Medicare Advantage Options, with Jim Koewler

*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

The following podcast is by Mr Jim Koewler, elder law and special needs attorney, helping and protecting those who need long term care. Welcome everyone to the answers for elders podcast network and we are excited to have you all here. And we had been talking about a lot about Medicare and it has been open in world annual enrollment. I always get those mixed up. And we are here with again Jim Koewler from the Koewler Law Firm. Jim, welcome back. Thanks, Suzanne. Good to be here. Yeah, and I am so excited. We’ve had a lot of response from individuals that’s been listening to your podcast on answers for elders and you know, obviously, obviously they need to discover books a far more entertaining no, no, no, no, they were wonderful and I’m really looking forward to continuing kind of wrapping up this conversation between us, because I think there’s one more missing piece that we haven’t really talked about, and that is maybe there’s a lot of seniors out there that can’t afford a supplemental and I know that you’re not a fan of met advantage programs, but sometimes that’s what we have available. So what happens if a senior doesn’t have enough income to be able to pay for supplement? Are there options out there? Yeah, there are options out there. And first let’s go to how you measure affordability based on your income. Okay, and I’ll be honest with you, that is perception. If a senior perceives that they can’t afford the cost of a supplement, right and frankly, they can’t, because the last thing I want them to do is a loose sleep at night worrying they’re paying too much for their health insurance. Yeah, so if they if they want, if they’re more concerned about having good health insurance, get a supplement, fight a way to pay for it. If they’re more concerned with not overspending on their health insurance as much as they don’t like it, get an advantage plan so you sleep better at night, because there are other things that I’d body of health insurance. Yeah, so it’s really the perception of the individual senior or the couple on what they can afford it, and that’s okay. That’s it’s their life, it’s their income, it’s their perception. So what can you do if you can’t afford or perceive you can’t afford, and we just run them together for the rest of our talk. There are there just you can’t afford a supplement. So you want to have something more than bare Medicare, but you don’t think you can afford a supplement and a separate drug card. Okay, so the first thing to do is look for an advantage plan that does the most for you. Now, you’re broker isn’t necessarily going to know how to do that, because advantage plans cover everything, but, as we’ve discussed before, they basically cover you with a sheet in the middle of winter. You’re covered, but not necessarily well. So my suggestion is to look for advantage plan specifically, ask your broker for advantage plans that are generous on Rehab, that have a history of supporting hubilitation after some acute medical incident, a fall, the onset of Alzheimer’s, whatever it is. Okay, because Rehab is expensive. So that’s one of the things that and that’s one of the things. Yeah, and it’s so this is a really good point because on Rehab, quote unquote, you know, for example, I know that even I had surgery on my right hand, I had complete rebuild of my thumb. I had to go to physical therapy for months. My supplement picked up all of it at like eighty percent, which was great. Supplement. Your over, sixty five, no way I am. I just three. You don’t look at it. Last year. Thank you, sir. Yeah, not, just a big suck up. Don’t take it serious. Yes, I just turned so I I’ve just been through this, you know. But you know, one of the things I’m very grateful for, because you’re right, medicare and and BETWIG. By the way, I had surgery while I was on my previous insurance and I was in the middle of physical therapy and then I turned sixty five, so everything got switched over in the middle of my real I would hate to have to sort that out. Like you. It was a little while and crazy, because here’s what happened in this system, and this is just kind of interesting. Just a side note. I had start in get a brand new referral for my doctor to to to go rick get Prime Rehab. Because of the the switching insurance, they had to have a new referral. So that so I had to go back to my surgeon and get that document, which is a lot of people we want, and a lot of people, sixty five or older or not, are going to be going through that just because we’re coming up on the end of the year. Yeah, now realize many of you’re going to be watching this after the first of the year. That’s okay. It the turn over every year with people changing insurance plans, whether it’s a medicure entrance plan or a affordable care act insurance plan or the insurance at their work is changing. have to go through these hassles, sure, but that’s not to the extent you can control and choose your insurance plan. That’s fine, but if you change, you’re going to be facing something like this just because the new place needs paperwork. Sure, but in choosing an advantage plan, look for one that’s strong on Rehab because if you have an ex something acute happened to you and you need to go to the hospital, if you have something that cute happened to you, period where you go to the hospital or not, you want good re have, but the entrance really kicks in only after hospitalization. At least. We’ll get back to that, presumably after the COVID public health emergency is over right. So good rehab means a better life after Rehab is over sure, even if you’re a long term care you coming out of Rehab stronger makes your long term care stay less bad. I’m never going to say a long term care stay as good. Well, rarely will I say that. Like a great aunt actually chose to go into nursing on we know you didn’t have to, because she have to cook or because I would do anything. It was great. But so you want to look for strong rehab now if you don’t like the prices of those and you’re really attracted to the the ones that get you money back on your social security, which think about a second. The less you pay for insurance, the less the insurance company has to pay for you. Think about that. So if you go with one that actually gives you money back or even has a zero premium, but you don’t get money back, they how are they ensuring you and everyone else with very little income? All they’re getting is Medicare. Is Money set aside for your part A. Yeah, isn’t it like hundred fifty dollars a month or something like that? That, yeah, it’s it’s the medicare part B premium that you would normally pay is what that amount is. Sure, okay, but Medicare still has its part a premium that it sets aside out of Medicare tax funds, not out of our individual payments, out of the tax funds. So everyone who’s working and paying the fight attacks and the Medicare attacks. That’s where part a comes from, and whatever subsidization comes on part B. Okay, and so the part a money is what goes to an advantage plan. If you sign up with an advantage plan and they like it because they still make money, and if they’re getting only the part a money, where you think they’re getting money by not paying on the back end for claims, right, but you know. Returning back to my if you want a really low cost advantage plan, I urge you to look at Nursing Home Rehab Insurance. I’m not talking long Term Care Insurance here. I’m not talking about them one that will take care of you in assisted living or nursing home or home here any down. That’s to okay. I’m talking about specifically you’re in a nursing home for x number of days for Rehab and this insurance will kick in. This is a similar type of product. Then that that you get that you see advertised from a flack. Now I’m not talking it’s the same insurance, okay, but it’s something you can buy that ensures a specific thing. A flack, you know, the duck and Nick Saban from the Alabam Alabama Crimson side gottings. Can’t get those words out because I’m not a fan. They are offering you medical insurance that pays cash because you can’t work. So it’s a sort of a short term disability thing. Okay, but it’s something that you don’t have to have right. You can just buy it because they can insure it, because they will sell you the insurance, just like you can get insurance on your cell phone. Okay, so this is similar sort of product. But if you want to advantage plan that is low cost, I urge you to consider getting yourself rehab insurance to it should be terribly expensive. It should not bring you up to supplement. I still like a suth lot better, no question about like some lot better, okay, but look at getting that Rehab Type Insurance, because that will then make the Rehab go better because there will be a source of funds to support it. Even if the advantage plan wants to cut you off. You’ve got money to continue that. You may just have to private pay the private pay rate, and that’s what the insurance is for. You can also look at additional things that, frankly, aren’t long term car related. Are On hospitalization, but you can get cancer insurance, can you really? Yeah, into and you can buy dental insurance through the same sort of practice. I mean I know that Medicare is looking at dental now and advantage. You can get dental. Okay, they’re going to send you to the cheapest damn dentist around and you may not like the guy and it’s not going to be the same dentist. We can go back in six months, okay. So don’t get attracted by all these sprinkles on the cupcake. Yeah, they get they’re going to start changing things, you know, with the infrastructure bill and get. And I’ve been hearing all that and of course, been dialed in, but I kind of agree with you and the fact that it’s just like the whole Medicaid portion. There’s only going to be certain providers and they’re not going to be the best ones out there. So what about the Medicare programs that give you like three thousand dollars a year. I’ve dental something like that. Is that a better opportunity option? Three thousand dollars of dental per year cover a couple of cleanings and if you have something go bad, that’s a lot of money. But it’s not going to be. It’s going to be a brand new dentist who doesn’t yet have a steady clientele. Okay, so you have to decide. Is that what you want? If you want to go into dentists, are US fine. Right. If you want to have a long relationship with your dentist, that’s not going to work. Right, just like the HMO style of having a doctor. If you want to go to a medical practice, which is kind of advantage, plans push you as well as before. You’re sixty five HMO plans and PPO plans. Okay, right. Well, you just go into this office and some doctor will see you. It’s almost like here an urgent care visit. Okay, even though you may not be there for virgent care. They’d been kind of treated as the doctors on call that day. That’s what you get. But if you want a relationship with your dentist and a relationship with your doctor, look for ones that aren’t Hmo and don’t use these dental plans you’re going to get from Medicare or the advantage plan, because they’re going to jam you into a practice that doesn’t have a steady clientele for a particular Klar dentist. Interesting. Okay, that makes total sense. So, Jim, how do we reach you? You can reach me at my phone number three six hundred five nine. Three five seven nine. That’s in Richfield, Ohio, halfway between Cleveland and Acron. That’s where the area code comes from again, three three hundred, six five nine, and then all the odd numbers. Three five seven nine, odd number. Seen a good thing for me. Yes, there you go, Yep. Or you can reach me via my email at a specific gameal for answers for elders, because it allows me to figure out how people reached me. It’s jkoe wler. Yeah, that’s how we pronounced Kaylor. How we how we spell Taylor? Doesn’t look in sound the same way. JK OEWELIRE AFE like answers for elders at protecting seniorscom perfect, Jim. I’m so excited to learn more about this because it is definitely very confusing and we’re going to have more contact from Jim Right after this state of Ohio residence. You have a friend to help you navigate long term care while protecting your assets. You can reach Jim at www dot protecting seniorscom or just email him at j Koewler afe. That’s j Taylor AFE at Protecting Seniorscom