Shownotes
Josh Kinzel from Seniority Benefits Group is back in the studio to talk about the 2024 Medicare Open Enrollment.
Josh starts off by explaining that when it comes to Medicare choices, you have some flexibility. You can go with a supplement and drug plan or opt for a Medicare Advantage plan. The decision really depends on your own risk tolerance when it comes to health insurance events. If you have chronic conditions, you might lean towards a safer approach with a supplement and drug plan. On the other hand, if you're not dealing with any health issues but like to play it safe, a Medicare Advantage plan might be more up your alley.
To help put things in perspective, Josh uses the analogy of car or home insurance. You can choose to pay more upfront for comprehensive coverage or take on more risk for potential savings. In the Medicare world, the fundamental choices are a supplement and drug plan for lower risk or a Medicare Advantage plan for more risk and savings.
One important thing to note is that when you initially choose Medicare, no one can deny you coverage based on your medical condition. Medicare is an insurance program offered by the government, with Medicare A covering hospitalization and Medicare B covering everything outside of the hospital. However, these plans only cover about 80% of your medical bills and don't include prescription medications.
That's where things like Medicare supplement plans (also known as Medigap) and Part D pharmacy plans come into play. You can purchase a supplement plan to cover the remaining 20% and also get Part D to cover your prescription meds.
Alternatively, there's Medicare Advantage (Part C), which is like having an all-in-one card for your healthcare needs. These plans are administered by private insurance companies on behalf of Medicare.
Josh also talks about the cost of medications and how they can vary. However, the good news is that the Inflation Reduction Act plans to implement a maximum out-of-pocket cost of $2,000 for all medications by 2025. That's a big relief for those who need expensive medications to stay healthy.
He also mentions that the premium and deductibles for Medicare have been pretty stable over the years, which is reassuring.
We also dive into some interesting stuff about how Medicare plans are advertised. Advertisements must be specific about the plans they're discussing, unlike those often misleading ads we've seen in the past. The goal is to remove the open-ended and misleading aspects of current ads and promote more focused advertising from specific healthcare companies.
He and Seniority Benefit Group specialize in helping small groups deliver affordable health insurance options. They even have a tool called Shop Our Plan that provides personalized recommendations on whether employees should stick with their employer plan or consider Medicare.
So, if you're gearing up for the 2024 Medicare Open Enrollment, give this episode a listen to get all the info you need to make the best decision for your healthcare needs.
Here is a list of resources mentioned in this episode.
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Recorded in Studio C at 511 Studios. A production of Circle270Media Podcast Consultants.
Copyright 2024 Carol Ventresca and Brett Johnson
Transcripts
Yeah, but somebody driving through the drive through came up to pick up their medication and the pharmacist said, do you know how much this is going to cost? And and they go, I don't know, I don't know. And the number that they gave out, I think it was like $800 or something. And she goes, well, I can't do that. And so the pharmacist being as great as they were said, but let me check just, just like you were saying, Carol. So I was going to bring up that point too, where talk to your pharmacists. They are people they know. And there used to, believe it or not, be this rule over pharmacists that they weren't allowed to tell you if they knew about those and now they are get out of here. So I have a lot of pharmacist clients that said it was very hard for me to still perform my job knowing I'm staring at the screen. If I hit this one button, you're going to way $5. If I run it through insurance, you're going to pay 500. But I'm not allowed to tell you about that button. But now they are.
Brett Johnson [:We are looking forward our way from studio C in the five one one studios that's in the brewery district to south of downtown Columbus, Ohio.
Josh Kinzel [:Hi.
Brett Johnson [: here to guide us through the: Josh Kinzel [:Thanks for having me. Carol was just mentioning this is my third time in. It's great. I feel like I'm a veteran.
Brett Johnson [:I think we got the gold jacket at five.
Carol Ventresca [:Oh, there you go.
Josh Kinzel [:Well, the way time is going, I'll have it before we know it.
Carol Ventresca [: ou know, when Brett just said: Brett Johnson [:When you came in, we started talking about things that we are all in common with because we all kind of grew up together over the last decade and a half when it comes down to it. But I didn't realize you've been there for 16 years.
Josh Kinzel [:It's like, oh my gosh.
Brett Johnson [:So talk about your journey through that and establish a little bit what you're doing there and really what Seniority Benefits group is doing as well, which will all explain why you're here.
Josh Kinzel [: hones for us? And this was in: Carol Ventresca [:And as a former career counselor for two different schools, it does my heart well to hear an intern is successful in a career that started in an internship.
Josh Kinzel [:Yeah, it did. And it wasn't what way doing necessary, but it was because of the internship. Yeah. Carol I ended up where I am now. So they are something that you really want to pursue if you can, and take those opportunities and more on just our company, seniority benefit group is we're solely focused on medicare and really trying to alleviate some fears around that topic, which has just been exacerbated with the commercials. And I think we're going to talk about that where they froth everybody up into this fever pitch of you have to do something. And we're trying to scream from the rooftops at seniority benefit group that just talk to us or someone like us more likely, you don't have to do anything. Don't be scared of these national ads because what you have probably is okay for you. But again, 17 years into this, I still enjoy what I do. US as a company, we still enjoy providing that service. So hopefully we'll continue to do that for many, many more years.
Carol Ventresca [:Wonderful. The health care costs are skyrocketing. We see that in the newspaper every day. Healthcare and pharmacy. It's not going to go down, needless to say. But I think that what is so daunting is that those of us who don't really have that knowledge of medical insurance coverage, it can be devastating financially for an individual if they are not on top of really making sure they have what they need in terms of coverage. Many of our listeners do know. They understand they've been on medicare for a while. I'm into it for a few years, so I kind of get it. But I also have, because of my retirement, somebody who helps me. So thank goodness that you all are out there, but let's make an assumption that some people who are listening are new to medicare, this horrible maze of information to get through and they don't realize the complexity. So there's lots of bits and pieces. Medicare a and b, the PharmD programs, supplemental plans and the advantage plans which your group works with. It's important that participants know and understand those changes that are happening in the medicare costs within each of those groups. Tell us a little bit about those groups.
Josh Kinzel [:Okay, so just the elevator pitch, if you will, of medicare here is that like carol mentioned, there's a couple standard parts, medicare a and medicare b that's through the government. So that's just an insurance program offered by the government. It's not an insurance company at that point. A is your hospitalization, b is anything outside of the hospital. But both of those combined are going to cover about, give or take about 80% of a medical bill. But it won't do anything when you go into kroger to fill a prescription or CVS to fill a prescription. So you have this original medicare benefit. It's called original medicare a and b through the government, the standard monthly cost. So that's about $165 for an individual. But then you look at that and you say, okay, that's great. I have this coverage that I can take anywhere that medicare accepts across the US. Great. But then I also have this 20% that it leaves on the table for me that has no limit. So people listening who have health insurance, at least they know, okay, maybe my deductible has gone up. Maybe my out of pocket has gone up. But there is a threshold where you stop paying. If you had just original medicare A and b, there's no threshold on that 20%. So what folks will have to decide is, how do we want to address that? That's where the insurance companies come in. And just like the path that Carol mentioned, there's two basic ways to go beyond that 80% coverage with original medicare. You either do a medicare supplement, also known as medigap. If you're talking to friends, they might refer to it as plan G or plan F or plan c. So there's some complexity there. But the bottom line is it's a medicare supplement. It's through private insurance companies that deal with that 20%. So you have medicare a and B covering 80%. You could have the supplement basically covering the other 20%. You'll pay a premium for that. But then that still doesn't address prescriptions. So you had a part d pharmacy plan. That's another cost. And there's complexity there. Again, we walk people through those choices. But the first option would be medicare a b supplement and a drug plan. Then not that long ago, a couple decades now, but Medicare advantage or part C came along. So another letter that's thrown into that alphabet soup there, but those are the ones that you see on TV more often than not are the ones describing very loosely and maybe misleading, but they're describing these Medicare advantage plans that are part c, that are managed care plans. You still have original Medicare A and b. It's assigned to a private insurance company, medicare. The government pays that private insurance company for them to administer this health benefit for you. So you have a plan that feels much like what you have through an employer. You have one card that you show the doctor, the hospital, the pharmacy, and you have a corresponding copay. So when you go into a doctor, you might have to pay a $10 copay. When you go to the pharmacy, you might have to pay a $20 copay depending on what medication you're taking. But those types of plans I really do like. But really recently with all the national ads, it almost makes it seem like, well, I don't even want to talk about those, because if Joe Namath is touting them as much as he is, there must be something hidden underneath that I just don't want to be involved in. And as long as you know what you're getting into, they can work very well. My mom is on a Medicare advantage plan. She loves it. My dad is on the first path medicare supplement, a drug plan. They've been married for over 40 years, and they just don't talk about the health insurance piece of it because they're both happy with each of their choices. So I'm glad that there's two basic ways to go like that. But it's Medicare A and B, which is original Medicare through the government. You either do a supplement and a drug plan through private insurance companies, which we help you navigate that, or Medicare Advantage Part C, which again is through a private insurance company.
Carol Ventresca [:I think that this all really brings to light what I mentioned before. If you don't have the information, it could be financially devastating. But the information is there and people to help you with figuring this out exist. So that's over and above and beyond everything we talk about today. My goal is that people that our listeners know there's help. You can get help.
Josh Kinzel [:Well, and it's funny, we have a relationship with one of the largest employers here in central Ohio, just helping folks. When they call their HR department, they say, hey, I'm turning 65. What do I do? And they say, oh, call Seniority Benefit Group. Call Josh. And I'll get the comment a lot from those folks. They go, this is the best benefit that they offer here. And the reality is that employer isn't paying us. We're not getting paid. But there's such value in the knowledge component of it and going to somebody that you can trust to tell you at least what's out there, I'm not going to tell you what to do because everybody has their own choice in the matter. But my job is just to clarify what those choices are. Yeah.
Brett Johnson [:So this year is bringing change to Medicare, including changes to monthly premiums, deductibles and program limits. Can you talk about some of those updates on the changes? Well, obviously additional cost that recipients are going to be fined in this new year.
Josh Kinzel [: but that won't roll out until: Brett Johnson [:It was in pretty good shape. Yeah, that's a good sign. You're right.
Josh Kinzel [:And I'm not expecting a lot of negative changes to what you referenced as far as premiums or deductibles go.
Carol Ventresca [:Even when Social Security took a huge increase last year, medicare didn't raise that much.
Josh Kinzel [:It went down, actually. Yeah. So it was one of those where it's a unicorn sighting, where your Social Security went up, your Medicare went down. That doesn't happen.
Carol Ventresca [:Well, and because people used to always say to me before I was on Medicare, oh, Social Security goes up 2% and Medicare goes up 2%. It's a wipe. Last year was a unique situation.
Josh Kinzel [:Yeah.
Carol Ventresca [:We're probably not going to get that again. Well, yeah, that's okay. We're doing okay. And given what people are struggling with in terms of many have had to have been taken off the Medicaid roles and trying to find insurance and deal with the cost. I mean, Medicare is such a delicious thing to have. It's just amazing.
Josh Kinzel [:And even talking to that point a little bit, Carol, where you're right, where some people are losing their Medicaid status right now over the summer and they just have to go back in and reapply, basically. But some folks don't realize that that's what they have to do. They get the letter that says, well, now I'm off of Medicaid, and if you are on Medicaid, you can have a really great Medicare and Medicaid plan that very little out of pocket.
Carol Ventresca [:Right.
Josh Kinzel [:But when you lose that Medicaid status, now you have those copays. So we've actually this summer helped a lot of people just navigate that change where, yeah, you may have lost your Medicaid status, maybe you can reapply and maintain it, but maybe you can't. So even the opposite where people are scared of, all right, I'm losing this benefit, what do I have to land in on? We're there to help say, yeah, it might not be all zeros like you're used to through the Medicaid system, which is great and well deserved, but now here's how it's going to work going forward. So they're not as scared of that change.
Carol Ventresca [:Yeah. There was an article in a national newspaper in the past week or so that some of the folks who are rolling off of Medicaid or not able to get it are children because the families aren't getting the information they need to re up the kids on the Medicaid system. So it was like a 15 month old who lost their the parents lost the Medicaid on this baby and couldn't get her back on. But anyway, and for listeners too, we actually do have a podcast coming up about Medicaid. It's really more a focus on Medicaid for older adults. But again, it's one of those issues where the more information and knowledge you have, the more powerful you are to protect yourself and your financial situation.
Josh Kinzel [:Absolutely. And you reference this too earlier, Carol, is that there are so many programs out there that people just don't know of where. That's going to be a great podcast and very helpful.
Carol Ventresca [:Josh. Whether an individual has been on Medicare for years or they're just now turning 65, they need to understand their own medical history and medication needs in order to choose the best plan. What's the most important in detailing health issues and physical abilities? What specific areas do they really need to pay close attention to?
Josh Kinzel [:Well, it's not even so much their physical disabilities or health conditions because the good news is we're not worried about those. You can go either direction that you want when you're making that first Medicare choice. You can do the supplement and drug plan if you want, you can do the Medicare Advantage and they can't ask you any medical questions. So it's more of a risk tolerance of how much risk do you want to take on when you have a health insurance event, let's say. So if you are someone who unfortunately maybe has a chronic condition, maybe you'd lean forward, more conservative approach of a supplement, a drug plan. Or if you're someone who doesn't have anything going on but you're somebody who thinks that the sky is falling, which we can't change that thought process. But maybe you don't want to be on a Medicare Advantage plan that might have a couple thousand dollars out of pocket if something were to come up. So it really does just come down to how much risk you want to take on with it. Just like your car insurance or your home insurance. Do you pay more upfront to have a lower deductible? Deductible just meaning what you have to pay before the insurance kicks in? Are you more of the person that, yeah, I'll take a chance at maybe having a lower premium, but then if something were to come up, we have to pay a little bit more out of pocket. Those are the two fundamental choices in the Medicare world too, where if you're the type of person likes to pay more upfront for lower risk, that's in general a supplement and a drug plan. If you're somebody that likes to take on a little bit more risk to go for that savings a little bit, then that's Medicare advantage. And back to what I was saying earlier from my previous years working with health insurance on the individual market where I had to tell people, oh, you can't have that because of condition. The good news is, the first time you make the selection, no one can tell you no.
Carol Ventresca [:Right.
Josh Kinzel [:So you can come into the system in real bad shape and they can't say, oh, well, I don't want to insure that because we didn't have to. Well, they do, which is great. So whether you go Medicare Advantage or a supplement, you still have those because people will come into my office and say, well, I have this going on, so what's really actually available to me? And it's nice to be able to tell them still, whatever you want.
Carol Ventresca [:Right.
Josh Kinzel [:I mean, we'll talk through it and we'll go through why you may want this or that or pros and cons, but ultimately it doesn't matter what kind of conditions you have, you still have the choice to make.
Carol Ventresca [:But the one thing that led me to do traditional Medicare A and B is because I have a nurse practitioner. And at the time and I don't know if it's changed since then, but at the time I was advised, if you want to keep your nurse practitioner, do Medicare A and B because they accept those where Advantage plans may force you to go to a doctor. Even if that doctor if the nurse practitioner works for the doctor, the doctor will be your primary care on record. So all of these bits and pieces of information are important to make sure you have it if you are first time going into Medicare.
Brett Johnson [:So I think TV is going to look different this fall, thank God, because we are so tired of seeing these commercials. We've talked about this every time you've been in in regards to the TV.
Josh Kinzel [:Commercials out there getting worse and worse. Yeah.
Brett Johnson [:So the new rules on how Medicare Advantage plans can be advertised, particularly the use of famous people to sell the programs and ensuring the ads are not creating false narratives on their connection to the government. So I think we all read the same article at the same time through HRP. I think we did, because if nothing else, I gave Carol a heads like.
Josh Kinzel [:We could talk to Josh about that. This changes. Yeah.
Brett Johnson [:Can you give us some details on what to expect and what those commercials are going to you're not in the production piece of it, but what we're not going to see now.
Josh Kinzel [: t is right now. You call that: Brett Johnson [:Oh, no.
Josh Kinzel [:But they got out of control. And so I'm glad that there is some focus on trying to reel that.
Brett Johnson [:In and maybe have your pause button ready because I have a feeling with my background in broadcast and such that they can get away with. A lot because of the little notations they make, the little exclusions and the font size that you really had to pause and then go up to your TV screen and read.
Josh Kinzel [:Yeah.
Brett Johnson [:So if you see a lot of that going on or a lot of fast talk at the very end but anybody can get a disclaimer, you know, that okay, something they just said has exclusions. Something's not as they state, but it is at that point in time, I.
Carol Ventresca [:Think I say this to you every year, whoever they are paying as their spokesperson who isn't already rich enough that they have to do these commercials, they should be able to say this is my insurance.
Josh Kinzel [:Yeah.
Carol Ventresca [:If so and so TV star is touting Anthem, he should be able to say, I use Anthem. Yeah, I pay anthem.
Josh Kinzel [:And it's one of those things for a broker like us where we can talk about those plans that are being advertised. And those plans can work very well. Sure. So it was even hurting us as an individual where when somebody would come in with this misnomer and then you'd have to rewrite that script a little bit. But there are regulations for even us. We have to put disclaimers down at the bottom of our emails. And when you call into our office, we have to say we don't represent every single plan that's available. And at first we thought, oh shoot, they're regulating. It's going to make us harder for us to do business. But really, when you look at the nature of these rules, I think it is to really go after these call centers and not to disparage anybody in that call center. Everybody's earning a living. But I think it's going to change where hopefully people aren't going to be tricked into changing.
Brett Johnson [:Like you said, when January comes along, they didn't realize what they just they after the transaction is done, they know what they did. That's all we can ask.
Josh Kinzel [:That's all we can just and I know, Carol Brett, you're the same way where you hear that what some of these practices are, and you just think, well, how are people okay with doing mean, I know you're getting a sale, but you just told somebody this and it's not that.
Carol Ventresca [:More money in your Social Security. Even if it's only $0.05, there's more money.
Josh Kinzel [:Yeah, which is crazy, very misleading. So I'm very curious to see what they look like this fall.
Carol Ventresca [:Yeah. So speaking of misleading, part D pharmacy is not much better. So that Part D program covering your pharmaceutical needs, they're incredibly complicated. This is going to take a little bit of explanation here about donut holes and catastrophic levels. We have heard also recently there's a new Alzheimer's drug that's been approved and it may come to play. It may make things more expensive. It could make things even more complicated. There's some changes. Tell us. Give us some guidelines here.
Josh Kinzel [: et's back off a little bit in: Carol Ventresca [: Is that: Josh Kinzel [: ing to as many people as I do: Carol Ventresca [: Branch and to the tune of not: Josh Kinzel [:Is one where the advancement in medication, if you removed all the prices of everything, it is great that they're coming out with these tablets. It's less harmful to you overall, they're saying it's more effective, it's less inconvenient to do things even. But just like everything else there's price tags along with that. So I'm glad that the government is putting some limits on how much the consumer has to pay for these.
Carol Ventresca [:Because I know several people who are in that situation in which the medications are astronomical. There are organizations that provide grants or scholarships that give you the dollars to get your medication. Oftentimes you don't end up paying anything. We can't really give that information our you need to work with your doctor, your pharmacist, because it's different in every place and it's different by each medication. But if you are in a situation in which they're saying oh yeah, oops, you have to pay $2,000 this month for this medication, step back a second, take a deep breath and start talking to the pharmacists usually know about those.
Josh Kinzel [:Programs, and it's usually through foundations to that point. I was in a Walgreens the other day picking something up for Allergies, so it was a minor thing, but somebody driving through the drive through came up to pick up their medication, and the pharmacist said, do you know how much this is going to cost? And they go, I don't know. And the number that they gave out, I think it was like $800 or something. And she goes, Well, I can't do that. And so the pharmacist, being as great as they were, said, but let me check, just like you were saying. Carol so I was going to bring up that point, too, where talk to your pharmacist, because they are real people, they know, and there used to, believe it or not, be this rule over pharmacists that they weren't allowed to tell you if they knew about those, and now they are. Get out of here. So I have a lot of pharmacist clients that said it was very hard for me to still perform my job knowing I'm staring at the screen. If I hit this one button, you're going to pay $5. If I run it through insurance, you're going to pay 500. But I'm not allowed to tell you about that button. But now they are. So again, more transparency, hopefully.
Carol Ventresca [:And even like that Good RX programs, I went to pick up a prescription, and I think it was only going to be like 15 or $20. And the young man who was he's just a clerk there he goes, oh, wait a hold on a second. And he pushed a button, and Good RX popped in. And so I paid $8.
Josh Kinzel [:I know.
Carol Ventresca [:And it's like, oh, my gosh, this is information. I got one more question about pharmaceuticals that I didn't tell you. I was going to ask you this ahead of time.
Josh Kinzel [:Sure, yeah.
Carol Ventresca [:Catch you off guard. Is it my imagination, or are there fewer Farm D programs, insurance policies?
Josh Kinzel [:I think that might be your imagination.
Carol Ventresca [: my pension. When I picked for: Josh Kinzel [:Yeah. And to defend the individual that you talk to, because people can't believe, because the way we are in this society, you just assume that, well, there has to be something better, and sometimes there just isn't. So I do feel for the individual you're talking to, too. I'm sure if there was something that was going to be better, they were going to tell you about it.
Carol Ventresca [:Carol well, I do think that in terms of what they could give me, they did. I just think they're probably limited on which programs work with this pension system, but the group that I have, you sign up for it thinking it's one company, but in actuality it's really a different company. So I think I'm working with blank blank, blank scripts and it ends up being something completely different. What I don't like about it is you should be able to go into the website and figure out what's going on and everything. It's impossible. I just like, okay, I'm not paying a lot, so I'm not going to worry about it. I keep hoping when it all kicks in I could get somebody else for next year.
Josh Kinzel [:Well, and that's that when we come back. And during the open enrollment time, which we're coming up on here, we spend the most amount of time talking about the prescription piece because that is a fixed cost, really. Folks need to take their medications, and they're trying to find how to make it less expensive, which we absolutely agree with and try to unfortunately, there is a lot of times where we're telling somebody, look, this isn't the answer I want to tell you, but what you have, really, is what you may need to maintain. Because these other plans, we're looking at them and we wish we could find something lower for you. But just the way the program is right now, sometimes it's a struggle. So I am very excited about the Inflation reduction act, trying to help specifically in that arena.
Carol Ventresca [:Speaking of open enrollment, too, before we forget, what are the dates for open enrollment?
Josh Kinzel [: nt. We know all the plans for: Brett Johnson [:Well, we are taping this before the open enrollment window begins. So there are going to be changes, but some have not been decided. Can you give us some tips on issues still undetermined and how listeners can find the most updated information before they choose their policies for next year? How about going with that? We kind of touched on it just with that answer you had. But let's take it the next step.
Josh Kinzel [: e same basic conversations in: Carol Ventresca [:And it doesn't seem like there's volatility in the companies that are in advantage. I remember when it first started, they were in, they were out back and forth. But it seems like it's kind of settled in now.
Josh Kinzel [:It has really settled in. There is a new company coming into the market that we just met with their CEO the other day and if you can judge it by the one dinner, this guy seems like he really is trying to change the way things are delivered. So I'm excited to be able to talk about that once it does officially come out that's positive that there are.
Brett Johnson [:Companies specifically getting started for this.
Josh Kinzel [:Specifically, yeah, and looking at how it's working and who knows if he'll be able to topple everybody else. But it's another player. It's another player at least, right? Yeah, but to your point, Carol, the other blue bloods, if you will, they're pretty much settled in now.
Carol Ventresca [:Okay. So Josh, you had sort of touched on this a little earlier. Your company, Seniority Benefit Group does assist employers in managing employee benefit packages and that can be critical, especially for small businesses if all of a sudden you can get somebody off your role because they go on Medicare. Yay. So tell us a little bit about the services and when employees are moving into Medicare, how you're helping them and assisting those employers.
Josh Kinzel [:So we've always prided ourselves in helping those employers because that's what we came out of. My boss started the company to help with employee benefits so he has that background. So we've always been in touch in that community. And when somebody is especially a small group, it's so hard to deliver health insurance at a reasonable price for anybody involved, the employer, the employee. And if you're a small group and in the eyes of the eyes of the government and Medicare, if you have less than 20 employees, as soon as you become eligible for Medicare, medicare is primary. So let's say you work for a small mom and pop shop and you're turning 65 in December. As soon as December 1 rolls around, you have to have Medicare A and B, even if you stay on that mom and pop insurance. So what we have done is really tried to outreach to these employer groups to say, look, we understand a lot of your employees do have these questions, let us help. And we've really got involved with a lot of large employers here because they see such a value in if Medicare is better for the individual and they leave the plan, the employer has less risk on the plan. The employee is happy that the employer told them that this was an option. Some people are scared that if they leave the employer plan that if they're working there, they have to be on the employer plan. That's just not the case. And a lot of times it looks better if you look, you know, I'm not even here and I'm not tied to your benefits. I still want to work here, but I have my own thing going on through Medicare. And we do have a new tool that's called Shop Our Plan, where we're going to employers and it will be group. So it really is just a link that they can put into any announcements to their employees that, hey, if you want these guys to take a look at your situation while you approach 65, the whole tool is they'll go in, give us the basic information we would need to make a recommendation. We know what the employer plan looks like, the costs for the employees. So we can compare and contrast and say, look, based on your situation, stay on that employer plan makes more sense for you, or based on what information you've given us, let's talk about Medicare and see if that's something you want to pursue. So it is just a tool that we have that can help.
Carol Ventresca [:Kind of an aside question to that. Doesn't somebody who turned 65 have to register with Medicare even if they don't actually take their Medicare?
Josh Kinzel [:Now, I'm glad you brought that up, Carol, because that is one of the biggest misconceptions out there, okay, where they do feel they have to do something as long as you have employer coverage. So through an employer, whether it's your employment or a spouse, and if they have more than 20 employees, that's the other piece of it, then you can delay all parts of Medicare if you're not drawing Social Security, you can delay all parts of Medicare without penalty as long as you keep that insurance. So the only time really that you would want to delay all parts, or at least consider it, is if you have a health Savings account where it's an HSA and not too much detail there, but it's where you can put money aside tax free. If you do have any part of Medicare, you can't put money aside tax free. And there's a lot of employers offering these plans because it's less expensive, higher deductibles, just the reality of group benefits. Now, so we will get calls to say, well, I have this health Savings account. I know I have to do something with Medicare, but when I do something with Medicare, I can't put into that HSA anymore. And that's where we can shine some light on the fact as long as you keep that coverage, then you can delay Medicare A and B. There's not this. You go in and tell them I'm registering, but I'm not going to actually take it now.
Carol Ventresca [:So you don't even have to contact them.
Josh Kinzel [:You don't have to contact them. They carol, when you go in to contact them to sign up later on, they're going to say, okay, well, now you're 67 and you haven't been in here since 65. Where have you been? You produce a form from your HR department saying, way been here. Government says, oh, you recovered. That's all we needed, come on in.
Carol Ventresca [:Okay.
Josh Kinzel [:Now in most cases, though, to go back, most cases you do want to at least get part A of Medicare because it is a zero dollar cost to most folks. The only nuance is if you have that health savings account. So the underlying theme of this podcast is just make sure you know your options right. So when you're getting close, reach out.
Carol Ventresca [:And if you're on Social Security, they are going to expect you to be paying for Medicare so they could ask some questions.
Josh Kinzel [:Yeah. And if you're on Social Security, you're automatically enrolled in part A. So that is another you have to know that as you're approaching 65, are you drawing Social Security benefit check? If you are, they're going to enroll.
Brett Johnson [:You and then employer, because I don't know the legalities of this. An employer can't force their employer employee to go on Medicare, though. Or can they?
Josh Kinzel [:Correct. They can't.
Brett Johnson [:They can't.
Josh Kinzel [:Okay. Not because of that would be age discrimination.
Brett Johnson [:That's what I figured. It would kind of be in that realm. But I could see but you're saving money by doing know that's that's a discussion behind closed doors, probably, but outward looking they can't force you to so it's still ultimately your decision.
Josh Kinzel [:Correct.
Carol Ventresca [:Okay. And the flip side of that question is they can't force you to maintain on their policy. Because my question is then it could be if you got a really small group of people on an insurance policy and you lose people to Medicare, it could affect everybody else on that group.
Brett Johnson [:Status because they don't have enough to be in it.
Carol Ventresca [:That's a good so employers seniority benefit group can walk you through these issues.
Josh Kinzel [:Yes.
Brett Johnson [:That borderline number of how many employee employees you have, that could be tricky. Wow, I thought about that.
Carol Ventresca [:Right, true. Because as you said, you have five or ten people and half of them are on a spouse's policy. Five or so may not be enough to get maintain that plan. That makes sense that the employer can afford and the individual employees can afford. They could go to the open market and get, you know, younger kids.
Josh Kinzel [:Yep. A lot of variables to that.
Carol Ventresca [:Yeah.
Brett Johnson [:Well, this has been a great overview on Medicare as always, every year we look forward to this episode just because we know we're going to get the facts and that we know listeners can just kind of go, okay, it's going.
Carol Ventresca [:To be okay, and we just want Josh to come in.
Brett Johnson [:Sure, exactly.
Carol Ventresca [:That's what it is.
Josh Kinzel [:I love coming in. Yeah.
Brett Johnson [:You got any last words of wisdom?
Josh Kinzel [: o somebody and maybe not that: Carol Ventresca [:And listeners, we're going to have resources on our show notes on our website for this. One of the things that Josh we may not have really been specific about, seniority Benefit Group is an organization that doesn't get paid by an insurer like a pharmaceutical company or an insurance agency based on who you get into their plans. There is a set governmental amount that is paid regardless of who you refer your clients to. And so listeners, you want to make sure that when you're looking at companies like Seniority Benefit Group, you're getting that same service. You don't want to go to somebody who's getting paid and they're all going to put you into ABC Insurance Company because that's where they're going to get more money from.
Josh Kinzel [:Yeah, that's so true. And we know that some folks do charge for Medicare reviews and everything and we've just never believed in that policy where if we can help you enroll in something great, the insurance companies will take care of us. But the government does tell them how much they can pay people like us at Seniority Benefit Group. So whether you do that first path of a supplement and drug plan or you go with a Medicare Advantage plan, to us, the financial difference is what we get. It's so minimal that as long as we're helping, that's all we really care.
Carol Ventresca [:Right, right. Thank you so much, Josh. This is amazing. And our Medicare expert who comes to visit every year from Josh Kinsel from Seniority Benefit Group. We really appreciate all of the expertise, time, knowledge that you've provided listeners. Thank you for joining us and don't forget to check our show notes for those resources that we just discussed on our website and for Josh's contact information also, you can find all of that at www.lookingforwardourway.com, and we're looking forward to hearing your feedback on this and any of our podcast episodes.
