Suzanne: And on this very lucky St. Patty’s Day weekend, we are coming to you from Greater Puget Sound across the United States, and we’re so thrilled to be in 19 markets here in the U.S. And we are here to share all kinds of issues that affect seniors today. And we’ve been hearing a lot of things in the news about Medicare, what is going to happen in the future, there’s all kinds of things going on. And so I was very much looking forward to having this guest back on my show. She was on a while ago and we are here to introduce Kristine Grow. She is the spokesperson for the Coalition for Medicare Choices. And we’re gonna talk all about Medicare, Medicare Advantage, what her organization does. And Kristine, welcome to Answers for Elders.
Kristine Grow: Thank you so much for having me.
Suzanne: Kristine, your organization really is kind of a watchdog, I would say for Medicare, you help to make sure that the strength of Medicare is preserved so that people like seniors, there’s a lot of fear out there right now with, you know, in the, in the world of Washington DC, that there may be people trying to take away these programs. Once we turn 65 there’s Medicare and then you have to enroll in Medicare and whether you’re on other insurance or not, you still have to enroll. But the thing is, my question is, is then there’s Medicare Advantage programs and there’s Medicare supplemental programs. First of all, what is Medicare Advantage? Because I think that’s something that maybe a lot of people don’t know the difference.
Kristine Grow: Sure. Thank you very much for the question. So when you become eligible for Medicare, you have choices and to what kinds of health care coverage you can enroll in original Medicare. Are the parts that are considered Medicare. Part A and Medicare part B A covers a chunk of hospitalization costs. Medicare part B covers a chunk of doctor visits in other sorts of visits. Medicare advantage is Medicare part C and Medicare advantage covers everything that original Medicare covers plus a whole lot more. So if you enroll both parts A and B, you can also choose part C. Some of the benefits that we hear from our seniors who are part of the Coalition for Medicare Choices, what they really like about Medicare advantage is the vast majority of these plans include prescription drug coverage. I think a lot of Americans are surprised when they hear that original Medicare doesn’t include prescription drug coverage. It also includes services like dental, vision, and hearing services which are very important. You have different parts of your health that are very important, especially as we age. Other services include coordination of care, particularly for conditions that are chronic conditions such as if you have heart disease or a heart condition, if you have diabetes, these are very common kinds of health conditions that if you proactively manage them, you can stay healthier a little bit longer and realize and achieve a better quality of life than you may otherwise. There are also more benefits in Medicare Advantage that are being included now, which are called supplemental benefits. And these are benefits to address what are called the social determinants of health, or social barriers to better health. For example, if you have a home that doesn’t hav very good air conditioning or heating, and you have some, some health risks, uou may be able to get additional services to help you keep your cold place warmer or your warm place a little bit cooler. You may get transportation back and forth to the doctor’s office, for the pharmacy to get the care that you need, even healthy foods and healthy meal programs if that is a risk factor for you. So there’s a lot of these Medicare advantage programs offer, beyond original Medicare.
Suzanne: You know, Kristine, I, I know for me, I turned 65 now, well, I’m gonna be 67 here. I can’t believe it. But I found it very confusing and I think even as much as I know about my industry, it was such a confusing situation, and I was very grateful for my representative that I got my Medicare supplemental program from, for her to walk me through it. Uh personally, and I think one of the things that I’m really luck lucky
Suzanne: about for me is that I had those relationships. But I think there’s a lot of things that you guys do that can help educate people like how I was um that people may not know about and that’s certainly um interesting. So obviously
Suzanne: original Medicare basically covers part A but it, and part B but here’s the thing, there’s also a ceiling or, you know, like a limitation. So for example, I know when my mom went to rehab, you know, after she had broke her pelvis, she went to a rehab center and Medicare paid for like six weeks and then she had a,
Suzanne: a supplemental policy that paid for more. So there’s advantages in that way that it does cover um you know, that that’s the supplemental side. What does Medicare Advantage go into that picture at that point?
Kristine Grow: That’s absolutely right. Medicare Advantage also has uh out of pocket limits, which are a limit how much you would pay out of your own pocket towards your own health care cost for this particular year. It’s part of how they improve financial
Kristine Grow: stability of the people that they serve. Um, these Medicare Advantage plans are offered by health insurance providers who compete for your business and they are also accountable to the federal government. The federal government oversees the Medicare Advantage plans. They review these plans and the benefits to ensure they’re offering additional value to seniors that they’re varies, regulations or requirements of what they should cover. Uh and that they’re a competitive value so
Kristine Grow: that when seniors are making a choice for their coverage, they have a lot of decisions they can make. Um what services do they want? What prescription drugs do they take that they want to make sure are covered? What are they comfortable paying for an out of uh for their premiums? What are they comfortable paying for a deductible? Um Maybe they qualify for subsidies to help them afford their plans. So these are a lot of different factors that go into thinking about what, what’s the choice? That’s right for you Medicare supplement plans or
Kristine Grow: another flavor of choice that people have. Uh And to the point that you made earlier, there are many brokers who are certified in these plans who get special education to make sure that they are informed, they know what these plans are, how they work and they can consult with you to make sure that you’re getting a plan that’s best for your personal
Suzanne: needs. Well, and what I love about, um, my, uh, Medicare Advantage plan is there’s so many preventative type benefits. Um, could you share a little bit about those types?
Suzanne: Some things that it
Kristine Grow: covers? Yes. And we find a lot of our seniors really appreciate these preventive services. These are services that help keep you healthy. It’s the best way to think about them. And these will be things like your annual check up with your doctor. Um who will check things like your, um, your medications that will check your blood pressure will, you know, check your blood sugars. We’ll check your heart to see if there’s anything that it might indicate a problem that you can get ahead of and make sure that you treat early
Kristine Grow: so that you don’t become very sick. Um It also includes things like vaccines and I know a lot of people when we think about vaccines, we initially, you know, think about COVID-19, which is very important. There are also flu vaccines, there are a lot of other vaccines that seniors may need and these are covered as part of that preventive care services. What we find is that um, when we talk to our senior voters who have these plans. Preventive services are one of the things that they’re most
Kristine Grow: Satisfied with these, you know, we talk to these seniors, what we find is 94% of them are satisfied with their coverage. 93% of them would recommend them to their family and friends and those preventive care services are a really important part of their satisfaction. I
Suzanne: And, you know, it’s really true. It’s like I, I was blown away. That was, I guess the biggest surprise because, you know, I get like fresh, so many. Um, so I think it’s $75
Suzanne: with the fresh produce every month on my policy. Uh, you know, we get, um, uh silver sneakers, uh part, you know, where we get a benefit to participate in those types of fitness programs. Um There’s all kinds of classes that, that we have the advantages to have and I’m trying to think of some of the other ones, but I was amazed at how many things. Um, and then the other part of it was when I had my, got my Hearing Aids bingo, I got every
Suzanne: for free. It was, it was incredible. So Kristine, we are going to be back in our next segment and we’re gonna talk a little bit about Medicare Advantage, who does it cover and how is it accessible? How do we access it? And we’re gonna talk also a little bit about demographics of the country where we are in, you know, across the US. Kristine, you and I are gonna be right back right after this.
