Aging ain't for Sissies
Aging isn't easy. My name is Marcy Backhus and I am your host! Make sure your complete well-being is handled with a community and information that can make it easier and FUN. Aging needs humor, which you can find in the "Aging ain't for Sissies" Podcast, along with informational guests that give us the information we need.
Aging ain't for Sissies
Medicare Made Less Terrifying (No, Really)
Facing down Medicare enrollment can feel like trying to solve a puzzle in another language. I've been getting bombarded with Medicare Advantage plan offers as my 65th birthday approaches, and I know I'm not alone in feeling overwhelmed by the options. That's why I invited Medicare expert Nita Wenrick (the Medicare Diva) to cut through the confusion and give us the straight talk about these mysterious Advantage plans.
Anita reveals something crucial right from the start: working with a Medicare specialist costs you absolutely nothing. These professionals are paid by the insurance companies, not by you, yet they can potentially save you thousands by finding the right plan for your specific situation. This alone might be the most valuable takeaway for anyone approaching Medicare eligibility.
We unpack exactly what Medicare Advantage Plans (Part C) are—essentially a way to receive your Medicare benefits through private insurance companies that contract with the federal government. Contrary to common misconception, you're not "giving up" Medicare with these plans; you're simply receiving your benefits differently. Most plans bundle your hospital coverage (Part A), medical coverage (Part B), and prescription coverage (Part D) into one comprehensive package.
Perhaps the most surprising aspect of Advantage plans is the additional benefits they typically include beyond what Original Medicare covers. Dental, vision, hearing aids, gym memberships, transportation to medical appointments, and even allowances for utilities or groceries are common perks. As someone who's witnessed my husband benefit from his plan paying toward our electric bill and covering most of his hearing aids, I can attest to the real financial impact these extras provide.
The limitations do matter: most Advantage plans operate within specific provider networks and require referrals for specialists. But Anita clarifies that emergency care is always covered at 100% anywhere—even internationally—which should reassure frequent travelers. She also dispels the myth that pre-existing conditions can prevent enrollment when you first become Medicare-eligible.
Take charge of your Medicare decision before you turn 65. Start exploring options three months before your birthday, be honest about your health needs, and work with an expert who can navigate the system for you. Your future self (and your wallet) will thank you for it.
Hello and welcome to the AGName4Sissies podcast. My name is Marci Backus and I am your host. Well, hey there, beautiful people, welcome back to AGName4Sissies, the podcast where laugh lines are badges of honor and wisdom comes with a side of sarcasm. That is me. I am your host, marci Backus, and today we're diving headfirst into the glamorous world of Medicare Advantage plans. I know, I know, try to contain your excitement, but seriously, if you've ever stared at a Medicare brochure and thought, is this written in code? You are not alone.
Speaker 1:Lucky for us, I've got a special guest today who actually knows what the heck she's talking about. That's my good friend, nita wenrick. She is the medicare diva and she has helped us. She is here to help us decode the mystery and explain what an advantage plan is and tell us whether it's really all that advantageous or just another way to make us cry into our prescription drug tears. So grab your reading glasses, pour yourself a strong cup of decaf or something stronger and let's get into it. Well, I am excited. I'm always excited when I have the Medicare diva, anita Wedrick, here with me and I've got Anita here. Anita, sorry, anita, anita, okay, losing my, I got, I got Advantage plan in my head and Anita and it's all coming together. So I have Anita Wedrick and she is our definitely our Medicare guru and helps us with all things Medicare.
Speaker 1:And today we're going to talk about, we're going to focus on Medicare Advantage plans, and there's a lot to unpack there. I think everybody has preconceived notions about it. The main thing that I first want to say is people like Nita and Nita's information will be on the website aging8forcissiespodcastcom the people that do the work that Nita does do not cost you anything, and I like to start with that right, because people think, oh, I'm going to call an insurance agent and now my plan that was going to be this much is now going to be that much, and that's not how it works. If, if nita isn't in your area, she can point you. She's given me someone here in chicago. It doesn't cost you a dime, and these are professionals that, as we go through this, are going to be able to answer your questions and gear a plan towards them.
Speaker 1:Is that all correct, nita? That's all correct, all correct. Okay, I want to get that off the table first, because I don't want people to stop listening, thinking, oh, I can't afford an insurance agent or I'm not going to do that. No, they don't cost you anything and they get you the right stuff, as Nita has always told me. Do not call the 800 number. No, please don't. All right, you have the floor, nita.
Speaker 2:Well, thanks for calling you know, letting me be on this podcast. I always enjoy educating people about Medicare. That's the main, main focus of what I do, because there's so much misinformation out there. So, absolutely Really quickly, I'm just going to do a real basic Medicare 101.
Speaker 2:So when you turn 65 or when you retire and need it Medicare, you have Medicare Part A, which is your anything that's in the hospital, medicare Part B, which is anything out of the hospital, so doctors, labs, x-rays, emergency care, anything like that. So those two pieces together we call original Medicare. Part A does not have a premium. Part B does have a premium. This year it's starting at $185 a month. But it depends, there's a scale, it depends on your income.
Speaker 2:So with those two things, there are several ways to go and we are going to focus today on the Medicare Advantage plans. Several ways to go. And we are going to focus today on the Medicare Advantage plans because that's what you see come and it'll be coming up shortly here. In the fall, that's what you see advertised on TV are the Advantage plans and there's a lot of misinformation. So I want to talk with you about that just to make sure we understand what it is exactly so people don't just shut it down and say, no, I don't want that, you know, and you know. I think people need the whole story.
Speaker 1:Well, and I'm turning 65 in January and I'm already getting barraged by Advantage Plan mail all over the place, either physical mail or online. It seems like everybody knows you're turning 65. That's exactly right, and especially my own carrier, blue Cross, blue Shield. They want to keep you, so I'm getting a lot of information from them, so I'm sure anybody else that's turning 65, that's happening to you too.
Speaker 2:Yeah, exactly right. So let me just explain very simply what a Medicare Advantage plan is. Okay, and they're in all 50 states. It's different from actually county to county and we'll talk about that. But a Medicare Advantage plan and this is according to Medicaregov it's known as Part C. Part C is Part A and B and then sometimes a prescription drug plan and we'll go over that Rolled together. So if you see Part C, that's the Advantage plan, okay.
Speaker 2:So it's a type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare and the reason that you want something other than original Medicare. I mean, that's all well and good, but you have big deductibles. For the hospital it's like over $1,700 a year. For doctors it's $257. So you know you're looking at about $2,300, $2,400 deductible before you ever even get to use Medicare and then they only pay 80%. So you would be liable for that other 20% or more because they can bill more than what Medicare approves and you'd be liable for that. So we don't want people to have big medical bills and that's why we want to look at other medical plans. So this is one way to cover those, that extra 20%, that Medicare, that original Medicare does not cover.
Speaker 1:Okay, so question already. I have a question. So if you get an advantage plan, you no longer are original Medicare. Your Advantage plan C, yes, okay. But you still pay for the original. Yes, yeah.
Speaker 2:Okay. People always say, well, you give up your Medicare, and that's not true. You still have Medicare. It's just a way that your Medicare is administered administrated. And what happens is, whatever the plan is, whether it's Blue Shield or united health care, whatever they take that a chunk of money and they give it to medicare, takes a chunk of money and gives it to your carrier to take care of you okay, that makes no medicare money. It's just an admin, it's just coming through.
Speaker 1:Let's just say I'm using blue cross, blue shield. They're taking my medicare dollars, they're beefing them up in a way and administering my health care. Yes, that's exactly.
Speaker 2:OK, ok, got it, so it's still. It's still, you're still using your Medicare, just in a different way. Yeah, ok.
Speaker 1:That makes sense. All right, I like that, and so do you have more? On that one I don't want to cut. No, okay, so then then okay, I'm paying for my medicare. So now I've chosen an advantage plan and I my part c. Do they charge me, or how does that? Do they charge me more money? So it?
Speaker 2:depends on where you are. So medicare advantage plans basically are county to county wherever you are in the country, and they're honestly. There are some counties, even here in like butte county in northern california, that don't have any medicare advantage.
Speaker 2:Well, that makes sense yeah, yeah so there are some, or they have them, but they're very limited coverage. So some, like here in Orange County where I work, most of the Advantage funds do not charge an added premium. But there are other counties, even you just go to, like San Diego or you know, even like Santa Barbara, and there can be some added premiums. You're looking at something between maybe $25 to $50 a month, depending on where it is added premium, but it's never going to be huge premiums. They're, all you know, relatively small premiums.
Speaker 1:Right. But you, from what I can see from Craig's Advantage plan, you get a bang for your buck with these Advantage plans Definitely, and we'll talk about that a little bit, ok, you got it OK. So then do these plans offer Medicare drug coverage which we, which you say is Part D, right, part D, mm?
Speaker 2:hmm, D for drugs. D for drugs, yes. So people might say, well, how do I enroll in Medicare Part D? There actually is no Medicare Part D to enroll in, like A and B Part D is just prescription drug plans. And so there are plans and we call them MAPD Medicare Advantage Prescription Drug Plans that do cover the Advantage Plans. I mean they do cover prescription drugs.
Speaker 2:There are some plans that are just we call them MA only, which do not cover prescription drugs and very often people that like have VA benefits or maybe they have, they're covered on an employer plan or a retirement plan and they have particular drugs and they're covered at a better rate than what we could get for them on a prescription drug plan or on an advantage plan. They can stay on that, they'll still have the other benefits, but there are just no prescription drugs on that. Okay, and that's for anything you get at the pharmacy. Now if you get something like in the doctor's office, like an infusion or injection, that's under generally under part B, as in boy, so you would still get that coverage, just not something from CVS or Walmart or Costco. So I don't I mean those, even if somebody is like has like VA benefits generally, it seems, and it doesn't cost no difference in the cost.
Speaker 2:It just seems more prudent to have a plan that has your drug prescription drugs because if, say, you went to the emergency room, you were a veteran, you went to emergency room and you got a prescription from the doctor at the emergency room. You couldn't fill it at the VA, right, so you can take it to CVS or wherever. So it I. It never has made a whole lot of sense to me to have um, you know to to not do not get that coverage. Yeah, so just for emergencies and such um. And then also there are what we call true PPO plans, which are kind of a hybrid plan has in and out of network benefits. They also cover the prescription drug plan, prescription drugs, yeah.
Speaker 1:So just a few minutes that we've been talking people. Do you see why you need an expert to work with you? I mean, this all is very you're telling us very clear and it makes a lot of sense, but it also opens up for each individual person that's listening today. It's going to open up a can of worms for them, you know, because everybody is individual. All of our needs are different. Like I didn't expect to get breast cancer this year, you know, and thank God, I had covered myself with a plan because my I mean I found out right when I went off of Cobra the next month I found out I had cancer. Now, unfortunately, I didn't know it before I picked my plan. I don't know if it would have shifted the plan I chose or not.
Speaker 2:You might not have been able to get it. Get a plan. That's fact too.
Speaker 1:All of us are just individual and as we age our health changes rapidly and things change. So having an expert like you I just want to point that out again people, no cost to you, but boy, oh boy. And I think this next question can I use any doctor or hospital that accepts Medicare for covered services?
Speaker 2:So sometimes. So with an Advantage plan, you have a network of doctors and hospitals that you work with. Here in Orange County we have tons of them. We are with my husband and I are on Advantage plan and we're with Optum Monarch is our medical group. So we stay within that group of doctors and hospitals. Now if we had an emergency, if we were visiting you in Chicago and we had an emergency, we would be covered for emergency or urgent care at 100 percent. So then you know, wouldn't matter what hospital or where you were, you know it wouldn't matter what hospital or where you were, but for just basic care, yes, you generally do have to have, you know, be within network. With the PPO plans that I mentioned before, again, you have in and out of network benefits. So if you went to a hospital like here, say you wanted to go to Cedars-Sinai, which is not in a lot of the plants here in Orange County for obvious reasons it's way up in.
Speaker 2:LA 60 miles away. But you with the PPO plans you could still go there. You would pay more in co-pays than you would at an in-network hospital.
Speaker 1:So yeah, but generally, just you know to choose. Like if you were having a tonsillectomy, you know you would need to. $1,500 a month, that's not cheap. But I have to stay within the University of Illinois Chicago system, which is fine. They're fabulous, they're great, I've gotten the best care ever there. But I have to pick things within that. But it's fine because they have everything I need. Now, funny enough, you mentioned Cedars-Sinai. When I lived in Orange County, my expert in my genetic disorder was at Cedars, so I'd have to go once a year to Cedars to see my expert at that time. So you just never know, you know, you never know, and I was in the Kaiser system, so I just have to pay out of pocket to go visit that particular person.
Speaker 2:Well, there are like in that case you can ask for an exception. So if that's the only person in the area that deals with whatever it is, then they might cover it. You know, you could ask your doctor to do an exception and they might cover it or cover it for less money. So there, there are. Sometimes you know ways around things like that. So, yeah, absolutely, sometimes you know ways around things like that.
Speaker 1:So yeah, absolutely Okay. So then back in the same vein, when I have an advantage plan. So two questions do I have to choose a preferred provider, like primary care physician, or what if I already have? Like I happen to love my whole system, I'm in and I need to go to an advantage plan.
Speaker 2:Yeah. So the answer is, most of the time you have to have a primary doctor, because they call it PCP, primary care physician. That is the gatekeeper for your plan and your health care In those PPO plans that I spoke about. No, you do not have to have primary care physician, but someone like you. If you were coming to me, if you were here and I was working with you, I would look at the doctors that you work with and I would say, OK, you know, doctor, your doctors are in network. I mean, if they're all in the you know University of Chicago, if they're all in the you know University of Chicago, Yep, yep, they are.
Speaker 2:And then we find, okay, which is it a Blue Shield plan, UnitedHealthcare plan? That they are in as far as the Advantage plan. So that's how someone like myself, how we work with people we want you to keep your primary care physician. Or I'll have people that say you know what I really love, my primary care physician, I don't care about the rest of the doctors. Or I say you know what I really love, my primary care physician, I don't care about the rest of the doctors, or I really love my dermatologist, I can get a new primary care physician.
Speaker 2:Okay, yeah, everybody kind of has their thing, right, yeah, so then I'll work. I'll go, okay, we'll work with the dermatologist and then we'll work backwards and we'll find a primary care doctor that could refer you to that person. Okay, yeah, but with the PPOs, no, you don't have to have a primary care doctor. They ask you to choose one, but you don't have to.
Speaker 1:Okay, All right. But if you have one you love, that doesn't mean you have to throw them out, that's right. You just look and work within the system that will help you see that doctor. Exactly, that's exactly right Now. So I deal with a lot of referrals with what I'm at right now and I have my primary care has to refer me. So do I have to get a referral to use a specialist when I'm on an advantage plan?
Speaker 2:Yes, that you do. Unless you are in that PPO plan, then no, you don't. You can just call and make an appointment and if they're in network, great. If they're not in network, then you're going to pay more to see them. So it just depends on the plan. Sometimes it's a $40 copayment, sometimes a 40% copayment. A lot of those plans this last year went to coinsurance, which is a percentage instead of copays. Yeah, so you understand what that is. Yeah, I have a co-pay plus co-insurance. Yeah, so, but but yeah, you, generally you do have to have a specialist, and you know people say, well, what if I don't like the specialist, I'm like ask for somebody else. You know, I've I've done that myself. I mean, I've had a couple of specialists that I got referred to that I really couldn't stand. So I just called my doctor and say, hey, could you refer me to another, whoever it is, you know, orthopedic guy or or ear, nose and throat person, or whoever, and, and they can do that, you know you're always able to do that.
Speaker 1:So well, that's funny because last week I also have another podcast inside Marcy's mind and last week on that episode I talked about taking care, taking control of your health care and, like you said, if you don't like a specialist, you don't have to go like just because and there's a big part of this and this, and I'm going to stress it here with going on Medicare and choosing plans and all of this Take control of your health care. Tell the NIDA in your life, the insurance person you're working with, give them the rainbow, everything that you want, and if you can't get it all, get the important parts, but don't sell yourself short. Don't assume that you can't have or they won't do, or you because I listen to more people give falsehoods about um, medicare and everything, including in Social Security as well, all these things that people think they know and they don't. Yeah, and you want to find out and you want to know for sure. So what else do you think we need?
Speaker 2:to know. Well, just kind of on that, be honest with the person that you're working with. So tell them you know the medications you're concerned about. So because not every medication is on every formulary. And I have people that will give me their medications and then when I run all the numbers I'll say, oh well, what about this medication? Well, you didn't tell me about that one. And then I find out that's not on their formula. So then we have to kind of start from scratch. So tell them anything. I mean with these plans you don't have to worry about pre-existing conditions, you're automatically accepted.
Speaker 2:I had a lady that was turning 65 and she had metastatic breast cancer. She was paying a huge amount for her blue shield plan and when she turned 65, I said I said it's going to go down to at that point it was like 140 a month, it was like 10 of what she was paying. I said I said it's going to go down to at that point it was like $140 a month, it was like 10% of what she was paying. And she said they're not going to accept me and I said yes, they will. She said no, they won't. I said yeah, they will Because it's right, you're at this point. It's still guaranteed issue when you get mage into Medicare, when you first go on to Medicare. So don't be afraid to tell your.
Speaker 1:You know that's a really good point, because people do get scared. You do get scared, you don't know. You know, once the rabbit's out of the hat, the rabbit's out of that. So you don't tell and you don't say things. But don't be afraid everyone. This is you've got to take control of your own health care. Yeah, and it stays with us.
Speaker 2:You know this is not something we report to people, but it helps us find the best plan for you, you know. So don't be afraid to do that. So if you do like you were given the example of having to go to theaters, if you do need to see somebody and you're just dying to see somebody, or you just have to see somebody outside of the plan, then there's two ways to do it. One, we can put you on a Medicare supplement, which is a whole different talk, but that's going to cost you more in premiums. It's more flexible but it's more expensive. So if that, you just have to do that, we can go that route. Or you, if you see them once a year, once every two years, then you would just pay out of pocket for that. Um, so that is how that is.
Speaker 2:Um, sometimes, most, most all um of the advantage plans, you have to have prior authorization for things like x-rays, cat scans, bone density, mammograms well, actually, not mammograms. Mammograms you do not need. You could just call and make an appointment for a mammogram, aren't we glad you don't have to wait for a referral for that. But anything you know like that, that you need to have done lab tests, you know, urinalysis, all of that. You have to have a referral and a prior authorization. So people will they always say well, I don't want to go on an HMO advantage plan because it's going to take forever to get the referrals.
Speaker 2:You know what I've learned, and I've learned it as an agent. I've learned it as having a husband that has a lot of issues, and also for myself it doesn't take that long to get the referrals. I mean ours come within a couple of days, if that Sometimes it's within hours, depending on what it is, yeah, so does mine. Yeah, they're very quick, but what it is, especially here in Southern California, it's getting to see the doctor. The doctors are so backed up, you know. I just I booked an appointment for my husband for a new doctor. It's not until the end of August and that's pretty good actually for specialists here in our area.
Speaker 1:And that's going to be.
Speaker 1:no matter whether you have a PPO or an HMO, that has nothing to do with getting a referral, and I'm glad you brought that up because you know the more you if you're an HMO person, which I've always been in. I've always liked HMOs, I've worked well within them, I understand them. So this, it works very well for me because I know how to work within that system. But my doctor I mean this today, my shoulders bothering me, and I had seen a doctor and I emailed my doctor said can you give me another referral? He goes. Oh, here's one, he goes. You won't need it though because it you know the one that you had before. If you've seen him within the year, it'll be fine, but here's one just in case and I like it just in case, cause I don't want to end up coming out of my pocket.
Speaker 1:But I called today and they could see me next week. So you know, here in Chicago, depending in the system, I know Northwestern, my girlfriends that are in northwestern really struggle with the same thing you're saying. They get the referrals, but it's a long time. I happen to be very lucky and I the system I'm in seems to have been very good to me. But I understand that. But it's not. That has nothing to do with referrals. That's the system and the doctors yeah, and it does.
Speaker 2:It has nothing to do with the plans, it has to do with the medical group and then the doctors. So, and again, if it's, you know, six months out and you're like I can't wait that long, contact your primary doctor and say, hey, this is going to take too long. Can you give me a new referral? And most doctors are pretty good to do that. So, yes, I agree, yeah, so, yeah, and so don't be afraid to ask. Don't and, like you said, be an advocate for yourself. Don't just take everything that's given to you, whether you have whatever medical plan you have. You know, if you think something's off, speak up, you know. And if, especially if you don't have anybody to advocate for you, you know, but advocate. If you have people in your life you need to advocate for, advocate for them.
Speaker 1:Well, and if you are, if you tend to know that you're a sit back kind of person and you're intimidated by it, take a pit bull like me with you. Find that friend that isn't afraid of the system and isn't afraid Like even today. Craig was with me for my final oncology appointment and they're putting me on medication that I have to be on for five years, but again I have this genetic disorder. That's the reason they're taking me off the chemo we really were advocating. Are you sure this is safe for me, do you? We went through this with the. We always get a student doctor not a student, they're a doctor, but they're junior doctors that come in first when you're in these systems and then your doctor. But you know we push.
Speaker 1:And then craig, like, asked some really good, strong questions and even though I'm a super strong person, it was good having another person there to kind of do that. So I would suggest that as well. If you are are timid, take someone who's not. Yeah, exactly Because, especially if you're experiencing something. I have another question about Advantage plans. Craig and I love to travel. What happens if I'm in Europe and I have an issue?
Speaker 2:So the interesting thing about the Advantage plans, as opposed to the supplement plans, which cost you more, is the Advantage plans most all of them cover you any place outside of your area. So, like I said, if I came to visit you and I had an emergency, they're going to cover me at 100%. If I go to Italy, they're going to cover me at 100%. I still tell people you probably should get a travel plan just in case, because they're not that expensive. But these plans that you do not pay as much for cover much better than the supplements.
Speaker 1:The supplements only cover you for $50,000 lifetime, which is interesting because and I couldn't answer this question intelligently I was on a Christmas cruise last Christmas in Europe with my sister-in-law and she had gone on Medicare. But she goes I didn't do the supplements because they won't cover you when you're traveling. I thought, yeah, they do, they do. But I wasn't sure and I didn't want to say, well, you're wrong. But she didn't want to say, well, you're wrong, but she didn't get in, I'm not a supplement, I'm sorry, an advantage plan. Because she said it wouldn't cover her when she travels and I'm like that doesn't seem right. But at that point I couldn't answer. So I was excited today to ask that question.
Speaker 2:Yeah, they, I mean they don't. It doesn't matter if you go abroad or if you go to.
Speaker 1:You know, nebraska, that they're going to cover you, not nebraska no, I'm not going back, in case you get corn stuck in your toe well, the thing is, you know people go.
Speaker 2:Well, what if they don't consider an emergency an emergency is is described as anything that you think is life threatening to you. So say you have a hangnail, and you know, the last time you got a hangnail it got so infected you almost lost your finger. That's an emergency to you, right? Yeah, so they're not going to say no, that's not an emergency. If it's an emergency to you, it's an emergency, yeah.
Speaker 1:And most of us don't go in unless it really is an emergency. I mean, that's, you're dragging people in. Yeah, even I fell in the street the other day and smacked my head. I mean into the street, I thought no, and then you know everybody's standing there horrified as I'm, bleeding out all over the place and uh, but there's always that thing, same thing. I mean, no, I could just go home because I was just too much. No, I can go home. No, you can't so.
Speaker 2:But you know what, if you hit your head, I'll always go in, yeah well I'm, yeah, no, I.
Speaker 1:I had to have stitches and all that, but yeah, okay, that's good. Is there any? Oh, I know, what I wanted to talk about is some of the perks, because I know Craig. So one of the perks and Craig's is we get 65. He gets 65 to put towards rent or house payment. I put it towards our electric bill every month. I just have it, that card saved in there that comes with his plan and it's 65 and I put it towards our electric bill every month. But there's all kinds of little this that he got most of his hearing aids paid for. He got the non-fancy ones. I think they were paid for almost 100%, but he wanted the fancier ones. But again, it was way less than if we didn't have a plan.
Speaker 2:Yeah, so the thing about these plans is and again it depends on the county and the state, wherever you are, but a lot of them cover hearing, dental vision. We will have, like what you said, something to go toward utilities or rent. Some have a food allowance, healthy food allowance. Some most of them have chiropractic and acupuncture to some degree, transportation to and from doctors or some of them even to get your medications or to go like for therapy, that sort of thing. There are gym memberships, that, and they're all included in these plans, um, and at no added cost.
Speaker 1:Uh, so did you hear that people dental and vision I mean there were all kinds of little fancy things she just said there but dental and vision at no extra cost. And I know Craig goes to our dentist. We go to the same dentist. He goes to the. He loves Costco, costco takes his his advantage plan. Yeah, that goes to the. He loves Costco, costco takes his his advantage plan. Yeah, that's where he got his eye. You know he gets his eye stuff done.
Speaker 2:So yeah, I mean, it's still like there's a network that you work within and the dentist it's a dental HMO. So you know, but at least here in Orange County you know so many dentists are a part of these plans and if it's a dentist you just have to have, well then that's a person we'll work with. You know, we'll figure it out. Sometimes there's no figuring it out and we have to go a different route. But yeah, there's just a lot of great. Some plans will provide respite care. Respite care, so if you care for a person care, if you have someone that helps care for you, then they will give you some hours of home care to come in and so that that caregiver gets some rest, a break. Ambulance and here in Orange County I mean ambulance is a couple of $3,000. We pay a hundred dollars, you know.
Speaker 1:So it is three thousand to even. It took me two blocks. It was three thousand dollars, yeah.
Speaker 2:So lots of things like that, that Medicare generally itself, but original Medicare does not cover. So and like I've said to people, these plans, most of them are either very low premium or no premium. Some of them have no premiums and so why wouldn't you do that? And because I have people that will say, well, I just want to keep original Medicare. I don't. I'm really healthy, I don't take any medications and I go why? You know we can get you all of this coverage that you may not need yet, but you know you might get hit by a bus and then you're going to have all of these medical bills and you're going to be liable for at least 20% of them.
Speaker 1:We are a gym membership.
Speaker 2:I mean just something as simple as that, you know over the counter you can buy your band-aids and aspirin and that sort of thing, you know. So it's like it never makes sense to me for people just to keep original Medicare when you can get something. I'm sorry that keeps stinging, oh, I can't hear anything. So you're good, Okay, Cause it's a ding in a mic when you, when you, you know, when you can get a lot of benefit for you know, and plus you get your mammograms and your screenings and your vaccines and all of that to keep you healthy. These plans are designed to keep you healthy, Right, Right, so, yeah, so that's kind of my take on it is I know you don't have a doctor and we can find you a doctor and I will look for a doctor that I've heard I have lots of clients that love you know, or so it doesn't make sense to me, but there are some people that are very stubborn and you know, and if you start with original Medicare, you know you've only got like three months to figure it out and then you got to wait another whole year.
Speaker 2:So you know, don't do that.
Speaker 1:And that's a good point too, that that you know that you get to change things in October if you pick an advantage plan that you, you know maybe maybe you have different needs and you want to relook at your advantage plan. So just know that everybody. It's just like when we were working and we had enrollment and all of that. So now let's the last thing I would just want to touch on is so I'm turning 65 in January. I can start talking in October to my, my insurance person here and pick my plan and everything. And you were saying that right now it's taking a little longer to enroll. It's, it's a busy, busy, busy. So the sooner you can start, up to three months before you turn 65 and you have three months after, but don't wait.
Speaker 2:Well, it's three months. So if you like somebody, if you're turning 65, the end of a month, it's it starts the first day of your birth month. So it's it's like for you it would be October 1st, you know, and it goes to the end of January, February, march, april. So you've got a seven month window there that you can, can do that, but don't, I don't weigh because it's taking a long, because social security offices have closed down and you can no longer just walk in and it's just taking longer, you know.
Speaker 2:so talk to your agent about that and see that they can assume it's going to take too long and get it done as soon as possible Because, honestly, once you get your Medicare in place, your enrollment that's the hard part. The easy part is what we do is helping you find a good plan. That's the easy part, okay.
Speaker 1:Okay, so you can also help people just sign up for Medicare right and then pick the Advantage plan. Okay, okay, okay. So for everybody out there, if you want Nita's information, it's going to be on my website at agingaimforcissiespodcastcom. You can find her information there. What states do you work in, nina?
Speaker 2:I work in California, arizona, nevada, idaho, oregon and Hawaii. Okay, very good, I have people everywhere. I work with a huge network of people, so it doesn't matter where you are. I can help you find an agent that's trusted, that's been doing this a long time.
Speaker 1:Yes, and you did that for us here in Chicago and I appreciate that. So you know, check with Nita if you're in any of those states. Even if you're not and you're not sure who to call, get a good referral from Nita Because, again, this costs you nothing and, to be honest, somebody like Nita saves you money.
Speaker 1:That's the truth it doesn't cost you anything and you pick good things and you help us make good decisions for our health care, which, in the long run, saves us money yeah, one more thing is if you move, so like when you move to chicago, that opened for craig, that opened a special enrollment period so he could change his Medicare.
Speaker 2:OK, so if you move, even if you move from county to county, that can open a special enrollment period. So so you, you know you don't, you can't wait until annual enrollment because you won't be have any coverage.
Speaker 1:That's great information because a lot of us at this age are moving. We're downsizing, we're changing states, we're we're going here or there, we're downsizing, we're changing states, we're going here or there and a lot of people live in two states, you know looking at places in Arizona.
Speaker 2:So that opens up a whole nother thing and that's something you want to talk to your agent about, so you do you want to check, I have to say check what the medical coverage is where you're thinking of retiring, because I've had people that have moved to beautiful spots in Oregon and there's like hardly any coverage up there and where they are. So check before you make a final decision. Yeah, and Oregon, if you want, if you're going to have big stuff.
Speaker 1:you're going to be going into Portland. Yeah, yeah, you know, that's just. I mean, I know my, my niece-in-law, my niece-in-law, her parents live on the coast and anytime they have to do anything big they have to drive into Portland. So yeah, you do need that. That has always been. I mean, I'm very blessed here in Chicago having, you know, three of the top hospitals in the country here Rush and the University of Illinois, chicago and Northwestern. So you know I'm pretty well surrounded, but that's not the case everywhere.
Speaker 2:So definitely Just check on that before you make any big moves. I agree, I'm not surprised.
Speaker 1:Well, as always, I want to thank you for being with us. You always give us great information, you give us a lot to think about, and I appreciate it very much. Thank you, my pleasure.
Speaker 2:So nice to be with you.
Speaker 1:And there you have it Medicare Advantage plans less scary than they sound, but still not as fun as bingo night and free snacks. I love a free snack. A huge thanks to Nita Wenrick for breaking it all down without our heads exploding. If you still are confused, don't worry. Half the country is too. Just breathe, re-listen and maybe give Nita a call. Or your niece, who's good with forms no, don't call your niece who's good with forms. Really call Nita. And if you need Nita, go to my website, agingaforcissiespodcastcom, and all of Nita's information is there. As always, getting older isn't for the faint of heart, but you, my friend, are a badass. Stay smart, stay sassy and don't let Medicare Mays mess with your mojo. Catch you next time on the Aging A for Sissies podcast, where we age boldly, we question everything and we laugh a lot. Go out and do something positive.
