Hi, Welcome to Caregiver cast. My name is Mary Elaine Petrucci, your host. My special guest today is Marty Silbernik, and he will be talking to us about Medicare.
I know that there’s been a lot of changes in Medicare, a lot of advertising on TV. So, I have Marty here to give us exactly what’s going on with Medicare at this point. Before I formally introduce Marty, I’m going to just read some information about him. Marty is a native Chicagoan, who began his career in marketing for one of the largest restaurant companies McDonald’s, over 21 years he at the corporate level, he helped the company grow from some 2300 restaurants, to over 23,000 restaurants. Pretty impressive.
Marty: Thank you.
Mary: In the mid 90s, Marty left Chicago and moved to South Florida, purchasing to McDonnell restaurants in Broward County. Sometime years later, he left the McDonald’s family and opened a couple of small sandwich shops also in Broward when the real estate market collapsed in the late 2000s. He left the restaurant industry after more than 30 years and embarked on a new career in insurance. His initial focus was on indemnity insurance, like accident, disability critical illness programmes that were used for voluntary employee benefits. These routes are still part of the overall services he provides. But the natural offshoot of that was to expand into Medicare.
Over the last 12 plus years, he’s brought his enthusiasm for customer client service and healthy people to the Medicare arena. Marty is with United experts in Boca Raton, Florida. He offers Medicare Supplements, Advantage plans and drug plans from all the major players in the Medicare industry, such as UnitedHealthcare, United American, Humana, Aetna, Mutual of Omaha, and WellCare. His primary focus is to educate his Medicare beneficiaries so they can make an informed decision that best serves their long term needs, protecting their health for years to come.
Welcome to Caregiver cast. Marty, how are you?
Marty: I’m wonderful. It’s my absolute pleasure to be here with you Mary Elaine.
Mary: It seems like you have been really busy with licences in 22 states.
So it’s pretty impressive.
So I feel honored that you’re here. So let’s just start with the basics. Because I know people are really confused about Medicare.
It seems to get more complicated year after year. So can you tell us how someone can enroll in Medicare?
Marty: Sure. You mentioned a very interesting thing on my normal zoom calls. When I do networking. I have a banner over my head that says everybody knows what Medicare is, but very few people understand it. So that that’s really my that’s really my thing and that my focus has become on educating people on Medicare, and if I educate obviously will make the right decisions. So to answer your question, how do you enroll in Medicare? It’s really very simple.
If you’re already collecting Social Security, let’s say you say that you started to collect early, you’ll automatically be enrolled in Medicare, you’ll get a Medicare card, it’ll have your dates, everything under the sun. Okay, if you’re working and you’re going to continue working after you’re 65 and you have outstanding employer coverage, you don’t need to enroll in Medicare. But I do recommend that you enroll in Medicare Part A because it doesn’t cost anything. And that way you have the ball rolling, towing that is very simple. You can do it online, go to ssa.gov, which is the Social Security Administration’s website.
Under the Apply for Benefits category, you’ll see enroll in Medicare. And then you can enroll in Medicare Part A Part B. Now
I fall into the senior category. So I’m going to say this a little bit.
I don’t know what the word is with some seniors aren’t comfortable with technology.
or you can always call the local Social Security office or the National Social Security number. And tell them Hey, guys, I want to enroll in Medicare, and you can do it over the phone. So it’s that easy.
Mary: Okay, great. That seems nice. I wish you had the banner, because that is so true. So how, what are some of the misconceptions about Medicare what they can and can’t insure you for?
Marty: That’s a great question. There’s a lot of confusion about what Medicare does cover and what it doesn’t cover. Let’s let me start real simply with what it doesn’t cover that people think it should.
Medicare does not cover long term care,
you have to have a separate long term care policy. There is no provision for that. And Medicare, there’s a limited provision in Medicaid.
Marty: So Medicare does not cover. And this has been a big thing in the last several months dental, vision or hearing.
Marty: As a standard coverage, it’s not covered the build a better American plan, or however they’re they’re phrasing the term with what’s going on in Washington originally had.
And we were excited about it coverage for dental, vision and hearing comparable to what Medicare covers for health care.
But that got knocked out in the negotiations between the administration and the Congress. And the bill that was signed the other day had no coverage for Medicare. So that’s one of the myths. Another myth is that it’s hard to get help with Medicare plan. Everybody has to be confused, I have to listen to TV, I have to listen to the phone calls they can. That’s not true. There’s some great resources to help you understand Medicare, first and foremost is medicare.gov. Anything you would want to know about Medicare as answered on their site. Now you have to do a little bit of digging, but everything is there. Number two, there’s people like me, there are people who are, and I won’t say salesman, because I hate that word, because I don’t sell Medicare. But there are people who represent a number of Medicare plans as I do, you mentioned all the companies, so I won’t go through that again. But as an independent agent, my job is to work with my clients with a Medicare beneficiary, and help them understand all of the options that are out there to take the time to explain them, tell them pros and cons and help them make an informed decision about their coverage. So there’s help out there, you just have to find the right resource. And finally, the right person, somebody you feel comfortable with somebody you can build a relationship with. Because a decent agent, a good agent will become your advocate as well. So you want to make sure you have somebody you can trust. Next thing is
Medicare is the same for everybody, I sign up for Medicare, I get my card, I go to the doctor, and I’m done. That is absolutely not true. Medicare has to be, I look at Medicare, as
custom tailor you, you can go to Walmart or Target or Macy’s and buy a suit off the rack
will find custom tailor and have a suit custom made to fit you perfectly
secure world, it’s important that you take the time to custom tailor that plan. Just because your brother in law or your neighbour has the best Medicare plan in the world doesn’t mean it’s the right plan for you. That person may have different doctors, they may have different health care issues, they may have different prescriptions, they may have a whole host of things that are different from what you have. And while their plan addresses their needs. Their plan may not address yours. So you really have to, you really have to be careful, it isn’t customed here.
One more myth about Medicare, it’s only for low income people. It’s not, it’s for everybody who turned 65 everybody in their working life has paid into Medicare and everybody is eligible for it. Now, that said, if you’re a high income individual, you’re going to pay more for your Medicare, you’re going to pay a higher Medicare Part B premium. There’s a sliding scale for 2022 that goes anywhere from $170.10 a month for your Medicare Part B premium, up to $519. So high income people pay more, but they’re eligible for it. So those are some of the common myths.
I mean, there’s a whole host of misinformation floating around the marketplace. It’s hard to address them all in a short time like this, but those are the pretty big ones that people just don’t understand more often than not.
Mary: Okay, thank you very much for explaining that. So, just to kind of reiterate, Medicare does not cover dental, vision or hearing correct
Marty: National Medicare.
Mary: Thank you. It doesn’t cover long term care. It doesn’t help with every all your medical problems necessarily correct.
Marty: It pretty much covers the Oh, again, it depends on the plan that you’re on and the coverage that you elect. But he covers the overwhelming majority of the healthcare needs of most people.
There, there are certain elective procedures that may not be covered. But for long term health care, they’re pretty well covered under Medicare.
Mary: Okay, thank you. We’re in the Annual Enrollment period, correct?
Marty: Yes, we are.
Mary: Yes, we are. And, um, so what’s the difference between the Medicare Annual Enrollment period from September to early December, and the open enrollment period,
Marty: That that’s an interesting one, the annual enrollment period, and we’re in the middle of that right now goes from October 15 through December 7 every year.
Marty: That’s when anybody can transition from Original Medicare to Medicare Advantage plans to transition from Medicare Advantage Plans back to original Medicare, which from one Medicare Advantage plan to another Medicare Advantage plan to switch from one prescription drug plan to another prescription drug plan. It’s the time period where you can make all the major changes to your Medicare coverage. My recommendation to all of my clients and to anybody I talked to, is you need to review your Medicare every year during annual enrollment. And you need to deal it with somebody who knows what they’re doing. Because just I’ll just use my example right now. And since October 15. And my client base, I probably saved my existing clients, somewhere to the tune of around $20,000 in costs that they would have incurred if they not made a change to their coverage.
Marty: Pretty large client base, but that’s still a lot of money. So it’s really important for those people who have never evaluated or reviewed their medic Medicare coverage. It’s absolutely critical. I have a client who hadn’t reviewed her coverage for 18 years.
18 years, she just let it ride.
Marty: The coverage I saved for over $5,000 a year in prescription drug costs.
Mary: Wow, that is amazing.
Marty: No Annual Enrollment period is really important. Now, and this is where it gets confusing, because we’re in the middle of also traditional health care open enrollment. But there’s a separate Medicare Open Enrollment Period. That’s the first quarter of every year January 1 through March 31. They call it open enrollment. I have a different name for it. It’s the oh my god, I screwed up my coverage and I need to fix it period. One time opportunity in the first quarter of every year, let’s state with a Medicare Advantage plan.
Marty: It’s strictly for Medicare Advantage plans, no other Medicare coverage. And you got your plan. And on January 15, you went to see your doctor and the doctor says, Well, you know, something, Mary Elaine, we don’t accept that plan anymore. And you’ve been with his doctor for 30 years, and you want to stay with his doctor. Pick up the phone, you say, Marty,
I just just went to my doctor and he’s not accepting my plan. What can we do? We’re going to find a plan that your doctor accepts and you have a one time opportunity during that open enrollment period and every year to switch to a new plan or another plan.
Mary: Okay. And that only happens with the Medicare Advantage plans. Oh my right. Okay.
Marty: Let me qualify something else. Medicare supplements can be changed anytime during the year. They’re not. They’re not restricted to the official enrollment periods. So you have more flexibility there. But with Medicare Advantage, that’s your options.
Mary: Okay. Thank you.