike Barnes:
Thanks so much for all the advice and great tips. We all need it.
Sherry Hoppmann:
Absolutely. Thank you for having me. It was a pleasure to talk with you.
Mike Barnes:
These are all great pieces of information for those of us helping our aging parents navigate Medicare. It also helps those of us getting closer to needing Medicare. If something comes up, like a surgery or health changes, know when open enrollment starts. Talk to an agent, plan ahead, and be prepared. If you have any other topics you’d like us to discuss, please let us know. Parenting Aging Parents.
*This transcript is auto-generated. Please excuse any typos or mistakes.
