Medicare Answers, part 2 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 back everyone to answers for elders radio. As we are talking about Medicare and how is it, does it work, what is it all about? And for those of us that are approaching the age of sixty five, what do we need to pay attention to? And we are here with Mr Jim Koewler from the Koewler Law Firm and Jim, welcome back. Thank you for like shedding light on all these things. So I have a first question, because everybody I will say that I talked to you about Medicare. They go. What’s the difference? What’s this? Part A, part be, parts, part D. How does it all work? What is it? So would you just kind of define what the part A, B, C and D is and how it in facts, AB, abcnd are the big four parts of Medicare? There are others and I’ll try to mention some of them, but those are the really the four big ones. Okay, I don’t know why they call him parts. That just that way written in the code of so that’s where part a, part be y’all came from. They should say just insurance, hospitalization. Done it and then people would have but if your crest, don’t do that. So I know. So part it a is free if you get Medicare. Now, mind you, you have to participate in the SOB security system to automatically get Medicare. Correct. If you had a job that didn’t participate in the security system, if you are on the table, you’re in nothing, and I you know you put it on yourself. But if you were a teacher in one of the states that has a separate pension system for teachers, r private and carticipate in the SOCI security system, then you don’t have medicare coming. Okay, but for those because there’s a medicare tax as part of the security system, you got the fike attacks, which is so security, and the Medicare tax, which is smaller but still built in that system. Okay, so you only get part a if you were paying the Medicare tax. Part A is other than the tax you paid while you’re working. Part A is free. That’s hospitalization. It’s only hospitalization. But that was the original part of Medicare in the s with the Great Society in the Linden Johnson Administration. So it covered that. What was really the expensive, at least at a time, expensive care part of healthcare, which is hospitalization. Imagine today hospitals can be two thousand, three thousand, ten thousand dollars a day. Wow, but what you’re there for. So Medicare part a covers those. Now with a, like everything else with Medicare, medicare covers eighty percent. So if your hospitalization is ten grand a day, you still got two granted a hanging out there you got to deal with and we’ll talk about that probably in another segment. I don’t think we’re can get to that on in this segment. Right. Okay, so part a is hospitalization and it has a zero premium because you already paid it with your taxes while you were working. Okay, part B is the one that they as we mentioned another segment. Part B is the part where social security will take a deduction from your Sol security payment of a hundred forty nine dollars. I think it’s one three hundred fifty, but I’m not sure of that. The something it’s like it comes out of my it comes out of your Sol security. Yeah, if you and I get a statement and it shows it’s deducted actually and now come out every month. That is other stuff besides hospitalization. It is doctors. It is observation status, if you’re in the hospital but not admitted, and that’s a different issue. That’s not a medicare enrollment issue. That’s a big bugaboo with older law attorneys and it so Dr visits, specialists, stuff like that. Okay, that is non admission to the hospital. Okay, again, lots of costs and as we’ve seen, as more and more doctors try to avoid hospitalization, especially now during the because this is being taper in the pandemic, folks, during covid. So fewer and fewer hospitalizations are happening because of covid right. Well, the other fewer entire age G and covid hospitalizations are happening because covid is taking so many beds and so on staff. That’s I knew. That’s where you much but but still the part B is out there for the cost that are not hospitalization, admitted hospitalizations. Okay, Parts Se is advantage plans, advantage plans, and you’ve Pi seen this on television, if you turn on your TV at all, especially on TV networks that probably have an older audience, like game shower network or CBS. CBS tends to have an older audience. You will see many Medicare benefits ads or advantage plan ads, although very few of them called themselves advantage plan adds. Call and get your Medicare or increase your medicare benefits. Those are advantage plans. Okay, that’s not meant as much as they want you to believe. That’s Medicare. That’s not Medicare. And you know, it’s interesting because starting about six months before I turned sixty five and April, I started getting this urgent Medicare information. I am envelopes that looked just like it was coming from Medicare itself. I mean they, oh, yeah, they and then down a little tiny print. It is is by Dada, DA, DA, DA, and I mean you could and of course the average person my age can’t read the tiny, tiny, tiny print, and so you’re going like you don’t know what to believe in it, and the thing that’s overwhelming. It’s like, finally, I’m not getting those anymore because I’m six. You know, I’m more than six months now past my birthday. But the whole point was was that with that. You know that type of a scenario. It’s like those of us that are about to turn sixty five. We’re getting all these postcards and and letters and you know, they look official, like they’re from the government, and it’s hard to decipher whether it’s official or not. Oh yeah, yeah, it’s all sales tactics because they want to sign up for this, because this is Medicare, when it’s not. Okay, now the thing is, if you set up for an advantage plan right, technically you’re not on medicare anymore. The advantage and takes over everything. Your art be goes away and the premiums you pay for that go to the medic go to the advantage plan. Your part a goes away and the the premiums that the federal government pays for that go to the advantage plan. That is why you can see an advantage plan offer that is for a zero premium or a anymore seen him a specil this year will put money back into yourself security. A thousand dollars a year, a hundred forty nine dollars a month or whatever. Okay, that’s a sales tactic. Yeah, okay. So remember this is health insurance. Actually, it’s insurance in general. Okay, so if you buy auto insurance for a zero premium, how much coverage you think you’re going to get when the river meets the road? To borrow firestones tagline years ago, not much. Okay, sorry for those who don’t like it, when it hits the fan, medical advantage is not necessarily going to be there for you, especially for your premium, and even worse if they put money back into yourself security, because now you have only the part a premium from the federal government covering you. Sure, but that’s what that’s what these things are. That’s why they call it. This is your Medicare plan, because if you set up for one, it is your Medicare plan. Sure, advantage. Notice how much advertising there is, how tricky the advertising is that even Suzanne has seen. Imagine the amount of money then entrance companies must make from these things. Yeah, in order to use these tactics. Okay, so if they make it a whole much of money off this, how much you think they’re paying out to cover healthcare? Absolutely absolutely go if, especially if, if you’re paying next to nothing or absolutely nothing in premiums, they’re still making a ton of money because they’re not going to pay you on the other side. Right, right. So that’s a part see and, as you could probably tell, I’m not a fan. Right, okay, part DU can dog is prescription drugs. Right, if you have a part see advantage plan, you probably like ninety nine and forty four hundred percent of the time, do not need a part d because part see advantage plan will include your drugs. Correct, that’s one of the things they sell. Oh, this is all closely if you get everything in one place. Well, yeah, he said. I will tell you advantage plans cover a lot, but they don’t cover it. Well, that’s the point. Okay, they will cover a lot. They are not lying when they say they will cover you, but they won’t cover you. Well, imagine where to sleep at night and covering yourself up with a handout. How warm are you in the middle of the night? Right, okay. Am I exaggerating? Perhaps it depends on the advantage plan, but generally I’m not. They’re different types. Like I know this company that I signed them with. Aren’t there because I had the choice hundreds, if not thousands of yeah, but I had a choice within the company that I went with. It was like gold flex and all these. So it was basically, you know, you enrolled, this is where you’re at and as your needs change, we can switch you within our umbrella based on what your your needs are. And obviously, for a younger senior, I’m going to I have different, you know needs then I will have twenty years from now, if I lived that long. Right. So the point that being, I think this really good about this is that there are in that’s a question that you obviously need to ask. And going for an advantage plan is what’s my long term, you know plan here because your needs are different. Is that? I mean, am I on track on that? You are on track, but I’m you’re not going to, at least I don’t think you’re going to the conclusion that I urge people to reach. Okay, thank you for correcting me. And and maybe that’s a different thing, but the thing about an advantage plan, well, actually, I guess a better way to put it the thing about not choosing a supplement, which is an advantage plan competitor. Okay, a supplement is a different form of medicare insurance. It covers the twenty percent that Medicare doesn’t cover and head of CARE pays, no questions ask. The supplement pays period in a discussion. There’s no in network, no out of network, none of that. Now there’s no drug coverage with a supplement. You got to go buy a separate drug card. But drug cards are chump change by comparison to hospitalization. Okay, yeah, and a supplement. So where I’ve described the coverage of advantage plan as trying to sleep underneath a hand towel, sleeping on a supplement is like sleeping under a nice blanket or being sleeping bag. Okay, yeah, it makes me wonder if I think I have covers it. I have two cards, plus a plus an over the counter card. I think I have everything. Yeah, yeah, you can get it. You can get other things too, but if you get the supplement and a drug card, yeah, yeah, that’s that’s my favor. Well, like when I had surgery on my hand, it actually covered all of my rehab and I didn’t have to pay for anything. That was my supplement. Is that correct? That’s correct. Well, it covered twenty percent medical, hundred and eighty. Okay. Well, I had I think I only had to pay like a hundred bucks. Yeah, yeah, it was not a big deal, which is anyway. Yes, Tur hundred and sixty five. You could not get one of the older supplements. That had not a doubt. Had to get an F supplement. I’m sorry, G supplement. G Supplement F is the one that went out two years ago. So you you have an annual deductible of a hundred eighty bucks. Again, no big deal. Fine, you pig your heard eighty bucks. You’re not covering for the rest of the year. Right, you do, have you actually you need you need three cards. Whence a jumping over the county you would need for you’re still have Medicare coverage. That’s one card. Your supplement that’s another card. The Medicare coverage, eighty percent, the supplement pays the next twenty a separate drug plan. That’s three cards. And then, since you got your over to counter plan, which is completely optional but a good idea. HMM, that’s your fourth card, for you in particular, for the listeners out there, three is all. I suggest. Anything else you want to get that help, just think night. Go for it. But the yeah, we suggested supplement drug planning your Medicare card to keep it great. Well, I am so glad you’ve explained this and we’re going to continue that Medicare conversation in our next segment and Jim will be right back, right up to 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.