A local business presents free seminars to the community to inform seniors and caregivers of their Medicare enrollment options and answer questions.
“There is a lot of confusion around Medicare, and there are not a lot of options to sit face to face with someone to learn about it,” Emma Carpenter, an agent with Midwest Medicare Solutions, said.
“As someone is getting ready to turn 65, they are getting a lot of information sent to them,” another agent, Lisa Hemby, said.
Hemby said many individuals can feel overwhelmed by the amount of information or are unsure of where to begin with the Medicare enrollment process.
During the seminars, Carpenter and Hemby walk attendees through what the enrollment process looks like, what their enrollment options are, and current-year costs associated with Medicare.
Their most recent seminar was held on Tuesday, Aug. 19 According to Carpenter, one can apply for Medicare enrollment up to three months before they turn 65, and for up to three months after they turn 65, with no penalty.
However, if one still has health coverage through their employment or their spouse’s employment, Carpenter said in that scenario, one could delay enrollment. In order to avoid penalties, one needs proof of coverage during that time.
Carpenter said she will often help clients make an informed decision.
“A lot of times, we will sit down and look at the coverage and the costs. A lot of the time, it does make sense to go ahead and move over to Medicare, but it is completely up to you,” Carpenter said.
Those who already receive social security benefits will be automatically enrolled, Carpenter said.
Original Medicare includes Parts A and B.
“Your Part A is going to cover your hospital, skilled nursing, hospice, and home health,” Carpenter said. “Your Part B is going to be everything else; your doctor’s appointments, your outpatient care, physical therapy, specialists, and other services.”
According to Carpenter, most individuals do not have to pay a premium on Part A, as most individuals pay Medicare taxes when they are in the workforce. If one does not receive premium-free Part A, the premium can be up to $518 per month.
With Part A, there is a deductible of For Part B, the average monthly premium is $185, and insurance holders will pay 20% of the cost of services out of pocket.
“So you have original Medicare, you signed up, and you have two options,” Carpenter said.
“The first option is Medicare supplement, or Medigap.”
The supplemental insurance does not cover prescription drugs, according to Carpenter.
“You’re going to hear a lot about a Plan G and a Plan N,” Carpenter said.
Plan G coverage typically has higher premiums, but offers more comprehensive coverage, while Plan N users should expect to pay a copay for services.
“These plans are standardized. A Plan G is the same no matter which provider is carrying it. They have to keep it the same,” Carpenter said. “A G is still going to be a G, no matter what premium you are paying.”
In Kansas, Open enrollment occurs 6 months after you receive Medicare Part B. After that period, insurance holders have to go through the underwriting process to make changes to their supplemental insurance.
These can all be paired with Medicare Part D, which offers prescription drug coverage. The drug plan does have a $2,000 cap in 2025. This does include the deductible, according to Carpenter. There is also a payment program, which allows members to cover out-of-pocket drug costs each month, rather than at the beginning of the year.
These plans do not include long-term care, dental, vision, or hearing services. However, Medicare Advantage Plans, also known as Part C, can offer such coverage.
Carpenter said that these plans are network-driven.
“It works like private insurance; you have to stay within your network,” Carpenter said.
Unlike supplemental insurance, Carpenter stated that these plans can be reviewed each year.
The annual enrollment period runs from Oct. 15 to Dec. 7. Carpenter said at that time, clients can review their plans and make changes.
“We encourage review every year,” Carpenter said.
These plans typically have no premium, and users pay a copay for services.
“There’s a lot to consider between the plans,” Carpenter said.
Hemby and Carpenter said they also meet with individuals outside of the office to offer information and answer their questions prior to enrollment, or when considering changes to their plan. Carpenter and Hemby said there are even more options for individuals in unique circumstances that they can help clients navigate.
“The great thing about using a local agent is that you aren’t stuck with the 1-800 number,” Carpenter
said.
Hemby and Carpenter spend a lot of time connecting seniors to community resources as well.
“You can never be too aware,” Carpenter said. “We want our clients to be educated. We want to help them make the best decision for them, and not find themselves in a position they don’t want to be in, or one that isn’t working for them down the road.”
To learn more about Midwest Medicare Solutions, visit https://midwestmedicarehelp. com or https://www.facebook. com/MidwestMedicareSolutions.
