On this episode of Medicare Moments with Toni King, Toni answers a question from James, a 65-year-old from Memphis who was recently diagnosed with Parkinson’s disease. James wants to know if he can enroll in a prescription drug plan during Medicare’s Annual Enrollment Period. Find out Toni’s advice for James, plus, the dates for Annual Enrollment and everything Medicare beneficiaries can do during this time. Medicare’s Annual Enrollment is going on NOW – so, don’t delay! Listen to Toni’s podcast and learn more about your options, because, when it comes to Medicare, “what you don’t know WILL hurt you!”
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*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.
From the Miss Medicare studios in Houston, Texas, it’s time for Medicare Moments with Toni King. Toni!
I am Miss Medicare, because I am on Medicare.
I just had to say that, because you are Miss Medicare, and we are here. Thank you for inviting me into the podcast. But we’re here to give you some answers to some questions that you have about various aspects of Medicare. And we really appreciate the questions when they come into the Medicare Moments podcast. The best way to do that is to just send your question to info@ToniSays.com. That’s info@ToniSays.com. So, Toni, we do have some questions to answer. We have a big one today. We have a question from James, and James sent this in. He says: “I turned sixty-five in February and did not enroll in a Medicare prescription drug plan. I’ve been told that I must wait until October for Medicare’s annual enrollment time. I need help now because I’ve been diagnosed with Parkinson’s, and my brand name prescription is very expensive. I thought I could enroll at any time of the year. What can I do? Signed, James.” Toni?
The best thing that I can tell James is, the best time for him to enroll—since he did not enroll when he first got on Medicare when he turned sixty-five—he needs to enroll during Medicare’s annual enrollment period. The time that you can enroll in or that you can change a standalone Part D plan. This is what gets confusing, Jim, because people don’t understand. They’re marketed to. I mean, they’re getting tons of emails and phone calls. The calls are just coming left and right, and they don’t even know what they’re supposed to do. So we’re going to let them know everything today, aren’t we?
We are. And what you say is true, because the mailboxes are stuffed with all kinds of offers, all kinds of information. But how do you determine what’s the best path for you to take with Medicare? So, Toni?
We’re going to talk about that today. Because what James needs to know, because he did not enroll at the time when he turned sixty-five, he didn’t think he was going to get sick. Now he has Parkinson’s. He’s finding out what the cause to prescriptions are. We’re coming to Medicare’s annual enrollment period. It’s when you can enroll in, or you can change your standalone Medicare Part D plan, or you can enroll in a Medicare Advantage Plan. That’s what it’s all about.
And let’s talk about that. This happens annually. So it’s called the annual enrollment period, and it begins October 15th of every year.
And it ends on December 7th of every year.
At midnight. So that’s very important. That must make people writing policies very busy.
Oh, you don’t even have five seconds to yourself. People need to understand. This is about enrolling in a prescription drug plan or changing your prescription drug plan, your Medicare Part D plan. Not Good RX, not Single Care, but your Medicare Part D Plan. Or changing or enrolling in a Medicare Advantage Pan. You can change or enroll in a Medicare supplement any day of the year. You can do that any day. That’s where people get confused.
That is confusing.
So there are two different situations. If you’re having problems with your prescription—such as what Mr. James is having—he doesn’t have a part D Plan. This the time for him to do it.
This happens annually, so it’s called the annual enrollment period. And it begins October 15th of every year—
—until December 7th of every year. Pearl Harbor Day. Most seniors, or most boomers, we all know Pearl Harbor Day. The plans will start January 1st, so we’re gonna go over all this, because this is the time when you make changes. You can make changes to your prescription drug plan or your Medicare Advantage Plan, or you can initially enroll if this is your first time to get in it. Such as, James, this is gonna be your initial time to enroll, and you will get a little penalty. You know, James is gonna get a little penalty, because he never enrolled. When was he supposed to do that? In February. So he’s got some some months that he will have a penalty, because he did not enroll in Part D. We tell people when they come into the Toni Says office and we do a Medicare consultation—we stress how important it is to get your prescription drug plan. If you’re not taking any prescriptions right now, you never know what the future is gonna hold. So everyone should get a Medicare Part D Plan. And if they are getting a Medicare for the first time with a Medicare supplement or without a Medicare supplement—and we’re going to go over the rules—they should get one. Or if they don’t, like James, now is the time. So we talk about this as the “AEP time”, which really means the annual enrollment period for Medicare. So what can we do? What can someone do during this time period, Toni?
We’re going to talk about that today. All the different situations—all of this in your Medicare and You handbook that everybody got. It was delivered to them by October 1st. All these little rules are in there. People get the Medicare and You handbook, and they put it on a shelf and don’t go through everything that’s in it. So we’re gonna tell them, “What can you change? What can you do? This is all for the Medicare beneficiary.” Do you know what a Medicare beneficiary is?
I do not. Tell us.
That’s what they call it. And that is a person that is on Medicare. They’re getting the benefits of Medicare, so they are a Medicare beneficiary. I am a Medicare beneficiary, and you are a Medicare beneficiary. And now is the time for Medicare beneficiaries. They can enroll.
So it’s called the “annual enrollment period.” It begins October 15th of every year, and it ends on December 7th of every year at midnight.
AEP annual enrollment period. Why do they make it so complicated? People get so stressed.
It is a stressful time, though. You want to make the right decision. You want to have the right plan for your needs. And, like you said, someone may not need medication this month. Doesn’t mean they won’t need medication next month or next year, so you have to plan ahead.
That is true. And a lot of people have the same Medicare Part D or the same Medicare Advantage Plan that they had from ten years ago. And they’re wondering why the cost has gone up. They’ve never looked at anything. Every year during the annual enrollment period, just look and see what’s on the Medicare.gov website. That’s where the prescription drug plans are found. You can do your research. Email us at info@ToniSays.com or give us a call at 832-519-8664. And we can help you find the right Part D Plan and Medicare Advantage Plan that’s in your area. We can help you search for that plan. But that’s what people need to do every year. You don’t have to go with the most popular plan. You want to go with whatever is going to improve the cost of your prescription drugs.
Right. You want to—you want to pay the fair amount that’s the best amount for you to pay for that prescription drug. So let’s—let’s talk about—let’s go down the list and see what we can do here.
Here’s what you can do during annual enrollment. You can enroll in a Medicare Part D Prescription Drug Plan. You can enroll in it. If it’s your first time, you can enroll. The second thing that you can do is, you can change from one Medicare Part D Plan to a new Medicare Part D Plan. To different plan.
But it has to be accepted by Medicare as an official plan.
Has to be on the Medicare side?
Has to be on the Medicare site. Medicare does not consider Good RX, or Single Care or Kroger’s discount card, if Walgreen’s has a special card. Those are not what they call “creditable coverage.” They’re not Medicare’s coverage. It has to be what’s in your Medicare and You handbook.
And the Medicare site is—
Medicare.gov. Their phone number is 1-800-633-4227. That’s important, because some people don’t know how to use computers, and they need some help with their prescription drug plan. Maybe we’re just overloaded with phone calls, and they need help. They can call Medicare’s direct line 1-800-633-4227, and someone from Medicare can help them with their prescription drug plan. We used to do that a lot, back in the day.
That’s a good number to have, and you have two options. You can go online, or you can make the toll-free call.
That’s correct, and you can get your kids to help you. They need to get in the game, totally.
I think we need to take a break, and we’ll be back right after this.
So today, we’re talking about the Medicare annual enrollment period, and what your options are. And that period, every year, is between October 15th and December 7th of the year. Toni, let’s go on and talk about some other changes that we can make during that time.
Let’s start all over from the beginning, in case some people are just joining us. This is what you can do during AEP—Medicare’s annual enrollment period. You can enroll from October 15t through December 7th, and your plan will start January 1st. The first thing you can do is, you can enroll for the first time in a Medicare Part D Prescription Drug Plan. If you never chose one, this is the time to do it. The second thing that you can do is you can change from one Medicare Part D Prescription Drug Plan to a new Medicare part deep prescription drug plan. You’re gonna want to look at it, especially if you’re on some expensive prescriptions. You can enroll in a Medicare Advantage Plan that has prescription drug plan. Medicare Advantage Prescription Drug Plan is MAP . If you’re looking into a Medicare Advantage Plan, now is the time to enroll, and it will start January 1st. You can change, and you can go to a new Medicare Part C Plan—Medicare Advantage Plan—with or without prescriptions. So it doesn’t have to have prescriptions with it. And you can go to a new Medicare Part C plan—Medicare Advantage Plan. MAPD. C, A and B, original Medicare. C is Medicare Advantage plan. And Medicare Part D—it’s just prescription drugs. Now is the time you can return to original Medicare. You can purchase a Medicare supplement and enroll in a standalone prescription drug plan. Now is the time. If you’re on an Advantage Plan and you want to go back to original Medicare and you’ve got to get a Medicare supplement—you want to enroll in a Medicare supplement. You can try to do that. And do you want to know why I say, “Try to do that?”
Because some people have health issues and the Medicare supplements—now you’ve got to answer all your health questions. So, if you’ve got a serious situation and you want to go back to original Medicare with a Medicare supplement, you want to make sure that you are accepted by that company. Don’t cancel your Medicare Advantage Plan yet. The second a person signs up for a Medicare Part D plan, it automatically pulls them off that Advantage Plan. So, you want to make sure that everything is done properly. It gets confusing, doesn’t it?
A lot of people don’t think about that when they sign up, and they could lose the benefit that they have—if they don’t think it through clearly like you just described it.
That’s right, because they think automatically, it’s going to be issued. They don’t have to answer any health questions. You want to make sure your Medicare supplement is accepted before you come off that Advantage Plan. And the way you come off the Advantage Plan is by enrolling in a standalone Part D plan. One of Medicare’s rules.
In your experience, when people apply and they answer the health questions, how long is the turnaround generally?
Some companies take longer than others, but it usually takes about, at least, two or three weeks to do that. We just had a client—I just had a lady come in that’s coming off her retiree benefits, and we did a Medicare supplement for her. She’s had Part A and Part B longer than six months, so he had to answer the health questions. And in her Medicare site, they have the wrong information. It said that she was a diabetic with serious issues, and she doesn’t have any diabetic situations. So someone had put the wrong information. The doctor gave out the wrong number, and that’s what happened.
Mistakes can happen, and that’s a big one to change, because you have to go back and have that changed before you can move forward and have a policy issued.
She’s got to get something from the doctor. She doesn’t have any diabetic situation. So, like I said, you can return to original Medicare and get a Medicare supplement, but you want to be careful while you’re doing that. You can also return to only original Medicare. Some people want to only have original Medicare. They don’t want to pay for the extra supplement. They think they’re never gonna get sick. They don’t have to worry about it. And you can enroll in a standalone prescription drug plan and go back to original Medicare. You can also return to original Medicare, and you don’t have to have a Medicare Part D prescription drug plan. People, they all have different situations, they all think differently. But want people to know that if you decide to not get a Medicare Part D plan, you can get a penalty down the road—if you don’t have it. And also, if you have to take prescriptions, guess what? You don’t have anything to cover you for expensive prescriptions. So we never advise anybody to do that.
So when you say penalty, you mean financial penalty?
Is it a one-time penalty, or does it go on for months or weeks or years?
It goes on forever. Right now, the penalty is one percent of what the average cost of Medicare Part D is nationwide. For this year, I think it’s like thirty-four cents. It’s thirty-four cents per month. So if you go ten years, that’s twelve months. That’s a hundred and twenty months times thirty-four cents. It adds up. So let’s just go over the different things that you can do again so people can remember. One, during AEP or annual enrollment period, you can enroll in Medicare Part D prescription drug plan. Number two, you can change from one prescription drug plan to a new prescription drug plan. You can change which one you’re on. Number three, you can enroll in a Medicare Advantage Plan with prescription drugs. Number four, you can change from one Part C Medicare Advantage Plan— with or without prescriptions to a new one. Number five, you can return to original Medicare purchase or a Medicare supplement, if you qualify and enroll in a standalone Medicare Part D prescription drug plan. Number six, you can return to original Medicare and enroll in a Medicare Part D plan. If you’re on a Medicare Advantage Plan, and you want to go back to original Medicare. And number seven, you can return to original Medicare with no Part D plan—and you don’t have to have one. You especially want to make sure if your health changes. That’s what people need to know about—if their health changes.
So that’s a lot of information to process. And, Toni thank you for laying it out. And we want to tell our listeners that you have a brand new book that’s published by Regnery Press. The Medicare Survival Guide: Advanced Edition, and it’s available. You can pick it up through ToniSays.com, and we would like you to go there and get a copy. Toni puts everything about Medicare into everyday language, and it’s something that you’re going to want to read. And it’s a lot easier than what the government sends you. Trust me—you’ll be glad that you picked up a copy of Toni’s book.
I put that book in “people terms.” And how the book got started, was because a gentleman called Social Security and got the wrong information and it cost him over 10,000 dollars. So we have all the information in the book about Medicare, Part A, Medicare B, Part C, Part D, the Medicare Advantage Plans, what’s going on during open enrollment, annual enrollment. Everything. It’s all in there, so it’s got a lot of merit to it.
So we have a lot of ways for you to reach out and touch us. You can send an email to info@ToniSays.com. You can ask a question. You can also go to ToniSays.com. You can buy a book. You can also go to SeniorResource.com. You can read Toni’s articles there, and you can hear the podcast there. Medicare Moments. So we’re trying to have as many resources available as possible, and we would like you to take advantage of them. Toni?
Well, I just want to tell you guys. Thank you for being part of Medicare Moments podcast. And I want thank you, Jim, for helping with this guide me along. For making this fun for people. And if they have questions and they want to personalize their Medicare, they can reach out to us at SeniorResource.com. Or email me at my website, which is info@ToniSays.com. And we just want to say, have a great day. And until next time, God bless America, and God bless you guys for being with us today. Thank you!
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What You Don’t Know Will Hurt You!
Turning 65 in America is a milestone and one of the markers is enrolling in Medicare. But the system is so complicated, and there is a lot of false information out there.
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Originally published October 21, 2022
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