163 Seven Ways to Maximize Medicare Benefits with Eleanor Laise from Kiplinger’s Retirement Report

Jason and Eleanor talk about health insurance expenses in retirement and how to get the most out of Medicare.

Eleanor Laise is Senior Editor at Kiplinger’s Retirement Report, where she covers issues ranging from income investing and pension plans to estate planning and health care.  She joined Kiplinger in 2011 from The Wall Street Journal, where as a staff reporter she covered mutual funds, retirement plans and other finance topics.

Below is the full transcript:

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Announcer: Welcome back America, to Sound Retirement Radio, where we bring you concepts, ideas, and strategies designed to help you achieve clarity, confidence, and freedom as you prepare for and transition through retirement. And now, here’s your host, Jason Parker.

Jason: America, welcome back to another round of Sound Retirement Radio, so glad to have you tuning in. You’re listening to episode 163, so if you’re driving down the road this morning in Seattle, remember all of these shows are archived for you online at soundretirementplanning.com. The episode today, number 163, is Seven Ways to Maximize Medicare Benefits. I’m excited, we’ve got a guest that we’re going to be bringing on in just a minute, but before we do, I’d like to get the morning started right. Two ways, the first one is by renewing our mind. I’ve got a verse here for us, Galatians 5:14, “For the entire law is fulfilled in keeping this one command: Love your neighbor as yourself. If you bite and devour each other, watch out, or you will be destroyed by each other.” It’s actually Galatians 5:14 and 15.

 Okay, and then I’ve got a joke here for us. How excited was the gardener about spring? So excited, he wet his plants. I like that one, Amelia, she picked that out for us. She’s not here with us this morning, but she picked it out. Okay, episode 163, Seven Ways to Maximize Medicare Benefits, it is my good fortune to have Eleanor Laise senior editor at Kiplinger’s Retirement Report. She covers issues ranging from income investing in pension plans to estate planning and healthcare. She joined Kiplinger in 2011 from the Wall Street Journal, where she was a staff reporter.

 She covered mutual funds, retirement plans, and other personal finance topics. Eleanor, welcome to Sound Retirement Radio.

Eleanor: Hi Jason, thanks so much for having me.

Jason: Absolutely, thank you for being a guest. I really enjoyed this topic, of seven ways to maximize Medicare benefits. Before we get into maximizing the benefits though, I want to just do like a quick couple-minute overview of Medicare part A, Medicare part B, and Medigap plans and Medicare part D, just so that all of our listeners are on the same page. Would you mind giving us just a quick rundown on what those different programs are?

Eleanor: Sure. If you’re on original Medicare, you generally have Medicare part A, which is free for most people, and that covers your hospital costs. Then you also have Medicare part B, which covers any outpatient services that you have, routine doctor visits, things like that. Now there’s a cost to that, the standard premium is $134 a month, and if you’re a higher income person, then you are going to pay more than that. Then you have part D, which covers your prescription drug costs, and those premiums vary depending on the plan, but they’re on average about $35 a month.

 Now, the sort of increasingly popular option is Medicare Advantage plans, and those are plans that are offered by private companies that contract with Medicare. Those generally have [inaudible 00:03:43] plans bundled into them. Yeah, this is not cheap for a lot of people, and actually the average person on original Medicare spent about $6,150 out of pocket in 2013 on their Medicare and Medigap premiums and doctor visits and drugs and other costs.

Jason: Yeah, but that’s a great number for people to know. We created something called the retirement budget calculator, and so healthcare is a big expense for a lot of people, they want to understand how much they’re going to be paying out of pocket once they are on Medicare. To have a target in today’s dollars of maybe $6,500 per year for Medicare part B premiums, Medicare supplemental, part D prescription drug, and then maybe some out of pocket expenses, that gives people a lot of clarity about how much they should be budgeting for that item, so that’s awesome.

 The very first sentence of this article that you have here in Kiplinger’s Retirement Report from March 2018 says, “Medicare is vital to the health of nearly 60 million Americans, yet many of its benefits are overlooked, underused or misunderstood.” Then you go on to provide some tips, but why is it, why is this so complicated, how is it that people are missing out on the money that’s available to them or the benefit that’s available to them through Medicare?

Eleanor: Well, there are just a host of benefits that are available under Medicare, and you know the information is out there, but it’s not always easy to find. It takes time, you know you have to do some homework, and there’s a Medicare new handbook that you can get from the medicare.gov website, but it’s 135 pages long, and while you’re healthy, you’re not thinking too much necessarily about all the services you can get.

Jason: That’s true, so people aren’t really thinking about it until their health changes, and then who wants to read through a 135-page manual as you’re in bad health? What are some of the most overlooked Medicare benefits?

Eleanor: Well, one thing that healthy people should know is that there are just a host of preventative services that Medicare will cover, and a lot of those are free, like the annual wellness visit, which is a good routine checkup and available to everybody who had part B for more than 12 months. Other preventative services range from bone mass measurement for people that have osteoporosis, cancer screenings, screenings for cardiovascular disease and depression, counseling to help you quit smoking, vaccines for flu and pneumonia. If you just signed up for part B, you can also get a free “welcome to Medicare” preventive doctor visit within the first 12 months.

Jason: I love that. You know, in the article you said less than 11% of Medicare beneficiaries took advantage of many of these benefits, these free screenings. Do you think it’s just because people don’t know about them, or what’s the reason, why wouldn’t people, if they have the opportunity to get a healthcare checkup, why wouldn’t they take advantage of that?

Eleanor: Well, so many people when they first become eligible for Medicare, they’re 65 years old, a lot of them are in very good health, really not thinking too much about this issue. But this is the kind of services that really helps you stay healthy for a long time in retirement, so it really is crucial.

Jason: You talk about the “welcome to Medicare” preventative visit within the first 12 months that you have part B, is that preventative visit only a one-time benefit when you first enroll, or is it an annual benefit that you’re eligible for?

Eleanor: Well, the initial “welcome to Medicare” visit, it’s sort of a one-time thing within the first 12 months, and then after that, you get that annual wellness visit. Another thing that can happen at that visit is advanced care planning, discussing with your doctor advanced directives, the type of care that you’d like to receive if you become incapacitated, and that’s really crucial planning that can be such a great help for your loved ones if something happens to you.

Jason: Eleanor, do you find that most people sign up for Medicare as soon as they become eligible for part B, or are there times when people don’t enroll in Medicare when they turn 65?

Eleanor: Well, generally everybody gets part A when they’re 65, because it’s free, so why not? If you continue working, then you may have health coverage under your employer’s plan, so you might hold off on signing up for part B.

Jason: If it’s covered by that, yeah.

Eleanor: But if you stopped working … Right, yeah, but if you’ve stopped working, and you don’t have any other health coverage, you definitely want to sign up for part B, otherwise you’re going to pay some late signup penalties down the road, and those stick around with you for the rest of your life, so you want to be on the ball about signing up.

Jason: How about this scenario? You’ve got a husband and wife, the husband’s still working, the wife has turned 65, but she’s covered under his healthcare benefits, even though she’s retired, she’s not working. Should she enroll in Medicare part B, even though she has coverage under his employer’s plan, or should she just stick with the coverage that she has?

Eleanor: Well, I guess it depends on how generous the employer’s plan is. She might want to take a look at the benefits and compare the costs and benefits provided by each plan.

Jason: Okay. Number one, the first tip here was, “Take the freebies. These include screenings for cardiovascular disease and depression, counseling to help you quit smoking, and flu and pneumonia vaccines.” Do you think this is one of the reasons we see such a push for the flu vaccine these days, because it’s a Medicare benefit and the pharmaceuticals are just trying to cash in on that? I mean, it seems to me like it’s a new phenomenon, where everybody’s supposed to get the flu shot these days.

Eleanor: Yeah, well I guess we’ve seen this year, a really devastating sort of flu season in the US, so maybe that’s helped to heighten the concern as well.

Jason: Yeah. Under the “take the freebies”, one of the things you talk about with some Medicare Advantage plans, wellness benefits like silver sneakers, what’s that?

Eleanor: Yeah, so that’s an exercise program designed specifically for seniors, and that is covered under a lot of Medicare Advantage plans, and that’s kind of a unique thing about advantage plans, they tend to offer these free wellness benefits that original Medicare doesn’t tend to offer.

Jason: I’ve heard things go back and forth on Medicare Advantage. When they first came out, it seemed like they were priced very competitively, people were moving to them. Then over time, it seemed like the prices started going up, and people started saying, “Oh, I wish I would have stuck with original Medicare.” What’s kind of the word on the street, what do you hear out there? Is Medicare Advantage plan still as popular today as they were when they first came out, or do you find more people are kind of leaning towards the traditional Medicare plan?

Eleanor: Well, Medicare Advantage plans are growing really fast, actually a third of all Medicare beneficiaries are now covered under advantage plans. Now, for healthy people, they tend to serve you pretty well, and they do tend to be a lower cost than original Medicare. The problem is, if you get sick, and there have just been a whole series of recent studies looking at people with more serious health conditions and how they fare in advantage plans versus original Medicare, and some of these studies finding people disproportionately dis-enrolled from their advantage plans and switched back to original Medicare when they do become really sick.

 There was another study also looking at the quality of nursing homes that people enter when they’re on advantage plans versus original Medicare, and finding that actually people on advantage plans are going into lower quality nursing homes. That has to do with the narrow provider networks that these advantage plans can have. They might only have one nursing home in their network, and it may not be the best one around. That’s something you definitely want to check out when you’re making this choice between advantage plans and original Medicare, are your preferred doctors and hospitals and nursing homes included in that plan’s network? If they’re not, you’re going to be paying more out of pocket.

Jason: That’s fascinating. I know here, even in the community that I’m in, the Medicare Advantage plans are sometimes county-specific, so what’s available across the bridge may not be available on the other side of the water. I mean, it’s just kind of crazy what healthcare plans are available based on the county that you live in. I wanted to ask you, item number two in your article, “choose the right provider”, talks about doctors that accept Medicare-approved amounts as full payment for services known as assignment. Walk our listeners through this, help them understand what is it, if you have Medicare, if you’re not going to the right doctor, it’s possible that the costs aren’t going to be covered, is that right?

Eleanor: Right. Now, if you’re on original Medicare, you can go to any doctor in the country who accepts Medicare, but finding a doctor to accept Medicare is only half the battle. You need to know whether the doctor accepts assignments, and that means like his will accept the Medicare-approved amount as full payment. If he does, then you know that you’re going to pay your Medicare deductible and co-insurance and nothing more than that. The good news is that most doctors treating Medicare patients do accept assignment, but there are a couple of categories of those who participate in Medicare that don’t accept assignment.

 There are non-participating providers who can charge you up to 15% more than a reduced Medicare fee schedule for services that are covered by Medicare, and you’ll be stuck with the extra charges.

Jason: You’ll be stuck because even your Medigap policy, because it’s not an approved charge, your Medigap policy won’t pick up that additional 15% then?

Eleanor: I guess Medigap policies may cover some of that, but it’s just something to be aware of.

Jason: Okay.

Eleanor: That you’re going to be billed for these higher amounts, and then are also opt-out providers who could charge you whatever they want. That’ll be outlined in the contract that they have with their patients.

Jason: That makes a lot of sense when you’re maybe healthy and you’re making some decisions, but what about when you’re in an emergency type of situation, you’re supposed to ask the doctor in the emergency setting whether or not they accept assignment? I mean, is that what the expectation is?

Eleanor: Yeah, I mean you definitely want to know what sort of status that the doctor has with Medicare. Another issue there is, concierge medicine is growing really fast in a lot of states across the country, and these are practices where you pay a membership fee in exchange for special perks like email access to the doctors, or same-day appointments, but Medicare does not cover concierge membership fees, and some concierge doctors have opted out of Medicare, so that’s another thing to be careful about.

Jason: If you have a doctor who has opted out of Medicare through a concierge program, you’re paying your monthly fee to see the doctor, don’t expect Medicare to pick up the tab if they’ve opted out.

Eleanor: Right.

Jason: You know, I ran into a situation recently where there was a woman whose doctor retired, and she needed to find a doctor that accepted Medicare assignment, but not just accepted Medicare assignment, but who was also taking new patients. I remember her telling me she had to call over 60 people before she found somebody to work with. Is that what this is coming to, are people having a hard time finding new doctors that accept Medicare assignment, in the world that we live in today?

Eleanor: Well, you know I haven’t heard stories about someone having that much trouble, I mean 60 doctors, that’s a lot of homework to go through to find a doctor.

Jason: In her case, it had to do with a specific prescription that she needed, and so there was more to it, but it was hard, I mean it was really hard.

Eleanor: Yeah, absolutely. Well, I mean fortunately there is a tool on medicare.gov, you can go and click on “find doctors” under health professionals, and they’ll show you doctors in your area that accept assignment, but of course depending on the area, like you say, you know maybe they’re not accepting new patients, so that can be a real challenge.

Jason: Yeah. Folks, if you’re just joining us this morning, you’re listening to episode 163. Remember, we archive all of these programs for you online. I’ve got Eleanor Laise on the program with us, she’s a senior editor at Kiplinger Retirement Report. This is a report that I’ve been reading for several years now, and occasionally the folks at Kiplinger will send me a headline that really catches my attention. This particular March retirement report was Seven Ways to Maximize Medicare Benefits. Medicare is the health insurance that most people, my experience is most people sign up for when they turn 65, if they’re no longer working.

 It’s really a wonderful benefit, I mean if you compare how much people pay for Medicare premiums, compared to say private insurance at age 63 or 64, it actually is really good coverage at a significant reduction from a lot of those private plans. We’ve only touched on two of the items from the list here, and I’m excited, I asked Eleanor before we got started if she would be willing to stick with us for our podcast listeners for a little extra, so we could get through all of the points.

 If you’re driving down the road this morning and you can’t catch, or you only get about 25 minutes of the show, Eleanor agreed to stick with us, so you can listen to the full interview at soundretirementplanning.com. The next one, Eleanor, is number three was “save on drugs”, and you say even if you have part D prescription drug coverage, your out of pocket costs can be eye-popping. Talk to us about prescription drug coverage.

Eleanor: I mean, this is such a huge issue for retirees, and part of the issue here is that part D does not have any cap on out of pocket spending. There’s a so-called “catastrophic coverage threshold”, you know after you’ve spent $5,000 on drugs in 2018, but even after you’ve hit that level, most people still have to pay 5% of the cost of their drugs. If you’re on some of these medications that can really add up. Now there are a few ways to think about limiting your drug costs. If you’re somebody who really has sort of more modest prescription drug costs, ironically one way to rein in your costs might be forget about your part D plan and just pay cash.

 That’s because a lot of these big box stores like Costco and Target are selling a lot of the generic drugs for just a few bucks. You might just pay $4 or so for your prescription there, whereas a lot of the part D plans have higher standard copays, like $10 for every prescription.

Jason: The idea there is you still enroll in the part D plan, you just don’t necessarily use it when you go to check out at the counter.

Eleanor: Right, you definitely want to have a part D plan, because you’ve got to think about the days when you do get really sick and have pricey prescriptions that you need. Yeah, if you’re a person who may not meet your deductible anyway, because if you are paying cash, then that payment isn’t going to go towards meeting your deductible, but if you generally have pretty modest drug costs, then that’s something to think about.

Jason: Okay, yeah. People generally aren’t getting healthier as they’re transitioning through retirement, and so healthcare costs, while they may not consume a lot of your budget in the early years of retirement, it’s usually one of those budgeted items that will increase over time, for a lot of folks. Number four is “understand home health benefits”, why is this important?

Eleanor: Well, this is a really tricky one. One problem is that even a lot of healthcare providers don’t understand eligibility rules for Medicare’s home healthcare benefit. To qualify for it, you must need skilled services like nursing, physical therapy, speech therapy, and you must be home bound. That doesn’t necessarily mean that you don’t leave home at all, it just means that you have difficulty leaving home without help, or that doctors have recommended that you not leave home because of your condition. If you meet those criteria, you can qualify, but you want to make sure that you’re going with a Medicare certified home health agency, and you can find those at medicare.gov/homehealthcompare.

Jason: Medicare.gov is a great resource for our listeners, but medicare.gov, what was it, compare?

Eleanor: /homehealthcompare.

Jason: Homehealthcompare, okay.

Eleanor: Right.

Jason: We’re just about out of time for our radio listeners this morning here, Eleanor. I want to remind our listeners, if you are thinking about retirement, we are going to be conducting a webinar on retirement planning, what a good plan should look like. You can enroll in that webinar at the website soundretirementplanning.com. I’m going to have the good fortune to continue this conversation with Eleanor, so if you can stick around for the podcast, that’s great. For our radio listeners, thanks for being here. Eleanor, hold on with me, and we’ll be back right after this.

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 Investing involves risk. Jason Parker is the president of Parker Financial, an independent fee-based wealth management firm located at 9057 Washington Ave. NW, Silver Dale, Washington. For additional information, call 1800-514-5046, or visit us online at soundretirementplanning.com.

Jason: Okay, welcome back everybody. The good fortune to have Eleanor Laise on the program with the Kiplinger Retirement Report. We’re continuing our discussion for our podcast listeners on Seven Ways to Maximize Medicare Benefits. Under this home healthcare benefit that may be available to people, one of the things I highlighted was even when patients meet all the requirements, they’re often inappropriately denied benefits. Then it goes on to say, “But improvement is absolutely not required in order to get home healthcare.” Sometimes people are kicked off this benefit because they think that there needs to be improvement taking place, but that’s not actually the case, is that right?

Eleanor: Right, yeah. Patients are often told that their home healthcare is going to be discontinued because their condition is not improving. There’s this so called “improvement standard” out there, but the improvement standard is a mess, it is not in the rules.

Jason: For home healthcare.

Eleanor: It’s definitely not required, right, definitely not required in order to get home healthcare. Medicare will cover home healthcare just to maintain your condition or to slow your decline, and that could be really crucial for people who may have serious conditions like Alzheimer’s or paralysis, things like that.

Jason: That’s interesting. We did run into this improvement condition when we had a family member enter into a nursing home under the Medicare eligibility rules. He spent three nights in the hospital, and then made the transition over to the nursing home, and Medicare says you have to be showing signs of improvement. He was only able, you know and Medicare says that they’ll cover the first 100 days of care, he ended up receiving care for about 13 days because he was no longer showing signs of improvement in the nursing home. That was an issue that we did run into, but that was not for home healthcare, that was for nursing home care.

Eleanor: Well, even with an issue like that, I would perhaps reach out to a patient advocacy group and really sort of try to figure out what your rights are. There’s a wonderful group called the Medicare Rights Center, there’s the Center for Medicare Advocacy. They’re also in every state, these state health insurance assistance programs. When you run into coverage issues like this, and you’re having trouble navigating a benefit, there are lots of folks out there that can help you.

Jason: That’s wonderful, because I was just going to say, this is confusing, it’s hard to understand all the rules, and so it’s great to know that there are these groups out there. Now, are these advocates people that you pay for, or are these organizations that are set up through government agencies, how do they get compensated for helping you navigate Medicare?

Eleanor: Well, the state health insurance assistance programs, they won’t charge you anything, I believe the other groups also do pro bono work. To find your state health insurance assistance program, you can go to www.shiptacenter.org.

Jason: Okay. The next item in the article was to explore money saving programs, it says, “Seniors living on a limited income may qualify for Medicare savings programs that will help cover part B premiums, and in some cases, deductibles and co-payments.” What are some of these money saving programs that people may be eligible for?

Eleanor: Yeah, there’s three or four Medicare savings programs, and they will help cover part B premiums, and in some cases your deductibles and co-payments as well. The programs, even though they cover Medicare costs, are actually administered by the state Medicaid programs, so the eligibility requirements vary from one state to the next. Generally, you need to have a thoroughly modest income to qualify, but some states have no limit on assets, so even if you’re somebody who’s built up a sizeable retirement nest egg, you might want to check out whether you could qualify for one of these. Again, the state health insurance assistance program can help you, or you can go to benefitscheckup.org, and find out if you might qualify.

Jason: Okay, great. You know, one of the things I’ve seen that is really interesting online, there’s some maps that show the most tax-friendly states for retirees to, if they’re thinking about retirement and taxes are a big deal to them, that they can go through these maps to see which state is the most tax-friendly. Is there any resource like that on Medicare that would help people who are trying to decide which state they want to retire to know who’s going to be the easiest to work with, and maybe have the most benefits available to them?

Eleanor: Well, in terms of original Medicare, I mean your benefits should be the same no matter what state you’re in. I mean, it’s kind of a unique aspect I guess of these Medicare savings programs, is that that is one aspect of it that’s administered by state. That’s kind of a niche thing that would vary from state to state.

Jason: Yeah, it’d be interesting to be able to say, “Well, if I need some money saving programs, which state would be the best for me to live in, based on the eligibility?”, I’d just be fascinated. I wasn’t sure if there was anything that existed like that, but it sure would be helpful for people that are maybe on the lower income side of things that are trying to make some decisions about where they want to retire, or if their expenses are going to be greater in certain areas. Like I say, with Medicare Advantage plans, because they’re county to county, or at least that’s my understanding, there are some counties where people, if they move to those counties, the options they have for health insurance coverage is not as, they don’t have as many options as they do in other counties, which you wouldn’t think that you would have to make a decision about where you’re going to live based on the health insurance coverage that would be available to you.

 Have you found that to be the case with other people or other places?

Eleanor: Yeah, absolutely. Well, that’s another reason you definitely want to check out those advantage plans networks before you sign up, and also keep in mind, those networks can change from year to year, but you really want to make sure that you have a decent selection in those doctors, hospitals, home health agencies, nursing homes in the plan that you’re considering.

Jason: My grandfather, who was in his 80s during the financial crisis, early 80s, my grandmother had Alzheimer’s, and he was providing the care for her at home. He lost his health insurance benefits that had been provided by his employer, it was part of his retirement package, but part of the bankruptcy proceedings that they went through, he ended up losing his health insurance. In his 80s, with his wife who had Alzheimer’s, had to go and make decisions about Medicare. For somebody that’s in that type of situation, where maybe you’re cognitive ability isn’t as sharp at 80 as it is when you’re 40, how does somebody start … I mean, is the best resource to pick up the Medicare pamphlet and read through 130 pages, or how do you make good decisions about whether it’s better to go Medicare Advantage or traditional Medicare, and which one is going to cover the greatest cost, how do people navigate that?

Eleanor: Well, for someone in that situation, I would definitely suggest I think reaching out to the state health insurance assistance programs, I mean they can provide so many different services, but definitely helping you think through that choice between Medicare Advantage and original Medicare, and then if you’re looking at advantage, which plan to choose, or if you’re looking at a Medicare supplement, which supplement to choose. That can really be an invaluable resource.

Jason: Okay. The seventh tip you have here says, “Care for those who need it most,” and you talk about hospice. Help our listeners understand this benefit that’s available through Medicare.

Eleanor: Hospice is another one that is often overlooked. It’s generally for people who are expected to live six months or less, and it can be so beneficial because it can help you stay in your own home, you know cover drugs for controlling your symptoms, relieving pain, and also provide respite care so that your family caregivers can take some time off. Now, going on hospice does mean that Medicare won’t cover treatments that are meant to cure your terminal illness, but you can still get coverage for treatments for other conditions, and like I say, controlling symptoms and pain relief and things like that. Some patient advocates say that they see people on hospice actually living longer, because the services addressed so many of their needs.

Jason: You tell some great stories in your article about people who were actually in this position, where hospice care, which is available to terminally ill, would have been really beneficial for individuals who did not want to be in a nursing home. This is a husband talking about his wife, “It would have given her some comfort.” I’ve heard stories about people that have gone on to hospice because they’re diagnosed as having less than six months to live, but then they end up living two years, and hospice continues to provide this benefit. Is that something that you’ve heard happening as well?

Eleanor: Yes, yeah, I’ve definitely heard that from patient advocates, that a lot of times people do well and live much longer than expected. That’s the advice I’ve heard, is don’t think of it as giving up, because it can be so beneficial to people.

Jason: Yeah, and the people that I’ve experienced that work in hospice are just absolutely amazing, just really have an amazing heart to serve people at a hard time in life. Eleanor, this was a great article, thank you for the work that you’re doing at Kiplinger’s Retirement Report. Is there anything else that you would like our listeners to know as they’re trying to navigate health insurance in retirement or Medicare? Oh, I had one more question that actually I wanted to ask you. You had talked about people switching from Medicare Advantage plans back to traditional Medicare when they needed a higher level of coverage. Is that something that can only be done once a year, or can they make that switch back any time?

Eleanor: Now, the rules on this are changing a little bit. Now, during the annual open enrollment period, which is generally like mid-October to December 7th, you can switch from an advantage plan to original Medicare, or just switch advantage plans. There’s also a Medicare Advantage dis-enrollment period, and traditionally that’s been in January and the first half of February, when you can also move from advantage to original Medicare. Now in 2019, that’s changing a bit, I think it’s actually the first three months of the calendar year that you can switch among advantage plans or switch from advantage to original Medicare.

Jason: Okay.

Eleanor: Now one really important point to keep in mind about advantage plans and the possibility of switching is that if you are sicker at the point when you are trying to switch from an advantage plan to original Medicare, you don’t necessarily have guaranteed issue Medicare supplemental insurance.

Jason: Ah, okay.

Eleanor: You can be charged more, based on your health condition, or you might be denied supplemental coverage altogether. That’s another thing to keep in mind when making that initial decision between original Medicare and Medicare Advantage. If you want that supplemental insurance, it is guaranteed issue when you are initially eligible for Medicare, but not necessarily after that, you know down the road when you may have a serious health condition.

Jason: If you’re switching, if you’re trying to do the old switcheroo, go for Medicare Advantage because it was cheaper while you were healthy, and then go to the traditional Medicare because maybe you feel like you’re going to have better comprehensive coverage, you may not be able to get a supplemental plan because it’s not guaranteed issue at that point, so you’ve got to be careful. That’s a great, great point. Any other tips or things that our listeners need to be thinking about as they’re trying to navigate health insurance and Medicare, as they transition into and through retirement?

Eleanor: I think we touched on all the major points, and I would just reiterate that these wonderful organizations are out there to help guide you, you know the Medicare Rights Center at medicarerights.org is a great resource, and then your state health insurance assistance programs. Don’t feel that you’re alone in navigating these benefits.

Jason: I would say, Kiplinger’s Retirement Report is a great resource too, because you guys are helping to uncover some of these really important opportunities, Seven Ways to maximize Medicare Benefits. Thank you so much for being a guest on Sound Retirement Radio, Eleanor.

Eleanor: Thanks so much for having me, Jason.

Jason: Okay, take care.

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