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Hi everyone! This is Pam Fuchs with the Aging and Disability Resource Center

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in Baraboo, Sauk County.

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I am going to do my best to

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provide you with an informational

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session here

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that you can access hopefully on our 
ADRC website

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and/or

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maybe ADRC Facebook page.

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Typically, throughout the year my coworker and I provide you with some

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face-to-face group

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informational settings where we give you information

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on Medicare and it's especially relevant to people who are

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turning 65 soon.
Due to CoVID we have not been able to do these sessions since January

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so, I thought i'd do my best to provide you with this information online.

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And, we'll see how today goes and maybe we can do some additional videos for you in the future if this goes well.

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So, I'm hoping you can see my Power Point

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slide presentation

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to the side of my screen here

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that says "Welcome to Medicare 2020".

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Typically when we're meeting in person, we ask people to silence cell phones and give some logistic information, but we're going to pass through that

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just to give you some basic information about our local Aging and Disability Resource Center office. We are located in the West Square Building

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at 505 Broadway in Baraboo. 
It's a big building right across the street from the Courthouse.

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Our office

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offers a variety of services and we also have

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six Information and Assistance Specialists who are licensed social workers

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who also can provide you with a ton of information about other resources outside of our office that are offered throughout Sauk County.

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So, if you have any questions about

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where to go -  you have a question - you don't know where to get the answer, give our office a call,

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and if they don't know the answer they can direct you to someone who does.

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We have some Disability Benefits Specialists

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who assist people ages 18 to 59

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in applying for Social Security Disability and also assisting with appeals if those disability

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applications have been denied.

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And then we also have Elder Benefit Specialists, which is what I am,

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and

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there are two of us.

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I provide Elder Benefits Services to the eastern half of Sauk County, which includes Baraboo

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Prairie du Sac, Sauk City, Merrimac,
North Freedom;

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and

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my co-worker, Mindy Schrader,

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provides

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the same services to the folks in the western half of the county.
And we provide services to people age 60 or older.

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Some of the EBS or Elder Benefit Specialists

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services provided

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include assisting with some consumer issues like billing, debt collections, 
landlord tenant issues,

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applying -

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exploring eligibility and applying for Medicare Savings Programs or 
Medicaid programs.

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We do help people age 60 or over apply for Social Security Disability.

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We do not assist with appeals, but we can get you resources

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on that if that is a necessity.
We do -

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the majority of what we do is related to

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Medicare,

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so helping -

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you know, helping you guys understand Medicare,

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the eligibility, how to apply for it, what the benefits are, what the costs are, and what your additional options are once you're on Medicare.

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We do work under the supervision of a program attorney,

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so if you do choose to work with us

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you are  - you are protected by that attorney-client privilege.

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So, what i'm going to try to get through

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in this meeting is a brief overview of Social Security,

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but mainly the information regarding Medicare.
I think that I'm limited to 40 minutes here,

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so i'm going to do my best to get through everything

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efficiently for you here

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so, just a brief overview of Social Security retirement benefits. This is the cash

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benefit money. This is not insurance. This is

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your cash money retirement that you have earned through working your whole life or that your spouse has earned through working

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throughout their lives that you're eligible for once you get older.

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You can apply for Social Security retirement benefits through the Social Security Administration.

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For folks living in Sauk County our local office is the Social Security Administration office in Portage.

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Due to CoVID19 they are currently closed and working from home,

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but you can still call them and and ask for an appointment by phone

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to apply for your Social Security retirement benefits.

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You can also apply for these benefits online at their website ssa.gov

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or you can contact

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either Mindy or myself depending on where you live in Sauk County.
We can help you do that application also.

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You can apply for Social Security retirement benefits at any age between 62 and 70.

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Everyone has what's called a full retirement age.

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If you wait until you reach your full retirement age

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then

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you are eligible to receive 100 percent

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of your benefits that you have earned

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If you want to, however, take your Social Security retirement benefits before you reach your full retirement age

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you absolutely can do that.

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You can take your benefits as early as age 62

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but your monthly

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amount, your monthly benefit amount will be reduced by about eight percent for every year that you take it early.

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So, for example, if you waited until your full retirement age to draw your social security benefits

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and your full 100% benefit is a thousand dollars a month

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you'll get a thousand dollars a month.

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If you decide to take it a year early

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you'll get about nine hundred and twenty dollars a month because you're taking it about a year early,

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so it'll be reduced by about eight percent.

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Likewise, if you don't want to take your retirement benefits when you reach your full retirement age you can also

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postpone taking them until

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a later date - as late as age 70.

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And,

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what happens then is your benefits increase by approximately eight percent every year

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until you reach age 70, and at age 70 they max out.

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So, your full retirement age is based upon your date of birth.

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I think for folks born in 1954

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the full retirement age is 66, but if you were born after that

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they've started adding on two months. 
So, for some people it's going to be 66 in two months

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then it's 66 and four months and so on and so on until age 67, I think

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for the younger folks.

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You want to apply for Social Security retirement benefits approximately three months before you want them to begin

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because it takes Social Security some time to process your application.

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If you have decided to take your Social Security retirement benefits before

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you turn 65, if you took them early,

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you will automatically be enrolled into Medicare at age 65.

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But, if you have not begun taking your Social Security retirement benefits early

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then you're going to have to sign up for Medicare at age 65.

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For everyone turning 65, they are eligible to sign up for original Medicare which includes two parts.

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Part A which is hospital insurance and Part B which is medical insurance.

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Medicare Part A enrollment.

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Again, if you've already begun drawing on your Social Security retirement benefits, they're just -

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Social Security is just going to automatically sign you up for Medicare Part A.

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They are going to mail you your card in the mail and

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you're just going to have a start date of the first of the month that you turn 65.

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Some people who are on disability

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who are under the age of 65 but have been awarded Social Security Disability

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and have been on disability payments for 24 months

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are eligible for Medicare regardless of age,

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and, again, they will be automatically enrolled when they're eligible.

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If you're not drawing Social Security benefits at age 65

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then you need to

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manually sign up for Medicare.

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And, again, that can be done either by going to Social Security office in Portage in person,

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normally, not during CoVID, but normally you can do that. Or you can call the Social Security office in Portage,

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or you can do it online through their website ssa.gov,

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or you can contact your local Elder Benefit Specialist at your local ADRC and we can help you with that too.

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Your initial enrollment period for Medicare

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is a seven month window. It's the three months before you turn 65,

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the month that you turn 65, and then the three months after you turn 65.

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So,

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if you don't sign up

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for medicare during this seven month window

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you will be automatically enrolled into Medicare Part A later, when you sign up for your Social Security retirement benefits.

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So, let's say at age 65 you don't sign up for Medicare, you keep working and then at age 67 you decide "Okay,

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I want to take my social security retirement money benefit now!"

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And you apply for that.

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Social Security office will start your Social Security Retirement Benefits

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and then they're going to automatically enroll you into Medicare Part A and back date that Part A start date

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six months.

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So, that is important information to know

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if you work for an employer where you have a high deductible

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health insurance plan

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with a Health Savings Account that you contribute money into

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because

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everyone who is turning 65 is eligible for Medicare, and once you are eligible for Medicare you are no longer eligible

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to make

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those tax

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deductible

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Health Savings Account contributions.

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So, it's important

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- it's important if you have a Health Savings Account to stop making those contributions

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before you're turning 65.

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You can still use up whatever money is in that account, but you have to stop making the

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contributions or you can face some tax penalties.

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Also, for folks who are enrolled in a marketplace plan or an Affordable Care Act or Obamacare

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it's important that if you are receiving any tax subsidies to help with those

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premiums being lowered for you

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you are also not eligible for those tax subsidies once  you're eligible for Medicare.

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So,

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it's important to call and cancel your Affordable Care Act plan when you're turning 65 and signing up for Medicare.

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Medicare Part A is free.

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You don't pay a premium for that.  It's only -

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it's only hospital insurance. So, it's only going to provide you with coverage

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for an inpatient hospitalization stay or inpatient nursing home stay.

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You earned that if you're eligible for Medicare, you're eligible for Social Security retirement.

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It means that you've earned 40 work credits throughout your life,

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40 work credits is equivalent to 10 years of full-time work

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added up over time.

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And so you get Part A for free.

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If you have Medicare Part A and you end up going into the hospital,

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Medicare Part A has a deductible of

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1,408 dollars per 60 day hospitalization.

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So, what that means is - if you go into the hospital in January and let's say you're in the hospital for a week,

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you're going to have a bill for 1,408 dollars

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and then the rest of your hospitalization stay would be covered in full.

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But, let's say you go back into the hospital in July of that same year,

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more than 60 days have passed,

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so, therefore you're going to pay that deductible a second time.

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So, that deductible is not per year. It is for 60-day hospitalization.

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And then there may be additional daily co-pays if you are in the hospital longer than 60 days.

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So, this just kind of gives you a breakdown.
If you're in the hospital between zero and 60 days

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you pay that 1,408 deductible and then the rest of your stay is covered in full,

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but, if you have to be in the hospital for up to 90 days

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there's a 352 dollar co-pay per day.

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Days 91 through 150 there's a 704 per day co-pay.

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Medicare part a also includes some home health services,

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some blood, hospice care,

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and it covers skilled nursing facility stays

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with a qualifying three-day hospital admission. So, what that means is if you go into the hospital

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and

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they say they want to transfer you to the nursing home for rehab

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you must have

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been admitted as an inpatient into the hospital for three days

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before being transferred to the nursing home if you want Medicare to pay for that stay.

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If you have that three-day qualifying hospital admission, then Medicare will pay for your first 20 days in the nursing home in full.

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If you're there for days 21 through 100, you will have a

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176 dollar per day copay, and if you're in there longer than 100 days you have zero percent coverage under your Medicare Part A.

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Now, there are some additional things that can help with those costs and we'll get there, but this is

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the starting point of your Medicare Part A coverage.

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We've kind of already covered this -

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You have to be admitted as an inpatient for at least three days into the hospital prior to being transferred to the nursing home.

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You cannot be held as on observational status. You cannot be held for one night or two nights.

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It must be inpatient three nights.

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Once you're transferred to the nursing home in order for medicare to continue paying for your stay you must be receiving skilled nursing care

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provided by nursing or therapy staff as ordered by your physician.

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So, things like

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occupational therapy and physical therapy. 
Skilled care must be being provided to you.

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Medicare Part B.

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Medicare Part B enrollment.

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Again, if you're already drawing Social Security retirement benefits

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then

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you will automatically be enrolled into Medicare Part B

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and your start date for Part B will be the first of the month that you turn 65.

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If you

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happen to have a birthday on the first of a month

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it will be backdated by one month. 
So, let's say you're turning 65 on

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August 1st and you're drawing Social Security,

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Social Security will automatically enroll you into Medicare,

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but your start date, instead of being August 1st - it will be back dated to July 1st.

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For most people

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your start date for Medicare A and B is going to be on the first of the month that you turn 65,

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but if your birthday happens to fall on the first it gets backdated by one month.

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Again, if you're under 65

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but you're drawing Social Security disability benefits for at least 24 months it also, you also will be automatically enrolled.

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If you're not drawing any Social Security benefits at age 65

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then again same process as Part A. You need to sign up for

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Medicare Part B through the Social Security Administration in person, by phone, or online.

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You have the same seven month window.

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If you have the three months before you turn 65,

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and if you sign up anytime in those three months before you turn 65

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you will get a start date of the first of the month that you're turning 65.

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If you wait until the month that you turn 65, your start date for Part A

237
00:18:19,920 --> 00:18:21,840
will still be

238
00:18:21,840 --> 00:18:24,580
the first of the month that you turn 65,

239
00:18:24,960 --> 00:18:29,260
but your Part B start date will be the first of the following month.

240
00:18:30,640 --> 00:18:37,600
So, for example if you're turning 65 in August and you wait until the month of August to sign up for Medicare A and B,

241
00:18:38,080 --> 00:18:43,600
your Medicare A will still start on August 1st, but your Part B will not start until September 1st.

242
00:18:45,820 --> 00:18:51,040
Likewise, if you wait until the three months after your 65th birthday

243
00:18:52,080 --> 00:18:56,160
your Part - your A will still start on the first of the month that you turn 65,

244
00:18:56,720 --> 00:18:58,400
but that Part B

245
00:18:58,400 --> 00:19:00,400
is going to be delayed for

246
00:19:00,480 --> 00:19:03,439
anywhere between two and three months and it gets kind of complicated,

247
00:19:03,440 --> 00:19:07,320
so i'm not going to get into that too much. You can contact us for information on that.

248
00:19:07,760 --> 00:19:11,760
But, just know if it's important to you to get your A and B starting

249
00:19:12,400 --> 00:19:18,600
when you turn 65 you do not want to delay signing up because the Part B

250
00:19:19,120 --> 00:19:24,800
start date will be delayed anywhere between two and three months depending on how long you wait.

251
00:19:26,800 --> 00:19:30,280
In addition to your initial enrollment period

252
00:19:30,480 --> 00:19:35,320
there are also some other times when you can sign up for Medicare.

253
00:19:35,840 --> 00:19:41,980
Every year between January 1st and march 31 there is an annual general enrollment period

254
00:19:42,800 --> 00:19:47,220
for people who did not take Medicare when they turned 65

255
00:19:47,440 --> 00:19:49,440
and did not have any other

256
00:19:49,680 --> 00:19:57,240
coverage through work, so they don't have any other special circumstances that allow them to sign up whenever they want.

257
00:19:57,600 --> 00:20:03,280
So, for people in that category they have to wait until

258
00:20:03,440 --> 00:20:09,460
January, February, or March of whatever year they're in and they can sign up for Medicare.

259
00:20:10,320 --> 00:20:12,159
Their Part A -

260
00:20:12,160 --> 00:20:16,880
or their Part B, however, will not start until July 1st.

261
00:20:17,200 --> 00:20:23,300
So, if you didn't take Medicare at age 65 and you just haven't had any other insurance and now you're

262
00:20:23,660 --> 00:20:25,660
68 and you want to sign up for it

263
00:20:25,760 --> 00:20:32,559
you'd have to wait until January, February, or March to sign up and then the Part B would not start until the following

264
00:20:32,560 --> 00:20:33,920
July 1st.

265
00:20:33,980 --> 00:20:38,980
So, and then those folks also would have a late enrollment penalty

266
00:20:42,400 --> 00:20:48,360
I'm sure I'm going to get into this in a future slide, but if you don't have if you don't take Medicare Part

267
00:20:48,800 --> 00:20:52,380
B when you turn 65 and you did not have any other

268
00:20:52,860 --> 00:20:56,140
creditable coverage, and I'll explain what that is in a minute,

269
00:20:57,040 --> 00:21:04,240
you're stuck with this general enrollment period and you're stuck not getting that Part B to start for you until the following

270
00:21:04,240 --> 00:21:07,060
July 1st. So, you could have a lapse in coverage.

271
00:21:07,060 --> 00:21:09,220
You might need it right now, but you can't get it right now.

272
00:21:09,600 --> 00:21:13,900
And then, secondly, you may very likely have a late enrollment penalty assessed which

273
00:21:14,560 --> 00:21:17,740
means that you know, they'll they will make you pay

274
00:21:18,240 --> 00:21:19,840
10 percent

275
00:21:19,840 --> 00:21:22,420
higher premium every single month

276
00:21:22,720 --> 00:21:30,380
for every year that you didn't have Medicare Part B that you were supposed to they're going to assess a 10 percent late enrollment penalty

277
00:21:30,640 --> 00:21:36,380
So, the current premium is about 145 dollars a month, if they assess you a 10

278
00:21:36,480 --> 00:21:41,700
late enrollment penalty, you're not paying 145 bucks a month you're paying about

279
00:21:41,720 --> 00:21:47,680
156 bucks a month every month for the rest of your life.

280
00:21:48,960 --> 00:21:52,500
Some people do have what's called a special enrollment period.

281
00:21:52,800 --> 00:21:58,600
If you're turning 65, but either you or your spouse is actively working

282
00:21:58,880 --> 00:22:01,140
and carrying the insurance

283
00:22:01,760 --> 00:22:06,980
you do have the right to sign up for Part A only and defer taking Part B.

284
00:22:08,140 --> 00:22:15,040
Creditable coverage for Medicare is insurance that Medicare considers as good or better

285
00:22:15,200 --> 00:22:23,180
than Medicare. The only thing that Medicare considers credible coverage is insurance through active employment

286
00:22:23,440 --> 00:22:25,440
of you or your spouse

287
00:22:25,520 --> 00:22:33,120
and that active employment is for a an employer that employs at least 20 or more employees. It can't be a small

288
00:22:33,360 --> 00:22:35,500
Company. It can't be self-employment.

289
00:22:35,520 --> 00:22:37,520
It has to be a large group

290
00:22:37,600 --> 00:22:38,799
employer.

291
00:22:38,800 --> 00:22:39,920
and

292
00:22:39,920 --> 00:22:42,980
you have to verify with that employer's

293
00:22:43,360 --> 00:22:50,120
personnel or HR department that the insurance that they're providing to you is considered creditable for Medicare.

294
00:22:50,120 --> 00:22:55,700
But, if it is you can defer taking Part B 
until you're ready to stop working.

295
00:22:56,160 --> 00:23:01,540
You have - you can sign up for Part B at any time while you're working or up to eight months after you stop working,

296
00:23:01,760 --> 00:23:04,500
and you can pick your start date for Part B.

297
00:23:06,000 --> 00:23:09,520
So, again, just kind of reiterating for people turning 65

298
00:23:10,860 --> 00:23:16,780
creditable coverage is health insurance that is provided by a large group employer of 20 employees or more

299
00:23:17,440 --> 00:23:21,160
that is earned by you or your spouse through active employment.

300
00:23:21,820 --> 00:23:23,900
Retirement coverage does not count.

301
00:23:24,000 --> 00:23:25,900
Cobra does not count.

302
00:23:25,900 --> 00:23:30,400
Marketplace does not count. 
It is only active employment of a

303
00:23:31,160 --> 00:23:38,220
of an employer of 20 employees or more and please verify with your personal department that your insurance is considered creditable.

304
00:23:38,640 --> 00:23:41,080
For people under age 65 who have -

305
00:23:41,600 --> 00:23:43,020
who are disabled,

306
00:23:43,760 --> 00:23:45,920
it's a little bit stricter and generally

307
00:23:46,080 --> 00:23:52,140
they have to be employed or their spouse has to be employed by a large group employer of 100 employees or more.

308
00:23:52,400 --> 00:23:55,300
So, again, please verify with your

309
00:23:55,680 --> 00:23:57,440
company

310
00:23:57,440 --> 00:24:04,060
that you don't - You don't want to not take Part B thinking that you have creditable coverage and then find out later that it wasn't.

311
00:24:05,440 --> 00:24:08,520
Again, what is not considered creditable is

312
00:24:08,940 --> 00:24:10,000
Veterans.

313
00:24:10,000 --> 00:24:12,180
Veterans is not considered creditable.

314
00:24:12,460 --> 00:24:17,220
Marketplace, Cobra, retirement coverage, federal retirement insurance programs.

315
00:24:17,680 --> 00:24:23,400
None of those - Some of those are great insurance programs, but they're not considered creditable coverage for Part B.

316
00:24:23,760 --> 00:24:26,040
If you delay taking Part B

317
00:24:27,440 --> 00:24:31,020
thinking that you have creditable coverage and then find out that you do not

318
00:24:31,280 --> 00:24:37,980
you will have a premium penalty of 10 percent more for life for each year that you were eligible for Part B

319
00:24:38,000 --> 00:24:40,000
but did not enroll.

320
00:24:41,440 --> 00:24:46,380
Medicare Part B monthly premium is 144.60

321
00:24:47,600 --> 00:24:51,060
for for the year 2020.
Those rates can change.

322
00:24:52,560 --> 00:24:54,480
If you have a higher income

323
00:24:54,480 --> 00:24:59,440
you could pay pay more than that, but most people pay 144.60 a month.

324
00:24:59,480 --> 00:25:04,320
If you're drawing Social Security they're going to take those premiums right out of your social security check

325
00:25:04,480 --> 00:25:11,520
and you're going to continue to get - receive the the remainder of your Social Security minus that premium.

326
00:25:11,840 --> 00:25:16,100
If you're not receiving Social Security yet, but you do take Medicare,

327
00:25:16,880 --> 00:25:23,880
they are going to bill you. They're going to send you a bill for that premium and the billing is done quarterly.

328
00:25:24,320 --> 00:25:28,640
So, they will send you a bill for three months worth of that premium at a time

329
00:25:28,880 --> 00:25:33,100
and the first bill that they send you when you first sign up for Medicare

330
00:25:33,360 --> 00:25:40,260
is sometimes even higher than that because it depends on when you're signing up within their billing cycle.

331
00:25:40,480 --> 00:25:44,240
And, again, Social Security can take some time to get things processed.

332
00:25:44,400 --> 00:25:46,840
So, you might sign up for Part B and have it

333
00:25:47,120 --> 00:25:50,960
for a month or two and not receive a bill, and then when you do receive the bill

334
00:25:51,280 --> 00:25:53,760
Social Security is going to send you a bill for the past

335
00:25:53,920 --> 00:25:57,200
two months and then the next three months, so you might get a bill for

336
00:25:58,000 --> 00:26:01,420
three months, four months, or five months that first - that first

337
00:26:01,760 --> 00:26:07,540
bill that you receive. 
After that they will send you a bill quarterly or

338
00:26:08,080 --> 00:26:13,920
they will send you information on how you can set up an auto withdrawal from a checking or savings account on a monthly basis if

339
00:26:14,000 --> 00:26:19,820
you want to do it that way. And then once you do begin receiving your Social Security retirement benefits

340
00:26:21,120 --> 00:26:23,780
then they'll start taking the premium right out of that.

341
00:26:24,240 --> 00:26:26,080
The Medicare Part B

342
00:26:26,080 --> 00:26:31,720
Is your medical insurance. 
So, remember I said Part A is hospital?
That only works as an inpatient.

343
00:26:32,160 --> 00:26:39,320
This is your medical outpatient health insurance. 
It has a 198 dollar per year deductible

344
00:26:39,840 --> 00:26:45,260
and then after you meet the deductible, 
it pays 80 percent of your medical bills,

345
00:26:45,520 --> 00:26:51,080
and the other 20 is your responsibility
and there is no cap to that.

346
00:26:52,240 --> 00:26:57,700
IRMAA is Income Related Monthly Adjustment Amount. This just means that if you have a higher

347
00:26:58,400 --> 00:26:59,520
income

348
00:26:59,540 --> 00:27:03,800
that your premium for Part B may be higher.

349
00:27:04,140 --> 00:27:10,020
They base this on your income from your taxes from two years prior

350
00:27:10,480 --> 00:27:17,919
and then they review it every single year, and if it changes they'll lower or raise your premiums depending on on what your income

351
00:27:17,919 --> 00:27:18,720
was.

352
00:27:18,720 --> 00:27:24,420
There is a Medicare Costs at a Glance handout that we usually give you,

353
00:27:25,680 --> 00:27:29,880
but you can find that information on Social Security's website also.

354
00:27:31,440 --> 00:27:38,680
Medicare Part B covers medically necessary outpatient services including doctors visits, specialist visits, lab work, x-rays,

355
00:27:38,960 --> 00:27:41,520
ambulance rides, emergency room, urgent care,

356
00:27:42,220 --> 00:27:46,240
outpatient hospitalization.
So, if you're kept on observation status

357
00:27:47,340 --> 00:27:48,480
or

358
00:27:48,780 --> 00:27:54,780
you have an outpatient day surgery or procedure where you're not admitted overnight as an inpatient. That's all under your Part B.

359
00:27:55,440 --> 00:28:02,760
Any outpatient therapies. Part B medications include things like chemotherapy or kidney dialysis where you have to go

360
00:28:03,120 --> 00:28:06,620
and have the the medicine or drug administered to you

361
00:28:06,960 --> 00:28:08,080
there

362
00:28:08,080 --> 00:28:14,480
and then there are some preventive services that Medicare Part B covers where you do not have to worry about the

363
00:28:14,480 --> 00:28:17,780
deductible or the 20 copay.

364
00:28:18,560 --> 00:28:20,560
And, again, there is a

365
00:28:21,520 --> 00:28:24,560
Guide to Medicare's Preventive Services brochure

366
00:28:24,880 --> 00:28:31,040
that you can locate. 
I would say we probably have them at the ADRC office.

367
00:28:31,520 --> 00:28:33,520
I know that we -

368
00:28:33,840 --> 00:28:37,320
that they are found on medicare.gov

369
00:28:37,500 --> 00:28:39,500
also.

370
00:28:40,480 --> 00:28:44,340
When you first start your Medicare, 
it includes a Welcome to Medicare Visit

371
00:28:44,880 --> 00:28:48,080
for the first time and then every year after that.

372
00:28:48,320 --> 00:28:55,300
it includes a yearly wellness visit. 
When you're scheduling these appointments it's very important to use that terminology

373
00:28:55,440 --> 00:29:02,740
when scheduling the appointments, because if you call and say i'm calling to schedule my annual physical

374
00:29:02,960 --> 00:29:05,200
or i'm calling to schedule an exam,

375
00:29:06,640 --> 00:29:10,280
that is not a Welcome to Medicare Visit 
and that is not a yearly wellness visit.

376
00:29:10,640 --> 00:29:14,640
The Welcome to Medicare and the yearly Wellness Visits are very -

377
00:29:17,040 --> 00:29:23,340
are very short, brief contacts with your doctor where they kind of go through a checklist with you.

378
00:29:23,840 --> 00:29:29,520
If you during those visits say, you know "I've been feeling dizzy." and he says "Well, let's check you for vertigo."

379
00:29:29,600 --> 00:29:32,080
or "Let's do some blood work and make sure you're doing okay."

380
00:29:32,560 --> 00:29:38,520
that gets flipped over into a regular office visit, and it will be subject to the deductible in the copay.

381
00:29:38,680 --> 00:29:40,559
So, it's very important to

382
00:29:40,560 --> 00:29:47,460
when you're scheduling those visits say i'm calling to schedule my Yearly Wellness Exam or my - i'm sorry - my Yearly Wellness Visit under Medicare

383
00:29:47,920 --> 00:29:49,920
so that they know

384
00:29:50,080 --> 00:29:55,660
what to schedule you for to make sure that you don't have to worry about that deductible and 20 copay.

385
00:29:58,000 --> 00:30:05,940
Services not included by your Medicare.
Medicare does not include any vision. 
No dental. No hearing aids. Nothing.

386
00:30:07,600 --> 00:30:09,600
No long-term care needs.

387
00:30:09,840 --> 00:30:13,020
No cosmetic procedures. Not, no acupuncture.

388
00:30:13,360 --> 00:30:19,160
It does not provide any health care outside of the united states. So if you're traveling anywhere in the country

389
00:30:19,600 --> 00:30:23,400
Medicare is a federal insurance. It's going to work anywhere inside the united states,

390
00:30:23,680 --> 00:30:26,280
but it will not work outside the United States at all.

391
00:30:26,400 --> 00:30:28,900
It does not include routine foot care.

392
00:30:29,040 --> 00:30:36,860
Basically, anything that's not considered medically necessary Medicare is not going to cover it. It also does not include prescription drug coverage.

393
00:30:38,640 --> 00:30:41,220
So, original Medicare is health insurance administered

394
00:30:41,760 --> 00:30:45,379
by the center for Medicare and Medicaid Services or CMS.

395
00:30:46,000 --> 00:30:50,179
For those of you that are already drawing Social Security retirement benefits,

396
00:30:50,640 --> 00:30:55,599
remember I said that they're just going to automatically enroll you into Medicare and then mail you your card.

397
00:30:56,159 --> 00:30:58,819
Watch in the mail for anything from CMS.

398
00:30:59,440 --> 00:31:06,480
That will be your Medicare card. I know that people turning 65 are being inundated with a lot of junk mail,

399
00:31:07,039 --> 00:31:14,339
and so sometimes they just start throwing stuff in the garbage. If you get anything that says SSA that stands for Social Security Administration.

400
00:31:15,039 --> 00:31:20,639
Anything from CMS stands for Center for Medicare Services. Don't throw that stuff out that's important.

401
00:31:21,600 --> 00:31:26,319
Again Medicare pays a big part of your health insurance expenses, but it doesn't pay for all of them.

402
00:31:26,799 --> 00:31:30,079
So, next we're going to look at your additional options

403
00:31:31,360 --> 00:31:33,360
to go along with your Medicare.

404
00:31:34,320 --> 00:31:36,320
So,

405
00:31:37,039 --> 00:31:42,559
before we start looking at prescription drug options the first thing that we kind of look at is:

406
00:31:43,120 --> 00:31:45,120
Do you want anything to go along with your

407
00:31:45,519 --> 00:31:49,039
Original Medicare A and B health insurance?
And you have two

408
00:31:49,679 --> 00:31:54,819
routes that you can go. The first option is that you can add on what's called a Medicare Supplement

409
00:31:55,760 --> 00:31:58,579
or those are sometimes called Medigap policies.

410
00:31:59,440 --> 00:32:06,799
The second option is that you can add on a Medicare Advantage plan, which those are sometimes referred to as Medicare Part C.

411
00:32:07,760 --> 00:32:10,739
So, we will start by kind of looking at the Medicare Supplements.

412
00:32:11,279 --> 00:32:14,159
So, a supplement, true to its name, is going to

413
00:32:14,700 --> 00:32:18,640
supplement your Medicare - your med -Your original medicare is going to pay first.

414
00:32:18,880 --> 00:32:25,439
Your Medicare Supplement is going to pay second. 
And you're going to have very comprehensive health insurance coverage.

415
00:32:27,440 --> 00:32:35,440
Medicare Supplements are sometimes called medigap policies because they fill in that 20 percent gap that's left over by Medicare Part B.

416
00:32:36,559 --> 00:32:44,239
If you want to buy a medicare supplement, the very best time to do so is within six months of your part b starting

417
00:32:44,880 --> 00:32:49,199
Because you have what's called six months of guaranteed issue.

418
00:32:49,980 --> 00:32:55,839
Guaranteed issue means that you are guaranteed to be issued any supplement that you want,

419
00:32:56,480 --> 00:32:59,939
No questions asked.
you do not have to answer health questions.

420
00:33:00,799 --> 00:33:03,699
You do not have to worry about pre-existing conditions.

421
00:33:04,559 --> 00:33:11,999
You can go to an insurance agent and you can buy any supplement that you want and they cannot ask you any health questions.

422
00:33:12,000 --> 00:33:15,120
However, once that six month window closes

423
00:33:15,760 --> 00:33:18,019
If you then want to purchase a supplement

424
00:33:18,640 --> 00:33:24,719
Your guaranteed issue window has closed, and at that time you would be subject to health underwriting.

425
00:33:24,960 --> 00:33:29,760
They can ask you health questions. 
They can deny selling you a policy they can

426
00:33:30,399 --> 00:33:31,500
exclude

427
00:33:31,500 --> 00:33:36,319
pre-existing conditions, or they can charge you more money for a supplement if you

428
00:33:36,960 --> 00:33:44,159
Do have pre-existing conditions. 
So, if your health history is not the greatest and you

429
00:33:45,039 --> 00:33:51,039
do want to have comprehensive coverage the best time to buy a supplement is right away when your Part B is starting

430
00:33:51,840 --> 00:33:54,000
so that you don't have to worry about that in the future.

431
00:33:54,880 --> 00:34:00,239
Once you sign up for a Medicare Supplement, it's guaranteed renewable for life. As long as you pay your premium

432
00:34:00,880 --> 00:34:03,359
It's the safest most comprehensive option.

433
00:34:04,799 --> 00:34:07,538
If you buy a supplement sold in the state of Wisconsin

434
00:34:08,240 --> 00:34:11,939
they are all monitored by the Office of Commissioner of Insurance or OCI

435
00:34:12,879 --> 00:34:14,879
and they are all standardized.

436
00:34:15,119 --> 00:34:17,939
In Wisconsin - these plans that are sold in Wisconsin

437
00:34:18,639 --> 00:34:20,639
are going to follow you wherever you go,

438
00:34:20,960 --> 00:34:25,599
so if you are a snowbird and you want to live down south part of the year,

439
00:34:26,079 --> 00:34:32,879
or if you want to travel a lot throughout the country, or if you plan to move maybe to a different state

440
00:34:34,240 --> 00:34:37,300
the traditional supplement sold in the state of Wisconsin

441
00:34:38,000 --> 00:34:41,919
Is going to follow you wherever you go. 
So, as long as you go somewhere

442
00:34:42,720 --> 00:34:48,480
and Medicare is paying first your traditional supplement that you buy in Wisconsin is going to always pay second.

443
00:34:48,960 --> 00:34:50,480
And, it's not going to matter

444
00:34:50,480 --> 00:34:56,500
if you go to the Dean network of providers, or the UW network of providers, or if you move to Alaska.

445
00:34:57,200 --> 00:34:59,200
It will follow you there.

446
00:35:01,339 --> 00:35:03,339
OCI mandates that

447
00:35:03,760 --> 00:35:09,679
all of these supplements are going to provide you with the same basic coverages and the same options to add on

448
00:35:10,400 --> 00:35:12,960
Medicare Supplements are sold by insurance agents.

449
00:35:13,359 --> 00:35:18,419
So, all insurance agents doing business in Wisconsin are licensed by OCI

450
00:35:18,960 --> 00:35:24,720
and, and they're all - all the supplements are mandated to provide you with the same basic stuff.

451
00:35:25,000 --> 00:35:31,780
So, you know if you if you see an agent and you have a concern you can always contact OCI

452
00:35:32,400 --> 00:35:36,020
to file a complaint or to check on an agent's license.

453
00:35:36,640 --> 00:35:38,640
Most of the agents, I think,

454
00:35:39,440 --> 00:35:43,119
do believe that their product is the best or they wouldn't be selling it,

455
00:35:44,320 --> 00:35:51,439
but if you ever feel pressured certainly you don't have to purchase a supplement from from that particular agent. You can feel

456
00:35:52,079 --> 00:35:55,919
safe in knowing that all of the Wisconsin supplements are going to do just fine for you.

457
00:35:56,720 --> 00:36:01,439
So, you can feel free to purchase one from whichever agent you feel comfortable with.

458
00:36:02,480 --> 00:36:04,740
Traditional supplements again are always going to pick up the other 20 percent left over by Medicare Part B

459
00:36:08,160 --> 00:36:11,359
They're going to include all of the OCI mandated benefits.

460
00:36:11,440 --> 00:36:17,599
So, OCI has a list of benefits that they mandate that every single supplement sold in Wisconsin has to provide to you

461
00:36:18,240 --> 00:36:20,959
and any supplement that you buy is going to provide that.

462
00:36:21,680 --> 00:36:26,240
You can see any provider who accepts Medicare first. Your traditional supplement is going to pay second

463
00:36:27,280 --> 00:36:31,040
and it's always going to pick up that 20 percent.
You can add on

464
00:36:31,520 --> 00:36:35,759
some optional riders if you are okay with your premium being a little bit higher.

465
00:36:36,480 --> 00:36:42,800
So, if you want your supplement to pick up that Part A deductible when you go into the hospital, you don't want that bill for

466
00:36:43,359 --> 00:36:45,359
1,408 dollars.

467
00:36:46,079 --> 00:36:47,680
You can add on

468
00:36:47,680 --> 00:36:52,639
a Part A deductible rider onto your supplement and your supplement will cover that for you.

469
00:36:53,359 --> 00:36:55,519
Or you can ask your supplement to pay 50 percent,

470
00:36:56,240 --> 00:37:00,740
so, if you go into the hospital your supplement will pay about 700 and you'll pay the other 700.

471
00:37:01,920 --> 00:37:03,920
For folks whose Medicare started -

472
00:37:05,520 --> 00:37:07,839
at least their Medicare Part A started prior to

473
00:37:08,619 --> 00:37:10,639
January 1 of 2020

474
00:37:11,599 --> 00:37:15,039
they can also purchase a Part B deductible rider to cover that

475
00:37:15,660 --> 00:37:23,060
198 dollar per year Part B medical deductible.
If your medicare is starting after January 1st 2020

476
00:37:23,520 --> 00:37:25,679
this is no longer an option for you to purchase.

477
00:37:26,880 --> 00:37:29,760
There's a rider called Part B access charges

478
00:37:30,320 --> 00:37:35,839
which means if you happen to go to a provider that does not like the Medicare assigned rate

479
00:37:36,240 --> 00:37:39,520
and they want to charge you more money than Medicare wants to -

480
00:37:40,240 --> 00:37:42,879
than Medicare feels the service is worth,

481
00:37:43,920 --> 00:37:50,399
they have the right to charge you what's called excess charges of up to 15 percent more.

482
00:37:51,119 --> 00:37:54,319
So, what that means is if you happen to go to the doctor -

483
00:37:55,200 --> 00:37:59,060
Let's say you go to the Prairie Clinic and you have an appointment

484
00:37:59,599 --> 00:38:05,519
and the Prairie Clinic bills it to Medicare and Medicare says okay that appointment's worth a hundred dollars,

485
00:38:05,920 --> 00:38:09,280
so Medicare is going to pay 80 percent of that, which is 80 dollars.

486
00:38:10,320 --> 00:38:14,079
Your supplement would pick up the other 20 dollars. You're not going to have a bill.

487
00:38:14,720 --> 00:38:17,780
But, let's say you have that same appointment at the Mayo Clinic.

488
00:38:18,560 --> 00:38:21,759
Mayo Clinic reserves the right to charge excess charges.

489
00:38:22,880 --> 00:38:26,800
So, Medicare is going to say well we still feel it's only worth a hundred dollars,

490
00:38:26,880 --> 00:38:29,440
so we're gonna pay eighty percent which is eighty dollars.

491
00:38:30,079 --> 00:38:33,679
Your traditional supplement is going to come in next and pay the other 20,

492
00:38:34,640 --> 00:38:37,540
and then the Mayo Clinic is going to have that extra 15 percent

493
00:38:38,880 --> 00:38:43,119
or 15 dollars hanging out there because they they reserve the right to charge more

494
00:38:44,160 --> 00:38:46,160
which would be your responsibility

495
00:38:46,560 --> 00:38:50,560
unless you have this Part B Excess Charges rider on your supplement.

496
00:38:51,520 --> 00:38:55,300
If you have that rider, then the supplement will also pick up that 15 percent

497
00:38:56,240 --> 00:39:00,560
extra charge that the Mayo Clinic is charging you.

498
00:39:00,560 --> 00:39:05,119
So, most of the providers in this area do accept Medicare assignment.

499
00:39:05,920 --> 00:39:09,760
The Mayo Clinic is the only one in this area that we are aware of that does not.

500
00:39:11,040 --> 00:39:15,519
But, we do see this a little bit more at places that sell durable medical equipment

501
00:39:16,240 --> 00:39:22,659
where they require you to pay in full for your durable medical equipment, and then they will bill Medicare,

502
00:39:23,119 --> 00:39:25,119
and then they will refund you the money

503
00:39:25,280 --> 00:39:28,959
that Medicare pays minus the excess charges.

504
00:39:29,440 --> 00:39:31,440
So, if you don't want to worry about any of that

505
00:39:31,440 --> 00:39:37,119
you can just tell your insurance agent to add on that excess charges rider, so it's taken care of.

506
00:39:38,619 --> 00:39:42,078
Supplements will also provide you with some emergency medical coverage

507
00:39:42,640 --> 00:39:48,160
if you wish to travel outside of the United States.
Remember I said Medicare is a is a federal insurance?

508
00:39:48,240 --> 00:39:51,119
It's going to work anywhere within the United States with no problem.

509
00:39:51,599 --> 00:39:58,799
Your Medicare supplement, if purchased in Wisconsin, your traditional Medicare supplement will also follow you wherever in the United States that you go.

510
00:39:59,359 --> 00:40:01,359
But, if you go outside of the country

511
00:40:01,839 --> 00:40:03,119
and

512
00:40:03,119 --> 00:40:10,259
have an emergency, Medicare isn't going to work.
If you add on the Emergency Foreign Travel coverage rider onto your supplement

513
00:40:10,640 --> 00:40:15,760
your supplement will provide you with some medical emergency coverage outside of the country.

514
00:40:17,040 --> 00:40:21,040
Your supplement also gives you the option to add on some extra home health care.

515
00:40:21,839 --> 00:40:25,359
Medicare and your supplement already provide you with some home health care

516
00:40:25,920 --> 00:40:30,879
if you need that upon your release home from the hospital or the nursing home. 
This is just an

517
00:40:31,680 --> 00:40:35,359
extra home health care benefit for continued services if needed.

518
00:40:39,040 --> 00:40:45,279
Most of the supplements are going to be - I would say an average price range for a supplement is probably going to be around

519
00:40:45,660 --> 00:40:47,940
140 bucks a month for someone age 65.

520
00:40:48,960 --> 00:40:55,919
They can be less they can be more. There are ways to keep your premiums a little bit lower.

521
00:40:56,880 --> 00:40:58,880
Most of them are going to be what are

522
00:40:59,359 --> 00:41:01,359
called Attained Age, which means

523
00:41:01,760 --> 00:41:06,959
the cheapest they're ever going to be is at age 65 and then in age 70 75 80 and 85

524
00:41:06,960 --> 00:41:09,599
they're gonna bump up their premiums just because you're getting older.

525
00:41:10,240 --> 00:41:13,040
There are some that are called Issue Age

526
00:41:13,599 --> 00:41:17,999
where they the premiums will not go up every five years because of your age,

527
00:41:18,319 --> 00:41:21,519
but they still can't increase for inflation and other reasons.

528
00:41:22,560 --> 00:41:25,619
Cost sharing means, you know, you're willing to pay a 25 percent

529
00:41:26,240 --> 00:41:27,420
or 50 percent

530
00:41:27,420 --> 00:41:28,480
co-pay

531
00:41:28,480 --> 00:41:34,500
in order to keep your monthly premium down. And then high-deductible same thing if you're willing to pay some sort of a deductible

532
00:41:35,760 --> 00:41:39,599
then some of the insurance agents can sell you a plan that is going to have a lower premium.

533
00:41:42,300 --> 00:41:45,060
Historically, there have been things called Select Supplements

534
00:41:45,920 --> 00:41:49,220
which work like HMO's. I'm going to skip over that because

535
00:41:49,920 --> 00:41:53,839
they're not sold anymore in Wisconsin. 
So, it's not an option for you.

536
00:41:54,960 --> 00:41:55,680
So,

537
00:41:55,680 --> 00:42:01,839
if you had chosen to go with the Medicare Supplement again, Medicare pays first Supplement pays second.

538
00:42:02,079 --> 00:42:05,039
You have 100 coverage. 
You can go to any doctor you want.

539
00:42:06,400 --> 00:42:07,359
If

540
00:42:07,359 --> 00:42:09,759
you know, you say well, you know, I

541
00:42:10,319 --> 00:42:16,179
live in Baraboo and I doctor in Baraboo and I don't travel and I don't want to spend 140 dollars a month on a supplement,

542
00:42:17,040 --> 00:42:19,679
some people choose a Medicare Advantage Plan.

543
00:42:20,480 --> 00:42:23,119
Medicare Advantage Plans are sometimes called Part C.

544
00:42:23,920 --> 00:42:26,560
They do not work like supplements at all.

545
00:42:27,280 --> 00:42:29,839
A Supplement pays second to Medicare.

546
00:42:29,920 --> 00:42:33,200
So, if you have a Supplement you go to the doctor you show them your Medicare card.

547
00:42:33,359 --> 00:42:36,639
It pays first. You show your Supplement card. It pays second.

548
00:42:37,440 --> 00:42:43,040
If you choose to instead sign up for a Medicare Advantage Plan, Medicare Advantage plans

549
00:42:43,280 --> 00:42:48,179
do not pay second to your Medicare. 
They pay instead of your Medicare.

550
00:42:49,200 --> 00:42:50,240
So,

551
00:42:50,240 --> 00:42:52,639
you still have to remain enrolled in Medicare A and B.

552
00:42:53,599 --> 00:42:55,759
You still have to pay that Part B premium.

553
00:42:57,119 --> 00:43:00,879
But, think of it like taking your Medicare Card and you're going to put it away

554
00:43:01,599 --> 00:43:04,879
on a shelf at home in a safe place because you need to have it.

555
00:43:05,280 --> 00:43:10,079
You need to be enrolled in it. You need to pay for it, but you're not going to be allowed to use it

556
00:43:10,800 --> 00:43:13,199
If you choose to sign up for an Advantage Plan

557
00:43:13,680 --> 00:43:18,879
the Advantage Plan steps in front of that Medicare and it becomes your only health insurance.

558
00:43:19,200 --> 00:43:26,319
It becomes your health insurance and your drug coverage. Usually all-in-one. 
Most advantage plans include your drug coverage right in them.

559
00:43:29,280 --> 00:43:31,280
So, it's - Medicare

560
00:43:31,819 --> 00:43:34,719
contracts with these Advantage Plans to take over

561
00:43:35,280 --> 00:43:41,679
providing you with your health insurance. So, they replace your Medicare. They do not pay in addition to it. They pay instead of it.

562
00:43:42,640 --> 00:43:46,400
They are not guaranteed renewable for life. They can end each year.

563
00:43:47,119 --> 00:43:51,439
Every year there's an annual open enrollment where you can get in or out of these Advantage Plans.

564
00:43:52,319 --> 00:43:54,319
They are monitored by Medicare.

565
00:43:54,400 --> 00:44:01,599
So, they have to pay at least as good as Original Medicare would have.
So, Original Medicare

566
00:44:01,920 --> 00:44:03,599
Part B is

567
00:44:03,599 --> 00:44:06,639
pretty much 80/20. It pays 80 percent you pay 20 percent.

568
00:44:07,520 --> 00:44:10,879
An Advantage Plan can't pay worse than that.

569
00:44:12,240 --> 00:44:18,500
But, they are not monitored by OCI, so they're not required to provide you with any of those OCI mandated benefits.

570
00:44:20,000 --> 00:44:26,959
Most Advantage Plans have lower premiums than supplements. I say most because there are some Advantage Plans that are

571
00:44:27,599 --> 00:44:29,440
200 to 250 dollars

572
00:44:29,440 --> 00:44:31,119
a month.

573
00:44:32,319 --> 00:44:34,000
Most -

574
00:44:34,000 --> 00:44:36,000
almost all of them are going to have

575
00:44:36,060 --> 00:44:40,399
co-pays, deductibles, co-insurance of some sort. Those 200

576
00:44:40,960 --> 00:44:42,960
to 250 dollar range

577
00:44:43,119 --> 00:44:47,838
obviously have much fewer, co-pays and deductibles, but they still have them.

578
00:44:48,640 --> 00:44:54,480
You have to buy an Advantage Plan that is sold in your county and you have to see providers that accept your plan.

579
00:44:55,920 --> 00:44:57,599
There are

580
00:44:57,599 --> 00:45:02,318
Advantage Plans that that are HMO's where they say you absolutely have to see

581
00:45:02,880 --> 00:45:10,339
our providers network or we will give you zero percent coverage if you go out of network. There are some plans that are called PPO's

582
00:45:10,960 --> 00:45:14,399
where they say we have a provider network that we want you to use,

583
00:45:14,560 --> 00:45:16,719
but we'll let you go out of network if you want to,

584
00:45:17,680 --> 00:45:18,720
but

585
00:45:18,720 --> 00:45:22,800
there's usually strings attached to that which include if you go out of network

586
00:45:22,880 --> 00:45:27,200
we're going to have a higher copay or we're not going to pay as well.
Not always but most of the time.

587
00:45:28,079 --> 00:45:31,839
There's some Advantage Plans that say that they are private fee for service

588
00:45:32,319 --> 00:45:38,159
and they say we don't have a network of providers that you can go anywhere you want, which is technically true.

589
00:45:38,480 --> 00:45:40,480
They don't have a network of providers

590
00:45:40,800 --> 00:45:44,079
but you still can't necessarily go everywhere anywhere you want

591
00:45:45,839 --> 00:45:50,639
because you have to ensure - you have to double check and make sure that whatever provider you want to go to

592
00:45:51,200 --> 00:45:53,200
is willing to accept that insurance.

593
00:45:53,760 --> 00:45:59,599
So, just because the the Advantage Plan says you can go wherever you want doesn't mean that the Doctor

594
00:45:59,680 --> 00:46:05,919
Smith down the road is willing to accept that insurance. So you still have to make sure that he's willing to take it.

595
00:46:09,920 --> 00:46:13,839
Let's see here. 
So you must see providers who accept the plan.

596
00:46:13,920 --> 00:46:17,119
If you go to a provider that does not accept your Advantage Plan

597
00:46:17,119 --> 00:46:19,838
then you're gonna get a bill for the full amount of the service.

598
00:46:20,240 --> 00:46:27,379
Because, you remember, you've replaced that Medicare Card with your Advantage Plan now so you don't have that Medicare card to fall back on.

599
00:46:28,480 --> 00:46:32,719
Most Advantage Plans are going to include drug coverage and they will offer you some perks

600
00:46:33,200 --> 00:46:38,179
like some vision, some dental, some hearing aid benefit, maybe some free over-the-counter medicines.

601
00:46:40,000 --> 00:46:45,619
The - the amount the amount of perks that you get is generally directly

602
00:46:46,160 --> 00:46:52,079
related to the premium that you pay, so Advantage Plans can be as low as zero dollars per month

603
00:46:52,640 --> 00:46:56,079
which sounds great, but for a zero dollar a month plan

604
00:46:56,319 --> 00:47:01,599
you're not going to get a lot of those perks, and you're going to have a lot of medical co-pays, and

605
00:47:03,020 --> 00:47:05,439
co-insurance, and deductibles, and medical bills.

606
00:47:09,839 --> 00:47:10,480
An Advantage Plan that has, you know, a premium of 200 or 250 dollars

607
00:47:10,480 --> 00:47:14,639
a month is probably going to come with a lot more of those perks and a lot fewer

608
00:47:15,440 --> 00:47:21,679
medical co-pays, and deductibles, and co-insurance when you go to use the insurance, so it's usually a pretty direct

609
00:47:22,460 --> 00:47:26,800
correlation there. Medicare Advantage plans do not ask you any health questions,

610
00:47:26,880 --> 00:47:33,440
so other than if you have had or if you currently have end-stage renal disease,

611
00:47:34,640 --> 00:47:41,119
which is kidney disease, if you have end-stage renal disease you are not eligible to purchase an Advantage Plan.

612
00:47:41,599 --> 00:47:47,999
If you develop end-stage renal disease while you're enrolled into an Advantage Plan they will not kick you out,

613
00:47:48,319 --> 00:47:51,219
but if you already have that they're not going to sell you a policy.

614
00:47:51,680 --> 00:47:52,400
Other than that

615
00:47:52,400 --> 00:47:57,940
they don't ask any health questions so you can get in or out of them every single year during that annual open enrollment.

616
00:47:58,880 --> 00:48:02,579
And they do have annual caps on your out-of-pocket costs,

617
00:48:03,040 --> 00:48:09,699
so what that means is if they charge you co-pays every time you go to the doctor, they're going to keep track of those co-pays

618
00:48:10,240 --> 00:48:15,359
and the co-insurance that you've paid, and if you need a certain cap per year

619
00:48:15,680 --> 00:48:18,079
they will cover you in full for the rest of the year.

620
00:48:18,160 --> 00:48:24,399
So, for example, if you're if your two hundred and forty dollar a month Advantage Plan has an annual

621
00:48:25,280 --> 00:48:32,479
cap of four hundred dollars that means that you will pay no more than four hundred dollars in co-pays or coinsurance per year.

622
00:48:33,359 --> 00:48:39,039
If your zero dollar per month plan has a cap of six thousand seven hundred dollars

623
00:48:39,040 --> 00:48:44,159
that means you're going to be paying co-pays and co-insurance until you meet that sixty seven hundred dollar cap

624
00:48:44,400 --> 00:48:46,740
per year, and then next year it starts over.

625
00:48:48,319 --> 00:48:55,439
Medicare Advantage Plans have that initial enrollment window at age 65 the same as Medicare Part A and B,

626
00:48:55,920 --> 00:48:58,319
so it's the three months before you turn 65,

627
00:48:58,880 --> 00:49:01,780
the month you turn 65, and then the three months after.

628
00:49:02,240 --> 00:49:08,399
You have that seven month window to sign up for an advantage plan at age 65 if you wish to do so.

629
00:49:09,040 --> 00:49:09,760
After that

630
00:49:09,760 --> 00:49:17,040
you have an annual open enrollment every single year between October 15th and December 7th where you can get in or out of them.

631
00:49:17,599 --> 00:49:19,679
Anyone on medicare is eligible to do that.

632
00:49:22,380 --> 00:49:26,480
Additionally, every January 1st through March 31st there's a second

633
00:49:27,280 --> 00:49:29,839
open enrollment period for people who are

634
00:49:30,720 --> 00:49:33,679
currently in an Advantage Plan if they did not

635
00:49:34,880 --> 00:49:36,800
take care of it during the fall.

636
00:49:36,800 --> 00:49:40,819
People who are currently enrolled in a Medicare Advantage Plan have a second opportunity

637
00:49:41,760 --> 00:49:44,559
to drop their plan or switch into a different Advantage Plan.

638
00:49:45,440 --> 00:49:50,159
That second open enrollment from January 1 through March 31 is not open to everyone.

639
00:49:50,240 --> 00:49:54,399
It's only open to people who are currently enrolled in a Medicare Advantage Plan.

640
00:49:55,280 --> 00:50:02,399
And then again, there's always special enrollment periods based upon different scenarios. So if you are ever feeling stuck

641
00:50:03,040 --> 00:50:07,519
you can always call us. We can always see if we can find a special enrollment. No guarantee.

642
00:50:07,599 --> 00:50:09,759
But, we can always see what we can figure out.

643
00:50:11,119 --> 00:50:18,239
I kind of already touched on this - there's PPO's, HMO's, and private fee for services and I kind of already explained those to you.

644
00:50:21,440 --> 00:50:26,579
In 2020, there are 29 different Advantage Plans offered in Sauk County by five different companies.

645
00:50:27,119 --> 00:50:29,858
The premiums range from zero dollars a month to 241.

646
00:50:30,960 --> 00:50:32,960
There are deductibles and

647
00:50:33,520 --> 00:50:34,800
co-pays

648
00:50:34,800 --> 00:50:40,239
ranging from zero dollars up to twenty percent depending on which plan - how much - how high of a premium you have.

649
00:50:41,040 --> 00:50:45,839
Most of them include drug coverage - not all of them - but most of them include drug coverage right in them.

650
00:50:47,280 --> 00:50:53,839
So if after hearing the difference between Supplements and Advantage Plans, you're leaning towards. "Oh, I think I want to go with a supplement.".

651
00:50:55,040 --> 00:50:57,439
Remember, Medicare does not include prescription drugs.

652
00:50:57,680 --> 00:51:04,559
So, a Supplement is only going to pay second to whatever Medicare pays so a Supplement is not going to include drugs either.

653
00:51:04,559 --> 00:51:10,399
So, if you're going to go with Medicare plus a Supplement, you also have to add on some sort of prescription drug coverage.

654
00:51:11,359 --> 00:51:16,799
And for people who are on Medicare, you have a couple of options. Well, you have a few options.

655
00:51:18,000 --> 00:51:24,159
You can sign up for a Medicare Part D prescription drug plan or you can have creditable coverage from another source.

656
00:51:25,040 --> 00:51:27,119
So, credible drug coverage

657
00:51:27,680 --> 00:51:33,440
for Medicare purposes does not necessarily need to be from active employment. Remember we said

658
00:51:34,380 --> 00:51:40,319
creditable health insurance for Medicare Part B does have to be through active employment.

659
00:51:40,319 --> 00:51:44,079
That's the only thing that's considered creditable for Part B (as in boy).

660
00:51:44,800 --> 00:51:47,119
But for Part D (as in drug),

661
00:51:48,079 --> 00:51:54,399
you can have creditable coverage from another source such as Veterans, Meds by Mail program is creditable,

662
00:51:55,020 --> 00:52:00,179
employer coverage, retirement coverage, Cobra, coverage from a spouse is insurance,

663
00:52:00,640 --> 00:52:05,839
State of Wisconsin Senior Care is another option in the state of Wisconsin and I will explain that to you.

664
00:52:06,319 --> 00:52:12,558
So, creditable coverage for Part D (as in drug) can be from various places other than active employment,

665
00:52:12,559 --> 00:52:15,539
but again, just verify that it is considered credible.

666
00:52:16,960 --> 00:52:23,679
State of Wisconsin Senior Care is a state of Wisconsin drug plan. It's called a State Pharmaceutical Assistance Program.

667
00:52:24,079 --> 00:52:29,439
You have to be a resident of the state of Wisconsin and you have to be at least 65 years old to enroll.

668
00:52:30,160 --> 00:52:36,879
State of Wisconsin Senior Care does not charge a monthly premium. It charges a yearly thirty dollar enrollment fee.

669
00:52:37,599 --> 00:52:40,318
Your gross yearly income

670
00:52:41,020 --> 00:52:44,800
determines if you have a deductible under Senior Care or not.

671
00:52:44,960 --> 00:52:48,319
If you are single it goes by your single gross annual income.

672
00:52:48,800 --> 00:52:49,680
If you are married

673
00:52:49,680 --> 00:52:54,099
it goes by your combined gross annual income regardless

674
00:52:54,400 --> 00:52:58,319
of whether you both are signing up for Senior Care or only one of you is.

675
00:53:00,400 --> 00:53:04,800
It's accepted at most Wisconsin pharmacies. You can sign up for it at any time of the year.

676
00:53:04,880 --> 00:53:09,280
You don't have to worry about "Do I have a special enrollment?", "Is it annual open enrollment?",

677
00:53:09,359 --> 00:53:15,679
"Am I in in my initial enrollment?". You can you can sign up for Senior Care anytime you want as long as you're 65

678
00:53:15,760 --> 00:53:17,200
or older.

679
00:53:17,200 --> 00:53:21,119
It is the lowest cost option for those with no medications.

680
00:53:21,520 --> 00:53:26,399
So, Medicare says you have to have some sort of insurance to cover your prescription drugs

681
00:53:26,880 --> 00:53:29,520
Sometimes people say well, I don't take any prescription drugs.

682
00:53:29,520 --> 00:53:36,159
So, why should I pay for a Medicare drug plan when I don't take any meds? Sign up for State of Wisconsin Senior Care.

683
00:53:36,240 --> 00:53:39,359
It's the cheapest. Something that you can have to satisfy

684
00:53:39,359 --> 00:53:43,679
the requirement that says you have to have something. It's 30 bucks for the whole year

685
00:53:44,160 --> 00:53:50,720
and it it meets the requirement. And what that's going to do is it's going to prevent you from having a late enrollment penalty,

686
00:53:51,359 --> 00:53:54,879
later, if and when you do need to sign up for a Medicare drug plan.

687
00:53:55,040 --> 00:53:58,399
So, you don't you don't want to do nothing  because if you do nothing,

688
00:53:59,119 --> 00:54:02,399
and then five years down the road you want one of those medicare drug plans,

689
00:54:02,720 --> 00:54:07,359
they're gonna charge you a higher premium every single month because you didn't have something.

690
00:54:07,920 --> 00:54:09,920
This is the cheapest something you can have.

691
00:54:11,599 --> 00:54:15,359
If you do take meds and you need a Medicare drug plan,

692
00:54:15,920 --> 00:54:20,720
again, it has the exact same initial enrollment period as Medicare A and B

693
00:54:21,440 --> 00:54:22,400
and

694
00:54:22,400 --> 00:54:23,359
C.

695
00:54:23,359 --> 00:54:29,199
Those Advantage Plans D (as in drug) has the exact same initial enrollment period.

696
00:54:29,280 --> 00:54:31,379
It's the three months before you turn 65,

697
00:54:32,240 --> 00:54:36,099
the month you turn 65, and the three months after you turn 65.

698
00:54:36,799 --> 00:54:40,419
If you don't sign up for a Medicare Part D drug plan during your IEP

699
00:54:41,760 --> 00:54:43,040
then

700
00:54:43,040 --> 00:54:49,040
you have the annual open enrollment of October 15 through December 7th every single year

701
00:54:49,359 --> 00:54:54,318
to get in or out of those drug plans. You can drop it. You can switch it. You can sign up for something different.

702
00:54:54,960 --> 00:55:01,040
You can enroll if you never enrolled before and then your coverage will start January 1 of the next year.

703
00:55:02,799 --> 00:55:07,359
If you sign up for a medicare drug plan and you're really happy with it this year, and everything's going great,

704
00:55:07,599 --> 00:55:11,999
and you think "Uh, i'm just gonna stick with it.", please check it every single fall.

705
00:55:12,799 --> 00:55:16,819
The medicare drug plans work on an annual contractual basis with Medicare

706
00:55:17,200 --> 00:55:20,879
which means that every single year these plans can change.

707
00:55:21,520 --> 00:55:24,419
They can raise their premiums, raise their deductibles.

708
00:55:24,960 --> 00:55:29,619
They can choose to no longer cover your meds. They can choose to no longer work at your pharmacy.

709
00:55:30,160 --> 00:55:34,399
A new plan might come out that is going to save you some money.

710
00:55:34,799 --> 00:55:38,399
Your medications could have changed in over the course of a year

711
00:55:38,799 --> 00:55:44,159
and you might get put on something - you might be on something different that maybe a different plan would cover better for you.

712
00:55:44,640 --> 00:55:47,839
So, even if you think this plan has been fine for me

713
00:55:48,640 --> 00:55:50,640
please double check it every fall

714
00:55:50,700 --> 00:55:55,679
because lots of times if you switch plans and get a new plan for next year

715
00:55:55,920 --> 00:56:01,200
you're gonna save some money. And if you don't know how to check that or don't feel comfortable checking that

716
00:56:01,520 --> 00:56:04,559
call the ADRC. We will do that for you every single year.

717
00:56:05,920 --> 00:56:10,879
Again, there's always the possibility that a special enrollment period might be available.

718
00:56:11,599 --> 00:56:16,479
We would just need to meet with you and or talk to you about that and see what we could figure out.

719
00:56:17,760 --> 00:56:19,359
This year for 2020

720
00:56:19,359 --> 00:56:25,919
there are 30 different drug plans to choose from. They range in premium price from 13 dollars a month up to

721
00:56:26,380 --> 00:56:30,720
124 dollars a month. They can have a deductible of anywhere from zero to

722
00:56:31,339 --> 00:56:35,859
435 dollars per year. And they can - and all of them are going to have co-pays

723
00:56:36,400 --> 00:56:43,540
that you pay at the pharmacy when you pick up your meds and that's going to just vary depending on is your medication a generic,

724
00:56:44,000 --> 00:56:46,399
are you using this at a preferred pharmacy.

725
00:56:48,720 --> 00:56:56,399
You know - does the drug plan have some special deal? So, we we can always run that plan finder for you -

726
00:56:57,339 --> 00:56:59,339
medicare.gov. www.medicare.gov

727
00:57:04,819 --> 00:57:11,119
is Medicare's website where we can sit down with you, enter your medications, and to the pharmacy that you like to use, and help you find the plan that's going to work best for

728
00:57:11,339 --> 00:57:15,599
you. Some people come in and say "Well, just sign me up for that 13 month plan

729
00:57:17,280 --> 00:57:19,999
because it's got the cheapest premium or the lowest premium.".

730
00:57:20,400 --> 00:57:25,440
It's not going to save you any money if it's not going to work at the pharmacy that you want to use

731
00:57:25,760 --> 00:57:28,959
and it's not going to cover your medications for you at the lowest cost.

732
00:57:29,599 --> 00:57:34,558
So, please, please, please run the plan finder into your meds.

733
00:57:36,000 --> 00:57:38,000
Don't just look at the premium.

734
00:57:38,000 --> 00:57:44,319
Don't let a plan with a 435 deductible scare you away because lots of times it's not going to affect you at all.

735
00:57:44,880 --> 00:57:46,960
If if it's confusing to you

736
00:57:47,520 --> 00:57:50,079
call us at the ADRC. We will help you

737
00:57:50,880 --> 00:57:52,960
review this and and look at your options.

738
00:57:53,839 --> 00:58:00,959
You need to look at your costs overall for the whole year when you add up the premium any deductible any co-pays,

739
00:58:01,680 --> 00:58:04,000
and find the plan that's going to save you the most money.

740
00:58:06,400 --> 00:58:07,440
Again,

741
00:58:07,440 --> 00:58:09,540
all of the plans can have a deductible.

742
00:58:10,240 --> 00:58:12,240
Many of them do.

743
00:58:12,240 --> 00:58:18,000
Lots of them will waive that deductible for you if you use their preferred pharmacy or if all of your meds are

744
00:58:18,880 --> 00:58:24,480
tier one generic, so, don't let the deductible necessarily scare you away.

745
00:58:25,280 --> 00:58:30,179
Then they're all going to bump you into an initial period of coverage where you're going to have some sort of co-pay.

746
00:58:30,880 --> 00:58:34,900
The donut hole kind of scares people. That's where your co-pays can go up.

747
00:58:35,339 --> 00:58:40,879
Again,  if you have a few generic meds, that's not going to affect you a whole lot, if at all.

748
00:58:41,359 --> 00:58:44,879
The donut hole really kind of affects people that have have

749
00:58:45,660 --> 00:58:47,660
insulins, inhalers,

750
00:58:48,640 --> 00:58:55,140
tier three, four, five - you know, tier three or four name brand, or tier five specialty medications.

751
00:58:55,680 --> 00:59:00,319
Those are gonna be the really pricey meds. That's where that donut hole is gonna -you're gonna feel that a lot.

752
00:59:00,880 --> 00:59:07,119
And, then some people end up in the catastrophic coverage phase where your co-pays go way down again at the end of the year.

753
00:59:07,680 --> 00:59:13,119
It really depends on your medications that you take. So again, just contact us.

754
00:59:13,200 --> 00:59:15,919
We will help you go through all of this. We will sit down with you

755
00:59:16,480 --> 00:59:18,480
and show you your data

756
00:59:18,880 --> 00:59:20,880
and help you pick the best plan.

757
00:59:21,839 --> 00:59:24,818
Medicare Part D plans cover prescribed medications

758
00:59:25,520 --> 00:59:29,919
that are on their formulary. 
Not all medications are covered by all plans

759
00:59:30,400 --> 00:59:38,160
So, a good example is if you are prescribed the pro-air inhaler, your plan may not cover that pro-air inhaler,

760
00:59:38,240 --> 00:59:42,879
but they will cover maybe the ventilating inhaler or the Advair inhaler.

761
00:59:43,000 --> 00:59:49,759
So, if you really need that pro-air you want to pick a plan that's going to cover that pro-air. If you can

762
00:59:50,640 --> 00:59:53,599
handle any inhaler, it doesn't have to be the pro-air,

763
00:59:54,319 --> 00:59:59,339
then you know maybe your plan would be okay, a different plane would be okay for you.

764
00:59:59,339 --> 01:00:05,679
You have - they will only cover medications that are being prescribed for the medically prescribed use,

765
01:00:06,400 --> 01:00:09,599
so if you're being prescribed

766
01:00:10,400 --> 01:00:13,059
an antidepressant to help you stop smoking,

767
01:00:14,000 --> 01:00:17,780
but it's not approved to stop smoking, it's only approved as an anti-depressant.

768
01:00:18,559 --> 01:00:24,319
A drug plan isn't going to cover that. You have to be being prescribed the medication for the prescribed use.

769
01:00:26,000 --> 01:00:33,280
Part D will cover insulin needles and syringes for the administration of insulin and medications that are approved by the FDA.

770
01:00:33,359 --> 01:00:37,598
So if you want to try a drug, that's not FDA approved Medicare Part D will not cover that.

771
01:00:39,119 --> 01:00:41,539
Part D will not cover over-the-counter meds,

772
01:00:42,460 --> 01:00:45,460
non-prescription meds, vitamins, mineral supplements,

773
01:00:46,400 --> 01:00:52,160
drugs for non-medically necessary purposes not approved by FDA, or for your need

774
01:00:53,119 --> 01:00:57,358
and not on your plan's formulary.
That being said if you sign up for a drug plan

775
01:00:57,680 --> 01:01:03,040
and then after you're on this drug plan your doctor prescribes you a medicine that your drug plan doesn't cover -

776
01:01:04,880 --> 01:01:06,880
again just know that sometimes

777
01:01:07,599 --> 01:01:10,879
things can work out - you can ask your doctor to request an exception

778
01:01:11,440 --> 01:01:15,760
to the drug plan to cover it for you until the rest of, for the rest of the year until we can

779
01:01:16,160 --> 01:01:18,399
look at a different plan for you for next year.

780
01:01:20,380 --> 01:01:21,920
Sometimes,

781
01:01:21,920 --> 01:01:26,079
like I said, with the the inhaler maybe your plan doesn't cover this brand of inhaler,

782
01:01:26,079 --> 01:01:32,159
but your doctor can prescribe you a different brand, sometimes doctors have programs where you can get samples or help

783
01:01:32,640 --> 01:01:34,400
with meds in another way.

784
01:01:34,400 --> 01:01:41,040
So, and sometimes we can find a special enrollment to get you out of your drug plan and into something else

785
01:01:42,160 --> 01:01:44,480
throughout the year. It just kind of depends. So, don't,

786
01:01:45,280 --> 01:01:49,359
don't just sit there and not get your medication because your drug plan says they're not going to cover it.

787
01:01:49,680 --> 01:01:53,919
Talk to your doctor or call the ADRC and we can see if we can try to help you.

788
01:01:56,000 --> 01:02:00,419
Where to go for help with a Medicare Part D drug plan? Again www.medicare.gov

789
01:02:02,640 --> 01:02:05,379
is Medicare's website. Do not go to Medicare.com

790
01:02:06,000 --> 01:02:12,399
or org. 
You will get connected to people trying to sell you something or get redirected somewhere else

791
01:02:13,359 --> 01:02:15,359
Dot gov is Medicare's

792
01:02:16,619 --> 01:02:24,019
legitimate website. You can also call Medicare or or the State of Wisconsin has a helpline called the Medigap

793
01:02:24,460 --> 01:02:26,319
Prescription Drug Helpline.

794
01:02:26,319 --> 01:02:32,959
But, the easiest way is probably - unless you're really good with computers - the easiest way is to just call us at the ADRC.

795
01:02:33,520 --> 01:02:41,520
Again, I cover Baraboo, Merrimac, Sauk City Prarie du Sac, and north freedom. And Mindy covers Reedsburg, Spring Green, Rock Springs, Plain, Lake

796
01:02:41,520 --> 01:02:46,079
Delton, Wisconsin Dells, and some of those outlying. I know i'm missing some communities, but there are some

797
01:02:46,960 --> 01:02:49,199
other outlying communities out there.

798
01:02:50,400 --> 01:02:55,039
But, you can always just call the ADRC regular number and the receptionist will

799
01:02:55,520 --> 01:03:01,139
get you connected with an intake worker, and they will connect you with the right person if you don't remember all this.

800
01:03:02,960 --> 01:03:09,359
If this is overwhelming as far as the prices are going, there -  there are programs that can help people

801
01:03:09,920 --> 01:03:12,720
pay for either their Medicare Part B premium,

802
01:03:13,280 --> 01:03:15,280
that 145 a month,

803
01:03:15,339 --> 01:03:19,538
or and/or their Medicare Part D for drug premium.

804
01:03:20,400 --> 01:03:22,819
They can get rid of those Part D deductibles.

805
01:03:24,160 --> 01:03:28,260
They can get you really low co-pays at the pharmacy for your medications

806
01:03:29,440 --> 01:03:33,440
and some of the programs even get you the Medicaid Card that

807
01:03:34,079 --> 01:03:40,179
can serve as a supplement to your Medicare, so you don't have to pay for a supplement you can just have Medicare plus the Medicaid.

808
01:03:40,960 --> 01:03:47,000
And those are all free programs if you're eligible based on your income and your assets.

809
01:03:47,000 --> 01:03:54,399
So again, this is just kind of a list of those programs. There's QMB, Slim B, Slim B Plus.

810
01:03:54,960 --> 01:04:00,899
There's other - a few other programs too. You can apply for those programs through the Capital Consortium

811
01:04:01,760 --> 01:04:03,760
which is

812
01:04:04,880 --> 01:04:07,700
- I'll give you the number at the end of the slide program.

813
01:04:07,700 --> 01:04:15,619
But, on the fourth floor of the West Square Building, we do have Economic Support intake workers who can help you make those - do those applications.

814
01:04:16,720 --> 01:04:20,020
But, again, the easiest way is probably to contact the ADRC

815
01:04:20,559 --> 01:04:22,079
and ask for

816
01:04:22,079 --> 01:04:25,279
either Mindy or me, and we'd be happy to screen you for those programs.

817
01:04:25,280 --> 01:04:30,239
And, if we think you might be eligible we can certainly help you apply for those programs as well.

818
01:04:32,720 --> 01:04:39,839
Even if you're not eligible for those programs, the Social Security Administration also has their own program called Extra Help,

819
01:04:40,160 --> 01:04:47,920
and, it specifically helps just with your drug medication costs. So, you again you can apply

820
01:04:48,480 --> 01:04:50,980
for that program through the Social Security Administration.

821
01:04:51,839 --> 01:04:56,078
But, the easiest way again is just contact the ADRC ask for Mindy or me

822
01:04:56,559 --> 01:05:01,999
and we can screen you for that program. And, if we think you might be eligible we can certainly help you apply for it

823
01:05:04,240 --> 01:05:09,839
Just some final words of caution.
Always review your quarterly Medicare summary notice.

824
01:05:09,920 --> 01:05:16,420
So, once you're on Medicare, Medicare sends you a statement or an explanation of benefits every three months that outlines

825
01:05:17,520 --> 01:05:22,639
where you've been seen, what services you've received, what Medicare paid, what was left over,

826
01:05:23,119 --> 01:05:27,358
what you might be billed if you didn't have a supplement.

827
01:05:27,599 --> 01:05:31,679
It's important to review those because if you see anything on there that doesn't look right -

828
01:05:32,079 --> 01:05:34,879
you know - if you get that Medicare summary and it says you saw Dr.

829
01:05:35,599 --> 01:05:42,259
X in July of 2019 and you didn't see a Dr X in July of 2019

830
01:05:42,960 --> 01:05:43,839
then

831
01:05:43,839 --> 01:05:45,119
that might be the case that

832
01:05:45,119 --> 01:05:49,838
somebody's got your Medicare number and they're trying to bill - it bill your Medicare for things that you haven't been receiving.

833
01:05:50,400 --> 01:05:54,160
So, it's important to not ever give out your Medicare number except to your doctor

834
01:05:54,720 --> 01:05:57,039
or a confirmed Medicare provider.

835
01:05:57,760 --> 01:06:02,659
Lots of times people say "Oh, I saw this commercial on TV for a free back brace!" or -

836
01:06:04,319 --> 01:06:06,319
Those are people trying to get your Medicare

837
01:06:06,880 --> 01:06:09,619
number so that they can bill your Medicare card for services

838
01:06:10,480 --> 01:06:12,240
that you don't receive.

839
01:06:12,240 --> 01:06:14,240
Or, they they have these

840
01:06:16,140 --> 01:06:19,520
braces that you get in the mail and they're not gonna - they're not in good quality

841
01:06:19,599 --> 01:06:25,038
or they're not right if you need a brace or some sort of durable medical equipment. Talk to your doctor.

842
01:06:25,119 --> 01:06:31,358
He can write your prescription. He or she can write you a prescription and you can go to a reputable durable medical equipment

843
01:06:31,760 --> 01:06:33,760
provider and get it covered.

844
01:06:34,799 --> 01:06:36,720
I caution people -

845
01:06:36,720 --> 01:06:40,559
Medicare doesn't ever call you or visit you or try to sell you anything.

846
01:06:41,280 --> 01:06:44,319
Social Security does not call you, unless

847
01:06:45,039 --> 01:06:51,599
under certain circumstances, if we do an application and I tell you Social Security might give you a follow-up phone call because we

848
01:06:51,980 --> 01:06:53,760
contacted them first,

849
01:06:53,760 --> 01:06:58,479
very rarely. But, Social Security will never call you out of the blue and say

850
01:06:59,119 --> 01:07:02,078
your benefits are going to be ending unless you do something.

851
01:07:02,960 --> 01:07:05,439
Be very wary of any offers for free

852
01:07:06,160 --> 01:07:08,160
medical services or products.

853
01:07:08,960 --> 01:07:13,139
Treat your Medicare card and your Social Security number like a credit card.

854
01:07:14,480 --> 01:07:20,719
If you suspect after looking at your explanation of benefits that there is has been some Medicare fraud or abuse

855
01:07:21,520 --> 01:07:23,520
call that provider to let them know.

856
01:07:24,319 --> 01:07:31,459
Gather as much information and documentation as you can and you can also contact the Wisconsin Senior Medicare Patrol

857
01:07:33,200 --> 01:07:35,200
at (888) 818-2611

858
01:07:37,760 --> 01:07:41,459
for free and confidential help to report your concerns.

859
01:07:42,160 --> 01:07:45,200
So, some final reminders and I'm hoping we're not running out of time here.

860
01:07:45,520 --> 01:07:50,559
You sign up for Social Security retirement between the ages of 62 and 70,

861
01:07:50,960 --> 01:07:55,839
but don't sign up, any earlier than three months before you want your benefits to start.

862
01:07:56,720 --> 01:08:04,159
You sign up for Medicare A and B at age 65 during your seven month initial enrollment period - the three months before your birthday month,

863
01:08:04,799 --> 01:08:07,679
the month you turn 65, the three months after.

864
01:08:08,700 --> 01:08:10,400
Medicare supplements

865
01:08:10,400 --> 01:08:12,400
are sold by insurance agents

866
01:08:12,400 --> 01:08:18,560
and you have six months of Guaranteed Issue from the start date of your part B to buy any supplement that you want, no questions

867
01:08:18,640 --> 01:08:19,520
asked.

868
01:08:19,520 --> 01:08:23,839
You can contact your insurance agent that you purchase your auto or your home insurance through

869
01:08:24,319 --> 01:08:28,079
and work with them, or you can contact the ADRC.

870
01:08:28,159 --> 01:08:33,699
We do have an Insurance Agent Resource Guide of some agents in Sauk county that do sell Medicare Supplements.

871
01:08:34,640 --> 01:08:37,839
Advantage plans, also known as Part C,

872
01:08:38,560 --> 01:08:43,839
and prescription drug plans known as Part D have the same initial enrollment period

873
01:08:44,799 --> 01:08:51,778
as Medicare A and B, so the three months before you turn 65, the month you turn 65, and the three months after.

874
01:08:53,120 --> 01:08:55,120
After that

875
01:08:55,199 --> 01:08:56,719
you're kind of stuck

876
01:08:56,719 --> 01:09:01,759
waiting for the annual open enrollment if you want to sign up for an Advantage Plan or a drug plan.

877
01:09:02,239 --> 01:09:05,839
The annual open enrollment is October 15th through December 7th

878
01:09:06,319 --> 01:09:09,939
and that's your time to sign up for a plan if you did not do so at age 65.

879
01:09:10,480 --> 01:09:12,799
And, it's also your time every single year

880
01:09:13,199 --> 01:09:17,519
to check the plan that you do have to make sure it's going to be good for you for next year.

881
01:09:18,000 --> 01:09:21,199
And, if it is great, you just stay in it.
if it's not

882
01:09:22,000 --> 01:09:25,359
then you might want to switch and, again, we can review that for you.

883
01:09:27,199 --> 01:09:29,199
If you're enrolled in the Medicare Advantage plan,

884
01:09:29,359 --> 01:09:35,758
you have a second opportunity to switch that plan or drop that plan every January, February, and March.

885
01:09:36,560 --> 01:09:38,159
And again

886
01:09:38,159 --> 01:09:45,599
if none of those apply to you and you're feeling stuck see us because sometimes other special enrollment windows may apply.

887
01:09:46,159 --> 01:09:49,839
So, if you've had other work coverage or something else and that's ending

888
01:09:50,239 --> 01:09:55,359
you may very likely have a special enrollment period to sign up for one of these things at that time.

889
01:09:57,280 --> 01:10:05,219
Some final - just information contact numbers: the ADRC office in Baraboo, our phone number is (608) 355-3289.

890
01:10:09,920 --> 01:10:12,739
Social Security office in Portage (888) 875-1681

891
01:10:16,880 --> 01:10:19,540
or you can go on their website ssa.gov.

892
01:10:21,600 --> 01:10:28,479
If you're a veteran or the spouse of a veteran, please contact our Sauk County Veterans Services Office

893
01:10:29,340 --> 01:10:31,340
at 355-3260

894
01:10:33,040 --> 01:10:35,020
to see what

895
01:10:35,020 --> 01:10:38,159
services or programs you may be eligible for.

896
01:10:39,679 --> 01:10:40,699
 

897
01:10:40,699 --> 01:10:42,699
Medigap Helpline

898
01:10:42,699 --> 01:10:46,019
Medicare - 1 (800) Medicare.
You can call if you have questions.

899
01:10:47,120 --> 01:10:50,559
State of Wisconsin Medigap Helpline for help with prescription drug

900
01:10:51,500 --> 01:10:53,500
insurance is 1 (800) 242-1060.

901
01:10:57,520 --> 01:11:00,739
Medicare again is 1 (800) Medicare or medicare.gov.

902
01:11:03,520 --> 01:11:06,799
The Office of Commissioner of Insurance, or OCI, can be reached at

903
01:11:11,280 --> 01:11:13,280
(800) 236-8517.

904
01:11:15,440 --> 01:11:18,500
The Senior Medicare Patrol (888) 818-2611.

905
01:11:22,719 --> 01:11:29,678
And, the Capital Consortium where you can call to apply for those Medicare Savings or Medicaid Programs is

906
01:11:29,678 --> 01:11:34,400
(888) 794-5556.

907
01:11:34,400 --> 01:11:45,760
But, again, if you just want to call us at the ADRD we are more than able and willing to help you with any of these

908
01:11:45,760 --> 01:11:48,239
programs. So, if you do not feel comfortable calling

909
01:11:51,360 --> 01:11:57,759
on your own to those places, please just feel free to contact the ADRC.
So, that's all I have for you today.

910
01:11:58,800 --> 01:12:04,820
If you have any questions or concerns, or would be interested in a follow-up appointment

911
01:12:06,400 --> 01:12:10,179
you can contact our office again, our ADRC office number is (608) 355-3289.

912
01:12:13,040 --> 01:12:17,760
or we do have a toll-free number of 1 (800) 482-3710

913
01:12:17,760 --> 01:12:21,460
And you can give us a call anytime.
Thank you.