Understanding Medicare

Transcript of Interview: “Understanding Medicare”

Kim Barnes:

You hear the terms Medicare, Medicare Part A, Part B, Part C. I don’t know, maybe there’s a D. I don’t know, Medicare Advantage plans. There’s so much, so many terms that are used when you’re talking about healthcare insurance for your elder parents. It’s tricky to know.

Mike Barnes:

And then supplemental plans as well. What do you need to do, especially when mom and dad, or dad or mom, whichever one, gets sick and you need to help them, and they’re not ready for it. Nobody’s ready for it.

Kim Barnes:

Well, or just to make sure that they’re seeing the right doctors. I recently reached out to Carol Eckelkamp, who has a company called Medicare Maven, because we had a situation with my mom where we wanted to change her primary care doctor. I just wanted to make sure that we didn’t mess anything up with her coverage. Carol, you were so great, and we’re so glad for you to be with us today because you were so helpful. Mom has been a patient at MD Anderson, and we want that to be able to continue. You were able to share some great information that helped us realize, oh, okay, that’s really important, and we need to really take that into consideration while we’re making some changes.

Carol Eckelkamp:

That was, yeah, your situation was fairly unique because it was something that I don’t see very often, but when I do see it, it was exactly what was working for your situation. I think that’s the number one thing I see, is just because it worked for somebody else. There’s a lot of misinformation and a lot of he said, she said, or my mom this, mom that. It’s all different. It’s very unique based on each individual, and I think that’s a key component to this whole Medicare maze. I like to call it the Medicare maze for sure.

Mike Barnes:

That seems to be one of the hardest parts. You talk to friends, you talk to other people, and oh, here’s what I did, and this one worked for my mom, and here’s what I did, this worked for my dad, oh, it worked great. But it’s different for everyone, isn’t it?

Carol Eckelkamp:

It really is. It’s so complicated, and everybody’s situation is unique. That’s why there’s not a playbook. I’d love to say, here’s my playbook, and you could do X, Y, and Z, but you can’t because the X and the Y and the Z may have different components for every different person, depending on whether it’s a retirement plan from an employer, of which a union might make decisions, or like the teacher retirement system where the teachers’ union makes choices, or if it’s just an individual plan on the open market. Everything has a unique component to it.

Kim Barnes:

So where do you start then?

Carol Eckelkamp:

I think the starting point is to find out exactly what a parent has, and usually that means to get all the ID cards out of the wallet. Oftentimes you’ll find there’s five years’ worth, and there’s multiple cards. The key is to find the current one, what’s in this year. Sometimes you have to call the number on the back of the card, or you have to call up to an insurance company to find out if it’s current and are the bills being paid. Really, it’s just kind of doing an audit of the plans and an audit of the wallet. You might find all kinds of things in there, credit cards you didn’t know about. It’s really the Medicare cards and the insurance cards.

Mike Barnes:

Well, that kind of happened in my family because both my mom and dad tested positive for COVID in January. My dad actually had to go to the hospital a couple of times and stayed three days on the second time. I went up there after he got out of the hospital because I couldn’t visit him in the hospital with COVID. When we got out of the hospital, we sat down and made a copy of both of their cards and everything. He also showed me, “Yeah, I also have the supplemental insurance.” “Dad, why do you have that if you have Medicare?” He’s like, “I don’t know.” So, as a son or as a caring person, what do I do there? Do I say, “Well, Dad, we need to talk to this person,” or do I reach out and find somebody? How do we find who to talk to to make sure that everything is set up insurance-wise?

Carol Eckelkamp:

I think the key is you find an insurance broker, an independent broker, someone who does cover the different plans. Some of them can be found on internet searches. Some of them can be found through the carriers. Humana or Blue Cross Blue Shield may have insurance agents in your area. I do get a lot of calls from certain carriers. People will say, “Well, this company gave me your name,” because I am listed as my appointments are. Sometimes it’s just reaching out into that, and also Medicare, the government agency Medicare, can also be helpful. 1-800-Medicare. As long as you’re not calling in the middle of the open enrollment period, which is the fall, you can actually, you don’t have to hold, and people are knowledgeable. So sometimes it’s going directly to the source, but having an agent answer those questions because we’ve seen a lot of it, and that helps because we help guide you to the questions that need to be asked. Oftentimes you guys don’t know the questions, and it’s the question. Even calling about an issue, it’s the question. If you ask the wrong question, you get the right answer to the wrong question.

Kim Barnes:

Right, exactly. So how do you know what the right questions are, in addition to having somebody like you help us?

Carol Eckelkamp:

That’s just understanding their coverage, understanding what they have and how it works. A lot of times, that’s just a little bit of research and just going in. If I have this plan with this carrier and it’s a supplemental plan versus a Medicare Advantage plan, then you just have to do a little bit of work to find out what that plan is and how it covers. Then, it’s just like a car or a house. If your parents have insurances, they have all kinds of insurances, and it’s really reading the policies. Boring as it is, I know.

Kim Barnes:

Yeah, and hard to understand sometimes.

Carol Eckelkamp:

Right. Usually, there’s a phone number on that policy, and that’s the person you would call, the person listed on that policy, whether it be homeowners, auto, or Medicare.

Kim Barnes:

And so much of it, I guess, too, would also depend on what they need, what kind of coverage they need.

Carol Eckelkamp:

Yeah, and a lot of times I find that coverage has been in place for a long time. It’s not something all of us just jump up and down wanting to change our insurance. It’s kind of like auto insurance; it’s like, oh my gosh. But we should, we should look at it. But in the Medicare world, especially in the older generation, I find that they often just, if it’s working, don’t mess with it. They don’t know it’s not working until something drastic happens—COVID, a surgery, a long hospital stay, or a fall. Oftentimes, there’s some trigger to what’s going to happen. So it’s just understanding what exactly is the situation.

Kim Barnes:

Can you very simply, is there a simple way to explain what the differences are? When I talked at the beginning about, you know, you hear Medicare Part A, Part B, whatever, is there a simple way to explain what the differences are?

Carol Eckelkamp:

There is. I actually have one graphic I use in almost every single presentation. It just literally says, okay, here’s your Medicare card—that’s a federal government program. Once you get Medicare, there are two ways you can go if you don’t have an employer plan. You either go Advantage using a private company, and it’s all bundled together. I like to say the Medicare Advantage plans are bundled together. They’ve got your dental, your vision, they’ve got various other benefits, plus they put the A and B of Medicare and the drug plan. The other side, option two, would be just original Medicare using your red, white, and blue federal Medicare card, and you buy a supplemental plan to go with it, and you buy a drug plan. So you either buy the individual policies, or you buy a bundled plan.

Kim Barnes:

So it’s really that simple.

Mike Barnes:

Makes it sound so simple.

Carol Eckelkamp:

Just to layer the complexity, one of the carriers in this area has 12 plans. You can choose from 12 plans. Now, you don’t qualify for all of them because some of them may require you to have a chronic condition or to have Medicare and Medicaid. But just on the surface, it’s option one or option two. Then you have to get into the weeds. Who are your doctors? Do you want original Medicare to be able to go to any doctor that accepts Medicare?

Kim Barnes:

That’s where somebody like you can definitely come in handy because you understand all of that where sometimes we may not have the… it’s a dirty dozen to us.

Carol Eckelkamp:

Right. I’ll go back to the first point of understanding where they are and what they have, and that means also who are their doctors. Who are their favorite doctors, and what medications are they taking? It’s an audit of a parent’s situation; you’re basically auditing their coverage and what medications, and who’s their caretaker. Do they have somebody that has been helping them with this? Maybe they have an agent that you just don’t know because a lot of times, same thing with financial advisors, they’ve been advising a parent for a long time. They may have a Medicare agent that’s helped them, but most of them don’t. It’s kind of a one-and-done for a lot of agents—they just sell it, and then it’s done.

Kim Barnes:

So we’ve just kind of opened the can of worms, I think, a little bit, but I am so appreciative of your ability to distill it and make it seem a little bit more simple than it might be. Thank you, Carol, so much. We appreciate it.

*This transcript is auto-generated. Please excuse any typos or mistakes.