Now or Never: Long-Term Care Strategy with Kosta Yepifantsev

What Your Medicare Advisor Wish You Knew with Debby Riskind

November 29, 2022 Kosta Yepifantsev Season 1 Episode 12
What Your Medicare Advisor Wish You Knew with Debby Riskind
Now or Never: Long-Term Care Strategy with Kosta Yepifantsev
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Now or Never: Long-Term Care Strategy with Kosta Yepifantsev
What Your Medicare Advisor Wish You Knew with Debby Riskind
Nov 29, 2022 Season 1 Episode 12
Kosta Yepifantsev

Join Kosta and his guest: Debby Riskind, Director of Medicare Insurance Sales and Marketing at  GM Goldman and Associates, helping seniors get the most out of Medicare. Whether you’re buying produce at the supermarket or shopping around for a new car, we all want to get the best deal. Unfortunately, shopping for medicare insurance plans isn’t always so clear, that's where our guest Debby and her team of experts comes in! 

In this episode: The most important factors to keep in mind when navigating Medicare, Medicare plans or supplements plans to avoid, what should people approaching 65 do to be prepared to get the most out of medicare when the time comes?

Watch this episode on YouTube:
https://www.youtube.com/watch?v=rfwCWbjcxCc

Find out more about Debby Riskind and  GM Goldman and Associates:
https://gmgoldman.com/

Find out more about Kosta Yepifantsev:
http://kostayepifantsev.com/

Show Notes Transcript

Join Kosta and his guest: Debby Riskind, Director of Medicare Insurance Sales and Marketing at  GM Goldman and Associates, helping seniors get the most out of Medicare. Whether you’re buying produce at the supermarket or shopping around for a new car, we all want to get the best deal. Unfortunately, shopping for medicare insurance plans isn’t always so clear, that's where our guest Debby and her team of experts comes in! 

In this episode: The most important factors to keep in mind when navigating Medicare, Medicare plans or supplements plans to avoid, what should people approaching 65 do to be prepared to get the most out of medicare when the time comes?

Watch this episode on YouTube:
https://www.youtube.com/watch?v=rfwCWbjcxCc

Find out more about Debby Riskind and  GM Goldman and Associates:
https://gmgoldman.com/

Find out more about Kosta Yepifantsev:
http://kostayepifantsev.com/

Debby Riskind:

But here's the thing I always like to point out, because people are always like, why are you talking about Social Security when I'm talking about Medicare, think of Social Security as Medicare secretary or as the gatekeeper. They're the ones that you have to go through to get it. And once you're in your care is going to be handled by the Centers for Medicare and Medicaid Services. Unless of course, you go to Medicare Advantage, and then it's going to be by a managed care company.

Caroline Moore:

Welcome to Now or Never Long-Term Care Strategy with Kosta Yepifantsev a podcast for all those seeking answers and solutions in the long term care space. This podcast is designed to create resources, start conversations and bring awareness to the industry that will inevitably impact all Americans. Here's your host Kosta Yepifantsev

Kosta Yepifantsev:

Hey, y'all, this is Kosta, whether you're buying groceries or shopping for a new car, in today's economy, we all want to get the most for our dollar. Unfortunately, shopping for Medicare and finding the most cost effective options for insurance isn't always as straightforward. That's exactly where today's guest comes in. Debbie reskinned, Director of Medicare insurance, sales and marketing at G. H. Goldman and Associates, helping seniors get the most out of Medicare. Welcome to the show, Debbie. Tell us a bit about yourself and the work that you do.

Debby Riskind:

Sure. So I work at my family business, GM, Goldman and Associates. That's my dad, he founded it back in 1968. I work with my brother. And basically what we do, I've been with them since about 2009. I used to practice law. And then when I had kids, I went a different path. And what we do is we help boomers and seniors with all the different insurance solutions that they have to think about in or near retirement with the bread and butter of our business being helping people navigate Medicare.

Kosta Yepifantsev:

Incredible. So we're going to take some rapid fire questions to sort of, to speak on the complexities of Medicare and hopefully answer a lot of the pressing questions that people have early in this video. And then we'll get to the to the nitty gritty essentially. Okay, are you ready? I'm ready. Okay, question one. Do you have to take Medicare at 65? If you are still working?

Debby Riskind:

So that is probably the top question I get we get calls all day long on this? The answer is yes or no, it depends on your specific facts. So if you are still working, and you work at a company that has 20 or more employees, then the Age Discrimination Act governs here, and you get to keep your insurance as the primary insurer. So in other words, they have to offer the exact same insurance that they do the younger employees. If you're at a company with a group plan, and it's less than 20 employees, then you do need to take Medicare, because then you don't have a primary insurer. That means that if you had a bill Medicare would come in and pay, you'd only have 20% covered by your plan, and you wouldn't have that 80% covered. So the bottom line though, Whenever anyone asks me that question, the one thing I say to them is, check with your HR. So I'm giving you the general rule, even when it's a client, and I'm getting more specific, you always want to confirm what you know, you think you know about your plan with your company.

Kosta Yepifantsev:

So let's say that you're planning on signing up for Medicare, How and when do you sign up?

Debby Riskind:

Okay, so that is a loaded question. Because there's so many different ways to answer that, right. So if you are somebody and you're taking your Social Security, and you're taking it six months prior to your 65th birthday month, then you're automatically going to be signed up. Okay. So that is a trigger for the Social Security Administration to send you a card effective the first of the month of your birth month. If you are not taking your Social Security, then it is on you to sign up. And you can start about three months before you could do it online. You could do it by phone. In other words, calling the Social Security Administration setting up an appointment, or you could set up an appointment and go into the local office. But here's the thing I always like to point out, because people are always like, why are you talking about Social Security when I'm talking about Medicare, and that is because think of Social Security as Medicare secretary or as the gatekeeper. They're the ones that you have to go through to get in. And once you're in your care is going to be handled by the Centers for Medicare and Medicaid Services. Unless of course you go to Medicare Advantage, and then it's going to be by a managed care company.

Kosta Yepifantsev:

And we are going to talk about Medicare advantage and medicare supplement. But before we do, what are the costs of Medicare?

Debby Riskind:

So it's really interesting because a lot of people, when they get to Medicare, they're thinking that it's free. They think that because they've watched a FICA tax come out of their paycheck every two weeks, that by the time they're retiring, and on Medicare, that they're done, but unfortunately, it doesn't work that way. So it's gonna depend on which path you go, but let me give you some generals first that apply to everybody. First of all, to qualify for Medicare, you have to have 40 work credits, that's like proximately, 10 years of work. But it can be based on your spouse, if you're if you're the spouse, that didn't work, okay. But bottom line is that that earns you Part A, which is hospital is zero monthly premium. Now, there's some people that could have less than the 40 credits. And they can pay for part A Part A but for most people that I talked to part a cost them nothing.

Kosta Yepifantsev:

So that's inpatient, right? You got

Debby Riskind:

it exactly. So all everything at the hospital, Part B is everything medical. So that is your doctors, your surgeries, it could be labs, etc, the list goes on. With that, just like the insurance, you're now you're paying a monthly premium. In 2022, the standard premium is 170 10. But there's something called an Irma adjustment, income related monthly adjustment amount, I think I'm saying that right. And if you're higher earners, in, in, in, when you're in your 60s and Medicare, then you're gonna pay more than the average 170 10. And by the way, for 2023, that 170 tends actually going down. There was a big uproar, there was a big increase in 2022, because of an all timers drug, but then they realize it was too much of an increase and it's going to go down. I think it's 164. I don't know I don't and some change. But the bottom line is that so everybody, whether you go Original Medicare, or you go Medicare Advantage, you're gonna pay that Part B premium. Okay? So go ahead

Kosta Yepifantsev:

is well, is there a cap on how much you can pay in for that Medicare premium?

Debby Riskind:

Well, there's not a cap for the premium, the premium is a set amount monthly. So think of it this way, that's your constant, you're going to pay that Part B premium that allows you access to Medicare by paying that, but once you're in Medicare, Medicare is not designed to cover every dollar. So there's gaps. So if you we have to kind of break it down. Let's talk first about Original Medicare. If you go Original Medicare, okay, and let's say you have a doctor bill, and I always use example, in all my videos, and let's say you have$1,000 MRI, and I know they cost more than that. But it's easy to do the math. So you have $1,000 MRI, and the doctor in Original Medicare has, you know, submitted the claim to the Centers for Medicare Medicaid Services, they approve the claim. Let's say it was medically necessary. That's the standard, but they're responsible for 80%. So there's that 80%, they pay the 800. What happens to the $200. Now, you could pay it yourself, right? Not going to supplement. Or you could get a Medicare Supplement policy, which is of course, what I would recommend, because that 20% That is not covered by Medicare is uncapped. So in other words, if you had $1,000 Bill, you pay 20%. If you had a million dollar bill, you'd pay 20%. Wow, I didn't know that. Yeah, it's uncapped. And that's why, excuse me, you want to get a Medicare Supplement policy. There's other gaps, there's deductibles. But that's the biggest reason of all because of that, that number. And if you're in go ahead, well,

Kosta Yepifantsev:

I was gonna say at the end, we're going to talk about Part D. And I'm sure there's costs associated to that as well. I want to touch on those briefly,

Debby Riskind:

sure, DT going into D before we even shift over to cost of Medicare advantage is that you would pay a monthly premium. And then with that monthly premium, you're going to have co pays. So in explaining it. I don't know, I want to let me give you a little bit more about advantage. And then we should get into detail D because I could go on forever about that. So your big overview, right? When it comes to Medicare Advantage. What happens is you eliminate your Medicare supplement premium, you eliminate your Part D premium. So you have a lower no monthly premium, but you have what's called a MOOP a max out of pocket that you could spend. So every time you go to the doctor, you have some sort of a service, you're gonna have a copay or coinsurance up to a max that you could spend. So there's two different systems. Think of it this way. pay upfront pay these monthly premiums whether you go to Doctor or you do not, or pay as you go

Kosta Yepifantsev:

and credible. Real quick, if you have a pre existing condition does that matter in terms of qualifying for Medicare.

Debby Riskind:

So in the beginning does not matter at all, when you come new to Medicare, you can go to any supplement you want the first six months that you start B, Part B, if you get a Medicare Supplement, when it comes to Medicare vanish, there are never qualifying health questions. But this is a really important question that you asked me because here's the deal. When you first start with Medicare Part B, you do have that six month window where you go to any supplement company, if you're going to stick with Original Medicare, right? They can't ask you any questions. But now let's say it's two years later, and you want to switch plans, please switch Medicare supplement plans, then they can ask you qualifying health questions. So what why is that so significant significant, you're gonna get increases with your supplement. And sometimes you want to shop at the premium. But here's the other thing I want you to know. If you go Medicare Advantage, right, and you go to that system, and now it's three years down the line, and you're like, I want to get back to Original Medicare. You may not you could get into Original Medicare, but you may not be able to get a Medicare Supplement, if you have health issues, it's gonna depend on your state, it's gonna depend on the health issues.

Kosta Yepifantsev:

So you'd be on the hook for that 20% Premium if you don't have a supplement plan, and that's a risk that most people shouldn't take. Right?

Debby Riskind:

Right. So if I like just to give an example, if I have somebody call me, and they're like, I want to go back to original Medicare, but that person has cancer, right? And they're trying to get back in and it's been a couple of years there outside of the free look period where you can try Medicare Advantage. They probably cannot it depends on the state, but they probably cannot get a supplement. And then I would have to say to them stay in that advantage plan, because then you have that max out of pocket that you can spend. It's defined by the plan.

Kosta Yepifantsev:

So you've spoken both on supplement and Medicare Advantage. What do you recommend to most people? And how do you make that determination?

Debby Riskind:

Okay, so great question. And the thing is, everybody wishes I could just give that exact answer, what would I recommend everybody? And guess what? Here's the deal. You want to work with somebody, an agent who specializes in both Original Medicare with supplements and advantage, because then when you're sitting with that person, you figure out what is the best fit for them. Now, there's obviously a simplicity to Original Medicare, because there's no prior approval needed for claims. There's no doctor networks, but you're paying that premium. And that can get expensive for people. So there's reasons I like both systems for different people. And again, really is going to depend on their situation.

Kosta Yepifantsev:

And correct me if I'm wrong, but like Medicare Advantage, they have benefits that the traditional Medicare plan does not have, right. So like, for example, I think they offer like gym memberships. In some instances, I believe they even offer a small stipend for in home care. I think they started that and 2020 or 2019, I believe. But like overall, does it is it a better value? I guess it just so just so people understand. I know that you got to kind of meet people where they are. But in your opinion when you're working with clients. For the majority of the time, do you say why don't you just start with regular Medicare and then transition to advantage if you don't like it? And then you can come back within that free look, period.

Debby Riskind:

Okay, so that was a long question. Let me deal. Here's the deal. They're both. Okay. You're when you see the commercials, obviously right now, everybody's been Mum, I almost forgot the question. So I gotta go back when you see those commercials, right? And you're seeing all these great perks. Perks are great. And this is what I always say to people, when we're looking at an and I'll get back to the value of it. But when you're looking at a Medicare Advantage plan, the first place you have to start as are your doctors in network and are your drugs cost effective under the plan. Once we determine that that's when we celebrate the perks all offer different kinds of perks. Some carriers offer incredible dental coverage. Others are going to offer over the counter benefits for your Advil and you're different. Some are gonna have a flex card some have a return on your Part B premium. I mean the list goes on in with every carrier where they give they take So meaning one carrier may give this but then less on dental. And another carrier may put more emphasis on a different perk and they all seem to offer gyms. Okay, so you're asking is the overall value? Yeah. Listen, if your care went smoothly, and you weren't denied prior authorization for something that you needed for your health care, what could possibly be wrong with having these perks? Right? Right? The issue is just that now you've gotten to manage care. So your doctors go

Kosta Yepifantsev:

ahead? Well, what is managed care if you could explain to the audience

Debby Riskind:

Sure, I'm gonna give it my best shot with that. So think of it now. You're a young guy, you're not on Medicare, you have a insurance policy and your doctor said you needed surgery, or you needed an MRI, somebody's got to approve it versus not just your doctor saying thumbs up. In Original Medicare. It's the system, there's not it's not managed care, the doctor has to show it's medically necessary. Okay. In man, so it's really very similar to what you have what most people are coming off of those kinds of plans. So it's almost like a gift in Original Medicare, there's, there's those steps that aren't required, right, you know, you're gonna get that care. Now, there's been some controversy over, you know, the managed care prior approval, that it's not exactly standardized. Because, really think about it, you have all these different companies offering managed care. And so they're applying their own standard, technically, it should be the same care that you get through Original Medicare. And I don't think any companies are out there trying to hurt anybody, they just need to figure out Medicare, some sort of standard that has to be used for all the companies.

Kosta Yepifantsev:

You know, and I, and I was gonna say that, I think that when you are on private insurance, through, you know, the main five major insurance companies, whether it's through your employer or privately, realistically, you're not going to use your insurance that often, you know, obviously, if a catastrophic occurrence may happen, but when you're on Medicare, you are over the age of 65. If you're on Medicare Advantage, the process of managing that population subset is probably there's probably a lot of unknowns in that system, that Medicare Advantage system is being tapped all the time. Do you think that in a lot of ways, and I know this is kind of like a technical question, and you don't work for CMS? I understand that. But do you do you think that it's going to take, it's going to take a lot more time for Medicare Advantage to figure out how to create that standard of practice that standardized approval process?

Debby Riskind:

I mean, here's the deal. Use, there was a report by the Office of the Inspector General this year, that put a lot of focus on the fact that there were claims that would have been approved in Original Medicare that were not approved with Medicare Advantage, that then were appealed. Right. And so there's been a lot more of a spotlight on it. And so hopefully, yes, I mean, listen, it's getting closer to 5050 between people in Original Medicare versus Medicare Advantage. Original is a little bit bigger in the in the statistics. But, you know, there's a lot of happy people in Medicare Advantage. And I have some people that, you know, money is no object clients, and they're still choosing Medicare Advantage. And it's worked very well for them. So, you know, you're going to hear a lot more noise from the people that have had bad results or something that they didn't, that it didn't go their way and understandably, so. I don't know how to answer that. Except for that. I think yes, with time because the system is moving towards that. Right. And it's got to work. People need their health care. And I and like I said, I don't think anyone's out there trying to hurt somebody. It's just there. It's there's a lot of different companies. And yeah.

Kosta Yepifantsev:

There's right, and there's a lot of people who are on Medicare, and that number is growing exponentially every single year. So yeah, absolutely. Right. The sense of urgency is definitely there, I think is what you're trying to say. Yeah. Well, I

Debby Riskind:

think it's important you we want that people got one life to live in when their health said issue. They need that care. It can't be resolved in three years. It's got to be resolved now. So yes,

Kosta Yepifantsev:

let's talk about Part D. Why? This is Part D. And do you need Part D, if you're not taking any prescriptions?

Debby Riskind:

Okay, so Part D is your drug coverage. Not to be confused with drug coverage under Part B, there's there's different categories. So you're going to think of Part B, I mean, D, excuse me, as what you're getting at the Walgreens or CVS, your pharmacy, right, the prescriptions you pick up, B is going to be more like the medications administered at a facility, someone needs chemotherapy or different kinds of medications to you know, an IV, that's under B. So D, again, is are those drugs. And here's the interesting thing. They did not offer Part D until 2006. So if Medicare was first, I like laws, I'm an attorney. So I, I like all the rules, even if it's already in the interview. But so Medicare first came to be in 1965. Okay, and when it first started, by the way, I want to explain this because this, to me, puts the bright light on for everybody the understanding 1965 It's it comes Medicare, it's just Amb. That's why it's called Original Medicare, right? Got part a hospitalization be in doctors, and your only option was that system. Medicare Advantage was an offer it did legislation wasn't passed until the late 1990s. And it's slowly been evolving, right? So you have Original Medicare, and then you have Medicare paying these managed care to manage Medicare beneficiaries, coverage as an alternative, right. So that's the framework. So when you talk about di, D didn't get offered till about 2006. It's continuously evolving, there's been some recent legislation that's slowly going to be implemented over the next couple of years, which will be good to lower people's costs. But so that's my tangent. But here's my thing to you 100%. If you are whether you take drugs, or you do not, you want to sign up for D, because a there'll be penalties if you come in later. So the penalty is for every month that you did not take it that you're eligible, it's 1% of the national average. So if the national average premium is $34 1% of that, and for every month stacked on top of each other, in the in the premium doesn't sound like a big number, but it can add up, and it never goes away. So that's reason number one. Reason number two is that you we don't know what's happening five minutes from now, right? So you could be perfectly healthy, and not get a plan. And then six months later, let's talk about your neighbor, your neighbor gets Parkinson's, and it's June and he's not in a plan cannot jump in no plan mid year, you have to do it during the election period. So he would be stuck paying those expensive meds out of his pocket till he could get in a plan next year plus it and penalties. So I'd say you find a low dollar plan at a minimum, even if you're not taking. And by the way, Part D gets like built into Medicare Advantage plans. So you still would have it even if you weren't medic, Medicare Advantage?

Kosta Yepifantsev:

How hard? Is it to navigate Medicare? If you don't work with an agent? And do you recommend that everybody actually does work with an agent?

Debby Riskind:

Well, of course, I know. I'm just kidding. That's the thing. I think once you're in it, you're okay. Right? Like you, but it's it's all the like, you know, it's like the two forks in the road. Which way are you going? Right? Is that the so you go one, you go one way you go the other? And so in? Do you have to sign up? And do you have to take and what are your costs gonna be? You know, my clients who are at, they're still working with me. I mean, we're not like a one and done like you, we help you and then we help you every year. So there's things to explore every year like are you in the right drug plan? Do you want to switch between the systems? Is your supplement premiums so high and you're healthy? Can you get lower? So full circle to answer in the beginning? I think you definitely need an agent. And even as the years go on, if you're lucky enough to find an agent that sticks with you and always is there to help you. Why wouldn't you want that help? You know, you don't you don't pay an agent, anything. Agents we aren't Commission's, you pay the same premium, whether you go directly to the insurance company or with an agent. So I always say, get yourself an advocate, get someone who knows their stuff that's going to look out for you and you know, help maintain your costs in retirement.

Kosta Yepifantsev:

Absolutely. And if we could just go back one to talk a little bit more about Part D, there's something that popped into my head as as you were talking. Can you speak on what is the doughnut hole that a lot of people encounter under Medicare?

Debby Riskind:

Sure, do my best so okay, here's the deal. First, I want to say this before I answer what is the doughnut hole? Okay? When you're looking at your Part D, you want to look at the overall big picture, what's it going to cost you, right? So people get fixated on the deductible, the doughnut hole, all that stuff. But bottom line is, when you're choosing a plan, if there's a plan that you're going to spend 500 for the year, versus a plan that you're going to spend 2000, we know you're going to want to go for the one that's going to cover your drugs at 500. So here's what happens. There's four phases, okay, and there is the deductible phase. Not every plan has a deductible, but those plans typically have a higher premium, then you have a initial coverage thing, I'm calling it the right thing. And then you have the quote unquote, doughnut hole, it's not really called anymore, and then the catastrophic coverage. So what happens is that with the doughnut hole, there's this period of time where your prices may go up, or they may go down, because you've you've fallen into this, the third stage of drug coverage. But again, you got I say, you focus more on the big picture. And I can tell clients, what, what is going to cost each month. But you don't really focus on it, you want to understand what it is, but you really want to know, with your pocketbook? How are you doing this the most cost effective way? If that makes sense?

Kosta Yepifantsev:

No, it does. And believe me, you are unpacking a lot of very complicated terms and putting them into kind of layman's terms. So I do appreciate that Medicare is is is complicated. And I think it speaks to why everybody should work with an agent so that they make the right decisions on their behalf. Last question. What is Medicare A EP?

Debby Riskind:

Okay, so the Medicare A p and this is funny to me, there's so many different abbreviations. Right, right. I think the Medicare AP is the Annual Election Period, but then you sometimes hear called the annual all different words that I hear, but it is basically the time of year where existing Medicare beneficiaries. So when you're in Medicare, you're called a Medicare beneficiary. Okay, though, is for people already in Medicare to make changes for the next calendar year, it runs from October 15 to December 7. So if I have a client who is not on Medicare, yet, the AP doesn't impact them, they are going to have what's called an initial enrollment period, or a Special Enrollment Period SCP or a general enrollment period. That's their own individual timing. The AP is for everybody else. So think of it this way. Right now, you probably have insurance, right? And there's a year where you're evaluating for the next calendar year of what you're going to do, are you going to keep the coverage? Are you going to switch it? Same thing with Medicare, which is, like I said, a reason why you want to have an agent that sticks with you, because you can revisit different topics every year, and then it becomes effective January 1,

Kosta Yepifantsev:

whatever. And if you could give us some examples about what type of changes you and your clients discuss, just so that, you know, listeners can kind of know Oh, okay, well, you know, I'm going through that. And maybe I should call an agent and talk to them about X, Y, and Z.

Debby Riskind:

Absolutely. So there's multiple things that you could be thinking about your ni p. So you break it down. First, let's say you have someone in Original Medicare. So that means that they have a supplement, and they have a Part D plan. The Part D plan that is the time of year where you must look at it to switch for the next calendar year if you want to. Now, not everybody has to do a review, you're going to receive from your carrier, a document called a Notice of changes. And it will tell you how your plan is changing for the next year. But I will tell you this, if you're somebody that has added new meds, you definitely want to do a review because what if that drug could be more cost effective with another plan. Or if you learned your premiums, doubling, you know something like that you want to look to see other better options. When it comes to Medicare Supplement policies, you actually can change that anytime a year. That's private insurance. So you don't have to do it within the AP, although a lot of people think they do. But really, you change that by qualifying with your health. If you're in Original Medicare with a supplement, that's a time where you can switch into Medicare Advantage for January one start date. If your Medicare Advantage that's the time you could switch to another Medicare Advantage plan, or it's a time of year where you could say hey, I'm done with this. I want to go back to original Medicare, but you got to make sure that you can get a supplement and you would have to apply for Part D plan. And again, remember October 15 to December Seven, offer a January one effective date.

Kosta Yepifantsev:

What do you think are the most common mistakes that people make regarding Medicare?

Debby Riskind:

The most common mistake that you don't want to see someone is to miss their enrollment period where they can initially start because they can end up with penalties. So if you don't sign up for B timely, and you think you're keeping your insurance, if you for every 12 month period that you don't take B, when you should have, you know, the medical part B, there's a 10% penalty that stays with you forever. I already mentioned the Part D penalty. Right. So that's another big one. And then just understanding what we had talked about earlier that like, if you if you start in Medicare, and let's say you already have a lot of health issues, and you go right to Medicare Advantage, chances are you'll never be able to get a supplement. So you want to really think that through

Kosta Yepifantsev:

what do you think, are the most important factors when you're navigating Medicare, and more and more importantly, enrollment into Medicare?

Debby Riskind:

So when you say the most important factor, so let me think about what you're asking me with that? Because, you know, the bottom line is this, it kind of goes back to what I answered a minute ago in that your timing, okay, understanding, like, first of all, do you have to take it literally, if you if you're working at craft, and you are in a company with 1000s and 1000s of employees, you can stay in your group plan, right. And it because if you turn on B, that's like paying twice, you're paying for a group plan, and you're paying for power B. So that's something that you want to make sure you're real clear on. You want to make sure that if you're staying in Original Medicare, you're gonna get that supplement to a lot of people think that when they sign up for a and b, they're done. You're not done. Now you got to figure out which path you're going, Are you you know, and how are you protecting yourself? So I don't know if that answered your question.

Kosta Yepifantsev:

No, I think we both agree. And I think people that are going to be watching this podcast, are going to agree that timing, and making sure that as you approach the age of 65, you get educated, you either start, you know, reading the guidance, the guidance on CMS website, or you talk to an agent about Medicare planning. And so I guess that kind of leads me to my next question. Are there any like insider secrets that you feel more people should be aware of when it comes specifically to Medicare planning?

Debby Riskind:

No, I try to share it to me that no longer feel like secrets because I'm I go on tick tock, right. And I'm trying to teach all the time, because I'm trying to share what I think are the important things that somebody needs to understand. And one of the biggest things that I always say, I posted this couple times is like, don't scroll by start learning now. Start getting comfortable with the conversation, so that you understand the kind of questions you need to ask. So you understand that there are deadlines that there are ways that you can mess up if you don't follow the timeline. So I, for me, there's no secrets, right? I'm, I'm here trying to be an open book and teach people and help them. So but you know, again, you're hitting it exactly right. It is about being on top of it, the timing, and getting comfortable with it and learning. So I mean, it's interesting, it's like that's why I went on Tik Tok because, you know, I have a 21 year old daughter that was on Tik Tok. And I was like, What are you doing on there? I want to see, so that's when I started, why not take my message there? And go ahead.

Kosta Yepifantsev:

Well, I was gonna say, I mean, how did you come up with because you have to? I mean, obviously you agree, you know, Medicare's 65 Plus, for disability, right? True. Yes, that's good point. But like it's for the it's for the baby boomer generation, people born between 46 and 64, that the average age of people that are on Tik Tok are people in their 20s. You know, we're in their teens. So So you take such a, you take a message that's meant first the 65 plus generation, and you put it on a platform like tick tock, and honestly, you have great success with it. How'd you? How'd you decide to do something like that?

Debby Riskind:

Well, so first thing, because I want to clear up, okay, is that well, I, first of all, because of my daughter, I started watching that I'm like, that might be fun. And I could share my message because my brother and I were teaching seminars and webinars and but people like information in small bits like that. So it's a great platform. But you know, the bottom line is this. I want to tell you, one of the biggest things I've learned through my work is that people in their 60s are actually a lot younger than you realize. If they're healthy, and they're hip. They're on hip. They're awesome. though, so yeah, maybe a bigger percentage of the people are younger, but sometimes I have people reach out to me for their parents. But honestly, people are, you'd be amazed at how many older people are on Tik Tok and are seeking the same kind of information that the younger people are on their dancing for, you know what I mean? It's, it's so it's become a wealth of information, there's so much to learn. And so it just worked. And so you know, sometimes, you know, I got I was doing it so much for a while that I, I took a little bit of a step, I felt like I was a teenager, always on my phone doing videos, and but I really do love doing it. Because I feel like if I'm giving someone that two minute thing, they slow down, they think about it. People reach out to me, I have people across the country, you know, because of that platform. I'm helping people I've clients all over.

Kosta Yepifantsev:

You know, I think the biggest point aside from obviously timing that people run into, and I know this from my own personal experience when my father in law was going through the Medicare process, turning 65 collecting Social Security, all that stuff. It's not free. Everybody thinks that Medicare is free. It's not right.

Debby Riskind:

You jaw dropping to people, they're angry. And I'm like, you know, you've never, this is more in response to videos. Oh, well, of course. Never insurance. It's free. But it's a good deal. You can have excellent coverage, but go ahead.

Kosta Yepifantsev:

Yeah, and it's accepted it pretty much everywhere. You know, every doctor will will well 95% of doctors and 100% of hospitals are going to take Medicare.

Debby Riskind:

Yeah, I mean, think about it. You hear in the newspapers, this statistics, that what are they say? 10,000 boomers a day are turning 65? Yeah, most medical facilities and doctors cannot afford to ignore that population. So you're right. And the fact is that people once they're on Medicare, I think Medicare is like a scary word to them. Because it makes them feel old, or it makes them feel like they don't understand it. But most people, once they're on it, they're really happy. They see they're very good coverage. They're getting the care they needed. Yes, there's an expense to it. But you know, as well.

Kosta Yepifantsev:

So before we wrap up, I do want to say one thing, and then I want to ask another question about Medicare plans and supplements. First thing is, I want the audience to know that Medicare does not pay for long term care. Yes, they will pay for the first 120 days if it's medically necessary in a facility, like for rehab and things like that. But they will not pay for you to receive non medical home health care services like help with baths and you know, in laundry and companionship that is only paid if you're looking for a government resource, and you don't have long term care insurance. That is Medicaid, which is another video for another time. Yeah.

Debby Riskind:

Yes. So if you look at the Medicare and you book, you're gonna see there's a list of what Medicare does not cover. And there's been bold print, Medicare does not cover long term care, you refer to skilled nursing facility care that's under Part A of Medicare, they will cover up to 100 days 100. I understand. Yeah, that's okay. People have to understand that. That's not your plan for long term care. And that doesn't even mean that if you needed to be in a facility that you would be have access to it, you have to have a three day hospital stay, to qualify, and you have to need skilled care. And you probably do a better job of explaining the difference between custodial care and skilled care. But skilled care, you're gonna think about, you know, let's say your neighbor fell, had a hip replacement. And he had a three day hospital stay and now needed to be in a facility

Kosta Yepifantsev:

to receive like physical therapy and stuff, and too

Debby Riskind:

hard to be in the home. And, and even with the 100 days, you're not guaranteed the 100 100 days. So what I always tell people is that is the biggest gap people are leaving in their retirement planning. Because if you need that kind of custodial care, help with two out of six activities of daily living, that is not Medicare's job. It's not.

Kosta Yepifantsev:

Yeah, for sure. And I run into that all the time being in the long term care space. You know, obviously we do a lot of non medical home health care, the custodial care that you're describing. And yet the same conversations that you have with individuals who are looking that are that are going to be receiving Medicare or going through Medicare planning. I talk about it all on the Medicaid side, yeah, you're fine if I talked about it on the Medicaid. Sorry. So I want to ask, are there any specific Medicare plans or supplements that you feel like people should avoid?

Debby Riskind:

Unrelated to long term care? Now you're saying in general,

Kosta Yepifantsev:

just in general, yeah. I mean, like already bad eggs out there that you were like, don't you know, don't do that?

Debby Riskind:

Well, to answer that in a video, but you know, there are definitely, here's the thing, we're, we're independent, and we contract with multiple multiple carriers. And when we're choosing to work with the carriers, because we feel good about that carrier, we don't contract with the carrier doesn't mean necessarily that we think they're bad. It's just sometimes there's only so much you can take on, right. So is there any, I mean, there could be a company that I'd be like, hey, great with a drug plan, but I wouldn't put them in Medicare Advantage, or, you know, there's different reasons, but I don't want to like, throw a name out there. Because it's not because of the company. But because every state is there's different states or different circumstances. So honestly, no, there's never it's more about which is the better path for someone. And then once we determine that we figure out which is going to be the best carrier, based on that person's needs with a supplement, it comes down to price. One thing you want to know about Medicare supplement plans, let's say there's 100 companies offering Plan G. They're standardized by law. So in other words, that means that G is handled the same benefits no matter which carrier with. So when I'm looking at a carrier, and one is charging 170 for the premium and one's charging 140. And they're both really good carriers, why wouldn't you pay 140 A month premium instead of the 170? Does that make sense?

Kosta Yepifantsev:

It does, does that span across states as well.

Debby Riskind:

As far as standard, I see, the standardized by law is is federal, it's the old passed in the 1990s. And basically, you know, I made a video g is g is g. And here's the logic because that doesn't make a lot of sense what I just said. But if you had a bill, right, let's go back to that $1,000, MRI, Medicare Original Medicare processes, they pay 800. No matter which insurance company with Plan G, they're sending, they're all paying the same 200 Because it 20%. And they all have the same responsibility suing you choose a plan that's covering the 20% to pay the 200. So you know, the sub but with Vantage, they're all different. And that's why you want to find someone that if you're looking at advantage, you want them to ask for your doctors in their addresses and their drugs, your zip code you want and then you figure out what fits you.

Kosta Yepifantsev:

You know, this has been such a fascinating, interesting, and I think important conversation. So we always like to end the show with a call to action. Okay, what's your best advice for someone entering the long term care industry? As a patient, a caregiver, or an industry professional?

Debby Riskind:

Okay, well, I mean, to me is, anybody who is aging, and thinking about their big picture, when they're older is to at least explore the topic of long term care. Because long term care, you know, I get a lot of comments. Sometimes it's not affordable, it's not. But the reality is you need to understand what is going to be covered through Medicare and what is not and where the gaps are in your retirement. So explore it understand that, like, there's options out there ways to plan ways to think about what if that, God forbid, did enter your life? What would you do? How would you pay for that care? So knowing that Medicare is not going to do it for you? Are you going to go to your savings? Are you going to take out traditional long term care, some sort of hybrid product, that's life insurance product? So you, you just need to educate yourself, just like what we're doing right here. The purpose right now as talking is for people to start thinking to start connecting to that big picture. Long Term Care is no different. You need to understand how it's going to fit into retirement. And it's like your checklist, either. Maybe it's something you're going to pursue, or it's not, but at least your eyes are open, right to understanding the impact of having it or not having it.

Kosta Yepifantsev:

Debby, thank you so much for being here and speaking with us. I think that we covered a lot and I'll be honest, I've talked about Medicare before And I am so glad that I finally have an expert that can sort of demystify and unpack this program for us. So thank you very much for being here. Thanks for having me.

Caroline Moore:

Thank you for joining us on this episode of Now or Never Long-Term Care Strategy with Kosta Yepifantsev. If you enjoyed listening and you wanna hear more make sure you subscribe on Apple podcast Spotify or wherever you find your Podcasts, leave us a review or better yet share this episode with a friend. Now or Never Long-Term Care Strategy is a Kosta Yepifantsev production. Today’s episode was written and produced by Morgan Franklin. Want to find out more about Kosta? Visit us at kostayepifantsev.com

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