Medicare Answers, part 1 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 and welcome every one to answer for elders, podcast network, and we are here with a wonderful amazing, Jim, Koewler, who is answering all of our questions that all of us have, and it’s that time of year, where you are probably witnessing a lot of commercials about Medicare. I know for us. I don’t know how many things that we talk about. You know when we’re watching a football game or any sort of TV show and all of a sudden you’ve got people like Joe Namath or you know, different types of celebrities. Talking about you know different types of plants- and you know those of us that are baby boomers. We all have to look at our sixty fifth birthday what’s coming up and we have a million questions just last night. It’s so amazing. My brother in law came to me, which is he’s three years younger than me, and he says you know. I don’t even know what this stuff is and I think the majority of us. I know when it came time for me to sign up for Medicare. I was totally clueless and I’ve been in the industry for ten years, so I am so glad that Jim, Koewler from the Koewler law firm, is here with us, Jim, welcome and thank you for being here and answering all of our questions about the daunting Medicare. I don’t know I can answer all of them. There are so many but I’ll answer what I can yeah yeah. Well, I’m really excited because that’s something that’s daunting and that all of us, no matter what you’re doing you know when you’re, when you’re in this world. You know you reach that sixty five years old year old mile stone and things change, don’t they and and I’m interested in telling you what could you first start and kind of give us an overview of you know what what is Medicare and why does it shifts when, on our 65th birthday, I mean what happens? That’s okay, Medicare is federally. Subsidized are actually Federally-funded health insurance for people who are 65 years or older and the magic number 65 is just what they picked, because in the 1960s when this was created during the Johnson administration, that was kind of the retirement age was 65, so medicare and at the time social security, thus care retirement right, 65. So that’s where the sixty five comes from. Okay, so it’s federally funded health insurance for seniors period. Now it’s also available for people with disabilities to the SSDI program goes to history, but they’re not significantly different. But there are some differences and we’ll talk about that another time, but for retirees at age sixty five they can. They can claim the social security or not. Now, people who are just now turning sixty five- that’s not full retirement age, anymore man, but that’s a social security discussion, but but that does create some confusion between full retirement age, for social security, which is not sixty five anymore right and Medicare eligibility, which is sixty five and still sixty five, and as far as I’m gonna I can tell is going to stay sixty five. So sixty five is the magic time. So if you are approaching your sixty fifth birthday start thinking about this, like you mention your brother in law, so someone can sign up for Medicare three months before their sixty fifth birthday, it full calendar months. So, if your birthday is September fifteenth, then you can sign up July, one all the way through the month of September and then three full calendar months later. Okay, that’s your magic window. You right hand sign up later than that, but you don’t want to because now you have a late enrollment penalty right and I think more importantly, but those who have to pay the late enrollment fees for the rest of their lives will not be happy about the monthly premiums that are higher for it. But if you miss that magic window, you may not be able to get the health insurance that you want to go with your Medicare right. So Medicare covers eighty percent of covered health costs. So if you go to the hospital, Medicare pays. Eighty percent, you pay twenty. If you go to the doctor, Medicare pays eighty percent, you pay. Twenty prescriptions are different prescriptions or, as far as I can tell always going to be different, or at least frank, I like time going to be different. We’re not talking about those today we’re talking about everything else that is not over the counter type stuff. Okay, visions, still not covereda dental still not covered unless it’s considered medical, okay vision, if you got diabetes, vision, a sob, the medical for example. Okay, so you want to sign up during that time unless you have your own plan through you work and you are continuing at work- we’re not talking to retire plans here, you are continuing at work and you have what is called a creditable just like credible with an it in the Middle Credit, a Le Plan and that’s something you check with human resources person sure now, if you have a creditable plan, you can sign up later after you are off the creditable plan, but you want your human resources office to give you a letter in writing. Phone phone calls not good enough. Okay, that you have a creditable plan. So now your employer may say no you’re, sixty five we’re pushing you out and you go get Medicare that’s happening a lot lately. I’ve heard and that’s that’s all right, because Medicare is really good. Okay, it is almost every doctor takes Medicare. Almost every hospital takes Medicare, you don’t have much in network stuff and, lest you go, do something weird with your own insurance and we’ll talk about that. Okay, but how you pay that twenty percent that Medicare doesn’t pay does have an impact on where you can go, get care so in that seventh month magic window, the three months before your birthday, the month of your birthday, the entire calling a month of your birthday, the three months after you can get any medicare additional will call it insurance that you want. Regardless of your health, you could be dying on your death bed and you hit that seven month window and you can go get whatever insurance. You want, regardless of your health, okay. So, in other words, even if you have a pre existing condition that you may be not disqualified from because you’re in that window, they by law, they have to cover you correct. Yes, in addition, if you were on s s D, I have Medicare before you could not get a medicare supplement. You can only get a medicare supplement at sixty five and later so. Yes, I I they have only advantage plans available to them this now, I’m talking about you, two different forms of the additional insurance that I mentioned. What at age, sixty five? If you’re on SSI you sixty five or that that seven month window, you can switch from your advantage plan to a supplement interesting just because you’re in that window, right right. That window is he to one picking the entrance plan you want and you’ve already knows, Susanna and our listeners will hear soon. I definitely have an opinion on that and to avoiding the late penalty, late, enrollment penalty and hang act on to your medicare premium for the rest right. So here’s another question that I have so you have this seven month window and, let’s say you’re working for an employer and it’s an approved insurance for with Medicaid credit creditable, whatever okay. So thank you creditable insurance. What happens if you lose your job, then you’re a window opens again and you can sign up because you have an amount of time after losing to insurance, that you have your open window. Okay. Now this is assuming that your employer Dinna Day, sixty five put you out of their plan and, as you mentioned, we are seeing that more and more right. If you can stand it, let’s face it. If you’re the boss, you probably have great insurance and yeah, you can tell a jar that you’re staying on it, but you’re still an employee, that’s fine tract, but when you retire or you otherwise get pushed out, you’re the boss and the board, but says no, we’ve had enough how you’re out right! You have, I think, it’s seven months, although I will admit I know it and then I kind of forget that that exact window, but when you lose your insurance, I got to turn around go sign up for Medicare, don’t Dolt and a lot of times. People can’t afford their Cobra. You know well Coles horrible cores, and you know I’ve heard people having to pay like nine hundred dollars a month to keep their Cobra going and I’m going like this is ridiculous. So obviously Cobra is continuation of benefit. I can’t remember it. The Ra stands for okay, but it’s a continuation or health benefits. If you lose your job, whether at or be if it didn’t matter your age, you can get playing if you’re on a health intrance plan. Okay, it’s expensive because, while you’re employed most employers are paying part of the health insurance premium. When you take Cobra, you are paying the employee part and the employer part you lose the subsidy that the employer was caving for current employees. That’s why pot so expensive! Yeah is that’s interesting for sure. So if somebody’s in we we’ve been talking about Medicare supplement insurance now medicare supplement. What I understand when you’re saying Medicare covers eighty percent, then the supplement will kick in. How does that work? If you buy a Medicare supplement, you have to go, get a medicare supplement. You have to tell you when you T git, that magic window, that’s the kind of insurance that I suggest you go get a medicare supplement. It’s also called a MEDIGAP policy M: okay, they’re all like okay, there used to be three different types. One of them went away decades ago. One of them went away two three years ago, but the one that’s still there is really good. It covers the entire twenty percent, except for a one time per year, Copaiba deductible of like a hundred and eighty bucks yeah. What do you do? Okay hundred eighty lousy bucks for great insurance, the way a supplement works if Medicare pays supplement, pays the rest of that hundred and eighty bucks and it’s not in any, but for incident one time per year, okay, but we and Washington state still have. I don’t know how it is. If it’s federal or whatever I know, I the basic you have to pay a hundred and forty nine something a month. That’s your medicare part B premium. Okay, that comes out of your social security. If you are in the social security system and your social security is paying at least one and forty nine a month. Okay, that is federal. If you want Medicare part B and you want Medicare part B. This is not a question. Take it: Okay, yeah! Your monthly premium is $149 a month, that’ll come out of your social security. Unless you know the you had, you had a pension job that wasn’t in social security and but you have a little social security because you have a side Gig. Okay, if your social security is not big enough to cover it, then you’re got to make up the difference. I still suggest you make up the different absolutely so so in our next segment. By the way, if you have a pension and no social security, you never participate for a social security system. You can still buy in, and I suggest you do it absolutely absolutely well. In our next segment, Jim, let’s go into this part a DC and talk about supplements and let’s go into how specifically we can make the best choices for ourselves and for futures. Jim will be right back, right after this.  State of Ohio residents, you have a friend to help you navigate long term care while protecting your assets. You can reach Jim at www.protectingseniors.com or just email him at  [email protected]