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In This Episode:
Dr. K talks with Michelle Allen, LCSW, about what all older adults and families should know about Medicare Open Enrollment and understanding your Medicare coverage. Michelle is an experienced social worker and geriatric care manager based in Atlanta, and is a featured expert providing guidance in Dr. K’s Helping Older Parents Membership. They discuss:
- The surprisingly common misunderstandings that people often have about their Medicare coverage
- The difference between traditional Medicare and Medicare Advantage plan
- What is Medigap, what is secondary insurance, and what is supplemental insurance
- How to find out just what type of Medicare coverage you or your older relative has
- How to know whether it’s worth considering a plan switch during Medicare Open Enrollment
- Why it’s a good idea to request a medication review before reviewing your Part D prescription coverage
- What to consider if you frequently spend time traveling or living in other states
- How to get free help understanding your Medicare coverage options
Related episodes:
093 – Interview: Hiring In-Home Care for Aging in Place: What to Know
096 – Interview: Paying for Long-Term Care: 2019 Updates
Related Resources:
- Medicare: The ABCDs to Know & Tips for Open Enrollment
- Medicare.gov
- MedicareInteractive.org
- MedicareRights.org
- State Health Insurance Insurance Assistance Program (SHIP)
- New York Times: “Medicare Shopping Season is Almost Here”
Transcript: Click here.
Note from Dr. K: We don’t have the funds to transcribe most podcast episodes, but we made an exception and decided to transcribe Michelle Allen’s episode because it is such an important topic.
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Lee says
Why isn’t anyone addressing my question or am I looking in the wrong place?
Leslie Kernisan, MD MPH says
Sorry, due to my busy schedule I only answer comments about once a week. The system is set up to hold comments for moderation if the person is new and hasn’t had a comment approved before. It looks like some of the other comments were posted by people who had previously been approved, so their comments posted right away (although I am only posting my answers now). Thank you for commenting and for your understanding!
Bronwen King says
Hi Leslie
It would be wonderful if you were able to provide similar information about Medicare and MY Aged Care in Australia. It’s an absolutely minefield:)
Bronwen King
Leslie Kernisan, MD MPH says
yes, it seems to be complicated in many countries. Hope you find a good resource to help you with Australian Medicare!
Lee says
Thank you for this very informative podcast. I am new to Medicare this year. My husband has a company Medicare Advantage plan. I will be enrolled in this also. My question is, if in the event he passes, I will lose his coverage, and will I have difficulty getting a Medigap plan? The speaker did say if you’re in a Medicare Advantage plan, you may not be able to get a Medigap plan without penalty? Or even be able to get one sat all? Thank you!
Leslie Kernisan, MD MPH says
Hm, good question. I don’t know the answer, but I suspect one of these State Health Insurance Assistance Program counselors would be able to assist you. There should also be someone in HR at your husband’s company that can help with this.
I can also see if Michelle Allen knows anything about this.
Lee says
Thank you!
Dave deBronkart says
(Oh and the Anthem supplement includes my gym membership at the Y, through SilverSneakers, which the Harvard Pilgrim plan does not.)
Dave deBronkart says
I’m surprised that this episode didn’t mention Medigap (supplement) Plan F, and the new(er?) Plan G. I’ve been paying $212 for mine on Harvard Pilgrim, but I’m switching to $181 through Anthem. Your show points out that Part A & B are basically 80/20, and there’s a $185 deductible … Plan F COVERS ALL OF THAT, the $185 and the extra 20%. My agent says that’s why 80% of New Hampshire people have a supplement (usually Plan F), not Advantage.
Plan G is identical but at a lower premium; the only difference in coverage is that G doesn’t cover the $185 deductible, and overall, G typically costs less. (I’m wondering if I got schnookered a little because Wendy said G is brand new, but everything I’m seeing online says it’s been around for a few years.)
This seems to be a great introduction to F vs G in seven minutes. https://www.youtube.com/watch?v=7R7eaukvndQ I love the comparison table 50 seconds in (Plans A through N).
I was surprised to learn on BoomerBenefits tonight that there can be high-deductible Plan F and G. Gotta ask about that! Back at age 62 I did a really careful study of plan options (before Medicare) and by far my biggest win was a plan with $10,000 deductible!
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One more thing on Part D: my wife’s AARP Part D (from a different agent) is rising to $100, and she has NO prescriptions at present. How’s that for nuts? So she’s switching to Envision, too, saving $86/month …. $1000 a year!
Leslie Kernisan, MD MPH says
Thanks for all this info re Medigap! We do touch on it in the episode but no, we didn’t go into depth. (As you know from researching this, it quickly gets very detailed and complicated, so there was no way we could be comprehensive in the setting of a one hour episode.)
So I’m very grateful to you for adding this terrific information about Medigap F versus G.
Dave deBronkart says
Hoo boy, timely for me! Just visited yesterday with my EXCELLENT agent here in New Hampshire. I had used her years earlier (pre-Medicare), and when I turned 65 and soon got head-spinning about Medicare options (as this episode describes), I quickly punted and went back to Wendy. Thank goodness.
My Part D with Humana was about to go from $28/month to $57, AND the previously free generics were about to bump up to $3/month total on top of that. Tiny money compared to what some people spend, but still… I’d be spending $384 more per year out of pocket for the exact same benefit! So she recommended an Envision plan, for $14.20 a month (instead of $57!!! Four times less! AND with free generics.)
Yes, now my Part D will cost $14.20/month ($170/year) including free generics, vs $60/month ($720/year).
On top of that, the colchicine I take for gout PRN had insane coverage under Humana – they only cover the brand name, not the generic! Turns out for that drug no plan is as good as GoodRx … $66 for 30 tablets vs $150+ on any insurance. So that doesn’t even enter into our thinking on Part D options.
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As often as I’ve looked at various Medicare options, this podcast was the first time it sank into me that Medicare “Advantage” is actually a Medicare REPLACEMENT. And what a minefield! I know a few super-careful scrupulous shoppers, and not one of them has chosen an Advantage plan, largely because of the restricted choice of physicians. OTOH, as you point out, it could be important for some people that you can get an Advantage policy that has vision or dental benefits.
More in the next comment … I do go on sometimes!
Leslie Kernisan, MD MPH says
hi Dave! Thanks for sharing these terrific examples of how revisiting your plan can make a huge difference in the costs. Sounds like it was very worthwhile to consult with your agent. (great that you have one you like and trust!)
Rachel Kaufman says
Thanks for sharing this podcast on Medicate Open Enrollment! I appreciate your recaps and links to related resources.
Leslie Kernisan, MD MPH says
thank you!
Dave Beine says
What great work you are doing. Your choice of speaker and her passion and caring attitude came through wonderfully. I encourage others to take time to better understand the changing Medicare community to gain the insight necessary to navigate to their best option.
Job well done by both you ladies. Thank you very much for your dedication in helping Seniors understand Medicare options being offered in 2020.
Dave Beine
Mesa, AZ
Leslie Kernisan, MD MPH says
Thank you so much! I’m so glad you found it helpful and I know Michelle Allen will be delighted as well.
Stephen Luptak says
How do I identify the resources available to disabled seniors in Memphis, TN?
Leslie Kernisan, MD MPH says
I would recommend contacting the local Area Agency on Aging in Memphis. You can use the directory at Eldercare.gov.
You can also use the State Health Insurance Assistance Programs website (https://www.shiptacenter.org/) to look up the local SHIP program for Memphis.