Medicare Made Simple

In this episode of The Community Check-In, we're joined by Elisa Brescia, Regional Medicare Consultant for Excellus BlueCross BlueShield, who is simplifying the complexities of Medicare. Medicare can often appear confusing with its multitude of plans, enrollment rules and eligibility criteria. Elisa takes us through the essential aspects of Medicare, including who is eligible, when and how to enroll and the significance of the Annual Election Period (AEP). Whether you're approaching age 65 or looking to make informed changes to your Medicare coverage, this episode provides a comprehensive guide to help you understand and navigate the world of Medicare.

Episode Transcript

(00:03):
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel USBCBS dot com and follow on Instagram

(00:27):
and Facebook. I'm Joel Lomonico andwelcome to the check in. Medicare can
seem very confusing, whether you're firsttimer or whether you've utilized Medicare for many
years. It often features a varietyof plans, coverage choices, premium levels,
enrollment rules. It's a lot tosort out. We're going to try

(00:47):
to do some of that for youon this edition or the community check In.
We have a Liisa Brescia with us. She's the regional Medicare consultant for
excel Us Blue Cross Blue Shield towalk us through some of the ins and
outs of Medicare, including who's eligibleand what kind of plans are out there.
Elisa, Welcome to the Community checkIn. Thank you glad to be
here. Excellus Blue Cross Blue Shieldis an HMO plan with a Medicare contract,

(01:08):
enrollment and Excell's Blue Cross blue shielddepends on contract renewal, you must
continue to pay Medicare Part B premium. Our health plan complies with applicable federal
civil rights laws and does not discriminateon the basis of race, color,
national origin, age, disability,or sex. To start us AWFULISA,
why don't you tell us who iseligible to receive Medicare benefits? Sure?

(01:33):
So, anyone sixty five years ofage or older is eligible for Medicare.
However, you could also qualify ifyou receive Social Security disability benefits for twenty
four consecutive months, or if youhave certain chronic conditions. Now, the
Annual Enrollment Period the AEP period runsevery year from October fifteenth through December seventh,

(02:00):
and all people eligible should enroll duringthis timeframe. So the way it
works is when your employer coverage endsor when you retire stop working beyond age
sixty five, you would generally optinto Medicare Part A because there's no cost
or premium associated with it as longas you or your spouse contributed to Medicare

(02:21):
payroll taxes for ten or more years. Now, if you want medical coverage,
you would also need to enroll inMedicare part B regardless of whether your
employer offers COBRA. You mentioned Aand B. Can you please explain a
little bit more about what those twoletters mean when it comes to what both
of those represents and what they cover. Yes, So, Medicare Part A

(02:45):
is your hospitalization coverage. That's goingto include in patient hospital stay, skilled
nursing facility, and hospice care.And then Part B is for medical coverage.
So think of those things as outpatientvisits, any office visits to the
doctor, specialist, X rays,lab work, things like that. Anything

(03:08):
outpatient related would fall under the partbe all right, So you mentioned that
some people choose to take their employercoverage past a certain age, or they
will suspend their employer coverage and thenmove over to taking Medicare benefits. Is
age sixty five a drop dead cutoffpoint or does it really depend on the

(03:30):
individual as to what they might decideto do or their employer might offer them
as continuing benefits. Yeah, sothere's a lot of different components where somebody
may want to maybe speak to somebodylike myself because Medicare is very, very
complicated and there is a rule whenit comes to Medicare which is an over

(03:53):
under twenty employee rule. So basicallywhat that rule states is that if you
were for a company that has morethan twenty employees, Medicare says you'll have
a choice. You have a choiceto either stay on your employer's company plan
medical plan and defer Medicare until you'reready to retire. Or your second option

(04:16):
would be continue working, drop offof your employer's medical plan and go on
Medicare Part A and B and thenadd a Medicare advantage plan on top of
that. So there's a lot ofdifferent options that we offer on the Medicare
advantage. So again, meeting withsomebody like myself, I can go over

(04:39):
current benefits and see if maybe theMedicare side offers better benefits. Cost savings,
you know, we look at howmuch is deducted out of your paycheck
every single week versus how much thecost of Medicare Part B is. So
again there's a lot of different variancesas to why somebody may or may not

(05:00):
want to join Medicare. Now,if you work for a company that has
less than twenty employees, there's nochoice. You must obtain Medicare Part A
and Part B when you're eligible,otherwise you can incur a penalty that stays
with you for the rest of yourlife. You mentioned that there's something called
AEP. There was that acronym thatwe talked about a little bit earlier on

(05:24):
and it's always referenced. Every timewe get to this time of the year,
we start to hear about this andwondering if you can tell us about
number one again, what AEP standfor and why is it so important.
Yes, so AEP stands for theAnnual Enrollment Period and again that happens every
year between October fifteenth and December seventh. AP is the time of year where

(05:49):
people can make changes to their plan. So it is a perfect time of
year right now for individuals to reachout and maybe take a look at their
current plan, seeing what else isoffered. Maybe there's another plan that might
be best for them going into twentytwenty four. Anyone who's already on a

(06:10):
Medicare plan should definitely pay attention toAP. It doesn't mean that you have
to do anything however, just takinga look and being aware of what available
plans and options are out there.Things do change from year to year.
Health changes, things come up,Maybe you need a procedure coming up in

(06:30):
twenty twenty four. So again it'sa really good idea to see what else
is out there, and now's thetimes take a look at your options at
the very least to have someone sitdown with you and make sure that it
is still the right coverage that suitsyour needs and also maximizes care and minimizes
out of pocket expense. That's oneof the things about Medicare that is similar

(06:50):
to how private insurance may have workedwith your employer. There was an election
period you had to do. Evenif there were no changes from you year
to year, you still have tokind of go through the process. And
I think it really is a goodexercise to go through to make sure that
everything still lines up because, asyou mentioned, there can be some significant

(07:11):
changes when it comes to what willhappen in your healthcare life from year to
year. Correct. Absolutely. NowI've heard that there are zero dollar plans
out there. Boy would I loveto get my hands on one of those
suckers. Now, first of all, I guess is that true number one?
And how is somebody going to notjust look at the price and say,
yes, that's what I want becauseit has a zero dollar on it

(07:33):
and they don't maybe investigate further,they just go buy the dollar amount or
what the price tag is. Absolutelyit is true. Excela's Blue Cross Blue
Shield has many great plans out therewith low or no premiums each month,
and the zero dollar plan means thatyou don't have a monthly premium each month,

(07:54):
but it doesn't mean you won't haveto pay any out of pocket expenses
such as copays when you go tothe doctor. So the zero dollar plans
are typically really good for those whodon't use a lot of medical services outside
of routine care, such as anannual physical cancer screenings, routine cancer screenings,

(08:16):
things of that nature, maybe seeingyour primary care physician from time to
time. Those zero plans provide greatbenefits as well as many extras that original
Medicare doesn't cover. For example,dental cares not covered, eye care is
not covered. So there's many extrasthat come with our plans, including our

(08:41):
zero dollar plan. Some even coverrides to appointments, transportation meals, gym
memberships, rewards, discounts, there'sover the counter benefits. The list goes
on and on. We have allof these great options on our plans.
We also have other really great optionslike a PPO plan. The PPO plans

(09:05):
tend to work really well for oursnowbirds, for example, so they are
covered all year round, no matterwhat region they're in. And our PPO
plan also provides access to doctors notonly locally, but also nationally and around
the globe. So again, lotsof options, lots of great plans that
we have here at Excelus, andwe want to make it clear that just

(09:28):
because one of these plans, asyou just mentioned, has a zero dollar
plan, that doesn't mean you areskimping on coverage. I want to make
sure that we make that clear thatjust because the premium is unbelievably low at
zero, it is not meaning thatit's some cut rate or no benefit involved

(09:50):
type of a plan. Absolutely not. Matter of fact, I would say
most of our membership lies in ourzero dollar plan works extremely well for a
lot of our folks here. Youknow, you still get the dental,
you still get the vision, youget an over the counter allowance, you

(10:11):
get hearing. There's just many,many great benefits on our zero premium plan
that works for most people here.Medicare made simple. Our guest is Elisa
Brescia, who is regional Medicare consultantfor Excellis Blue Cross Blue Shield. More
of the community check in next.For everybody who believes the care they deserve
should always be within reach. Foreverybody who wants to be confident about insurance

(10:35):
for the next phase in life.For everybody who's looking for the best way
is to take care of their employeesand their families. At Excell's Blue Cross
Blue Shield, we're making care moreaccessible and affordable in more ways and for
more people in our community, becausewhen we do that, everybody benefits.
Learn more at EXCELL'SBCBS dot com.I'm Joelmonico and this is the Commune check

(11:00):
in. Our guest is Elisa Bresha, Regional Medicare consultant for Excellius Blue Cross
Blue Shield. The annual enrollment periodis October fifteenth through December seventh. All
eligible individuals should enroll. If youmissed any part of the earlier bit of
our discussion, remember podcasts of thisshow are available on the iHeartRadio app.

(11:22):
You can always go back and listento it again to know exactly what your
obligations are and what your options are, or you can choose to just sit
down with a professional, which isreally something that we're going to encourage you
to do. And we'll talk moreabout that later on in our discussion,
Lisa, some of the other benefitsthat are available to community members. They're
ready to enroll in excel Us,Blue Cross, Blue Shield medicare so how

(11:46):
do you want to lead them intothat process, whether they've been through it
before and they're going, you know, they're doing a check up, or
whether they're starting off for the veryfirst time. So we are going to
be all over the community of thisannual enrollment period for those local here in
Rochester. We also have an officeright here in Greece, New York where

(12:09):
we take walkins Monday through Friday fromnine until four thirty. But again,
I personally will be in the communitythis annual enrollment period. I will be
providing member meetings for those that arealready enrolled and would like to learn more
about the twenty twenty four plans andpossible changes that may be happening. I'm

(12:31):
also going to be hosting seminars atvarious locations, both virtually as well as
in person. We have phone appointments. We have also an inside sales team
that is going to be assisting bothmembers and those interested in becoming a member

(12:54):
during our AEP season as well withextended hours. They're going to be open
from eight am until eight pm,seven days a week beginning October first until
March thirty first. Also, theywill be open on the weekends as well,
Saturday and Sunday when someone comes into see you. First of all,
is there a cost to utilize theseservices for assistance in finding these medicare

(13:20):
plans? And number two, howprepared should they be and what types of
things should they be bringing along ifthey're going to have these meetings, if
they're going to sit down and getsome real targeted answers for their particular situation,
what kind of information would you liketo see to make sure you're being
able to have a productive meeting.That's a great question, Joe. So

(13:41):
there is absolutely no charge for comingto meet with somebody like myself or anybody
on my team. It is completelyfree. What I usually recommend my clients
to bring with them before they meetwith me is a couple things. I
like to see a listing of theircurrent prescription, so just jot down all

(14:03):
of the prescription medications that you take, bring the list with you. Bring
a list of your doctors and yourdentist. That way we can search to
make sure that they are all inthe network and there are no issues.
And then I'm going to ask yousome personal questions about your health. You
know, what do you have goingon? Are there any upcoming surgeries or

(14:26):
any treatments that you know of thatwe should be aware of. That way
we can make a really informed decisionon which plan to go with. I'll
ask you if you do any traveling, are you a snowbird, things like
that. Those are questions to beprepared to answer for me so that I
could assist. And these are veryimportant. And I know that prescription drugs

(14:48):
is also a big part of whatmany seniors especially face when it comes to
budgeting for their healthcare long term.So having a good understanding of what you
take and talking with your doctor maybeabout some alternatives that might be available,
could help you have more options whenit comes to choosing the right plan for

(15:09):
you. Because as I look downthe list of benefits, Alisa, there's
a lot of benefits that excel Us, Blue Cross, Blue Shield Medicare plans
offer. It really is a questionof trying to take some of those benefits,
and we wanted to talk about nowand kind of lining them up with
the rights individual within the community tosay, look, here are the options.
Now you have choices. You mighthave thought you didn't have as many

(15:30):
choices ahead of you. Oh,yes, absolutely, we've added so many
great benefits these last couple of yearsthat people still are not aware that they
have. So absolutely great time totake a look at your annual notice of
change that's going to be coming yourway. Come into our again, our

(15:52):
local office. We've got all ofour changes listed for you there. But
again, just come talk to ussee what's available. If you're already a
member, will go over everything that'schanged that's added with you right in person.
We would love to meet with youand talk with you. I also
notice here that I believe this mayhave been a recent change, correct me

(16:15):
if I'm wrong, but offering dentalcare and I care has start to become
more maybe prevalent or widespread that it'snow more available for people that are getting
into the Medicare plans. For alot of older members in the community,
that can be one of their largeuncovered medical expenses, but now they have

(16:36):
an alternative and an option. Yes, absolutely, an annual eyewear allowance of
at least one hundred and twenty dollarsis included on all of our plans.
This year you touched on dental.Dental is included on all of our plans
as well. This year you getup to one thousand dollars of dental services
covered. You Also, on topof that will have your annual cleanings,

(17:02):
so you get your cleanings and Xrays covered twice a year with a participating
dentist. And again that comes withall of our plans. So you know,
we've got so many great things happening. We have Silver and Fit,
which is our fitness center membership freeon all of our plans. We have
an over the counter allowance that isat least thirty dollars a quarter. Every

(17:26):
three months, you get thirty dollarsto spend on over the counter and wellness
items, non prescription items tailanoal vitamins, minerals, cold medicine, the list
goes on. So again, lotsof great, great benefits even on our
zero dollar plan that I just mentioned, and so definitely come talk to us.
Medicare made Simple. Our guest isElisa Brescia, who Is Regional Medicare

(17:49):
Consultant for Excella's Blue Cross Blue Shield. More of the community check in next.
For everybody who believes the care theydeserve should always be within reach.
For everybody who wants to be confidentabout insurance for the next phase in life.
For everybody who's looking for the bestways to take care of their employees
and their families. At Excell's BlueCross Blue Shield, we're making care more

(18:12):
accessible and affordable in more ways andfor more people in our community, because
when we do that, everybody benefits. Learn more at EXCELSBCBS dot com.
I'm Joelmonico and this is the communitycheck in. Our guest is Elisa Bresha,
Regional Medicare Consultant for Excellis Blue CrossBlue Shield. We're doing a broad

(18:33):
overview of the Medicare benefits that areavailable Annual Enrollment period AEP October fifteenth through
December seventh. That is for ifyour first time into Medicare, If you
are in Medicare and would like tomake changes or at the very least have
a review, this is the timeto do it. So we've talked a

(18:56):
lot about the benefits that are available, but talk to us about some of
the reasons someone might want to thinkabout altering a plan or changing from one
to another because maybe their medications arechanging, maybe they've got something with their
health that might be different. Iknow that's just scratching the surface. I
don't want to steal your thunder,but I'll have you take it from there.
Yeah, So shopping around each AEPperiod for the best medicure plan that

(19:22):
works for you is encouraged. Weknow that things change from year to years,
so it's always a good idea todo your research. It's also important
to consider any changes in your healthor your life situation that might impact your
needs. If you've recently been diagnosedwith a chronic condition, or maybe your

(19:42):
income has dropped drastically, you're planningto have a surgery or a procedure in
the upcoming year, Any of thosethings would justify a conversation. You know.
One of the things that I didn'tmention that I would like to mention
is that one of our Z zerodollar plans has a Social Security rebate which

(20:03):
we offer here in Rochester. Yourrebate is going to be thirty one dollars
a month that goes right back intoyour Social Security check. So again,
if your income has changed, oryou know, maybe you have a plan
that has a premium, but maybeyou're doing great and your lifestyle has changed,

(20:26):
your chronic condition has gotten better,whatever the case is, come talk
to us at least about the zerodollar plan that rebates you that thirty one
dollars a month, and that's goingto be something that is going to be
able to help our members, especiallyin this time of the way we are
these days. Before we wrap upour conversation on the community, check in

(20:47):
about Medicare plans and benefits. Imean, we've kind of skirted around the
topic throughout the entire conversation, butlet's get right into it. Does excel
Us Blue Cross Blue Shield offer Medicareplans? Yes, absolutely, it's our
mission and to help people in ourcommunities live healthier and more secure lives through
access to high quality, affordable healthcare. We believe that no one should have

(21:08):
to wonder if they'll be able toafford coverage or will they'll turn to if
life changes things up. So that'swhy making affordable and accessible Medicare plan options
is crucial to us here at excelUs. When we help others live healthier
lives. Everybody benefits. So thatbeing said, how can then someone reach

(21:30):
out to your team at excel AsBlue Cross Blue Shield to get information,
get the help they need to complarethese plans because there seem to be a
lot of options available so they canfigure out how to maximize their coverage and
minimize their costs. We have alot of tools, a lot of resources.
Excel Us Blue Cross Blue Shield isa local organization and our medicare experts

(21:52):
live and work in our community,so we have many different ways to connect.
We can walk you through all availableoptions to help you choose a plan
based on what's right for you,and we can connect either in person via
telephone, We have seminars, wehave online seminars, video chats. You

(22:14):
know, we have a lot ofdifferent options, So the best way is
to either contact us at excel usfoMedicare dot com or you can call us
at one eight hundred six nine sevenzero seven zero zero from eight am until
eight pm, seven days a weekfrom October first through March thirty first,

(22:38):
and that website then will allow peopleto go and see where you might be
in the community when virtual seminars mightbe available so everything's sort of warehoused right
there, so people can find somethingthat's going to fit within their calendar.
Absolutely. You can even register forone of the seminars right online if you
wanted to be in. Entire seasonof seminars is listed right there, and

(23:03):
they are in various areas of ourcommunity. So yes, everything is right
there online. The annual enrollment periodfor Medicare runs October fifteenth through December seventh
for all eligible individuals to enroll.We're going to land the plane in sixty
seconds, Alisa, but I justwant you to give your last pitch for
why someone would want to work orshould really need to work with a professional

(23:30):
when they're making these very important decisionsabout their health coverage. I think it's
important to work with somebody like myselfbecause rules are different for different people.
So it's a great idea to justcome and talk to somebody and talk about
your specific situation, because everyone's situationis different. We're the experts and we

(23:55):
could definitely point you in the rightdirection as far as which plan to go
with. We take care of allof the necessary paperwork for you, so
you don't even have to do anythingexcept for sign at the very end.
So we're here to help and wewould love to earn your business. Elisa
Bresca is the regional Medicare consultant forexcel Us Blue Cross Blue Shield. You

(24:15):
can find their resources excel Us forMedicare dot com. It is all right
there for you, easy for youto find. Alicia, thank you very
much for giving us some information.I know there's a lot more we could
discuss, but thank you for joiningus this time on the Community check In.
Thank you for having me, Thanksfor joining us on Community check In.

(24:37):
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