00;00;18;18 - 00;00;44;23 Moe Jackson And now America's health care advocate, Cary Hall. Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across USA, from Florida to Hawaii, all the way to Alaska. We are broadcasting across the country on 294 affiliates. My producer name is Lisa Cox. I'm your host, Cary Hall. This is your show, America. Thank you for joining us and making us one of the most listened to talk shows throughout the United States. 00;00;45;00 - 00;01;06;03 Cary Hall This show is on Aging Into Medicare. So if you're chronologically challenged and you're turning 65 and you're concerned, I just had a lady call me today about her mother and she was 65 and she wasn't even in Medicare and confused and didn't know what to do. We're taking care of her. The lovely Joyce Thompson is handling that. 00;01;06;10 - 00;01;26;14 Cary Hall But if you are one of those people, maybe it's your husband, maybe it's your wife, maybe it's your grandmother, whatever. You can go up on the podcast platform and listen to this and they can listen to it, and it'll give them a wealth of information on what to do with the alphabet soup. That is Medicare, meaning Medicare A, B, C, D, E, F and G. 00;01;26;17 - 00;01;39;17 Cary Hall Yeah, there are that many of them. Okay. And today in studio with me is Moe Jackson from BlueCross BlueShield of Kansas City, doing her 134th show. I just made that up, but it may be something close to that. What do you think? 00;01;39;17 - 00;01;44;18 Moe Jackson We're getting there or getting there, Cary? Almost there, but thanks. I'm happy to be here today. 00;01;44;22 - 00;02;10;09 Cary Hall Moe is Blue Cross and Blue Shield's, resident expert here talking to us about Medicare Advantage and Medicare supplement. And that is what we're going to talk about today. By the way, my website, if you want to reach out to me, if you have a question like the lady who reached out to me today through an email at the website healthradio.us,. HealthRadio.us. If you want to reach out to me, if you've got a question, if I can help you with something, whether it's medical insurance, whatever the case may be, please feel free to do so. 00;02;10;09 - 00;02;28;17 Cary Hall I am happy to respond. Okay, so let's just start. You know, we're going to talk about aging into Medicare today. We're going to talk about the Blue Cross and Blue Shield products. We're also, though, going to kind of explain to people about basically two products, Medicare Advantage and Medicare supplement. 00;02;28;17 - 00;02;51;02 Moe Jackson Yes. Yes. That's what we're going to talk about today. We're going to try to help you navigate and figure out what's better for you, what suits you the right way, because everybody's different. Some people like to get that coverage up front, pay their premium and know that everything's going to be taken care of. And then you have those that like to be the savers, the people that go, I'm not going to pay for it unless I use it. 00;02;51;02 - 00;02;52;08 Moe Jackson So we have two options. 00;02;52;29 - 00;03;10;15 Cary Hall Yeah. And that in that that's we're going to talk about before we get to that, though, let's talk about the first two letters in the alphabet soup, because without Medicare A and Medicare B, you can't get a medicare supplement or Medicare Advantage plan. Medicare either automatically enrolled in. But to get Medicare BMO. 00;03;10;17 - 00;03;26;17 Moe Jackson They need to make sure that they sign up for Part B and that they have figured out how they're going to pay their Part B premium, because that is something everyone has to pay and they can do that. Normally, they'll they're going to get something in the mail about three months before they turn. 00;03;26;17 - 00;03;27;29 Cary Hall So you're going to have lots of things in the. 00;03;28;02 - 00;03;47;17 Moe Jackson Yeah, but they're going to get something from the government that says, hey, here's your part B, do you want it or do you not want it? If you don't get that notification, you need to reach out and call Social Security to get that started because that is important. That's the only way that you're going to be able to move forward with the alphabet soup of Medicare Part A and B. 00;03;47;22 - 00;03;55;29 Cary Hall And the reason why you want to get a part B and this is important to understand. If you only sign up for A, you are liable for 20%. 00;03;55;29 - 00;03;56;12 Moe Jackson You are. 00;03;56;19 - 00;03;57;22 Cary Hall And that is. 00;03;57;23 - 00;03;58;18 Moe Jackson Never ending. 00;03;58;18 - 00;03;59;04 Cary Hall Thank you. 00;03;59;15 - 00;04;00;14 Moe Jackson It's there again. 00;04;00;14 - 00;04;00;23 Cary Hall So the. 00;04;01;02 - 00;04;10;15 Moe Jackson Never ending. It's there and there and there and yeah, 20% can go on and on if you have additional services throughout the year and throughout your lifetime. 00;04;10;15 - 00;04;21;07 Cary Hall Yeah. And that's what Medicare B covers and it also qualifies you then to get a Medicare Advantage or Medicare supplement plan because without it, you can't have either one of those, right? 00;04;21;07 - 00;04;34;23 Moe Jackson That's correct. Now, you can get a part D plan standalone on prescription drug plan with Medicare Part A or B or both. But you can't have the Medicare supplement or the Medicare Advantage plan without A and B. 00;04;34;23 - 00;04;52;12 Cary Hall Yeah, and that is really important. And it's also important that you deal with people that are reliable, I mean, this is important. You know, you see these ads on television, you got Joe Namath and the guy from Good Times and they're up there. You know, they're going to give you money and they're going to show you something and nobody else has. 00;04;52;22 - 00;05;16;05 Cary Hall And that's a lot of baloney. Okay. You know, Blue Cross Blue Shield has been here 80 years, their 4.5 star rating on Spira Care, their HMO plans. They've got superior customer service and they're local. They are here in this community. So when you call up somebody, a Blue Cross, one of those people, and you they answer the phone and you ask them about, well, what hospitals are available north of the river. 00;05;16;13 - 00;05;18;00 Cary Hall They know where north of the river is. 00;05;18;01 - 00;05;21;12 Moe Jackson Exactly. And they also know how to pronounce your city's name. 00;05;22;08 - 00;05;33;02 Cary Hall And so and but but when you go to one of these national call centers and you get somebody in New Jersey, it's a it's an agent, a certified agent. They don't know Kansas City. 00;05;33;02 - 00;05;33;21 Moe Jackson They don't they. 00;05;33;21 - 00;05;45;18 Cary Hall Don't know St Luke's from Advent, from Olathe Medical. Okay. And to me that you're losing your providers, you're important to seasoned citizens. Okay? 00;05;45;19 - 00;05;46;04 Moe Jackson They are. 00;05;46;04 - 00;06;05;09 Cary Hall We like to know who we're going to see. Yeah. And that's part of the equation. And that's again, I come back to, you know, Blue KC has been here 80 years and you're dealing with people that are here in the community, understand community, and they're there. If you have a problem, you can reach out and you can actually talk to somebody. 00;06;05;11 - 00;06;06;09 Moe Jackson Absolutely. Yeah. 00;06;06;09 - 00;06;07;18 Cary Hall And that's a big deal because. 00;06;07;21 - 00;06;10;03 Moe Jackson You can come down and see, is it 2301 main? 00;06;10;14 - 00;06;13;22 Cary Hall You hear that? You can actually just show up and go make an appointment to be there for you. Yeah. 00;06;13;22 - 00;06;32;20 Moe Jackson I mean, we, we hold the same office hours. We still have people there that can help you. But keep in mind, we're community based. We do a lot for the community. We make sure that we're out there doing outreach and the things that we're working in and dealing in the same things that you all are experiencing every day. 00;06;32;20 - 00;06;55;12 Cary Hall Yeah. And that I think that really is important to understand that that Blue KC's place in this market is significantly different than a lot of the national carriers who they're really not invested in this community. And that's that's important to understand. It's also important to understand, like you said, you know, you see these ads on television and they're telling you they're going to do something for you that nobody else is going to do or they're going to find money for you. 00;06;55;16 - 00;07;12;21 Cary Hall We're going to explain that. Okay. Because there's a little bit of a shell game there. Yeah. And I think it's important for people to understand, you know what? So let's just talk about that before we go to break here. So first and this is where you actually getting money back, okay. Yeah, yeah. So explain that. 00;07;13;00 - 00;07;18;10 Moe Jackson So it's called a give back and it's part of the part B premium. 00;07;18;10 - 00;07;18;27 Cary Hall B as in boy. 00;07;18;28 - 00;07;40;09 Moe Jackson B as in boy and Blue Cross and Blue Shield actually offer one of those plans right now. But it is a give back plan that gives you money back for your part B premium. You're give up things to get that you here in Kansas City you don't necessarily get a plan with the benefits that you may need. So you need to look at all of those. 00;07;40;09 - 00;07;59;10 Moe Jackson But when he's talking about the shell game that he's speaking about, when you call in to one of those numbers, you're actually calling someone that has no idea what's available in your area. And it's more of a call me, call me and I'll see what I can do to get you into a plan that I'm selling right now. 00;07;59;10 - 00;07;59;28 Cary Hall Yeah. 00;07;59;28 - 00;08;02;02 Moe Jackson So with that in mind, and. 00;08;02;02 - 00;08;21;03 Cary Hall That's that's the thing, okay, here you're in this program, what you're looking at a blue cross. They're going to tell you they've got the exact same program. They've got the money back on the part B, if you choose to do that. But they're going to explain all of the other options. And what are you giving up to get back, whatever it is, $56 a month. 00;08;21;14 - 00;08;37;16 Cary Hall I don't know what the number is, but whatever it is, what are you going to give up in order to get that back? It education around this topic is important. And it's important that you can talk to somebody that's a trusted source. It's going to give you good information because with the information, you make good choices right now. 00;08;37;19 - 00;08;55;10 Moe Jackson That's correct. And I think what you said hit the nail on the head. A trusted source. We've been in Kansas City for over 80 years. We understand what Kansas City's made of. We understand what your needs are. And we've built a portfolio of products across the board that can help you with almost every situation that you're in. 00;08;55;20 - 00;09;06;16 Cary Hall Yeah. And that and that's important because you've got choices. You do. And everybody not everybody is the same. I always say exactly this size 44 overcoat doesn't fit everybody. 00;09;06;16 - 00;09;07;15 Moe Jackson It does not. 00;09;07;15 - 00;09;20;14 Cary Hall It doesn't fit everybody. Yeah. So having said that, it's important to know what are those choices and how do they affect providers and how do they affect networks and how does all that work and how does all that work for you? 00;09;20;24 - 00;09;24;22 Moe Jackson And the main thing is how do you operate? That's the key. 00;09;24;24 - 00;09;47;07 Cary Hall Yeah, it really is. When we come back from the break, we're going to continue this conversation with Moe Jackson from Blue KC. We are talking about Medicare, Medicare Advantage. We're going to talk more about it in the next segment and how you qualify and how you get into these plans. We'll have more about that. If you want information, go to the website MedicareBlueKC.com, MedicareBlueKC.com or you can call them. 00;09;47;13 - 00;10;05;11 Cary Hall Yes, they will answer the phone at 833-261-1596, 833-261-1596. They'll be happy to help you. Stay tuned. We'll be back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across USA. We've got more. 00;10;05;13 - 00;10;17;13 Music ♪ What? Tell me, why am I wrong? ♪ 00;10;18;18 - 00;10;36;00 Cary Hall Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the U.S. You're on the HIA Radio Network. You can find out more about us by going to the website HealthRadio.us. HealthRadio.us. A lot of information up there. You're listening to the show. Maybe you want to tell somebody about the show. 00;10;36;00 - 00;10;53;23 Cary Hall Remember all the podcast platforms, Spotify, SoundCloud, Audacy, TuneIn, iTunes, Apple Play. It's up on all of those sites and you can listen to it up there if you want to tell somebody about it. This is a great way to learn about Medicare. Go to the go to the website or go to the podcast platforms and it's there. 00;10;53;23 - 00;11;15;09 Cary Hall My producer, Ms.. Alisha Cox. I'm your host, Cary Hall, in studio with me, Moe Jackson from Blue Cross and Blue Shield of Kansas City. We are talking about Medicare, Medicare Advantage products and Medicare support. What's the difference? How do they work? If you want any information on that, maybe you want to connect with somebody. You heard me say you can actually go down to Blue Cross on Main Street and meet with them if you choose to. 00;11;15;14 - 00;11;42;24 Cary Hall You can call 833-261-1596, 833-261-1596 or the website. All information is up there: MedicareBlueKC.com, MedicareBlueKC.com. So let's just start with enrollment because it's not that far away, not starts starts in mid-October. So we're like about a month and a half, two months away. And let's talk about, first of all, do people have to wait if they're turning 65 for open enrollment? 00;11;42;24 - 00;11;43;20 Cary Hall Let's just start with that. 00;11;43;22 - 00;12;02;00 Moe Jackson So yeah, the annual election period, to Cary's point, starts in October, October 15th, and it runs through December 7th. We're not quite there yet. So there may be some of you that are aging into Medicare turning 65 and you're going, what do I do? How do I navigate this? I have so many questions. Well, first thing is, you can call us. 00;12;02;00 - 00;12;21;17 Moe Jackson We can help you with that. The second thing is, keep in mind, you have a seven month window when you're new to Medicare that you can enroll into a Medicare Advantage plan or a Medicare plan. You have the three months prior to the month your birthday, the month of your birthday, and the three months after your birthday, to find the plan that suits you. 00;12;21;26 - 00;12;34;28 Moe Jackson Now, if you, let's say your birthday's in September, you can enroll right now for one of these plans, the Medicare Advantage plans or Medicare supplement plan, and have the effective date be September 1st. 00;12;35;28 - 00;12;55;00 Cary Hall So that's important. People are saying don't confuse open enrollment with when you if you're aging in can get Medicare you just heard more explain three months before the month of your birthday and three months afterwards seven month window. If you don't do that and you let that pass, what happens then? 00;12;55;00 - 00;13;17;07 Moe Jackson You can be penalized. Penalized because you didn't take advantage of the time period that Medicare allows you to enroll than appear in to a plan you have to have drug coverage as soon as you're eligible for a Medicare plan and you sign up for those, then you have to have drug coverage. If you don't have drug coverage within the first 63 days, then Medicare penalizes you for that. 00;13;17;19 - 00;13;18;26 Cary Hall And that penalty goes on. 00;13;19;08 - 00;13;20;09 Moe Jackson Forever. Ever. 00;13;20;09 - 00;13;33;25 Cary Hall Yeah, it's yeah, that's the part you need to understand is they don't do it. And then a year later, oh, I've got to take all these meds now. Well, you're going to get penalized for that year and you're going to keep paying that for the rest of your life. 00;13;33;25 - 00;13;48;12 Moe Jackson That is correct. And the and it's not necessarily the carrier that is with you that you're with that will, you know, that's responsible for this. It's actually Medicare telling us, hey, you have to go get that money. So we send out the bills for them. We collect that. 00;13;48;15 - 00;14;09;04 Cary Hall Yeah, they it's important to it's again. Okay. You know, when I first opened the show, I said the Medicare alphabet soup. You're hearing some of that now. You're hearing what? It's complicated, okay. It's confusing. The government website is not really that great in terms of helping you understand this stuff and all the stuff you're going to get in the mail is even more confusing. 00;14;09;04 - 00;14;27;05 Cary Hall The best thing you can do is reach out and talk to somebody. Yeah. Okay. Again, you can call the folks at Blue Cross. They're happy to chat with you, okay? And they'll walk you through it all, explain it to you, or you can go online to their website and look at it. But you need to have somebody help you with this because it is complicated. 00;14;27;05 - 00;14;43;17 Cary Hall It is. It's like just like you say, the call this morning. And it was her mother and she said, I've just I've look, I'm so confused. I've looked this. I'm just pulling my hair out. I said, just stop. Take a deep breath. I'm going to put you in touch with Joyce Thompson. Yeah. Joyce is going to walk you through the whole thing. 00;14;43;17 - 00;14;58;08 Cary Hall Just show me how to sign it. I said, Well, you could sign up for probably. Oh, no, I tried that. It's very complicated. It is. I know. I said I just she said, can I go down and see her? I said, Yes, you can and go sit with her. She'll walk you through how to sign up, just show you the plans. 00;14;58;13 - 00;15;00;19 Cary Hall And then because it's complicated. 00;15;00;19 - 00;15;18;16 Moe Jackson It is very complicated. And even myself at times get complex, get confused on, you know, the do's and don'ts and the what ifs and all of those scenarios. But we work through it and we'll get you the information that you need. So reach out. Give us a call. There's other times of the year that they can enroll to carry. 00;15;18;16 - 00;15;27;24 Moe Jackson It's not just around the time that they turn 65. Sometimes they're moving, right. Sometimes they move out of the service area into a new service area that gives them opportunity to enroll. 00;15;28;04 - 00;15;39;26 Cary Hall So if you're on a plan in Nevada and you move here, then you're going to want to change plans. And that's that's an opportunity to do just that. Let's before we go to break, you've got about 3 minutes. Medicare up and Medicare Advantage quick. The differences. 00;15;40;02 - 00;16;04;15 Moe Jackson Okay. So a Medicare supplement plan covers everything that original Medicare covers. And then it the Medicare supplement plan pays the rest of what Medicare doesn't pay as long as you're paying your premiums and take care what you need to take care of. The supplement payment plan pays for that Medicare Advantage. Medicare Advantage works like this. The government or Medicare pays the carrier to be the insurance company they administer. 00;16;04;15 - 00;16;26;05 Moe Jackson The insurance company administers the benefits. They pay the claims. They also have co-pays, coinsurance associated with most of the services that they're going to receive. Most of the plans are in Kansas City. Don't have a premium on them. You can get an HMO or a PPO, and then they have a network that they work with. When you're talking about a supplement plan, it's the Medicare doctors. 00;16;26;05 - 00;16;29;22 Moe Jackson Anybody that accepts Medicare, you can go see them with Medicare Advantage. 00;16;29;22 - 00;16;30;08 Cary Hall That I have. 00;16;30;09 - 00;16;31;26 Moe Jackson Right? You have that. 00;16;31;26 - 00;16;58;15 Cary Hall Blue Cross Blue Shield Medicare supplement. Both Lori and I have it. And when Lori broke her leg in Hawaii and we had over $127,000 worth of bills, we didn't pay one dime. Yeah. Medicare Supplement and Blue Cross covered it. All right. And then that was ambulance. That was surgery. That was rehab. That was all of it. I mean, if if you can afford it and you want to pay for it, the Medicare supplement is very different. 00;16;58;15 - 00;17;12;08 Cary Hall Medicare Advantage when we come back from the break, we're going to go into a deep dove on Medicare Advantage. But I want to talk just for a moment or two with Moe here about Medicare supplement, because it there are people who prefer that I'm one of those people. 00;17;12;08 - 00;17;13;19 Moe Jackson Yeah, my husband's one of those people. 00;17;13;20 - 00;17;20;12 Cary Hall My might. There is no way Lori will ever let me leave that Medicare stuff a plan, or he would leave it because of what our experience has been. 00;17;20;12 - 00;17;36;21 Moe Jackson Your experience is good, but it's that type of person that wants to know that they don't have to worry about anything else the rest of the month they're taking care of. They paid their premium because Medicare supplements come with a premium. They do. And you pay that premium at the beginning of the month. And you know that anything that Medicare covers is going to be taken care of for you. 00;17;36;21 - 00;17;44;03 Cary Hall And if you're on a meds sub, you have to buy a standalone part D, you do. We have a stat, each of us has a standalone part D, so that's how that works. 00;17;44;03 - 00;17;47;16 Moe Jackson Right? So now you've got your AB and D taken care of of that alphabet soup. 00;17;47;22 - 00;17;50;15 Cary Hall And mine is that if somebody have A, B, D & F. 00;17;50;18 - 00;17;53;02 Moe Jackson Right, so you, you've got that taking. 00;17;53;16 - 00;17;56;10 Cary Hall The alphabet there from mine. Mine's a plan F on the Medicare. 00;17;56;19 - 00;18;03;06 Moe Jackson But keep in mind, not everybody works the way they carry works. Or my husband, they sometimes they don't want to pay up front. 00;18;03;07 - 00;18;21;12 Cary Hall Yeah. And that's that's a choice that but so and so when we come back, we'll talk about it in great detail, the Medicare Advantage. But on meds sup's as Moe said, anywhere in the country, it doesn't matter where you are. Hawaii is an example. You're covered because they take Medicare, they take the Medicare supplement and it covers everything. 00;18;21;12 - 00;18;39;19 Cary Hall And that's exactly how things worked for Lori. Whenever she broke her leg in Hawaii and we were in the hospital and had to come back here and have surgery. So those plans are very different in the way they operate. If you want more information on that, you can call 833-261-1596 and speak to a Blue KC representative or MedicareBlueKC.com. 00;18;39;26 - 00;18;51;00 Cary Hall That is the Web site. We'll be right back after the break with the Internet advantage. Stay tuned. This is America's Healthcare Advocate. We've got more. 00;18;51;00 - 00;18;55;08 Cary Hall ♪music♪ 00;18;55;08 - 00;19;16;02 Cary Hall And welcome back. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA here on the HIA radio network. You can find out more about us by going to the Web site. 00;19;16;08 - 00;19;40;10 Cary Hall HealthRadio.us. HealthRadio.us. Send me an email if you've got questions. I'm happy to answer it. My producer, the always perfect Miss Alethea Cox, I'm your host, Cary Hall in studio with me, Moe Jackson from Blue Cross and Blue Shield of Kansas City. We are talking about Medicare Advantage, Medicare supplement, all things Medicare in this segment, we're going to deep dive into the Medicare Advantage plans and talk about what Blue KC has to offer. 00;19;40;16 - 00;20;16;08 Cary Hall 80 years in this community, local people right down here on Main Street. If you want help, 833-261-1596. I have the plan. Lori has the plan. I had plans. I turned 65. I'm 73 and I have a Med Sup and it's a wonderful plan. The website, Medicare MedicareBlueKC.com All right, so let's just start down the line with, with the Medicare Advantage plans and talk a little bit about, you know, first of all, deductible coinsurance, co-pay compared to Medicare Advantage. 00;20;16;12 - 00;20;16;21 Cary Hall Moe. 00;20;17;06 - 00;20;47;05 Moe Jackson Okay. So with a Medicare Advantage plan with Blue Cross and Blue Shield of Kansas City, we have zero cost premium plans and all six of our plans. We have four PPOs and two HMOs. None of them have a premium. None of them have a deductible. None of them actually this year have a PCP co-pay. So we've got a portfolio of products for just about anybody out there that wants a Medicare Advantage plan for 2022. 00;20;47;22 - 00;21;01;12 Moe Jackson We have a plan that we have for PPO plans that give you access to a national footprint, a national network where you can find a physician that is in Arizona, a physician or a hospital that's in Florida. 00;21;01;13 - 00;21;17;24 Cary Hall Okay. I don't want to make a point here that is unique to Blue Cross and Blue Shield of Kansas City and other Blue Cross plans do it, too. But there are not a lot of other carriers that do that. That's a that that's typical with a Med Sup but Blue Cross Blue Shield of Kansas City prior to this a long time ago. 00;21;18;13 - 00;21;21;07 Cary Hall What's it about three or four years ago this we finally started all this. 00;21;21;07 - 00;21;21;26 Moe Jackson Yeah, yeah. 00;21;21;28 - 00;21;30;17 Cary Hall Now you could because before if you were out of the service area, then you were out of the service area. Yeah, that's not the case now. It's very, very different. 00;21;30;20 - 00;21;52;00 Moe Jackson It is different because if you were out of the service area a few years ago, you would have to go ahead and pay out of network costs. But we actually have a network available across the nation in almost every state and a couple territories actually that you can find physicians, hospital system specialists, whatever that are in the network paid the same cost here that you would in Kansas City. 00;21;52;18 - 00;21;54;15 Moe Jackson So for a PCP is zero. 00;21;55;03 - 00;21;57;29 Cary Hall And they say, what do you mean by PCP? 00;21;58;00 - 00;22;16;02 Moe Jackson So primary care physician. So if you're on an HMO plan, you need to pick a primary care physician on a PPO. You don't have to pick one. We like to know who you're seeing as a primary care physician, but you can see one in Texas and pay a zero cost share for the one in Texas, just like you would pay in Kansas City. 00;22;16;02 - 00;22;33;07 Cary Hall Which is really, really quite remarkable. So that question you and if I go on vacation in my am I going to be covered? The answer is in most cases, yes. Yes. That's a question you would ask. Okay. Yeah, yeah. We vacation in Florida. Am I going to be covered? We vacation in Arizona. Am I going to be covered? 00;22;33;07 - 00;22;34;19 Cary Hall You can ask that question then you'll know. 00;22;34;19 - 00;22;52;21 Moe Jackson Right? It's a great question. And remember, on all the Medicare Advantage plans, emergency and urgent care is going to be covered. But if you're looking for that maintenance care, let's say that you heard about this great knee doctor down in Texas, then you can actually find out that doctors in the network go down and get your knee worked on and all is well. 00;22;52;24 - 00;23;09;21 Cary Hall Yeah, so it's really quite remarkable how that works. Let's go back to something we talked about briefly earlier, and that is this giveback thing that we see these ads all over the place, some Joe name it and good times guy. Let's talk about the plan that Blue Cross has. What is that? How does that work and who qualifies for it? 00;23;09;23 - 00;23;18;27 Moe Jackson Okay. So it is the simply blue Advantage plan. They call it the advantage plan for 2022 because it gives you $75 back on your part B premium. 00;23;19;11 - 00;23;20;28 Cary Hall $75. You get back. 00;23;20;28 - 00;23;38;12 Moe Jackson $75 you get back and there is no criteria. So in other words, it doesn't require that you're a veteran, doesn't require that you're low income, doesn't have any requirements. Anybody can be on that plan, but what it does is you do give up a little bit to get that $75 back. Let's think about the person that might want that 00;23;38;12 - 00;23;58;13 Moe Jackson Newly to 65 somebody that doesn't go to the doctor a lot. They're wondering, why am I paying all this part B premium. I only see my PCP once a year. They can get $75 back and continue to get the care that they need. And, you know, use that money in a month, 75 a month, then it comes back on to their Social Security benefits. 00;23;58;14 - 00;23;58;22 Moe Jackson Right. 00;23;58;27 - 00;24;01;21 Cary Hall That's a pretty significant amount of money over a year period. 00;24;01;21 - 00;24;09;06 Moe Jackson Absolutely is and even if you pay it quarterly, it's taken off your quarterly bill once you signed up with that plan with Blue Cross and Blue Shield. 00;24;09;23 - 00;24;18;09 Cary Hall So that's one of the plans. Let's talk about. You've also got a plan now that allows veterans to get their I'm a veteran, so you need. 00;24;18;25 - 00;24;19;27 Moe Jackson Well, thank you for your service. 00;24;20;01 - 00;24;34;05 Cary Hall How this works. So this is important because for a long time, if you were at the VA, you couldn't do a medicare supplement, a Medicare Advantage plan, rather, because of the conflict with VA and the drugs in, so explain that one that's different now, right? 00;24;34;05 - 00;24;54;26 Moe Jackson So we have what we call a flex plan and it's flexible enough to not allow the Part D that didn't have the Part D on that plan. So you can still get the care at the VA that you need to get and get your drugs at the VA. But you also have the ability to go to the network doctors and hospitals and seek care there. 00;24;54;26 - 00;25;05;24 Moe Jackson If you have something that you want to see someone else about and not just the VA, it's a zero premium plan, but it doesn't have the drug part, the part D on the plan. 00;25;06;01 - 00;25;07;11 Cary Hall To get your meds at. 00;25;07;12 - 00;25;08;04 Moe Jackson The VA. 00;25;08;05 - 00;25;12;18 Cary Hall Right. And yet you can still have a Medicare Advantage plan. That's kind of the best of both worlds. 00;25;12;18 - 00;25;13;23 Moe Jackson It is. It's really. 00;25;13;23 - 00;25;31;08 Cary Hall Really don't want to wait six months for an appointment of VA. You want a Medicare Advantage plan. You have direct access to carriers. The only thing you have to get from the VA is your medications. That's a pretty good deal if you're a vet. I strongly suggest you take a look at this because it's a big improvement over what happens in V.A.. 00;25;31;10 - 00;25;53;12 Moe Jackson Both these plans. We were talking about our PPO plans and we actually have four of those. There's one called the Essential PPO plan that has a very low maximum out of pocket, $3,425. And that maximum out of pocket is in, out or combination of Cary, which is another unique feature that Blue Cross and Blue Shield of Kansas City offers on all our PPO plans. 00;25;53;19 - 00;26;08;18 Moe Jackson The maximum out-of-pocket, the amount that you're going to pay if you were on one of our plans, Medicare Advantage plans would be $3,425 on that essential plan out of your pocket before the plan picks up at 100% for Medicare covered services. 00;26;08;18 - 00;26;15;27 Cary Hall Right. And but that 3400 is not like an upfront deductible. It is not explain that because the people hear that in the globe I got away. 00;26;16;08 - 00;26;38;23 Moe Jackson With is that. Yeah. So those are all those little costs that you have. So let's say that you have a MRI done and it costs you 100 or 150 or $250. That $250 goes toward that maximum out-of-pocket. And you make most cases, I'll just tell you, in most cases, people never even get close to maxing out of pocket. 00;26;38;23 - 00;26;42;26 Moe Jackson They never even see it. It's a little cost that go toward that those. 00;26;42;26 - 00;26;43;24 Cary Hall Co-Pays at $45 for this and that 00;26;43;24 - 00;26;44;11 Moe Jackson Thats co-pay. 00;26;44;13 - 00;26;48;23 Cary Hall This that if you are hospitalized what is it $250 for the first four days. 00;26;48;23 - 00;27;03;21 Moe Jackson 285, I believe for the first five days. And then after that, the plan pays 100%. But all those little costs go toward that so, you know, for a safety factor. Right. That you're never going to spend more than this amount of money. 00;27;03;21 - 00;27;09;14 Cary Hall Yeah, and that's really important. Before we go to break here, let's talk a little bit about insulin for those with diabetes, that's a big deal. 00;27;09;14 - 00;27;10;13 Moe Jackson It is a big deal. 00;27;10;13 - 00;27;18;29 Cary Hall And that's a lot of people that are seasoned citizens and on fixed incomes have difficulty with that insulin issue because they can't afford it. 00;27;18;29 - 00;27;43;28 Moe Jackson Sometimes drug adherence, I mean, that's big. Everybody wants to ask, are are people to stay drug inherent and keep taking their insulin because we know that that keeps them healthier. So we offer a program on our plans that has the insulin program. What that is, is $35 a month to get your insulin filled, whatever insulin you're on, if it's on our formulary, it's going to cost $35 a month and that's through the coverage gap. 00;27;43;28 - 00;27;56;24 Moe Jackson So $35 a month for novolog or whatever it is, they continue to get that. And then we actually have pharmacists that will follow up and talk to you about the insulin to make sure that everything's working well. 00;27;56;24 - 00;28;13;26 Cary Hall Yeah. And I want to mention we forgot to mention it that you could also qualify for that plan, the plan we call the VA plan if you're on TRICARE. So if you're on TRICARE, it's the same as the VA works the exact same way it does. Yeah. You can get the Medicare Advantage and you can use TRICARE is prescription drug. 00;28;13;28 - 00;28;32;12 Moe Jackson That is correct. But also, keep in mind on that flex plan, you don't have to be a VA. You can be that person that's never, ever had a drug plan. And all of a sudden you're like, you know, I really like to have a Medicare Advantage plan, but I never had a drug plan. You can get on this plan and you don't have to pay that penalty keeps you from having to pay the penalty. 00;28;32;15 - 00;28;35;16 Moe Jackson The VA has has that taken away. Right. 00;28;35;16 - 00;28;47;29 Cary Hall So so that's that's an opportunity that's important. People are said that's their quickly, let's we're going to go to break here real quick coverage gap is that area on the part D prescription drug where they cover up to 4000. What is it this year? 00;28;48;27 - 00;29;03;07 Moe Jackson Yeah, you're making me rich right now. But there is a set amount that you have to cover yourself that you pay for out of your own pocket. And once you reach that, then you're in the coverage gap. And when you get in the coverage gap, then you're paying for all of it. 00;29;03;07 - 00;29;25;17 Cary Hall And then you come out of the coverage gap and we'll get into that this next segment. Kind of explain that a little more. So you understand what it is if you want information, 833-261-1596. That is the phone number at Blue Cross Blue Shield of Kansas City, the website, MedicareBlueKC.com. MedicareBlueKC.com. Once again, the phone number 833-261-1596. 00;29;25;23 - 00;29;44;06 Cary Hall They'll be happy to talk with you and just walk you through this stuff and explain it to you if you want some help. Or you can go down to Main Street and sit down face to face to somebody and again, they'll be happy to help you with it. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast from across the USA. 00;29;44;07 - 00;29;51;10 Cary Hall We've got more stay right there. 00;29;51;10 - 00;29;53;14 Cary Hall ♪music♪ 00;29;55;18 - 00;30;14;16 Cary Hall Welcome back. You're listening to America's Healthcare Advocates show broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to HealthRadio.us. HealthRadio.us. My producer, Miss Alicia Cox. I'm your host Cary Hall. In studio with me, Moe Jackson from Blue Cross and Blue Shield of Kansas City. 00;30;14;19 - 00;30;35;01 Cary Hall We are talking all things Medicare, Medicare Advantage, Medicare supplement, like drinking out of a fire hose, isn't it, to listen to all this stuff, go to the podcast platform, SoundCloud, TuneIn iTunes, Audacy, Spotify, the shows posted up there. You can listen to it again. You can tell somebody about it until your husband to your wife, whatever the case may be. 00;30;35;07 - 00;30;56;23 Cary Hall That's a great way to understand this a little better and be able to listen to it and kind of get all this information. So, you know what? You're doing. Here's the other thing you can do. You can call 883-261-1596, 833-261-1596. They are happy to talk with you. You don't have to buy anything you can call them. They'll walk you through all of it. 00;30;56;23 - 00;31;11;13 Cary Hall Then you can make a decision about Do I want to do this or not want to do it? I want Med Sup Do I want one of those for Medicare Advantage PPOs? Do I want the HMO? They'll explain all that. You can even go down there to Blue Cross on Main Street. They'll be happy to do it in person. 00;31;11;13 - 00;31;35;08 Cary Hall The website, if you want to go look at all the stuff on the website. Medicare Blue KC dot com MedicareBlue.KC.com. Ah, let's just start off with this this so part D, you've got $4430 of coverage. Now, folks, let me explain this. That's not $4430 of $25 co-pays. That's $4430 of the cost of the drug. 00;31;35;08 - 00;31;35;24 Moe Jackson That's correct. 00;31;35;24 - 00;31;56;20 Cary Hall So my wife takes a drug that is a $1,000. Okay. The cost Yeah, $1,000. Okay. We have a co-pay for that. And then part of that is picked up by Part D prescription drug coverage, right? Well, that whole thousand dollars is what goes into that $4430. So in theory, we could do that four times and then we're and then we're in the gap. 00;31;56;21 - 00;31;56;29 Moe Jackson Right. 00;31;57;00 - 00;32;04;29 Cary Hall And that's what I want. You understand it's $4,130. The value of the drug, not the $25 co-pay you're going to pay. Right? Okay. 00;32;04;29 - 00;32;21;07 Moe Jackson Because people's plans were the same. All plans work the same when it comes to the part D, you know that thousand dollars he was just talking about. It goes toward that coverage gap. Once you get into the gap, then you have a set amount. 25, 25% of the cost of the brand name drug is what you're going to pay. 00;32;21;07 - 00;32;25;16 Moe Jackson But the whole cost of that drug goes to getting you out of that coverage gap also. 00;32;25;18 - 00;32;41;27 Cary Hall And we're not going to go into that in great detail on the radio because it's confusing to people. But that's, again, that's what thank you. That's why you want to make the call and talk to somebody. They'll walk you through or go down there and see him. So let's talk about another thing that Blue Cross and Blue Shield of Kansas City does it's kind of a recent thing, but I think it's very cool. 00;32;42;05 - 00;32;43;16 Cary Hall Blue Benefit bucks. 00;32;43;16 - 00;33;10;06 Moe Jackson Yeah, Blue Benefit Bucks oh my gosh. Has been so much fun this year, experiencing something new. It's kind of a flex benefit card that has three wallets inside that card that our members get when they sign up with us. Some of the cards have a $100 a quarter for over the counter. Some of the cards have a fully loaded $500 for over the counter when they sign up for our plan. 00;33;10;16 - 00;33;35;16 Moe Jackson Some of the cards have $500 worth of flex benefit that they can use for hearing vision, transportation or dental. Some of them have $1,000, depending on what plan you sign up for. And then they all have what we call the healthy benefit, healthy reward benefit that gets loaded on there. So up to $50 is what they're going to get back if they do healthy things like their wellness check, their mammogram, they're diabetic. 00;33;35;16 - 00;33;41;10 Moe Jackson eye check, their flu shot. If they do those things up to $50 will be reloaded back on that card and they can use. 00;33;41;10 - 00;33;42;08 Cary Hall That's pretty cool. 00;33;42;09 - 00;33;43;12 Moe Jackson It is pretty cool because. 00;33;43;15 - 00;33;56;15 Cary Hall They get the thousand depending on the plan or whatever it is. You can go back and add 50 to it just by doing the things like going to get your physical. Yeah, getting your blood pressure, your get the stuff you mammograms. 00;33;56;27 - 00;34;09;23 Moe Jackson It's stuff that you're probably going to do anyhow. Now we're going to reward you for doing that and you can take that $50 and spend it kind of the way that you want to spend it. You can, you know, buy food at Walmart or the grocery store or whatever you want to do. 00;34;09;23 - 00;34;29;21 Cary Hall Yeah, it's pretty nice. I mean, this is how it's called Blue Benefit Bucks. There are series of different benefits and different amounts depending on the plan. Once again, if you reach out to Blue KC, they'll be happy to explain all of that to you. This is one where I get a lot of calls on this, and when I was back actively writing these policies, we had this got confusing of her people. 00;34;29;21 - 00;34;47;23 Cary Hall If you're on a group health insurance plan, do I get off the plan and do I go to a Medicare plan? And this this is this gets tricky for people. It does add to me, there was just there's a very simple way to understand this. When I would sit down with a group of people and I told you a story off air about a group downtown that did watch parts all over the country. 00;34;47;23 - 00;35;09;27 Cary Hall It's fascinating. Most of them are over 65. There's only about three of them that weren't. And they were trying to decide did they want to go to Medicare and get off the group plan. So it really kind of boiled down to two things. How many prescription drugs you've taken? Yep. You've got $4,430 worth the benefit. If you're getting $20,000 worth the benefit on your group health insurance plan, you might want to consider staying on. 00;35;10;01 - 00;35;10;24 Moe Jackson I would say. 00;35;10;24 - 00;35;26;17 Cary Hall They're you're only going to get 4430 on Part D and then you're going to the donut hole and you're going to pay it. Then you're going to come back out again, yada, yada. On the other hand, if you're paying 50% of the premium and you're 65 and you're continuing to work, and that's seven or $800 a month. Right. 00;35;26;22 - 00;35;34;09 Cary Hall You probably really ought to think about move it over to a Medicare supplement or Medicare Advantage plan, because when you do the math and that's really kind of what it comes down to. 00;35;34;10 - 00;35;34;24 Moe Jackson It is. 00;35;35;00 - 00;35;54;19 Cary Hall If you're not on that thousand dollar every two month drug type of thing that I talked about that my wife's on, you might want to give serious thought to if you're paying 400, 500, 600, 700 because as you age those numbers go up. Okay. On group health insurance plans, typically, okay. Unless you've got a composite rate, that's typically how they run. 00;35;54;19 - 00;36;08;24 Cary Hall So having said that, and that was the case with this group we talked to downtown, this was a number of years ago. And Joyce did the did all the work on it, but it saved them a ton of money. And they and they moved out of the 15 people there, 13 moved to Blue Cross Blue Shield, Medicare Advantage. 00;36;08;28 - 00;36;10;26 Cary Hall It was like, yeah, we're moving. 00;36;11;03 - 00;36;35;13 Moe Jackson Yeah. Okay. It only makes sense. I mean, in my world, just write it down. Write it down, then take a look at it. Do the math whiteboard. It is what I always say, because everybody, every individual is different. You hear some people that take these big expensive drugs, then most people don't. They take generics. So if you're taking generic drugs and they're not costing you that much, I would absolutely take a look at a Medicare Advantage plan or a Medicare supplement plan. 00;36;35;22 - 00;36;50;02 Moe Jackson Medicare plan. They have Tier one and two drugs for 100 days through mail order or retail, a zero cost. So that is going to help you save a lot of money. But no premium, no PCP. It's a win win. 00;36;50;02 - 00;37;10;08 Cary Hall Yeah, it is a win win. And again, you know, I know this know there's a lot coming at you as you're listening to the show get on the phone and give them a call. They'll walk you through it. 833-261-1596, 833-261-1596. And the folks over Blue Cross are happy to chat with you. You can go down there, meet with them if you want to. 00;37;10;12 - 00;37;32;13 Cary Hall The website, MedicareBlueKC.com, MedicareBlueKC.com. But what I said at the opening of this show, it's really important to be able to trust the people you're working with. 80 years in Kansas City, 4.5 star rating for the Spira Care plans, superior dedicated local service, community impact and involvement that they do local, honest and reliable. That's really what it's all about. 00;37;32;21 - 00;37;55;06 Cary Hall Thank you for listening. You've been listening to America's Healthcare Advocate broadcasting here coast to coast across the U.S. And now I leave you with this thought from Dr. Martin Luther King. Americans must learn to live together as brothers and sisters, or we will surely perish together as fools. Truer words were never spoken. Thank you for listening. Goodbye, America. 00;37;55;06 - 00;37;59;13 Music ♪music♪