Confused about Medicare changes for 2027? Discover the latest enrollment tips, cost shifts, and plan insights here.

Open enrollment for Medicare is 10/1/26 through 12/7/26, and with rising costs, shifting plan options, and potential pitfalls, it’s more important than ever for adults turning 65 and over 65 to stay informed.

Carol Ventresca and Brett Johnson welcome back Josh Kinzel from Seniority Benefit Group to break down what’s new and what to watch out for in the 2026–2027 enrollment period.

You’ll learn:

• A clear, jargon-free explanation of Medicare, Medigap, Advantage, and Part D prescription plans, and how their coverage and costs may change
• The most significant shifts for 2027, including fewer available Part D and Advantage plans, premium increases, and drug price negotiations
• How to assess your personal healthcare needs, risk tolerance, and avoid surprises with plan coverage or provider networks
• Real-world scenarios of plan mistakes, like employer coverage, COBRA pitfalls, and why spouses may need different plans
• Actionable advice to avoid scams, telemarketing traps, and misleading plan marketing

Whether you’re enrolling for the first time, updating your coverage, or supporting loved ones through the process, this episode arms you with the language, questions, and resources to make a smart, confident Medicare decision.

Key Takeaways:

• Do your homework: Know the differences between Medicare, Medigap, and Advantage, and how upcoming changes affect your options
• Part D plan choices are shrinking and premiums are rising; check for newly negotiated drug prices
• Don’t assume the cheapest or employer-offered plan is best. Evaluate for your health, risk tolerance, and provider preferences
• Beware of scams, even “official” calls, emails, and flex card offers can be fraudulent
• Use trusted, local resources for Medicare advice; never hesitate to ask questions before choosing or changing plans

If you like this episode, please let us know. We appreciate the feed back, and your support of offset costs of producing the podcast!

5 Frequently Asked Questions about Medicare Open Enrollment

1. When is Medicare open enrollment for 2027? Open enrollment runs from October 15th to December 7th for Medicare plans covering 2027.
2. What are the biggest changes to Medicare Advantage and Part D plans for 2027? Fewer plans will be available, premiums and Part D costs may rise, some extra benefits are being reduced, and more drugs have negotiated prices.
3. How can I avoid Medicare scams during open enrollment? Remember, Medicare will not call you unsolicited. Never give out your Medicare number over the phone, verify all sources, and beware of “flex card” offers or calls requesting payment for new cards.
4. Should my spouse and I enroll in the same Medicare plan? Not necessarily; spouses may have different healthcare needs, risk tolerances, or provider preferences, so evaluate plans individually.
5. Is COBRA considered credible coverage to delay Medicare enrollment? No, COBRA is not recognized as credible coverage by Medicare, so relying on COBRA can result in penalties if you delay Medicare enrollment past eligibility.

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The views and opinions expressed by the experts interviewed on this podcast are their own and do not necessarily reflect the views of the podcast hosts or any affiliated organizations. The information provided in these interviews is for general informational purposes only and should not be considered as professional advice. Listeners are encouraged to consult with qualified professionals for specific advice or information related to their individual circumstances. The podcast host and producers do not endorse or guarantee the accuracy, completeness, or reliability of any information provided by the experts interviewed. Listener discretion is advised.

Mentioned in this episode:

This episode was recorded at Brick House Blue Brick House Blue at TruePointe in Hilliard

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Brick House Blue Hilliard

We are looking forward our way. Hi, this is Brad. It seems

the Medicare open enrollment time period rolls around earlier each year.

Our friend Josh Kinzel, benefit advisor for the Seniority Benefit Group,

continues to support our efforts to provide you with up-to-the-minute

changes affecting this important program. Josh, he's got an

overview on changes to Medicare for 2027. Wow, I'm already

saying 2027. I thought we just— Yeah. 2020, a few years ago. and how

you can prepare for the open enrollment period that happens from October

15th through December 7th. Josh, thanks for joining us again and being our

expert guest on this. No problem. I'm honored to be back.

Thank you. Well, and I think last year we were talking about Josh

being the only guest with 6

visits. So that means you're the only guest with 7 visits this

year. So it works well. So before we get started, though,

listeners, we are taping this program a little before open

enrollment actually begins. So you need to stay tuned

for any late changes that may come around when you're going through your

open enrollment. We're going to provide you with resources you can

use to make your 2027 healthcare decisions in

our show notes. But Josh, thanks so much for joining us.

We always love seeing you, getting all of the updates on the

munchkins. Oh yeah. So we hear about the kids. But

before we get into those nitty-gritty details, we always want to make sure that

people hear your journey to Seniority Benefit Group and the

Medicare programs. Yeah. And it's one

that I've told many times. And every time I tell it, I feel

just— it's something that it's guiding. I've

been guided to this moment in time by just different things that I've gone through.

And not in a negative way. But when I was growing up,

I always wanted to— we hung out with aunts and uncles all the time. And

my aunts and uncles, well, my aunts would stay home with the kids, my uncles

would be pipefitters, so they were always working with their hands, and I knew real

early on that wasn't me, but I had one uncle in HR, so

he was like, Josh, you gotta be in HR. You gotta talk to people. You're

a people person, and so that's what I pursued at OSU. I went into human

resources, and as soon as I got to the point where they said, well, part

of the job is letting people go. Part of the job is delivering bad news

to folks, and I couldn't stomach it, but I was paying my

way through college, and I said, I'm just gonna get a degree. where that takes

me. And that took me basically to Seniority Benefit Group right out of college in

2006. So this is 20 years. September

2006 is when I started. Wow. So 20 years ago. And even there, it

was, I started on individual insurance. And at that moment in time,

I was still telling folks, hey, I know you really need this. This is something

that is, it's necessary to have,

yet something within your medical file is telling insurance companies you

can't have it, and I'm sorry. And again, it was that delivering bad news that

kind of came back from HR. I was like, I was trying to get away

from this. And we got— my boss recognized it, thankfully.

And he said, Josh, why don't we try— we're getting more questions about Medicare.

Why don't you be our Medicare guy? And I said, okay, you know,

I'll learn up on that and I'll figure out what's going on there. Not

thinking coming out of college or before college that I would be talking about Medicare

for the next 20 years, but it was a— It was a very soft landing

for me, 'cause it checked so many boxes that I wanted with the HR degree.

I wanted to help people. I wanted to be able to explain things when

people came in confused, bring them clarity. And I wanted

to do it without delivering much negative news. And with

Medicare, when you're first eligible for it, there's no medical questions. So it's just a

positive. It's a good spot for me to be, because you explain it.

It's kind of a teacher. My mom was a teacher. I kind of got a

little bit of that from her. And here we are 20 years later, still talking

about Medicare. and helping. So, yeah. Goodness. 20 years.

20 years. Yeah. Okay.

Time flies when you're having fun. Yeah,

exactly. You know, the only constant with

Medicare and the Advantage plans seem to be change, which is why we

have you every year. It's not an easy subject. And even those who have

been on Medicare for years are confused. Let's first

review the Medicare, Medigap, and the Advantage plans, then

what are they supposed to cover and what they don't cover? Because I think that

sets the table for the changes. Otherwise, you're kind of going back, well, wait a

minute, how does that affect that? How does that affect that? So with

Medicare, you're eligible for it at 65. Not everybody takes it because they might

still be working. But let's go down that path of somebody just turning 65,

needing to jump into the system. So you have Medicare Part A, which is

hospitalization. That's free. We have Medicare Part B, which is everything

outside of the hospital, like doctors, outpatients, X-rays,

rehab, those types of things are addressed by Part B. That has

a premium. And I'll tell you, 20 years ago, it was about half of what

it is right now. And like Carol said, we're recording this

prior to knowing 2027's rate, but right now it's $202.90 for Part

B. That's what the standard rate is for everybody to pay. A and B is

through the government. Okay. So the government is running this health plan for you.

A is a hospitalization, B's outpatient. Those 2 combined cover about

80% of a bill. Take it anywhere across the United States that takes Medicare,

show 'em your red, white, and blue card that says A and B on there,

that card will cover about 80% of a bill. So then

people say, well, what about, what does that card do when I go to CVS

to pick up my prescriptions? What is that, when does the 20% stop?

At my work, there was a maximum out-of-pocket and coinsurance, but at least there was

a, time that the bleeding stopped. With Original Medicare, it's just

80%. You pay 20%, theoretically, forever.

So then there was a moment in time where the insurance companies came in and

said, okay, we can help with that area. We can insure that

20%. We can bring in some prescription coverage. So that's where we are

now, where we have Medicare A and B covering 80%. Then we have

2 basic choices beyond that. There's either a Supplement,

Traditional Medicare, Medigap, Plan G, Plan F, all one and the

same things. That's what makes it confusing. So if someone's listening and they say, well,

my friend has Plan G, and somebody else is listening and said, well, my mom

has a Medigap plan, we're talking about the same things. And

so that path, you're just going with a private insurance company to address the

20%. So it's the simplest path where you say, hey, I'm going to

pay Company A over here. When I show my Medicare card, it's going to

cover 80%. When I show my supplement card, you guys are going to cover the

other 20%, essentially. So with the Supplement, you have that other

20% coverage. Then you add a Part D prescription drug plan on

top. So this first path, you have A and B through the government covering 80%.

You have a Supplement covering the other 20%. You have Part D addressing your prescriptions.

That's one path. So shut the door on that for a second and open up

the other path. This door is a Medicare Advantage plan, like you referenced,

Brett, where there is some nuance to these. These aren't as

straightforward where it's just not covering the 20%. With a Medicare Advantage, you're assigning

your Original Medicare benefits to a private insurance company. and kind of

transforming it into a plan like you've had through your work,

or an Affordable Care Act plan, where now there's networks involved. So we have to

make sure your doctors are in network. Now, there are some out-of-pockets. There's a maximum

out-of-pocket anywhere between $5,000 and $6,000. So you're

taking on more risk with these. They include prescription coverage, though. So there are

some positives to it. And there's no premium on most of those plans.

So it makes them very attractive to folks where someone who

is on a budget or just saying, hey, I don't use the— The benefits. my

insurance very often. Why am I going to pay for that? Because with the supplement,

we pay more to have that 20% coverage, to have that freedom to go

wherever you want. With a Medicare Advantage, it might be $0, but

there's some trade-offs. They can absolutely work. They work for millions of

Americans, but they do have— that's what we spend the most amount of time at

Seniority Benefit Group is explaining the differences between the two. So what is

your trade-off for that being zero? And I think one of the

messages we're going to have throughout this podcast is you got to

do your homework. Yeah. You really have to understand what the plans are

because it's real easy to be surprised in—

if there's a medical, especially an emergency. So hopefully,

listeners, we're going to have all the information you need at the end of this.

So, Josh, changes in 2027

plans could have significant impact on

participants. I always do my homework with Josh because I'm

actually preparing for my own Medicare updates. So I'm always

like looking at the details here. The podcast is just a self-help. self-serving

vehicle. That's all it is, this episode specifically.

Exactly, this is the one podcast I do every year where I'm actually getting something

out of it. Well, and I was thinking the same thing, it's like I'm now

5 years away from the scenarios. I'm gonna be fairly

well-educated walking into it. I'm not gonna be braggadocious about knowing

everything, but it's one of those, at least I kind of get— Enough to be

dangerous. Exactly, maybe ask the right questions, and to be prepared

better than I probably was before. That's a really good point too, Brett, because

that's what I did when I was getting Medicare

eligible is I went to a workshop just to get the

language down. That was what was so hard because,

as you said, most of us have been on some kind of an

employer plan for so long. The only thing that we were looking at is, you

know, Blue

Cross Blue Shield versus Anthem, you know, kind of

thing. Yeah. So it's a huge change. It's a huge change. So anyway,

so here, there are lots of changes, but here are a few that I found

that I wanted to make sure we talked about. Rates are increasing. We

won't know for sure for another couple of weeks. Mm-hmm.

Cost for Part D plans may increase

significantly. While, this is more important,

the number of available plans actually decreases.

That's huge. Mm-hmm. oftentimes

the plans don't cover what you need them to cover. So you have to be

really, really careful. Advantage plans are decreasing

coverage and they have actually been dropping enrollees from

their plans. So that's a big issue. Part D

subsidies have been phased out by the federal government,

another huge issue. And that's, I guess, likely why

the plans are increasing in cost. Part D. On the

positive though, 19 drugs have been price negotiated

to the benefit of participants, and the maximum

AGI level has increased. This is

important when you do your taxes, depending on how much income

you have, it could change the cost, increase the cost of

Medicare. So it's something you always have to watch over. So

do you have more information on those changes, or are there any other issues

out there that we should watch for? Well, specifically on that, that prescription drug

plan point where that Part D insurance, where we

saw this year in Central Ohio, at least, it was decreased to 10 plans.

We won't know, even as someone in the industry, we don't know exactly

all the plans until October 1st. So we're recording this the day before we'll know,

but I won't be shocked if I open up medicare.gov tomorrow and see even

less than 10 plans available for prescriptions. And it

is, I wanna explain that reduction in the subsidy or the phased-out

subsidies. So when the Inflation Reduction Act came in a couple years

ago, it was great, because it put a maximum out-of-pocket

on what somebody would have to spend for prescriptions. So it set a limit.

Before that, there was still that open-ended, if you had an oral chemo medication that

was $1 million, you were still spending a lot of money, even with your insurance.

Now with the Inflation Reduction Act, they put it at $2,000, and it's kind of

worked its way up. Now it's $2,100. Next year it'll be $2,400 is the

maximum. And they had, for next year, in the Inflation

Reduction Act, that the subsidies, they were gonna start with some subsidies

to help offset some of the costs that the insurance companies would

have with the change, and they were just gonna phase it out, and the current

administration just said, we're gonna let it sunset like it was supposed to,

and insurance companies, always taking advantage of any type of

crisis, went to the, everywhere out there saying, they're stripping us

of what they were paying us, and what it really equated down to is what

they said actuarially is about $10 per person per month was a subsidy,

but you know the insurance companies are gonna turn that into Well, we can't offer

as rich benefits, 'cause we're not getting paid as much. And so there are changes,

but it's still positive. There's still a limit of $2,400. So if you are in

a situation where you have expensive medications, most you're going to spend is

$2,400. Not discrediting $2,400. Oh, no. That's a lot.

$2,400 for the year or per month? For the year. For the year total.

And like you said, Carol, there are these lists of medications

that are names that you've heard of, like Eliquis, that next year

it's going to be price negotiated, which we're hoping turns into a positive

for folks. So there, it's not all bad, but what we have seen

with some of the changes to the Medicare Advantage plans too is over the 20

years, it was almost, I was hesitant because they were new-ish

20 years ago, and then they came roaring in a couple years back,

and there were so many extra things that they offered where people were just

thinking like, am I even buying insurance anymore? Am I buying a gym membership? Or

am I buying shoes for my grandkids? Oh, wow. I mean, it was, because

insurance companies wanted people to enroll, and they get paid by the

government if somebody enrolls in their Medicare Advantage plan, so they put all these extra

things and bells and whistles in there so somebody would just sign up. So they

would just sign up, and then the government finally got wise and said, wait, wait,

wait, wait, you guys are making this not about what's important, is

the network of doctors that folks can go to, the services that need

prior authorization, things like that, and you're trying to add too many extras.

So we've seen, some forced pullback on. So

when it's said out in the news and everything that

Medicare Advantage plans are slashing and cutting back, it just was to a point

where it wasn't— people were

able to get people to enroll in an Advantage plan for a

flex card or some grocery benefit where they weren't

looking beyond, like Carol, to your point, they were just looking at, okay, that's gonna

save me a couple bucks a month at the grocery. I'll deal with the rest.

And when they were dealing with the rest, they realized that wasn't— the best choice.

Right, because oftentimes an Advantage plan, you

have to have prior approval before you do

even, I don't want to say normal, but not

extraordinary type of tests or

lab or whatever, which for Medicare, it's

pretty automatic. And what I've heard from

people is that they're saying, Well, I can't get it. I can't get approval.

Or they have to wait forever, or they go to their local television

station and report the insurance company. And then all of a sudden,

oh yeah, the insurance company will cover it. You're like, what?

Yeah, it is. It's interesting. I had a

doctor come in and he said, on my professional side, I would

never talk to you about Advantage plans because of the extra hassle on our

our staff to get things approved. But as a consumer, those

Advantage plans sound pretty good. So when he removed the extra

effort that he was gonna have to go through as a professional,

and he said, ah, well, let's look at those. And I don't wanna

say they're all bad, but what I think we

saw with telemarketers and just the churning

and pressure sales, talking about things that weren't necessarily the

most important piece of it. There are a lot of folks that ended up on

these plans for the wrong reasons. For the right reasons, I do think they fit

a need. I think they can work very well if you can live with the

tradeoffs. Right, because— so those

guardrails on the sales and marketing of Advantage

plans have been eliminated. Not entirely.

And it's one of it where they're just trying to— it's almost Like the AI

situation where they're just trying to figure out how to contain it,

and as soon as you try to put something up there, the people who aren't

doing it for the right reasons are finding ways through, which changes it for everybody

else. So that is the most frustrating part of what

we do and I do and have been doing for 20 years, where

it puts a bad light on everybody for the 3% of

people that are really doing the bad things. So for our listeners, the guardrails were

things like, Requirements, when you're calling and

talking to a representative of an

Advantage plan, they have certain things they're supposed to

disclose at the beginning of the conversation. Now

they can give you the sales pitch, you're ready to sign on the

dotted line, and, oh, by the way, let me tell you this.

Yeah. And so that's where a lot of the confusion is coming in.

Mm-hmm. And it seems overall, living through it, that,

as odd as it's going to hear or sound, but it is a little better

than what it was a couple years ago when it was the wild, wild west

with these Medicare Advantage plans. Sure. So they are doing

a little better, and I do think they recognize the spirit of it

is that it's not helping anybody to let— to release the hounds, if you will,

of the cold callers. And the interesting part, too, is in Ohio,

the state of Ohio, it is illegal for someone to cold call you about your

Medicare. It's illegal. But if they call from out of state, we can't police it

here in Ohio. So you're— most of the time when you get a call, it's

from somebody from out of state, too. So if you're thinking you're talking to somebody

next door, you're not. They're, they're, they're from out of state. That's really good point.

They don't really know your markets. They don't know the hospital systems, the doctors,

the negotiations. They just look at their screen and say, hey, that's another number if

I can close this. And so it's, I mean, that's always going to

be there. But, but it is frustrating to— they're trying to put

guardrails and remove, and because some of the guardrails they put up actually hurt

the agents like myself that are trying to, to be helpful.

But, but yeah, there's a— it's ever-changing. In

order to choose that, the best Medicare plan for yourself, an

individual, you've got to understand your own medical history.

How should a person describe their health and physical abilities? And are there

specific items they often forget that can be

detrimental in meeting healthcare needs and choosing a Medicare plan? I guess ultimately it

comes down to, you know, what questions do you ask and

make it— make a checklist? It's like, these are the things you really should address

because you're going to ask this because it's important to choose the right plan.

Well, and it's interesting, one of those guardrails used to be you can't

really ask those questions. You weren't allowed to because you weren't allowed to not

suggest something based on someone's health history or how— they were

trying to make it so you weren't leading them one way,

but that was counterproductive because you want to try to figure out what someone really

needs, and it is a combination of not only the health of an

individual, and if you're chronically ill or if you're

someone who has some of the injections

for bone density and some of the things that we know we're going to always

have, Sure. It does help as an advisor to say, okay,

we may talk about a supplement with you, a Medigap with you, because when you

go to have those things done, there'll be less of a hassle getting it done.

Not that it can't ultimately be done the other way. And it's going to cover

more of that bill. But what our struggle

now is, back to your— the first thing you said, Carol, about the changes,

rates across the board are going up. So as

people are pinched on one side, it's hard for them

to find a way to also pay for that supplement

premium that keeps going up and up and up and up. And—

but what we try to do at Seniority Benefit Group, and what

I've really tried to hang my hat on, is that when I go in and

I start talking to somebody, I don't have any preconceived notion of which way

they're going to ultimately end up. And my own parents, who, trust me,

they've asked me a million questions about this, My mom is on a Medicare Advantage

plan, couldn't be happier. My dad is on a supplement, couldn't be happier.

So I've seen both ways work. And I remind

my mom some of the things that, hey, this is a $0 plan. You're not

paying anything for it. But remember, and she says, oh yeah, there's been times where

I've had to call the doctor's office. Oh yeah, there's been times where the doctor

that they wanted me to see wasn't in my network. My mom was

totally fine with navigating that system. She did not have a problem with that.

It would drive my dad Bonkers. So he said, I'm going to pay this premium

and not have to deal with that. My mom's sitting there, she's saying, Keith, why

are you paying $250 a month now for that? I'm over here paying

zero. Yeah, I got to make a call every now and then, but it's just—

so you have to read the individual. My parents are still married.

They're in a loving marriage. It didn't cause a divorce. They just think of it

differently. And interestingly enough, my mom is the one with more health

history than my dad. He was buying it for convenience.

My mom was buying it trying to be economically savvy,

and so you just ask those questions about what's your

risk tolerance? How much do you want to

put into the category of maybe I'll need to be on the phone a little

bit more? Is that gonna bug you, or is it okay if when you

wanna go see a doctor, they might not be in? Some people, you'd be surprised,

say, that's fine with me. If it's a $0 point, then fine. And it's great

that you've got those stories to illustrate

what can or can't happen. And like you said, it's the risk tolerance.

Yeah. It's that, okay, for the next year, what do you think? Yeah. That sort

of thing. And it's always roll the dice. We don't know

what's going to happen. I know. That kind of thing. So yeah, that's probably the

hardest part of it. Yeah. Is guessing. Yeah, and it's

sometimes, it's when people say, well, what would you do, Josh? You're the expert. What

would you do? And I said, I'm not trying to dodge the question, but

what I would do doesn't matter, really. I mean, I will guide you.

I will educate you in whatever decision you want to try to make here.

But I can't make it for you. Josh, I want to go back

to the Medicare Advantage plans, because there's a lot in the news lately,

things like network negotiations. We hear about folks

losing their insurance. Can you give us some notion of what's happening in that

industry, what we should be aware of when we're choosing an

Advantage plan versus the traditional Medicare? Yeah, and

that is something that we have very much been aware

of, obviously, over the past 18 months, where you're hearing big name

brands, like your Humanas, your Aetnas, your

Anthem Blue Cross Blue Shield, your UnitedHealthcares, big brands that

somebody comes to us and says, oh, I have UnitedHealthcare through work, so

I know my doctor's taking UnitedHealthcare. We really have to pause them there and say,

UnitedHealthcare has negotiated a network for employer plans like you have right now,

and their Medicare Advantage plans, 2 totally different networks, and as

the insurance companies are still trying to navigate what

they're allowed to do with Medicare Advantage, and really, quite frankly,

squeeze every penny out of profitability in that,

They have pushed it off a little bit onto the hospital systems

and saying, well, we can't pay you as much. And so

it has created over the past couple of years where just a few years ago,

there were multiple insurance companies that if somebody came to us and

said, well, I'm worried about, I want to be able to go to all the

hospital systems here in town, just in case. I want to be able to go

to Mount Carmel, OhioHealth, Ohio State. And we'd say, okay, that's fine.

On these 5 plans, they have all 3 of them. And now we've seen

over the past couple years, and even, we're recording this on September 30th,

Humana's losing OSU tomorrow, October 1st, which we've had to tell our

members, hey, you can't get out of that boat yet. You gotta stay in that

boat until the end of the year, even though that boat no longer has what

you signed up for in January, no longer has that network. Wow. So that's

another trade-off with those Medicare Advantage plans. You do have an

escape route at the end of the year, but you don't have it mid-year just

because your insurance company wasn't able to negotiate with the hospital system. Goodness.

I would have thought they had the ability to do a short—

You would think of like a gap thing. Yep. Yeah. And every

now and then, the government will step in and say, okay, we realize there's a

lot of affected members here. If you call us, medicare.gov

or 1-800-MEDICARE, we're able to pull some strings that an

agent down the street won't be able to. But we as Medicare, if you need

the coverage, just call. And so they are aware of some

of these really being hurtful, and I am proud of the government

for allowing some of the changes to happen mid-year, which normally isn't the

case. But it all goes into that

conversation of risk tolerance, whether it's an out-of-pocket risk or whether it's a

risk of the doctor potentially not being in network. Are we okay with these things?

Interesting, okay, yeah. Costly mistakes can be

made if a participant doesn't thoughtfully review the coverage that

they've got. We kind of referenced that. They may assume that plans have remained

the same, or their spouses should be enrolled in the same plan, or even

their healthcare needs differ. They may be still working, which can create

Medicare penalties. Or they may even forget to timely enroll in

Medicare, which is why we do this podcast, to remind people to, you know, get

it going. What issues have been most detrimental? I mean, what advice do you

give your clients to avoid those costly mistakes.

Yeah. Around the employer piece of it,

we're strong there because we really came out of the

employer-employee benefits space. So

we're very aware of the challenges that employers have just

delivering a product that is cost-effective to them as an

employer, but not so high of a deductible

that isn't really a benefit to the employee. So we get more and more

calls when somebody's turned 65, and they say, well, we're still working,

but I know I have to do something with Medicare. And I'm glad to catch

them prior, because, yes, you may want to, but as long

as you have coverage through an employer of more than 20 employees, you're allowed to

delay Medicare without penalty, as long as you continuously have that coverage.

So then people will say— as soon as I say that statement, they'll say, well,

I know I have to Do I have to tell Medicare that I don't want

it yet? No, as long as you have that employer

coverage. So there are ways where people freak out about a lifelong penalty,

where I say, you don't have to freak out about it. As long as you

just don't go without insurance for 8 months, you're not going to have that lifelong

penalty. Is that same coverage or that same mindset with a

spousal cover? Like if I'm on my wife's plan?

Yeah. monetarily, it's more

advantageous to be a part of her plan. Uh-huh. Okay. So same situation.

Same situation. And that's where I've seen that conversation change in my 20

years too, is where it used to be employers were able to offer

a very high-level benefit to the employee and the spouse at a low cost.

Now, we've seen deductibles go up, and a lot of the employers say, hey, we

still will pay for the employee, but we can't pay as much towards your dependents.

So we're seeing more people choose Medicare, especially as a dependent,

over the employer plans. And so the other thing I want

to say is, don't make the assumption that the employer plan or retiree plan

is the, the quote-unquote best option. Right. Where

sometimes when we have that Medicare discussion and we say, okay, you can have this,

this supplement and drug plan, and you have very low out-of-pocket, and it's going to

be about $300 a month, or whatever it is. And they say, well, I'm paying

$700 a month at the employer, because they work for a a smaller company maybe.

And so just don't make— you want to avoid assumptions. The one

thing I've seen recently too is COBRA is another

one of these things where when you leave an employer, some people, their

employers will pay for your COBRA benefit. And COBRA is just a

federal law that allows you to extend benefits up to 18 months. So most of

the time people say, well, if my employer is going to help subsidize it, I'm

just going to keep that for 18 months. But the government doesn't

recognize COBRA coverage as credible coverage. So then you

do find yourself in a potential penalty situation later on there.

Hmm. So where people say, well, COBRA is the exact same plan I

had, and it is true. Those are some of the nuances that just make sure

you talk to somebody before you turn 65. Just make sure you talk to somebody

before you retire or have that choice of COBRA, because there are some things

that aren't obvious, and quite frankly, don't make total sense

that are out there. And so it's fun to be able to catch people before

they make that mistake. Yeah, sure. Oh, that's interesting.

COBRA wouldn't be recognized. 'Cause it's, yeah, it's secondary to Medicare. They

flipped the switch of who pays primary and secondary. And then, so

yeah, it's kind of crazy. Okay, so

just another reminder, everybody, talk to somebody.

So one of the things that I really wanted to talk about today are

Medicare scams. It's like a tsunami running

through the country. I've been getting

MyChart scam emails. Oh, really? Oh,

it's— yeah, they, they— oh, I have to respond if I want a

free gift. MyChart does not give free gifts. So just

be really careful. But we're all getting those

unsolicited phone calls asking us to verify our Medicare

number to receive a prize, or they will provide us

with a new card, new Medicare card for a small fee. There are

no charges for your Medicare card. So— Correct. Don't send anybody money.

What should our audience do to avoid such scams?

Yeah, the, the big one is to remember Medicare is not going to call

you ever. And if it's ever seeming like they're pressuring you,

they're not going pressure you into giving out information that

you don't want to. So just always practice caution like you

do anywhere else, where if it doesn't feel right, it probably isn't right. And especially

now with AI being able to manipulate voices, it's not even taking much of

an effort for these scammers. It's not even taking their own voice to scam you.

So just, if it doesn't feel right, don't

answer any questions. Like you said, Carol, There's no Medicare card that costs

any money. If you need a replacement card, you can contact Medicare. They'll send it

for free. The big thing that, again, was running rampant

was those Flex cards that you'll get a call that says, if you're on

Medicare, you should be eligible for a $2,000 Medicare

Flex card. It doesn't exist. It's not, it doesn't exist.

What it is, is it's a one-off where you have to

really, fit into a certain box and check off

a lot of different things to be— you have to be on Medicaid, for

instance. That's normally a trigger. Whenever you hear Flex Card or cash

benefits or grocery benefits, it's normally tied

into the Medicaid piece. And that's the other sad

part about it is that when some— if somebody is on Medicaid,

they are looking to save wherever they can because they've been in a

situation where it's just tough. So when they see a

lifeboat coming out, they'll follow that lead sometimes, and it ends

badly. Sure. And so just really, phone calls

unsolicited to you very rarely turn into something

positive. So if you do have the— and I know sometimes

people are just nice people that don't want to hang up, me being one of

them. I feel like even though I know it's— it would be— it's just odd

to just Just hang up on somebody. But it does seem like that's the approach,

especially during this time, especially during the open enrollment time when people are allowed to

make changes to Medicare. Be very, very aware of who's on the other end of

the call. Right. When you see TV ads, there's a phone number

across the screen, really make sure that you're really calling

a legitimate organization. Yep. Yep. Go to their website if you can and

make sure you've got the right phone number. It, you know,

it's really a shame, but

so many older adults who are likely

alone are the ones who are somehow targeted

and getting scammed so easily. And the scams are, they

sound legitimate. Yeah. But they really aren't. Just

remember, chances are Medicare, Social Security is the same. If there is an

issue or a question, They're going to send you a letter. Yeah, they will. So,

yeah, they will. Seniority Benefit Group and other connectors support individuals

and organizations in their evaluation of Medicare plans.

So talk to us more about Seniority Benefit Group and particularly

the role in assisting employers as they manage their

employee benefits packages. Well, and like I referenced before, these

employee benefits packages just deliver to employees just like everything

else in our world, have skyrocketed to a point where you just, you

can't even really fathom offering it anymore, and

unless there's some ways to help defray that cost, and

normally to defray the cost, the employer turns into watered-down benefits. Not

even that they want to, but normally results in a higher deductible or a higher

copay, or maybe a narrower network in certain situations,

and— So that is where I do have a lot of conversations with

people when they're turning 65, that 20 years ago, if

they said, well, I'm on my employer plan, it was probably pretty easy for me

to say, well, then you, you'll want to stay there. It's probably a

good, low-cost, decent coverage. Now, it's just

harder and harder for employers to offer that low-cost plan anymore. Yeah.

And so Medicare has been a safe haven for a lot of

employees and the employer, because then And then they save on some of their payroll

costs, too, for employee benefits. And so we

try to get in front of as many employers as possible and do our

educational events for them, our Medicare 101s, just so they're able

to know that, hey, this is an option. You don't have to leave the plan,

but it might work out for you. Yeah. So we've contacted and

have a whole lot of HR folks who will give us a call

when employees turn 65 and just saying, that's this is not my area of expertise.

Hey, Josh. Hey, Seniority Benefit. Can you talk to Mr. Smith about him turning

65? And we're happy to do it. And so it can turn into a

win-win for them. Right. I remember when, I mean, Carol and I got

connected when she was the executive director of Employing for Seniors

and I was on the board. And there was those discussions to

employers because it was that ageism thing. It's like, okay, you get to that

certain age, you can't be on our insurance. We don't want to hire anybody at

that certain age because of this, that, and the other. And,

um, it was a falsehood, basically. Yeah. You know,

you can continue to have that person of age be there,

and it's not gonna— they're gonna flip over. So it's really, you're just looking for

an excuse not to hire or continue to work with a, at

that time, maybe 63, 65-year-old. So, um, there was an education process.

on our part too of just, you know, working with our clients saying,

you can call them out on that. Well, and it has helped a lot of

folks where if you come to the employer and say, hey, look, before we even

talk about it, I have my own insurance through Medicare. You don't— yeah, to your

point, don't have to worry about that point. Don't hold that against me. I have

my own. Yeah, let's just talk about— Yeah, actually, I'm a cheaper

employee. Yeah, potentially. I mean, that's what the employer looks at. that sort of thing,

if they need to add more people. But it's just one of those little nuances,

like, don't— it's not true, you know, and

understanding it is better than being hoodwinked into

a scenario that you don't want for it to be. Yeah. Yep.

We are going to share resources, articles, and information

to give to you and also to give you an

overview of what we've talked about today. And a link to the

Medicare& You Handbook, which is

available on the Medicare website. Mm-hmm. So

that is going to be in the show notes for the podcast. And as Josh

mentioned earlier, we're taping this on September 30th.

Open enrollment doesn't start for another week or so. Be sure you've

got the most up-to-date information. If you need

assistance, We encourage you to call someone like Josh and his

company to make sure that you've got all the updated

information that you can get. So, Josh, as

we said, this rolls around quickly every year. Sure does. And again,

we've gotten through this quickly. Thank you for all this

important information on the changes to Medicare for

2027. Any last words of wisdom you'd like to

provide our listeners? Well, and I probably say this all the time,

but even, don't be afraid to reach out to resources,

whether it's us or someone else. I mean, as an example, again, my own

mother last year, she was dealing, again, on a Medicare Advantage plan. Her

primary care doctor had sent her a letter saying, I'm going to be out-of-network next

year. And my mom didn't even think to call— that time, my mom

didn't think to call me to say, hey, Josh, is there another plan? out

there that has my doctor in network. We talked over Thanksgiving like we do. It

turns into business for a little bit, and I was just asking her, like, did

you look at the changes? Let's go over next year for you, and she was

like, yeah, I really want to keep my doctor in network, and I was like,

Ma, this is what I do. If it's something like that,

a quick call, and I can tell you, we'll just change you to a different

plan that has your doctor next year, but she was scared to even ask me

to put, like, the burden on me or make

it it more cumbersome because she knows it's a busy time for me. Don't let

that affect you as a listener here. It is

totally fine to ask questions. There are so many people out there like us that

are willing to answer, happy to answer those for you. And

just don't go it alone. And don't listen to unsolicited advice,

but try to solicit advice. Go out to some of these local resources. Go

to a Medicare 101 shop just to get a refresher. Right.

Absolutely. What your neighbor or

your cousin or your brother is getting is not

necessarily what you need. And so, as I

said, we're going to have the resources, but great places to get information,

your local library. For us, Central Ohio Area

Agency on Aging, that's the workshop I went to. Mm-hmm. I'm under

a state pension plan, so we have our own connector we have

to go through them. But I wanted to learn the language.

So when I talked to the connector, I understood what was going

on. So it's just really important to keep

asking questions. Yeah, absolutely. Exactly. Well, many thanks to

our Medicare expert guest, Josh Kinzel, from Seniority Benefit Group for joining us

today. Listeners, thank you for joining us as well. You're going to find the contact

information and resources we talked about in the podcast show notes. And

on our website at lookingforwardourway.com. And we are

looking forward to hearing your feedback on this or any of our other

podcast episodes.