Baltimore County, MD Time of Your LIfe, 3 Nov 2016

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From YouTube: Time of Your Life: The ABC’s of Medicare

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Join Sherry Kolbe, Program Manager, State Health Insurance Program (SHIP), Department of Aging, as she discusses the ABC's of Medicare.

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( ♪♪♪ ).

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Welcome to the time of your life, with the baltimore county department of aging., I'm your host, ethel rasmussen..

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Today's show keeps you in the know, by conveying important.

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And interesting information about the contemporary topics that impact you,, our viewing audience.

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with the holidays, approaching, the season of giving is upon us.

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What better way to give than to share your time and talent.

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By being a volunteer. alison, vogrin,, director of the retired senior volunteer program,.

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At the department of aging is on the show to talk about the rsvp program,, along with a range of volunteer, opportunities.

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Also on the show is debbie orlove, community business liaison.

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At the department of aging. debbie closes the show with information about senior center travel,.

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Senior box office, and what's happening at your local senior center..

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Let's start today's show with an important topic: medicare.

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Navigating medicare can be quite challenging.

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to learn more about medicare,. Let's start the show with sherry kolbe,.

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Program manager of the state, health, insurance assistance, program,.

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Known as ship, at the department of aging.

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welcome to the show, sherry. thank you, ethel., it's always great to be here.

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Before we start our conversation about medicare,.

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Can you briefly discuss the responsibilities of the state health insurance assistance, program, known as ship?.

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Well,, when medicare was created,, there really were no local offices.

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To go to in the community.

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therefore, ships were established across the nation.

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And the mission of my office is to educate, baltimore county residents.

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About their medicare beneficiaries.- and I do that through a team of very,, very dedicated volunteers,.

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Who assist with the counseling.? So let's talk about what we're here to talk: about:, medicare.

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What is medicare and who is eligible?

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well, medicare, really is a federal benefit.

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We don't really often realize that the laws were passed by congress.

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And that the center for medicare and medicaid services establishes the rules and the policies.

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who's eligible for medicare?

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well,. Those of us who age in at age, 65;.

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Individuals who have successfully applied for social security, disability,.

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They get medicare the 25th month, they receive a check;.

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Those who have their fourth month of renal dialysis,.

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Kidney transplant, and those with lou gehrig's disease.

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Are eligible for medicare.

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how and when should perspective beneficiaries enroll in medicare?.

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Well, this is a very important topic.

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first of all,, whenever somebody --, if you're already receiving.

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A social security benefit and you age at 65,,.

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You'll automatically get your medicare card in the mail three to four months before your 65th birthday..

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If you are receiving a social security, disability check,.

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You will also receive your card in the mail about three to four months.

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Before the 25th month that you collect a check.

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Otherwise,, you must take action..

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You need to apply for medicare, a and b through social security.

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And you can either go in person,, you can go online,, you can call them.

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The initial enrollment period that you need to contact social security.

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At this time is three months before your 65th birthday,.

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The month of the 65th birthday and three months, afterwards.

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So it's a seven-month window for you to enroll in medicare a, b,, c, and/or d.

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Now,, if you or your spouse, are actively working,.

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Then you may delay enrolling and have a special enrollment period later.

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For medicare a,, b, c, or d.

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if none of those--, if at no point there did you enroll,.

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Then you can have a general enrollment january 1st through march 31st, to join.

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Your medicare won't start until july 1st and may have a penalty.

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Because of the delay.

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Well, you've mentioned different parts of medicare..

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Can you go ahead and explain to our viewers? What are the abcs of medicare?.

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Okay, medicare part a pays if you're literally admitted to the hospital.

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If you then spend three midnights in the hospital and you're transferred to a skilled, nursing, facility,.

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If, after that, you need some skilled home, care, pt,, ot,, speech,.

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And it also pays for hospice.

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medicare part b pays for the doctors --, whether you're admitted to the hospital, in the er, clinic, office. --.

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It pays for the doctors, blood work, x-rays, mris,, storable, medical equipment,.

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Even your flu and your pneumonia shots, and that's part b.

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Part c is your medicare advantage plans --.

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Medicare hmos and ppos,, which literally, are really substitutes for parts a and b.

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For those private companies,, medicare --, or rather the center for medicare and medicaid services, -- pays them to administer the original medicare benefit for you.

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And with those plans,, not only do you have coverage for doctor and hospital.

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But you also, your drug benefit is enrolled in that.

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All right. we're going to take a short break.

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when we return, we're going to continue our conversation with the abcs of medicare.

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Let's continue our conversation about the abcs of medicare, with sherry kolbe,.

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Program manager of the state health insurance assistance program.

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At the department of aging. sherry,, let's continue our conversation by turning our attention to medicare part d,, which is medicare's prescription benefit.

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Can you explain the benefit as well as some important facts to remember in selecting a plan, each year?.

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Okay,, the part d benefit, first of all,, is for those.

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Who do not have a retiree health benefit with a prescription? Coverage.

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Sometimes individuals are a little bit confused about that.

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The way the medicare part d works is that, first of all,.

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At the beginning of the year, --, let's say january -- your plan may or may not have a ¤400 deductible for 2017.

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And yes, that number did go up to ¤400..

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More and more plans are having a deductible,, although there's a still a few, without a deductible.

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from the zero cost at the january, until ¤3,700 in total.

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Has been spent for drugs between you and the plan,.

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A person in that time range will pay basically, 25 percent of retail.

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For brand drugs and the program will pay 75 percent of the drugs.

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When you hit the wall of ¤3,700,, that's when our person hits the donut hole and there, for 2017,.

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An individual would pay 40 percent for brand drugs and 51 percent for generics.

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Now that number has come down from last year and that number will continue to diminish until 2020.

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When the donut hole will be considered to be closed because our beneficiary will be paying 25 percent across the board for the drugs.

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Unless they take some really expensive drugs and hit catastrophic,.

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Where, then, they would only pay five percent.

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The important thing to remember about the part d is that.

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There are 18 part d plans right now for baltimore county.

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And these plans all vary, and the plans are permitted to change themselves. Each year.

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They're permitted to change their formulary tier structure,.

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Premiums, deductibles, pharmacy contracts., so we highly, highly recommend every single year.

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Have the part d research done,, which is why we are actively going out.

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Into the community --, I take teams out almost every single day, --.

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And we give one-on-one assistance.

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come to us,. Let us check to see: is your part d plan that you have for 2016, really the best for 2017?.

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We had a woman last week, by changing her plans. We saved her ¤1,000.

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We can't save everybody ¤1,000,, but let us check your plans.

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That's good motivation.

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I understand some beneficiaries do need supplemental insurance or a medigap.

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Can you talk about what is the information about these plans.

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And when would you need them? okay. whenever some--, if they just choose their red, white, and blue card,.

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There are many holes in medicare where you have to pay out of pocket.

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And some people- say, "well- I don't really like that.".

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So therefore they want to buy an insurance that will literally fill in the holes and that's why a medigap is called a medigap --. It fills in the gaps.

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all right,. These insurances are all-- first of all,, they're, overseen.

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By the maryland insurance administration- and they are private, companies.

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The medigaps range an alphabet soup of a to n.

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F is the most comprehensive,, so it's the most expensive.

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And others,, if you're willing to pay some out-of-pocket,, you can have a lower premium. the time to buy. These is the first six months, you're on medicare part b.

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That's your guaranteed issue.. After that,, you will not have a guaranteed issue.

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companies will look at your age and your health.

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they'll do medical underwriting to see if they would like to cover you.

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And not one of them has to.. So if you really want a medigap,, it's best to get this in the beginning.

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There's confusion on tv. there's a lot of ads.

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and you hear "open, reenrollment" and medigap's being advertised side by side.

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There is no open enrollment on an annual basis for a medigap.

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It's only that first six months, you're on medicare part b.

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Okay. for those beneficiaries that may be on a limited income,.

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Can you talk about some of the programs that can assist with the medicare costs?.

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Every time we get a call,, we are always assessing income and assets.

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To make sure people are on the programs that will help them.

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First of all, there's a program called qmb.

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The income level for this would have for an individual,.

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It would have to be under ¤1,010, and their assets like under ¤8,700.

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Okay, there, the state of maryland would pay the medicare part b premium.

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And they would get a gray and white card, which would pay copays and deductibles associated with medicare.

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For basically a free, medicare, supplement.

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If the income's a little bit higher,, they might be eligible just for slmb.

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That's where the state would only pay the medicare part b, premium.

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Okay, people on those two programs.

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Are consistently eligible for full extra help.

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Extra help is a program that you get through social security.

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That helps pay for medicare prescription costs.

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There they would likely have no premium,, no deductible,.

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And pay in 2017 a little bit over ¤3 for each generic.

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And a little over ¤8 for each brand.

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if their income's a little bit higher than those programs --, maybe an individual's income's under ¤1,505.

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And their assets are a little bit higher like ¤13,000 --.

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They can get partial extra help.

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if their income's even higher,, then there's a program called the maryland senior prescription, drug assistance, program.

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The bottom line is, please call us..

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We would like to review to see if you're eligible for the programs.

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To get you enrolled in these programs so that you can get the help that you need.

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wonderful! in closing,, is there any other information.

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That you would like to add about medicare?.

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Well,, if somebody is new to medicare,, they need to call our office.

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We do do transitioning to medicare workshops on a monthly basis.

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We try to move them around the county.

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and also to please call our office.. We are there with ship counselors monday to friday,.

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All year round, to answer any question you have about medicare.

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If we don't know the answer, we'll try to research it to assist you with, whatever your need may be.

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Thank you, , sherry,, for sharing this valuable and informative segment with our viewers..

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Thank you for having me. we're going to take a short break., but first, I'd like to tell you about bcda's latest resource.

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Called the last chapter,, which is now available.

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The brochure helps to support those who are faced with the loss of a loved on.

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The last chapter brochure is now available at your local senior center or map office..

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This resource is sponsored by the redemptorist cemeteries.

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When we return, learn about the department of aging's retired senior, volunteer program, known as rsvp.

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