Sage Insurance Advisors LLC, specializes in Medicare plans and represents insurance companies offering Medicare supplements, Medicare Advantage Plans, and Part D prescription drug plans.

Serving Northeast Indiana from 4233 East State Boulevard in Fort Wayne and online at SageInsuranceAdvisors.com.

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>> Hello and thanks for watching LIFE Ahead on PBS Fort Wayne.

I'm your host Mark Evans and this of course is a program providing very vital information for adults of all ages and tonight's topic is Medicare enrollment.

Now in commercial TV you've probably seen commercial after commercial about enrolling in Medicare and various insurance plans you can enroll in.

But we're going to be talking about things like who needs to enroll?

Is it mandatory?

What benefits does Medicare cover and also what changes are taking place in 2027?

So very important program especially if you're going to need to enroll in Medicare this year.

So everything you need to know about Medicare but we're afraid to ask so to speak and we have a very special guest.

>> He's been on the program before Greg McDonald.

He's an insurance adviser.

So thank you for coming on to tackle this particular subject tonight.

>> Well, you know, I've been doing this for a few years.

It's nice to be on with you and so, you know, Medicare changes so much year to year there's always the standard stuff but there's always changes too.

>> So this is the time that everyone really if you have a drug plan or an advantage plan, you really do need to take time to check it out.

>> We have that opportunity.

All right.

Well, I also want to invite our viewers to either call or text us with your question.

Both numbers are on your screen .

>> Call us and if you want to be on the air live and talk to Greg, that's fine or talk to me.

That's fine.

You probably don't want to talk talk to that anyway or you can ask us the question.

>> We can transcribe that for so I could read it for you on the air.

Another way is to text and that's a fairly new way here at PBS for waiting for us to retrieve your questions and to interact with you.

So when you do so that text number of course is on the screen as well.

Make sure you give us your name and the town you're calling or texting from.

Thank you so much for doing that in the meantime, we're going to go ahead and get started.

Let's get started here, Greg.

For those who don't know exactly what Medicare is, who is what is it first of all and who's eligible?

>> Well, it Medicare is health insurance for seniors who qualify and most people who have worked 10 years throughout their life qualify for Medicare and it is they have two parts to Medicare and B A after 40 quarters of work or 10 years is free because you've paid into it during your working career.

>> Part B which covers your doctor's outpatient facilities, the E.R.

that they have an additional premium for that that most people that will just come right out of your Social Security check and if you don't have Social Security they'll believe for that now especially when you are approaching the age of 65 or at 65 I mean obviously because you have to enroll it doesn't click in automatically does it depends.

So if you are collecting Social Security they will automatically enroll you.

>> In fact you have to tell them that you don't want it.

Oh, but if you are most a lot of time people at 65 have retired or are retiring so they will accept it if however someone is working and they're on their companies group health plan and they want to continue on it, you don't have to enroll in Medicare.

In fact, if you have a health savings account you don't want to enroll in Medicare because that would prohibit you making contributions to your savings account.

>> Well, that's very interesting.

I never thought of that.

OK, and explain the enrollment period what goes on during that time and how long does it last?

>> So we're coming into right now in the fall it's called the annual enrollment period and it runs from October 15th to December 7th.

This is the time when people who have Medicare Advantage plans or prescription drug plans have a chance to review their plan, see how it how the 27 plans in this case look and is it still a good fit?

>> And the reason I encourage people to look at that because things change.

OK, I've got a drug plan and it's OK the price I can deal with the price because you see it on television or you get a letter.

>> What it doesn't necessarily tell you is if your drugs are still covered and I have seen just on reviews that I've done so far common drugs like Jardins and Sorento, some of the companies have dropped them.

So you want to check but don't take it for granted that you're good to go make sure you check on it because advantage plans you have a period of three months the beginning of the year.

>> You can make a change on a drug plan.

You can't.

So if you don't you're not on the right plan now you set it up before December 7th and you're stuck for the year.

>> All right.

And can you enroll in Medicare on your own or should you seek some help?

>> Well, Medicare itself yeah.

You enroll on your own either go to Social Security to do it and you can do that on line or go to the office Social Security office when it comes to Medicare plans, can you enroll?

>> Yeah.

I mean the insurance companies will gratefully take people who want to enroll or you can go to Medicare dot gov and you can enroll in plans and you can do a lot of your own research.

What I find however with people I talk to it's very confusing because there's a lot of different plans out there.

>> There's a lot and there's ins and outs to them.

>> What an adviser or an insurance agent who does this all the time can do is they've looked at all these plans.

>> They can really cut down the time and effort that you have to research them and make the process a whole lot simpler.

>> Yeah, and hinging on that, Greg, I've been on Medicare now for what, four years and each of the years I've done this or had to enroll, I have sought out an adviser I have had the same one for the last four years and she actually does specialize in Medicare in the Medicare plans that go with that.

And so we're going to talk about the other parts of Medicare where you can actually select your own insurance company to provide various benefits but I guess what I'm driving at is I've actually changed in the last four years.

I've changed my insurance company my my supplement plan twice because of either the company that I was with drop some benefits and another company had those benefits and so I think that would be OK.

I mean you got to shop around as the song goes but but the thing is I mean is that a good idea to kind of jump from plan to plan if it's necessary?

>> Well, yeah, there's nothing that that inhibits you when it comes to Medicare Advantage plans.

OK, these are plans that are through individual insurance company.

>> They cover all Medicare benefits but you get your your claims are going right to the insurance company and they have a variety of benefits that regional Medicare does not have.

And so when we look at things like having a plan that includes prescription drugs, things like dental hearing vision include gym memberships, people like those extra benefits and you have those do change from from year to year.

>> And in fact in 2007 we see some of these benefits going on some of the plans.

So just because you've had these gym memberships for example, don't take it for granted since you have a membership this year that you're going to have it next because some plans have cut them out, other plans have not and we have some plans limiting thanks but this is a competitive environment and some plans have beefed them up.

>> So it is a nice time to shop and to see what's going to be the best fit.

>> And I know the adviser that I work with you're one as well but they make it so easy and they get the paperwork and the forms for you to sign.

Usually they fill those out.

My adviser actually would go through and select at least three plans to choose from and we go through each plan kind of get the get the skinny of each one and figure out which one would be best for me and I always felt confident and more comfortable when I had a professional doing that for well and that's particularly true when you start looking at your prescription drugs because prescription drugs typically drive.

I do the same thing.

We get it.

I get their drug list, we run it through software program we're able to see OK, what's the cost of your drugs on each of these programs and then we are able to narrow it down as to all right, let's look at the ones that minimize your cost here.

>> How does it play out with the other things that fit your provider network and other amenities that you might want?

>> Now let's go ahead and talk about the the big age 65.

>> What happens when you turn 65 and you don't enroll in Medicare?

Well, if you don't like I said, Social Security is automatic, OK?

If you do not enroll, if you do not have insurance then you face possible penalties down the road.

>> OK, part B is one where this is the the portion of Medicare that you have to pay for monthly regardless of whether you have a Medicare supplement or Medicare Advantage plan if you do not enroll in Part B after year they start penalizing you 10 percent a year.

Oh that if you do not enroll if you do not enroll in a drug plan they start penalizing you one percent of the national average cost of a drug plan per month doesn't sound like much but it adds up over time.

>> So yeah it doesn't it makes sense to sign up now why wouldn't you take part why would you take A and B you wouldn't unless you're a veteran sometimes I have guys on the VA who say Hey I'm the VA covers all my drugs and that I want to I'm just going to go to V.A.

fine.

I mean that's great and you actually I shouldn't say this if you are on VA and B the thing is you can't come back to B unless you pay that penalty.

That's the downside.

You aren't penalized for the drug portion but you're penalized for part B.

>> All right.

Well speaking of veteran, yeah, we have a veteran texting question right now.

>> We'll bring that up.

It's from Lance of Fort Wayne and he said he's 66 years old, military veteran getting Medicare from VA.

Do I need to stay with my Medicare plan?

>> What are advantages of keeping both disadvantages a A lot of times with vets they will go use the Medicare Advantage plan so they don't have to pay additional premium for the plan and you get a plan that that meshes with the VA so that you can have outside services if you choose to.

>> You can have just get your drugs from the VA if that's what you're doing you can pick up a plan that has drugs outside the VA and you can use both but it does make sense to look into what options are there for you because you can get benefits that are really a an a plus for what your health care is by looking at some of these plans that really don't cost you anything and you can still mission with the VA.

>> OK, if you're joining us just now we're talking to Greg McDonald who is a insurance advisor and the topic tonight is Medicare Medicare enrollment which is going on as of tomorrow, isn't it?

>> October 15.

October 15th is when it starts.

All right.

So we're opening our phones and our texting network here for any questions that you might have and we still have a good solid I'd say fifteen minutes or so for the show left.

So get your questions and we'll address those as soon as they come in.

So I go ahead and do this enrollment and figure out which supplement plan I want.

When does the coverage start?

>> Well if you're turning sixty five it'll start then ok typically when you enroll in a Medicare plan and it starts the first of the month following you can designated depending on what you're doing if you're retiring from a group health plan and you want that to start two months from now you can designate it OK.

But typically when you enroll in a plan if you don't have it and it's not your birthday, it usually starts the first month following.

>> OK, excuse me my plan particular in particular starts like January 1st.

>> All advantage plans and drug plans begin January 1st if if you'd enrolled in the annual enrollment period OK that's when that will start.

>> That's the big difference right there.

So let's break this down because I even get confused in this we have Medicare Part A, part B, part C, Part D, what do all those OK, all right.

>> Just give you the skinny up.

So skinny is a is hospitalization ok ok b is your outpatient facilities your doctors E.R.

ok C is Medicare Advantage and that's what the individual insurance companies directly OK and D is the drug plan.

>> All right so you laid out there we go.

>> Well so you mentioned earlier that if you're working you don't necessarily need Medicare.

>> You have to go on Medicare though you automatically get into don't necessarily have to go on Medicare, OK?

In fact that's what I was I was saying if you are in a group health plan, OK, you do not need to enroll in a in Medicare and if you're having a health savings account you do not want to enroll in Medicare.

>> Wait until you retire and then you can make your contributions without any hindrance.

>> OK, ok.

Yeah.

Now some people don't have a health savings account.

They get paid a fine it and I let me have a caveat here because I don't want to cast this with a broad brush.

>> It depends on the size of your employer if you have a large employer meaning twenty plus employees you're fine.

>> You do not necessarily want to enroll in Medicare.

However, if you are in a small employer where there's fewer than 20 employees, you do want to enroll in Medicare because Medicare becomes primary to any insurance that your company has.

>> So I back up a little bit.

I apologize small employers you do want to enroll in Medicare at that point.

OK, and you might have addressed this a little bit earlier in the show but am I able to have Medicare and employer coverage?

>> You can but then it becomes a question of why would you want to because unless your employer is picking up the entire cost of your group plan, you're going to pay for your part B premium at least.

>> OK, so why make two payments if your employer is is giving you adequate coverage and you're happy with that, don't enroll Medicare.

>> OK, well it makes sense.

Yeah.

All right.

Let's talk about the something that I came across I thought was interesting.

>> It's Indiana's birthday.

We're all it has to do with Medicare that is brand new this year.

>> OK, and so the thing with Medicare supplements and this is a difference between advantage plans and supplements when you have a Medicare supplements, the claim itself goes directly to Medicare and then your supplement kicks in to pay what you normally would have to pay.

>> In the past when people signed up for a Medicare supplement if they wanted to change supplements in the future they had to undergo medical underwriting.

Ask answer the health questions and if the company didn't like the answers they can say no and so you're stuck so a lot of people did not could not change because of their health and so they were kind of stuck in plans which continued the premium went up and up and up and up and what are they to do right.

They can't move.

Their only option would be go to an advantage plan or just opt out of opt out altogether and just go to original Medicare.

>> So it had a birthday rule started this year.

What it does it creates an open enrollment period 30 days before and 30 days after your birthday.

>> OK, and during this time you can change insurance companies.

>> Silver example most popular plan out there right now is a plan.

Gee, all right.

>> You're you have a plan G with Company X and they're premium is three hundred dollars for the for your G company Y has a plan G for one hundred and fifty dollars.

Is there any reason not to change.

>> Well no unless the amenities on your original plan some have gym memberships associated with it ok if you don't want to lose that you may not want to change but for the medical coverage it's exactly the same a G as a as a G regardless of who you get it from.

So is there any reason not to change?

No and I used to do analysis of whether OK, what's the company's record of of increasing insurance rates you know what's their profit margin going through now it really doesn't matter because now we have an annual enrollment period around your birthday where you can change similar to an advantage plan where you don't have to answer any health questions.

>> Well, Greg, I want to I don't mean to cut you off but we just had a text come in from John and if we can go ahead and show that on the screen, this might have to do with the question I just ask you.

>> So yeah, it exactly it it answers I just answered that.

So is there a good reason not to change plants?

>> No, no.

This is a this is an opportunity to do that in a way that's safe and it's the companies can't ask health questions.

>> It's a guaranteed issue.

So OK, let's get into some of the acronyms involved.

I'm sure some of our viewers might come across these and go what is that?

>> It's an A.S.

and Anarch.

That's the annual notice of change.

OK, so everybody that has a drug plan or an advantage plan will receive those notices in September and they outline how the plan is going to be different for the coming year.

>> And this is I encourage every people to look at them.

>> I realize it's insurances.

People don't like to do it but take them on what they try to make it simple as possible and I'm sure it's worthwhile.

>> Yeah, it really is.

And and Erma IRBM AA what is that?

>> That sounds like one of my aunts and her mother had in my hand about I did so that is an income adjusted amount for year part B premium.

>> The more you make the more Medicare is going to charge you for part B and so people are saying oh they're not paying their fair share some of the wealthier people well they are when it comes to to their Medicare premiums because they do go up they have different strata for that for part B and Part D that they're going to pay more.

>> You know, in our conversation I didn't hear anything about long term care and I've actually done programs on long term care before.

>> Does Medicare cover that?

No.

Oh, well that was a blunt no, that was a default no.

>> So if Medicare is acute care which simply means that something is wrong, you're going to they're going to treat you and you're going to get better long term care is is where they treat you and it's like OK, we're holding steady.

We're trying to make things as good as they possibly can.

Medicare is not designed for that.

And in fact one of the biggest complaints sometimes I get with with Medicare plans is somebody goes to rehabilitation and after a while they're going to kick them out.

Well, yeah, they don't see progress getting better.

Medicare is not designed to just keep you there in Medicare even at the best case scenario at 100 days it's really so at that point you're on your own so you would have to actually take out a long term policy.

>> Yeah, but if you're in that situation you're not going to get one.

>> So it's like having your calling for fire insurance when your house is on fire not going to happen.

>> So you need to do it in advance.

You need to do it when you really don't need it as an insurance advisor, do you think that's a good idea?

>> It is.

It's become more of an issue now simply because long from care insurance rates have really gone up over the last decade and we find more people instead of getting traditional long term care they get long term care benefits through a life insurance policy.

>> All right.

You know something else?

You triggered a thought from me earlier I saw that some Medicare plans I guess the advantage plans are actually exiting some of the counties in Indiana.

Yeah.

So if you have double checking you should have had notices if he particularly if you live in Stuben or Adams County where some of the companies are pulling out, I don't have a good reason for it.

Evidently they're not making money at that.

You people in your counties you're not you're either too sick or not sick enough.

>> I'm not sure which but but the good news is there's still options.

But you want to take a chance on that.

>> And by the way, here's here's an opportunity to if you are on a plan that pulled out of a county, he should have received a letter stating that.

And if you want to use if you like to go to a Medicare supplement, that's your ticket because you can get a supplement without underwriting at that point.

>> Oh, is that right?

OK, and another question I had was what are the hospital indemnity plans?

I've never heard of that and how important are those?

>> They're becoming more and more important.

So hospital indemnity plans are traditionally designed to go along with Medicare Advantage because with an advantage plan you have a daily copay for hospitalization.

OK, and the indemnity plans will come in and paid that similar to what someone would do if you had original Medicare.

>> So it helps pay those fees.

And the other thing that I personally attach with a plan like that as a cancer plan to and so what it does it provides protection on the two things that are the greatest exposure and advantage plan prolong hospital stay and cancer because that will get you to the maximum out of pocket that advantage plans have.

So if you are able to mitigate that risk and the cost of these are significantly lower than buying a supplement.

>> So you kind of get a little bit of the the benefits of both worlds and those premiums will go up.

>> So it's a really it makes sense to get particularly as these advantage plans out of pocket limits are going getting higher.

>> Well, and lastly I want to ask are there going to be some big changes in 2027 versus 2026 when it comes to some of these Medicare plans?

>> Well, as I said, there's going to be some of these plans where the benefits aren't as rich as they were but there are plans that have come out that aren't pretty rich.

So if you have an advantage plan, you know, take a look, you may not want to change at all and that's fine of a plans working for you and your drugs are covered in your doctors are in great.

But if you're missing some things I know people have called because their plan no longer has a gym membership or the drugs.

>> Those are opportunities to say well is there another plan that does well?

Let's find out.

All right.

And we have a one minute left.

I'm going to give the floor to you for some Take-Home points for our viewers actually they probably at home.

>> So take away points for our viewers when it comes to medical Medicare enrollment.

>> We'll just keep in mind we have this opportunity to look and evaluate the plan that you're on and look at what it's going to be like in 27.

>> Is it a good fit?

>> Not of all of them are going to be as good a fit this year I should say next year as they were this year.

So take a look.

>> This is the opportunity to do it and for those on Medicare supplements look around your birthday.

>> What are you paying now?

What could you pay for the same type of plan that's out there?

>> So yeah, I've had guys seriously I've had I've saved one guy three hundred dollars a month on changing a plan so yeah, that's a it's a big deal.

>> It does pay to shop around.

It does.

Well Greg MacDonald, insurance adviser, great to have you on the show and can't wait to have you again.

>> Thanks.

My pleasure.

We'll have some more insurance .

>> There we go.

Oh, how exciting.

And for our viewers, we thank you so much for watching LIFE Ahead.

And of course if you want to watch this and other episodes, please go to YouTube or to our Fort Wayne website PBS Fort Wayne Exact and you'll find the show there until next time.

We sure hope your life is enjoyable and very healthy.

Thank you so much for watching Sage Insurance Advisors LLC, specializes in Medicare plans and represents insurance companies offering Medicare supplements, Medicare Advantage Plans, and Part D prescription drug plans.

Serving Northeast Indiana from 4233 East State Boulevard in Fort Wayne and online at SageInsuranceAdvisors.com.