S2 E8 - The A,B,C, and D's of Medicare

Katie White [: 00:00:11

Welcome to Pretend I Know Nothing About. I'm Katie White, your host, Administrator of COAAA. Today, we are concentrating on Medicare with Andy Haggard, Medicare Outreach Manager. Tune in to learn the ins and outs of that, as well as a little bit about the safety and emergency preparedness work we do at c o triple a. Let's get into it. Welcome, Andy. Thank you for being on the podcast. We are excited to learn about all things Medicare Outreach.

Katie White [: 00:00:40

But first, tell us a little bit about yourself, how long you've been here, and what all you do here at COAAA.

Andy Haggard [: 00:00:47

A. Sure. And thank you for having me on. So I started here about 23 years ago. So, I started as a PASSPORT case manager, actually. So I did that for a couple years, and while I was doing that, I was also getting my master's degree at the same time. So I did a couple internships with our community education and outreach division. I did some stuff with the caregiver program.

Andy Haggard [: 00:01:13

We had a senior Medicare patrol project that I worked in for a little bit. And then when I graduated, I was considering actually leaving the Agency, and, my supervisor at the time convinced me to stay.

Katie White [: 00:01:27

Okay. Great. And,

Andy Haggard [: 00:01:29

helped create a position for me in the community education and outreach division doing the senior Medicare Central project full time.

Katie White [: 00:01:36

Okay.

Andy Haggard [: 00:01:38

When we lost that grant, around that same time, Medicare was undergoing a lot of changes, specifically White adding prescription drug coverage, and we saw how that was gonna impact, you know, the people that we serve directly and then also just in the community, as well. And so we, decided to just make a make it a whole, like, Medicare outreach program

Katie White [: 00:02:03

Okay.

Andy Haggard [: 00:02:03

So that we could help, folks transition into the prescription drug benefit and then just on, you know, doing education and outreach on a one basis.

Katie White [: 00:02:13

I didn't know any of this. The PASSPORT case management start, that's awesome. I feel like all roads, not all roads, but a lot of roads here lead to PASSPORT Case management.

Andy Haggard [: 00:02:22

Yeah.

Katie White [: 00:02:22

And then getting your master's and being an intern and CEO. That's cool. Mhmm. Okay. So was Lynn Dobb there at the time?

Andy Haggard [: 00:02:30

She was. Okay. Yeah. So she was a coworker of mine.

Katie White [: 00:02:33

Okay.

Andy Haggard [: 00:02:34

So, yeah, I've known Lynn forever today as well.

Katie White [: 00:02:36

Okay. So then, was Linda your supervisor at the time?

Andy Haggard [: 00:02:39

Actually, it was, it was Lisa Durham.

Katie White [: 00:02:42

Oh, Lisa Durham. Okay. That's right. Great. Great.

Andy Haggard [: 00:02:45

Yeah. She was awesome. She helped me get the job here, and, you know, actually told me about working here, and then was the one who said, look, we really don't wanna lose you. What can we do?

Katie White [: 00:02:54

And Yeah.

Andy Haggard [: 00:02:55

So I'm glad she she did that.

Katie White [: 00:02:57

Yes. Lisa Durham was my supervisor at Ohio State too. And so she she too took took a risk in taking me and the project on for age friendly. So I guess a lot of roads lead to Lisa too. Yeah. So, okay, tell us about your role here. Today, we'll mostly concentrate on Medicare, but you obviously do more than that here. So tell us about that.

Andy Haggard [: 00:03:17

Yeah. So on top of doing the Medicare outreach, I also do our internal Agency and disaster preparedness and staff safety.

Katie White [: 00:03:26

Mhmm.

Andy Haggard [: 00:03:26

So I kinda help coordinate all those efforts. So, yeah, just just making sure that we have things in place that help keep our staff safe, and to make sure that if we do have to deal with some kind of disaster Agency situation, that we're prepared, not only to keep our staff safe, but also to make sure we can continue to provide services to our consumers, because that's our main main goal, obviously.

Katie White [: 00:03:53

Yeah. So when there's a fire drill, when there's a tornado drill like there was this week, you know, Andy is the one kind of running those, evaluating how we're doing, making improvements, and then making sure that next time we're even better when something really does happen, that we're ready to go. And there's also a safety committee that you chair too. Right? Tell us about that.

Andy Haggard [: 00:04:13

Yeah. So we do have an internal safety committee that meets quarterly. The main goal is to kind of review any incident or safety reports that have come in, over the past 3 months. Review those. What happened? Was there any recommendations made, is there training that's needed, or is it something that needs to be brought to the administrative staff team for follow-up? And then just any general safety concerns. The security team is on that committee as well, so they talk about things that are happening around the building, And I guess we're gonna be getting a new building person. Yes. So definitely wanna bring that person into the committee as well, just so that they're at the table to discuss.

Andy Haggard [: 00:04:55

Because a lot of times, you know, we're talking about safety issues when we're talking about things here at the building, specifically. A lot of it has to do with maintenance.

Katie White [: 00:05:05

It does.

Andy Haggard [: 00:05:06

You know, like, if someone reports to the safety committee that there's a handrail that's loose. Well, yeah, that's a safety concern, but it's also a building issue. So it makes sense to have that person on as well.

Katie White [: 00:05:18

And that's really a cross disciplinary committee, too. I know HR is on Area, and then really, I think anyone can join.

Andy Haggard [: 00:05:24

Yes. So we do we do try and make sure that we have representation from all the different programs in the agency. Because while we're out there doing similar things, some programs have different things that they're Aging. And so we just wanna make sure that they're equally represented, you know, based on what their experiences Area, because we're looking at what happens out in the community as well. Right.

Katie White [: 00:05:46

Yeah. Oh, on home visits.

Andy Haggard [: 00:05:47

Home visits. Like that. Sure. Absolutely. Yeah. Trips and falls, you know, pets, you know, dogs, things like that that people run into.

Katie White [: 00:05:55

Okay. And then, you also have helped spearhead the rolling out of a rolling out of a new, not only mass communication for Agency staff members, but also we're working on rolling out, a safety app through RAVE. And so I know that's been a lot. I know what it's like to, like, identify something and roll it out. It's been a ton of work, and I appreciate that. But, yeah, I'm on COAAA about that too.

Andy Haggard [: 00:06:18

Yeah. No. It's been it's been fun to actually work on that. Like you said, it has been, rough going at times, kinda learning as we go, but the alert system, I think, is fabulous. I agree. It's really awesome. It's really easy to use. We've got all of our templates in there for different types of things that we typically would experience, you know, fire, tornado, power outage, you know, those kinds of things.

Andy Haggard [: 00:06:43

We've already got kind of our messages loaded in there for that. So the app, yeah, we still need to work on that. That could be a little bit trickier in terms of how we use it. Just

Katie White [: 00:06:54

And we don't wanna rush into that. We wanna make sure we're getting it White. And so it just we'll get there, but we kinda can only roll it out once. Right? And we wanna make sure we get it right. So

Andy Haggard [: 00:07:10

Right. And for those who don't know the app, what we're talking about is Guardian. It's the Guardian app, and, there's different features to it. There's, like, things like safety timer White, you know, we're thinking about Aging, like, if someone goes on a home visit and they're you know, it's a home they've been into before, White maybe they don't feel very comfortable, and they want somebody to be kind of following what's happening. And, you know, if if we don't hear from you in a half an hour, we're gonna call you and make sure everything's okay, that kind of thing. And there's like a chat feature too that could be monitored If someone comes in in the morning and there's something suspicious happening in the parking lot, they can actually use that chat feature to notify a security team. Yeah. So

Katie White [: 00:07:54

There's a lot that goes into the staff in the building, having a guest in the building, weather preparedness, then, of course, everything being out in the field, driving to a visit, being in a visit. And so, it's kind of cool that you're the comprehensive, like, nexus that all of those different pieces come together. Okay. And last but not least, but also there we have something called the COOP. And then so if you can explain what that is, just an overview, and then a little bit about the committees that you serve on, like the county emergency management.

Andy Haggard [: 00:08:29

Sure. So the COOP stands for Continuity Of Operations Plan, and that kind of is kind of what spells out an emergency disaster situation. How are we gonna make sure that we remain as open as we can be? In other words, making sure that we're still being able to respond to needs from the community Mhmm. And still coordinate the services that we do on a regular day in, day out basis. So that's pretty, you know, a lot of businesses have that. Of course, every business can be a little bit different than what theirs looks like, depending on what they do. But, you know, it looks at it looks at everything from IT to, our front door Mhmm. And contacting consumers and all that kind of stuff.

Andy Haggard [: 00:09:13

Yes. And what was the second part of that? I'm sorry.

Katie White [: 00:09:16

Sorry. And I was like, come on, and we'll talk only about Medicare. But yeah. And then just let us know a little bit about how you're serving externally on those county emergency management committees.

Andy Haggard [: 00:09:24

Yeah. So, every county has a health Area coalition, but those health care coalitions have their on their membership have emergency disaster preparedness folks from the county, emergency management agency and also public health.

Katie White [: 00:09:45

Mhmm.

Andy Haggard [: 00:09:46

And so, you know, how Department of Aging wanted to make sure that we were involved with public health and with EMA, and that was a great avenue to to be able to do that to already a a standing meeting that was already happening, out in the county without having to, you know, make sure you're making special meetings, so that you're talking with these folks on a regular basis. I can do that just by Aging, to these meetings. And so, all 8 counties have them. Some I go to more than others, just depending, you know, on my schedule and when they have theirs. Sure. Some are monthly, some are quarterly. It just it just depends. But having those relationships built, I mean, it took a while to get my foot in the door.

Andy Haggard [: 00:10:30

You know, pretty much folks were pretty, open and receptive, but I've been doing it for so long now that, if we have a question or if we need something that's related to emergency or disaster preparedness, I know who to reach out to, and they always respond. And conversely, they've reached out to to me as well. I've had a couple instances. On in particular in, I think, it was Fairfield County, where White the fire chief reached out to EMA about some situation that involved an elderly person living in the community. And so they reached out to me, and I was able to help link them with some services. So

Katie White [: 00:11:08

Yeah. And it's great. It I mean, I'm sure those, relationships and, you know, communication were fully tested during COVID. We've learned so much. And on the other side, like you're Aging, that having that ongoing relationship, in preparation for what might come really helps to make any kind of emergency response more successful. Yeah. Absolutely. So okay.

Katie White [: 00:11:30

Thank you for sharing all of that about your role as well. Super important to us. Now let's shift it on over to Medicare.

Andy Haggard [: 00:11:37

Okay.

Katie White [: 00:11:38

So the very basics. I know we've got a lot of information on our website and some recorded trainings. But, just give us sort of the general overview of what is Medicare and what you do with individuals or groups around Medicare.

Andy Haggard [: 00:11:52

Yeah. Sure. So I do wanna start out by saying, we are partners with the Ohio Senior Health Insurance Information Program or

Katie White [: 00:11:59

OSHIIP. Mhmm.

Andy Haggard [: 00:12:02

And I actually went through their, volunteer training program way back when when I got started in this. And we actually I I guess, I say we, but I kinda developed it. Not to brag, but,

Katie White [: 00:12:17

Brag it. I love it.

Andy Haggard [: 00:12:19

Kinda developed our outreach program here based on what they do.

Katie White [: 00:12:22

Got it.

Andy Haggard [: 00:12:23

The only thing that and I'll kind of explain that further, but the only thing that we, don't really do here, which I don't know if we would at some point, but hasn't been really necessary, is that we don't, use volunteers to do outreach. Okay. They use volunteers to do their outreach because they're covering all 88 counties in Ohio.

Katie White [: 00:12:40

Right.

Andy Haggard [: 00:12:41

And so and they only have, like, 5 or 6, you know, staff people who are who are on the ground out in those counties, so they have to use volunteers. But, primarily, it's a lot of, you know, answering phone calls Mhmm. When people have questions about Medicare Aging in and kinda having those discussions, whether it's someone who's new to Medicare and is trying to figure out their options, or if it's somebody who's experiencing an issue, claims related or access related, or just wanting to know if something might or might not be covered. So that's one big piece of what we do. We also do presentations, and we can do those out in the public. Any Central that's interested. We've done church groups. We've gone to senior living communities, done a lot of professional education, which I love doing those.

Andy Haggard [: 00:13:33

I love it when hospitals and doctors' offices ask me to come out.

Katie White [: 00:13:37

Okay. Noted.

Andy Haggard [: 00:13:38

Because they're dealing with that on on, you know, they're dealing with Medicare patients on a day to day basis, and the more I can educate them, about some of the basics, you know, they can kinda deal with that right then and there Yeah. Instead of having to, oh, I'll get back to you, or I'm not sure. So I love doing those kinds of things.

Katie White [: 00:13:57

And we actually met when I was with the Alzheimer's Association, and you would come and do the presentation to the caregivers. So we would have a whole series, and that's how yeah. I don't know if you remember that, but it was about 13 years ago. Oh, boy. And so no. You would always you would always come and do a great job. It was always a really good session. Uh-huh.

Andy Haggard [: 00:14:17

So that's the structure of the outreach program. And, you know, like, a lot of what we do right now with so many, folks working past age Katie, you know, whether it's out of necessity or just wanting to or whatever the reason, we do see a lot more people working past age of 65. And so, you know, trying to help them decide what they should or shouldn't do when it comes to Medicare. Mhmm. Because, because, you know, they hear from their friends. On, if you don't sign up, you're gonna be penalized. Well, do I really need to sign up? So Aging through all that kind of stuff. And, you know, just breaking down the different parts of Medicare.

Andy Haggard [: 00:14:58

There's so many different parts and pieces. That's kind of the the core of our education when we do presentations is kind of explaining those parts and how they work. So you have part A of Medicare, which is hospital insurance.

Katie White [: 00:15:13

Mhmm.

Andy Haggard [: 00:15:15

So if someone goes into the hospital, it's helping to pay for that. Part B, as in boy, is the medical insurance, and that's what pays for all the outpatient services. So doctor's visits, primary care or specialist, home medical equipment. It will pay for any medications that are administered through, durable medical equipment, such as a nebulizer, that kind of thing. So part B is probably the the biggest part of Medicare that people are using on a day in and day out basis.

Katie White [: 00:15:48

Okay.

Andy Haggard [: 00:15:50

Part D, and you'll notice I skipped C. Mhmm. I realized it's next letter in the alphabet, but I'm skipping it for a reason. So part D is the prescription drug insurance. Okay. And that's only been around since 2006. I'm I'm always amazed, and I wish somebody would do a research study on this, and maybe they have. But you think about Medicare being around since 1965.

Andy Haggard [: 00:16:15

Mhmm. And we've only had prescription drug coverage since 2006. Yeah. So what it happened during that time? How do people get their medication? You know, I I was doing Medicare outreach for a little bit before we got prescription drug coverage and don't really recall that coming up as much as an issue. So it's just curious. Right?

Katie White [: 00:16:38

And I'm curious now. Of course, I wanna immediately go Google and do some research, but I won't at the moment.

Andy Haggard [: 00:16:44

And one of the things that I think might be happening where so now we have prescription drug coverage, but it's still a huge issue. Mhmm. The cost of prescriptions is still a huge issue even though now we have prescription drug coverage. Before, we never had prescription drug coverage. And was it an issue back then? I don't know. So I think we've become a medication dependent society and has a lot to do with it. And and not necessarily that that's a terrible Aging. It could be in some cases, but I think because of science and technology and all that, we have a lot of new medicines

Katie White [: 00:17:21

Mhmm.

Andy Haggard [: 00:17:22

That are really helping people to remain healthy and maintain some quality of life, but they're very, very expensive.

Katie White [: 00:17:31

Yes.

Andy Haggard [: 00:17:32

Very expensive. So it could be that too. Just that we've got so many new expensive medications out there that maybe we didn't have before. Okay. Don't know.

Katie White [: 00:17:43

Well and a a good example of what you're talking about was, it really came about last year. And AARP advocated a lot around the cost for diabetic related prescriptions. Right? And how expensive those were and, you know, how much the companies were making versus how much it really cost and really denying people that needed that access. So, yeah, I think it came up in all kinds of legislation last year. Right? There was a big. Yeah.

Andy Haggard [: 00:18:13

Yeah. So the, the inflation reduction act made some significant changes to, Medicare prescription drug coverage, and on was capping the cost of insulin at $25. On is it 25 or 35? Sorry. Somewhere around there.

Katie White [: 00:18:30

Okay.

Andy Haggard [: 00:18:31

And then it's also going to cap out of pocket expenses starting in 2025 at $2,000 a year.

Katie White [: 00:18:40

Which is still a lot.

Andy Haggard [: 00:18:41

I mean,

Katie White [: 00:18:42

that's still a lot, but I would imagine, and you know this better than anyone, that is monumental for folks. Absolutely.

Andy Haggard [: 00:18:48

Okay. Yeah. So, yeah, we're looking looking forward to that, obviously.

Katie White [: 00:18:54

So, A, hospital, B, outpatient Central. PCP, the one that people use the most. D, prescription drug coverage. Are we still skipping C, or we're coming back to that later?

Andy Haggard [: 00:19:06

We can talk C.

Katie White [: 00:19:07

Let's talk C.

Andy Haggard [: 00:19:07

We can talk C right now.

Katie White [: 00:19:09

Okay.

Andy Haggard [: 00:19:09

So C is basically A, B, and D all rolled into 1. It's Medicare Advantage. And so the, you know, the challenge with something like that where you have A, B, C, and D is that people have A, B, and D, and now they're like, why don't I have C?

Katie White [: 00:19:31

Sure. It is a little confusing. Right.

Andy Haggard [: 00:19:33

It's confusing, and and I don't blame them. I mean, that would be logical. Right? I've got A, B, and D, but there's this part D, so why don't I have that as well? Well, it's because it's something completely different.

Katie White [: 00:19:42

Okay.

Andy Haggard [: 00:19:43

It's it's managed care. It's called Medicare Advantage, and, basically, private insurance companies will contract with Medicare, and they will enroll Medicare beneficiaries and cover all of their medical expenses, their hospital, their outpatient services, their prescription drugs. Okay. So it's A, B, and D all rolled into one.

Katie White [: 00:20:09

Okay.

Andy Haggard [: 00:20:11

They're becoming more and more popular. When I first started doing this outreach work, it was probably, like, 75 in original Medicare and 25% in Advantage, and we are now close to 50/50.

Katie White [: 00:20:24

Interesting.

Andy Haggard [: 00:20:25

Yeah. You know, a lot of different reasons for that that I can speculate. Probably on of the bigger ones is that, you know, they offer a lot of added benefits, you know, things that Medicare wouldn't cover Mhmm. Or doesn't cover.

Katie White [: 00:20:41

And market those. Right? Market the benefits. Yeah.

Andy Haggard [: 00:20:44

Yeah. Yeah. So things like transportation or home delivered meals, dental, vision, hearing, health club memberships. There's even these, what are they called? There's even these cards that they can get now that they can use to pay for rent and groceries. Mhmm. You know, and, but not everybody's eligible for all that stuff. So that's the trick that people get hung up on as they hear about all these things that people are getting or they see the commercials for things they can get. Well, there's more to it than that and there's, you know, because it's managed care.

Andy Haggard [: 00:21:23

It's like, okay, great. So you're joining this plan so that you can get a health club membership. And then next month, you go to your doctor and they say, we don't take this plan. What are you on do now? Right. Was the health club membership worth it?

Katie White [: 00:21:35

Right.

Andy Haggard [: 00:21:36

So you have to kind of vet that kind of stuff out first, and that's White I talk to people about who are calling in because they saw the commercials or they got advertisements. Wow. What is this? This looks great. Why am I not getting this? It's It's like, well, that's fine, but, you know, you need to make sure that you can still go see your doctor. You know?

Katie White [: 00:21:55

And Are there websites and resources that you point people to to go in there and make sure that they're seeing everything that's eligible or not eligible if they switch plans, or how do you help people navigate?

Andy Haggard [: 00:22:05

Yeah. I mean, medicare.gov obviously is a place where you can compare, plans. But with the part c White the managed care, because there is a provider network, what I generally do with folks is have them check with their provider, to see what plan they're in network with. And you have to use those words because if you say, what plan do you accept? I've gotten feedback from people who have told me that their doctor's office told them that they accept everything.

Katie White [: 00:22:36

Mhmm. But that doesn't mean you're in network.

Andy Haggard [: 00:22:39

Yeah. It doesn't mean you're in network. So Yeah. On network is the is a keyword. So once they find out that out, then we've narrowed it down because there's, you know, 40, 50 different Medicare Advantage Plans out there. So, so that kinda narrows it down because they're certainly not gonna be a network with all of them. Maybe a few. Okay.

Katie White [: 00:22:57

Those are your anthems, your Molinas, your Right. Adnanas. Those

Andy Haggard [: 00:23:01

are UnitedHealthcare. Yeah. Humana. White. Central Mutual.

Katie White [: 00:23:04

Those are those managed care organizations. Yep. Okay.

Andy Haggard [: 00:23:07

Yep. And so once they have it narrowed down, then we can do things like go to that plan's website, You know, skip over the medicare.gov at that point. Go to the plan's website. There's generally a place where you can put in your doctor's name to see if they're in network, you know, just to confirm that. I always have people follow-up with the doctor's office too, because when you're looking at that information on the web, it's based on making sure that they're keeping that up to date. Right? So

Katie White [: 00:23:34

And that's a big deal, particularly a PCP or a specialist you've been seeing for a long time that knows you and knows your needs, and that continuity of care is huge. So Aging that double check is really important.

Andy Haggard [: 00:23:44

Yes. Very much so. Okay.

Katie White [: 00:23:47

Yep. Oh my gosh. Pretend I know nothing about it's like I thought I knew some things, and then I really don't. You're so you're very good at this. Okay. So general qualifications for an individual to get on Medicare, just in case somebody listening doesn't know anything about? What are the general requirements?

Andy Haggard [: 00:24:06

So, most cases, it's folks who are Katie and over.

Katie White [: 00:24:11

Mhmm.

Andy Haggard [: 00:24:12

However, people under the age of 65 can also qualify for Medicare, if they're receiving Social Security disability income benefits Okay. For 24 consecutive months. They can also qualify for Medicare. So we do, I think the youngest person I've ever talked to is 25. He was on Medicare, injured themselves at COAAA, and qualified for disability.

Katie White [: 00:24:37

Okay. So if you're on, Social Security disability insurance for more than 24 months, then you can also apply to get on Medicare. But to be on SSDI, that has its own requirements, which we won't get into today.

Andy Haggard [: 00:24:49

Yeah. Okay. Yeah. Yeah. So Social Security is the gatekeeper for Medicare. So, in terms of applying, that's where folks would go to do that, not Medicare. Doing it online is probably the quickest and easiest thing to do. But if folks don't feel comfortable with that, I mean, obviously, that's something we could assist White.

Andy Haggard [: 00:25:07

But, if folks don't feel comfortable with that, they can also call Social Security to get that done.

Katie White [: 00:25:13

Okay.

Andy Haggard [: 00:25:14

If somebody is receiving Social Security income benefits before turning 65, their Medicare enrollment will be automatic.

Katie White [: 00:25:23

Hey. That's nice. Mhmm.

Andy Haggard [: 00:25:26

Yeah. Okay. Yep. So that's good. They'll automatically get it, but they still have all those other decisions to make that we talked about. Yes. Prescription drugs, Medicare Advantage, supplemental insurance, you know, that kind of thing.

Katie White [: 00:25:40

Okay. So you have to be 65 and older unless the SSDI, which we talked about. If you're already on Social Security, then you're automatically enrolled. But say I am, Katie. I'm approaching this big Katie number. How early should I start looking, and what are some of those processes? And how long does it COAAA? And what is open enrollment? And when is that?

Andy Haggard [: 00:26:08

Yeah. So in terms of of applying and when to start that process, there's a 7 month initial enrollment Area, and it starts 3 months prior to the month that you turn 65, the month of your 65th birthday, and 3 months after.

Katie White [: 00:26:22

Okay. Wait. Say that again.

Andy Haggard [: 00:26:24

7 month initial enrollment period.

Katie White [: 00:26:26

Okay.

Andy Haggard [: 00:26:26

3 months prior to the month that you turn 65, the month of your 65th birthday, and 3 months following.

Katie White [: 00:26:34

Got it.

Andy Haggard [: 00:26:35

Okay. So in terms of timing, ideally, you'd wanna sign up for Medicare within those 1st 3 months.

Katie White [: 00:26:40

Okay.

Andy Haggard [: 00:26:40

That way, your Medicare starts on the 1st day of your birth month.

Katie White [: 00:26:45

Okay.

Andy Haggard [: 00:26:46

If you wait and do it on your birth month, it'd be the following month, etcetera, etcetera, going forward until, you know, you would have to do it at least by that 3rd month after the month that you turn 65.

Katie White [: 00:26:59

Because the month that you sign up on, it takes 1 month for it to actually kick in. Right. Okay.

Andy Haggard [: 00:27:04

Right.

Katie White [: 00:27:05

So then in an ideal situation, you're signing up in that 3 month Area. But before that, you are going to some classes. You're researching some stuff online and really thinking about all these decisions. Because when you get there, from what I understand, it's a lot of choices all at Agency. And you you have to be, you know, choosing what you want, and it can feel really overwhelming.

Andy Haggard [: 00:27:26

Yes. Yeah. And that's what our workshops are are for, that we do here and out in the community. And that's the way they're being utilized. You know, as people who are registering are saying things like, turning 65 later this year. Perfect. That's exactly the kind of person, you know, we wanna get this information out to. Occasionally, you get somebody that's, I'm turning 65 next month.

Andy Haggard [: 00:27:48

I don't know what I'm doing. You know, we do occasionally.

Katie White [: 00:27:50

You're like, tsk. Yes.

Andy Haggard [: 00:27:52

That's your thing. Everybody has has their moments like that.

Katie White [: 00:27:56

Yes. Well, and if you don't know, you might not realize that there's this whole long process or, you know, or that it takes an extra month or there's an enrollment period.

Andy Haggard [: 00:28:04

Mhmm.

Katie White [: 00:28:05

Okay. So that is when you first sign up. So you sign up. You turn Katie. And then for 3 years, you're going along. Your choices are great. But then you're like, I saw this commercial. I might wanna change something.

Katie White [: 00:28:18

So then can you change what your choice is, and what does that look like?

Andy Haggard [: 00:28:21

Yeah. So there is an annual open enrollment period. Okay. And you can change your prescription drug coverage or your, Medicare Advantage Plan during that time. You know, it's it's a good opportunity to just evaluate your coverage, what you have, and just make sure that maybe there isn't something better, especially when it comes to part d.

Katie White [: 00:28:47

Okay.

Andy Haggard [: 00:28:48

When it comes to part d, you know, that's just stand alone prescription drug coverage. So, you know, your medication needs may have changed during the year. The plan may have changed their benefit structure during the course of the year. So, you know, comparing that is very important because a lot of times, we have found, and we I mean, myself and John Lamott, who helps me with this work here, you know, find that people can save money by switching, and sometimes a lot of money.

Katie White [: 00:29:17

Okay. Yes. So it is important during open enrollment to really take a look and see what's changed and what's different. Okay.

Andy Haggard [: 00:29:24

Now where it gets more ambiguous is with the part c. Okay. Because, again, this is managed care. There's provider network. So the frustrating calls that I get are the ones where people are basically just hoping the grass is greener somewhere else.

Katie White [: 00:29:39

Okay.

Andy Haggard [: 00:29:40

And it's and those can be Aging.

Katie White [: 00:29:42

Sure.

Andy Haggard [: 00:29:43

Because, you know, there's so many different options, and they have to be competitive with each other. So there there aren't. I have not found huge significant differences in terms of the Medicare benefits and what they cost. I mean, they all have to cover the exact same things in terms of what Medicare would traditionally cover.

Katie White [: 00:30:02

They have to cover what Medicare would cover, but then there's also a lot of rules and guidelines around how much they can offer, this or that. Like, they really have they have they're bound by a lot of rules, which is what keeps them all pretty similar.

Andy Haggard [: 00:30:15

Yes.

Katie White [: 00:30:16

But then on one might have a really great marketing that makes them feel like they stand out or something, which is why then somebody's calling on saying, oh, this looks better than my current plan.

Andy Haggard [: 00:30:24

Yeah. Yeah. So it just Yeah. We just try and do some We I'm not trying to be judgmental and say, you know, and try and talk somebody into doing something that maybe they don't wanna do. It's just basically educating them about, you know, what their options are and what some consequences could be

Katie White [: 00:30:41

Mhmm.

Andy Haggard [: 00:30:42

And letting them make that decision, instead of just saying, oh, no. You don't wanna change. You know, it's not my job to do that.

Katie White [: 00:30:49

Right. Right.

Andy Haggard [: 00:30:50

My job is to help them be able to say, no. I don't wanna change Right. And feel confident about that. So it's just, you know, like, if things are if it's not broke, how's that go?

Katie White [: 00:31:04

If it ain't broke, don't fix it. Yeah. White. Yeah. So there's people like you. There's, OShip. There's the medicare.gov website. And then aren't there other people out there kinda selling their services to help people do this? But you don't have to pay anyone to do this.

Katie White [: 00:31:21

There are lots of free services out there. So I feel like just I don't know if we can share a little bit about that because sometimes that messaging is a little confusing where somebody says, oh, no. I had to pay to, you know, get some help.

Andy Haggard [: 00:31:32

Yeah. When I hear that, it is it's it's a little concerning. But on the other hand, having worked with folks for as long as I have, you do run into people who you're meeting with them and you start talking and you start explaining things and you start seeing this, like, really puzzled, confused, maybe even upset look on their face. And they're like, I thought you were gonna tell me what I needed to I thought you're gonna tell me what I should enroll in. I thought you were gonna tell me what was best for me. Okay. It's like and we have to explain. Sorry.

Andy Haggard [: 00:32:05

We can't we can't do that. I'm gonna I'll stay with you as long as I have to to help you understand what your options are so that you can feel comfortable making an informed decision. So I think sometimes those services are for those people, possibly

Katie White [: 00:32:21

Okay.

Andy Haggard [: 00:32:22

Who basically just want to go in and have somebody do it all. All the thinking Mhmm. All the decision making.

Katie White [: 00:32:30

Mhmm.

Andy Haggard [: 00:32:31

So for them, that White be worth the money, but I would for service. Sure.

Katie White [: 00:32:35

Gotcha. But

Andy Haggard [: 00:32:36

I but I would hate to think of of folks who think that's the only way they can get the information and get help Yeah. Is to pay for it because that's just not true.

Katie White [: 00:32:45

So you make a good point, though, and I appreciate that. It's like maybe some people do need that extra help of saying this is what I would recommend for you. It's not required. You can get similar type help all the way to the point of me recommending what I think you should do, from a lot of free services. But it it might be something that somebody else truly feels like the money and the value is there to pay for it.

Andy Haggard [: 00:33:08

Mhmm. Mhmm. And and it's like with the agents as well who who, represent different products and help people sign up. Nothing against against those who are honest and and trying to help people. Mhmm. But if folks can, you know, take one of our classes first or, you know, talk with us or OSHIIP first, just so that they know understand the basics and what their options are.

Katie White [: 00:33:32

Mhmm.

Andy Haggard [: 00:33:33

That way if, by some chance, they were to talk to an agent who was maybe trying to push them in a certain direction because of commissions higher or White, if they have that basic, foundation of options, then, you know, they'll they'll pick up on that. You know? Oh, wait a minute. I don't I don't think that's quite right or Yeah. That's really not what I'm interested in.

Katie White [: 00:33:55

Yeah.

Andy Haggard [: 00:33:55

And I already know what my options are, and I was really interested in this.

Katie White [: 00:33:58

Okay.

Andy Haggard [: 00:33:59

So Okay. Yeah.

Katie White [: 00:34:00

That's important.

Andy Haggard [: 00:34:01

Yeah. That's really, I think, on, big asset to having a free program like

Katie White [: 00:34:06

ours. Okay. This is all super helpful. And I feel like I've learned so much. I actually think this is the most notes I've ever taken on an episode. And it's just great. Okay. So tell me, the difference between Medicare and Medicaid, what the benefits are, and who qualifies for that because I feel like that's really easily confused for folks

Andy Haggard [: 00:34:27

too. Oh, absolutely. It's easily confused. I mean, the names are so similar. Right?

Katie White [: 00:34:32

Almost the same word twice.

Andy Haggard [: 00:34:33

It's almost. Yes. It is. Maybe 1 or 2 letters different. Yeah. So that's, you know, that's not helpful. But, Medicaid is state funded. Mhmm.

Andy Haggard [: 00:34:44

But really state funded. So from every state to state to state, Medicaid is administered on that level. So the eligibility criteria here in Ohio might be different than it is in Pennsylvania, California, etcetera. Whereas Medicare is a federally funded program. So no matter what state you are, no matter where you are in the United States, it's the same for everyone. And Medicaid is based on a person's needs. So, based on their income and assets, based on their age or disability, and then the eligibility criteria are more falling around those things, whereas Medicare eligibility, again, is age, or disability only.

Katie White [: 00:35:30

Mhmm.

Andy Haggard [: 00:35:33

When it comes to Medicare, Medicaid has a couple different programs that can actually help, pay some of Medicare's expenses

Katie White [: 00:35:41

Okay.

Andy Haggard [: 00:35:41

For those who have limited income and limited resources.

Katie White [: 00:35:44

Is that just in Ohio, or is that everywhere

Andy Haggard [: 00:35:46

as well? That's everywhere. Those programs are everywhere. Again, it's just that the income and asset guidelines might be a little bit different depending on where you're at. But Yeah. So that's really, really important for folks to know. I never assume assume that somebody might may or may not be eligible for that. So always We always talk about that during presentations. We're always screening people that we talk to on the phone.

Andy Haggard [: 00:36:12

So there's something called limited income subsidy, and that helps for Medicare That helps pay for Medicare part d.

Katie White [: 00:36:19

Okay.

Andy Haggard [: 00:36:20

So if someone qualifies, they can have their co-pays, premiums, and deductible lowered, or in some cases, on, just down to 0.

Katie White [: 00:36:32

Okay.

Andy Haggard [: 00:36:34

Social Security actually handles that program, not Medicaid. Okay. But we can assist people with applying for that. In terms of applying for public benefits, it's probably the easiest thing I've ever helped people do.

Katie White [: 00:36:47

Okay.

Andy Haggard [: 00:36:47

Online application, it takes just a few minutes, honestly, because there's no burden of proof. They don't have to submit, you know, verifications or documents or anything like that.

Katie White [: 00:36:58

Because it's through Social Security, so they already have

Andy Haggard [: 00:37:00

it. Yeah. They already have that information. Okay. Yeah.

Katie White [: 00:37:02

See, those are the systems. We need it all like that. Like, there's not a ton of information in time and headaches to put in, and it's a could be a huge benefit on the other side.

Andy Haggard [: 00:37:10

Gosh. Yes. Okay. Yeah. And then in terms of, Medicaid programs that help pay for Medicare expenses, there's what's called Medicare Savings Programs. It's also referred to by some county JFS as Medicare premium assistance, but it's the same thing.

Katie White [: 00:37:29

Okay.

Andy Haggard [: 00:37:30

And I always, you know, say those different terms when I'm talking with people. So that way, if they call somebody and call a county JFS and say, you know, Medicare Savings Program, and the person goes, I don't know White you're talking about. Try saying Medicare, you know, premium assistance. Oh, yeah. Okay. Mhmm. Anyway, so that would help pay that premium monthly monthly premium for Part B, would also possibly help pay for co-pays not covered by Medicare A and B or part C.

Katie White [: 00:38:07

Okay.

Andy Haggard [: 00:38:07

So even if you're in a Medicare Advantage Plan, if you have co-pays and you qualify for Medicare Savings Program, you could also have those co-pays covered.

Katie White [: 00:38:15

Wow. That's

Andy Haggard [: 00:38:16

great. So huge huge benefit. So yeah.

Katie White [: 00:38:21

I have learned so much. And the thing about many of these programs and plans and things is they're constantly changing. Right? And so that's, again, why it's so important to, think about things ahead of time, get to those education sessions, and to check your benefits, and what you are, qualified for every single year, just in case. Because maybe a couple of years there aren't anything major, no major changes. And then if there is something huge, you wanna make sure you're on top of that. Mhmm. Okay.

Andy Haggard [: 00:38:56

Yep.

Katie White [: 00:38:56

So the biggest resource is it sounds like, obviously, Social Security, but also medicare.gov, going to COAAA's website or OSHIIP's website and learning about those education opportunities.

Andy Haggard [: 00:39:07

Mhmm.

Katie White [: 00:39:07

Okay. Anything else about that before I ask, one more question to you, semi unrelated to Medicare?

Andy Haggard [: 00:39:15

I don't think so. I think we've I mean, we could spend all day. Don't get me wrong.

Katie White [: 00:39:19

But in terms of what's important Yeah.

Andy Haggard [: 00:39:22

For right now, I think we're good.

Katie White [: 00:39:23

Okay. Seriously, so awesome. I have, like, hardly any space left on my paper front and back. Okay. My final question for you is well, that's 2 parter. What's your biggest challenge in this role, and then what's your biggest success in this role?

Andy Haggard [: 00:39:40

Start with challenge.

Katie White [: 00:39:41

Mhmm.

Andy Haggard [: 00:39:43

You know, I talked about financial assistance programs just now. I'm sure there's a lot of people out there who are eligible who just aren't getting it. And, you know, we've we've tried all sorts of different outreach methods, even even buying advertisement on, pharmacy bags. You know, at the pharmacy, when you get your medicine and they put in that little bag, we've even advertised on there.

Katie White [: 00:40:04

Okay.

Andy Haggard [: 00:40:05

Not much from that either.

Katie White [: 00:40:06

Okay.

Andy Haggard [: 00:40:07

So outside of going to door to door, you know, which is obviously not practical. Yeah. Just just, you know, trying to reach those folks. So that's a challenge. And then, I guess, challenge slash frustrating is when you talk to people who are looking for financial assistance, they don't meet the eligibility criteria.

Katie White [: 00:40:26

Okay.

Andy Haggard [: 00:40:27

That's a challenge as well. So

Katie White [: 00:40:29

Especially if they're, like, just over it. That has gotta be just excruciating

Andy Haggard [: 00:40:34

Yep.

Katie White [: 00:40:34

For everybody involved. You, them.

Andy Haggard [: 00:40:36

It is. It is. And I struggle with with how to tell them that, you know, because you say, logically, what would you say? You make too much money. And they're like, what? Right.

Katie White [: 00:40:48

Right.

Andy Haggard [: 00:40:48

Too much money. What are you talking about? Right. Yeah. And so it's basically just, I'm sorry. Your income is over the guideline.

Katie White [: 00:40:54

And it is a hard it's like a black and white. You're over the guideline by a dollar. Yeah. You're over it.

Andy Haggard [: 00:40:59

Yeah.

Katie White [: 00:41:00

Okay. Yeah. That is difficult. Yeah. Okay. How about a success or a favorite story?

Andy Haggard [: 00:41:04

Well, I was thinking about that, and I couldn't really pinpoint one favorite story. But the reoccurring theme that I consider to be a a success is when people tell me when they're very appreciative and thankful of the assistance that we've given them here. Yeah. When they tell me that I've talked to so many people and you're the 1st person that's helped made sense or, you know, just things like that. Those are successes, a reoccurring success that makes it all worthwhile, when people are telling you that, what you have what you have done has, you know, relieved a lot of pressure off their back. Has you know, they've been up nights thinking about this stuff, and now they feel so much more confident and so much more better. Yeah. Those are those are huge successes in my mind.

Katie White [: 00:41:55

Definitely. And just the impact you have made, in your work has got to be monumental. I mean, again, I've spent 45 minutes with you, and I feel like I have learned so much. And it is it's a big decision, and it's a big deal. And and so providing that one on one help or the education, yeah. Very awesome. Mhmm. Thank you so much for being here.

Katie White [: 00:42:17

Oh, thank you. Appreciate it. Uh-huh. Okay. I hope now you know something about Medicare.