October 21, 2025 • 50 mins
It's Medicare annual enrollment period and our guest, Steve, is here to discuss Medicare scams, tips on how you can protect yourself, and Medicare rules.
Definitely an episode you do not want to miss!
Let’s Talk About Scams is broadcast live Tuesdays at 8AM PT on K4HD Radio - Hollywood Talk Radio (www.k4hd.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). Let’s Talk About Scams TV Show is viewed on Talk 4 TV (www.talk4tv.com).
Let’s Talk About Scams Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.
Disclaimer: The information contained in this podcast is intended for informational purposes only and is not a substitute for individual professional / legal advice. The podcast information was carefully compiled from vetted sources and references; however, R.O.S.E. Resources / Outreach to Safeguard the Elderly cannot guarantee that you will not fall victim to a scam.
Become a supporter of this podcast: https://www.spreaker.com/podcast/let-s-talk-about-scams--6483699/support.
Definitely an episode you do not want to miss!
Let’s Talk About Scams is broadcast live Tuesdays at 8AM PT on K4HD Radio - Hollywood Talk Radio (www.k4hd.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). Let’s Talk About Scams TV Show is viewed on Talk 4 TV (www.talk4tv.com).
Let’s Talk About Scams Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.
Disclaimer: The information contained in this podcast is intended for informational purposes only and is not a substitute for individual professional / legal advice. The podcast information was carefully compiled from vetted sources and references; however, R.O.S.E. Resources / Outreach to Safeguard the Elderly cannot guarantee that you will not fall victim to a scam.
Become a supporter of this podcast: https://www.spreaker.com/podcast/let-s-talk-about-scams--6483699/support.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
This program is designed to provide general information with regards
to the subject matters covered. This information is given with
the understanding that neither the hosts, guests, sponsors, or station
are engaged in rendering any specific and personal medical, financial, legal, counseling,
professional service, or any advice. You should seek the services
(00:23):
of competent professionals before applying or trying any suggested ideas.
The information contained in this podcast is intended for informational
purposes only and is not a substitute for individual professional
legal advice. The podcast information was carefully compiled from vetted
sources and references. However, Rose Resources outreach to safeguard the
(00:45):
elderly cannot guarantee that you will not fall victim to
a scam. Let's talk about scams. It's the must listen
show for anyone who wants to protect themselves and their
loved ones from scams. Every Tuesday at am Pacific time
on K four HD Radio, Joyce Petrowski, founder of Rose,
(01:06):
and her guests will provide valuable insights and practical tips
on how to recognize and protect yourself from scams. And
now here is your host, Joyce Petrowski.
Speaker 2 (01:19):
Hi, everybody, welcome, back.
Speaker 3 (01:21):
I trust you enjoyed last week's show with Brian talking
about the urgency and why we need the scam prevention
through education out there to educate everybody on how to
recognize a scam and prevent yourself from falling victim to it.
(01:42):
Today it is we are in the annual open enrollment
for Medicare, and so we are going to be talking
to Steve Slatnik about he's a Medicare agent and about
some different Medicare scams and how you can protect yourself.
But first, don't forget to go to the website Roseadvocacy
(02:03):
dot Org. On the homepage you'll find our social media
links and scroll down to the bottom you can sign
up for our mailed and or emailed newsletter. You're gonna
want to hit subscribe so you don't miss an episode,
and you can also find all the episodes on YouTube.
But also are Let's talk about Scams dot com website.
Speaker 2 (02:22):
So now let's bring Steven so we can get going.
Speaker 4 (02:27):
Hi Steve, Hi Joyce, thanks for having me.
Speaker 2 (02:30):
Thanks, how you doing.
Speaker 4 (02:33):
I'm doing great this morning. Like you said, it's open enrollment,
so this is my busy time of the year, but
things are going well.
Speaker 2 (02:40):
Good, good, good.
Speaker 3 (02:41):
Could you just take a minute and let everyone know
your background and what it is you do.
Speaker 4 (02:48):
Sure. Yeah, I've worked in the financial services industry for
about fifteen years. For the past over five years now,
I've had my own insurance agencies and independent insurance agency.
It's called Panga Insurance Services, and I'm an independent insurance broker.
I specialize in health insurance and Medicare, so I work
(03:08):
with a lot of seniors. And you don't necessarily have
to be sixty five plus to have eligible for Medicare,
but many of my clients, of course, are the majority
of people in Medicare are sixty five plus, so I
work with a lot of our seniors and Medicare eligibles.
Speaker 2 (03:28):
All right, well, very good.
Speaker 3 (03:31):
So annual enrollment started October fifteenth, Is that right?
Speaker 2 (03:37):
About a week ago?
Speaker 4 (03:38):
Correct? Yeah? And depending on what plan you have, I mean,
if you have an advantage plan or if you have
a supplement plan, they make it as confusing as possible,
of course, but open enrollment can be a little bit different.
But really for most people, if you want a January
first effective date, so if you're making any changes in
open enrollment, that will be done from Octo over fifteenth
(04:01):
to December seventh is our window.
Speaker 2 (04:04):
And those changes take effect January first.
Speaker 4 (04:07):
That's correct, okay.
Speaker 2 (04:09):
And is there some other.
Speaker 3 (04:13):
Enrollment period that starts in January and runs for a
few months.
Speaker 4 (04:20):
And that would be specific to if you had a
Medicare advantage plan, so you do have a little bit
of a buffer there. So if you're signing up for
a Medicare advantage plan in January, or you have even
a little bit after that, it could it would then
take effect the first of the following month. So if
you make a change in your Medicare advantage plan in January,
that change would be effective for February first, for instance.
(04:42):
But that's a specific to the Medicare advantage only for.
Speaker 2 (04:46):
That window, okay, all right, And then.
Speaker 3 (04:51):
I also want to clarify that my understanding of when
you have to sign up you have a window to
first when you first sign up for Medicare, and that's
the three months before the month you turn sixty five,
the month you turn sixty five, and three months after
that that's your seventh month window.
Speaker 4 (05:10):
That's correct. The biggest I guess question or uh, what
people don't always get right though, is if you are working,
still working in your over sixty five, you don't have
to sign up for Medicare if you have what's called
(05:31):
credible coverage, and that normally means you have a large
employer of twenty five plus employees. You'll get a letter
every year saying that this is credible coverage. My prescription
drug coverage is credible coverage, my health insurance is credible coverage.
If you have if you get that letter every year,
you work with a large employer, you have health insurance,
(05:53):
and say this employer UH covers your health insurance one
hundred percent, it might make sense you just keep that
and you don't necessarily have to sign up for Medicare
when you're sixty five. In that seven month window that
you referred to, you then can have what's called a
special election period, so when you decide to retire or
(06:15):
you lose coverage, there's some other instances where you can
have that. You can then can sign up for Medicare
and be sixty seven years old, sixty eight years old,
so you your age of turning sixty five no longer
matters because you had credible coverage insurance this whole time,
and you will not be penalized. So that's the Okay,
one of the big things I think people just information wise,
(06:36):
providing information wise that I do out there a lot,
because a lot of people are still working a little
bit later past sixty five, you know, ten years ago,
twenty years ago, that might have not been in a case,
but I think, I mean, I get a lot of
people that are in their sixties that are still working,
and we hold off on getting them medicare, especially if
their plan is one hundred percent covering their insurance. So
(06:59):
no pointing that you know, part be pretty much you know,
almost two hundred dollars now every month.
Speaker 3 (07:07):
So and you can is it your current employer that's
offering that coverage for you? Is it their responsibility to
send you that letter?
Speaker 4 (07:17):
The insurance carrier, the insurance carrier, one of the two. Yeah,
normally the insurance carrier takes we'll provide that that's part
of their responsibility. Okay, So it'll normally directly come from them,
but you know, depending on how the plan is set up,
you know, maybe the HR, it.
Speaker 3 (07:34):
Could go to the HR of the company and then
the HR distributes it to all the people that it
applies to. So that's interesting I didn't know that part
about it.
Speaker 4 (07:44):
One.
Speaker 2 (07:44):
Yeah, yeah, and so, and.
Speaker 3 (07:50):
You mentioned you won't get penalized because you have the
credible coverage.
Speaker 2 (07:54):
So is there a time limit.
Speaker 3 (07:56):
Let's say let's say I'm sixty seven and I am
still working and I have credible coverage, I have the
letter to back it up, and then I decide to retire.
Do I have a certain time limit before then I
need to sign up for Medicare?
Speaker 4 (08:16):
Correct? Yeah, you don't have that seven month window. I
believe it's a sixty day window in that case. Okay,
Now the other thing is now when we're applying for
Part B and these Medicare programs, processing takes a little
bit of time. So if you know you are, my
recommendation is if I know I'm sixty seven, I'm sixty eight.
(08:39):
I held off on doing anything with Medicare and going
in there. Signing up through Social Security is where you
sign up for Medicare Part and B. Sometimes you're automatically
sign up for Part A. But say you're sixty seven,
you have not yet signed up for Medicare Part A
Part B. You know you're retiring in September. We want
(08:59):
to be pro active in that sense and and be
signing up for Part B, you know, a month or
two ahead of time, because processing times are based on
how busy they get over there. So sometimes it's a
couple sometimes it's three weeks processing. Other times it's been
much longer. So make sure we're doing that early. Used
to they used to let you in the Social Security system,
they used to let you pick your effective date, like
(09:21):
so I could an individual could go in there and say,
I want my Part B to be effective September one,
and they're doing this month in advance. They don't Maybe
maybe if you go in person they would allow that,
but when you're at least online, they're no longer like
giving you that option. So they're just kind of processing
it as quickly as they can, and then it's becoming
(09:41):
effective you know, the first of the next month. But again,
you know, sometimes that can take over a month or
two months, you know, and in certain instances, right and
going on with the THAL shutdown right now, I could
be a basic if you're you're looking at medicare right now, man,
you know, get on that as soon as possible.
Speaker 3 (09:59):
I bet they're not right, yeah, And you mentioned you
know you might be able to pick your starting date.
If you go to Soil Security in person, that's you
better plan a whole day, because I know I had
to do that. My mom passed away almost six years
ago and I had to go down to SOL Security
because we had an issue and it required a manager
(10:21):
that I had to sit and go through everything with.
And I made an appointment, and I thought, oh wow, okay,
this is great.
Speaker 2 (10:28):
I can make an appointment.
Speaker 3 (10:29):
And all that did was get me through the first line,
and then you have to go to the second line,
and that could be really long, and then you check
in at the second line, and I still waited two
and a half hours before I could see somebody. So
it was literally like a four to five hour you
know timeslot, and everybody's busy, you know, like I say,
(10:52):
you don't set aside time to talk to the irs
or the sole security here or anything.
Speaker 2 (10:56):
But all right, so that's interesting. So scams.
Speaker 3 (11:04):
Have you seen or heard from your clients or maybe
read anything about some current Medicare scams that are going on.
Speaker 4 (11:15):
Yeah, you know, my dad actually worked in this field
as an attorney for quite some time. He's retired now,
but he worked on like government scams which would include
the Medicare and Medicaid system. And so this is huge
amounts of money, right that they absolutely into these programs.
(11:37):
So there's a lot of incentive right for fraudden because
there's I mean we're talking millions plus.
Speaker 2 (11:43):
Right right, more Yeah, billions.
Speaker 4 (11:46):
I mean there's hundreds of million dollar scams constantly going
on where they are people are.
Speaker 2 (11:55):
Billing frauduling charges right, quaduling.
Speaker 4 (11:59):
Charges and using people's information, whether they know it or not,
to run up these charges.
Speaker 2 (12:07):
So that's a that's I have a question there with that.
Speaker 3 (12:11):
You know, That's one of the things we warn people
about in our presentations is you really need to monitor
your Medicare statements because if you find fraudulent charges, then
what's the best thing for them to do. Go directly
to their Medicare agent about it, or go directly to
(12:32):
the Medicare government office.
Speaker 4 (12:35):
Yeah, I go go. Medic recommends that you go directly
to them. I can assist in a lot of different ways.
I mean I so obviously my my expertise is more
along the lines of the whole I can help you
sign up with Medicare.
Speaker 2 (12:50):
I can getting people on the right plan.
Speaker 4 (12:52):
I get you people on the right plan. I analyze
different prescription drug plans and things like that, but yeah,
I can. I can certainly point you in the right direction.
But in terms of managing that, yeah, directly through medicare.
Contact them as soon as possible. Contact your carrier as well.
Most people ninety nine point nine percent of people are
going to have their medicare connected to either an advantage
(13:13):
plan or supplement plan. So you want to contact you know,
your supplement or advantage carrier as well so that they're aware.
And these carriers might pick up on it, you know,
even before you and be the ones that are notifying
you of chargers that just don't look right to them.
Speaker 2 (13:29):
Yeah, all right. Yeah.
Speaker 3 (13:31):
I had a lady once tell me, you know, she
was monitoring her statements and there was like ten thousand
dollars in catheters and she's like, I've never used a catheter, so,
you know, and it happens, right, and there might be
some little charges that get slipped through in the beginning,
right that kind of like credit cards. Sometimes they'll charge
(13:51):
a little bit just to make sure the card's active
and it's working, and then here comes all the other charges.
Speaker 4 (13:57):
They're just so sophisticated. These days are easy to miss
this I second guest, My you know some emails as
you know a business owner as you as well, Joyce.
I mean we get these constantly through the through email,
through the phone. They're just so sophisticated. Now, one thing
Medicare recommends that you do if you know, if you
(14:18):
have someone calling you directly. First of all, Medicare is
not going to call you directly, it says, I believe
on the website. It says like, very very rarely in
certain specific instances is someone from Medicare going to actually
call you. So there's a lot of scams out there.
Medicare is contacting you and they need and they're trying
to you know, verify your information. So here ID number
(14:39):
this and that and then you're going to know more
on that subject. But yeah, in very rare circumstances are
they are they doing this. So what they recommend you
do is if someone calls you and they're bringing up
a concern fraudulent charges or wherever they're however they're trying
to get to you and your information, you say, okay,
thank you, you know, I'm going to hang up now,
and then you call the Medicare phone number and then
(15:01):
say this is so and so I got I just
was received a phone call from someone claiming that they
were Medicare representative. And then that's you know, the best way,
and you know that's how we have to do it
as well. On certain scams that like come directly at
me that aren't Medicare related, it could be something else.
Speaker 2 (15:18):
Oh yeah, absolutely.
Speaker 3 (15:19):
In fact, I am during the presentation yesterday, I did
out in the West Valley, you know, and this lady
was talking to me about I think it was the
irs or no, I'm sorry it was it was her
bank maybe that called her, right, and they weren't trying
to sell something. It was they were talking to her
(15:42):
about are you really writing these checks? Could be the
same thing, right, if they're pretending to be a Medicare agent.
You know, we think there might be fraudulent activity on
your account, but I need to verify you, right, And
and I said in that instance, by you saying no,
I wasn't writing those checks, you're not giving out any information.
(16:04):
But your next thing you say is if you want
to be nice and say thank you, I'll get I'll
go to the bank myself and hang out or just
hang up, right, and then verify by calling Medicare or
calling the bank with their you know, you have their
phone number, going down in person and checking things out.
They're going to try to give whoever's on the other
(16:25):
end of the line is going to try to give
you a phone number. Oh, I have the bank's number,
I have Medicare's number, let me give it to you.
It's just going to reroute you right back into that
group that they're in, right, and it won't be them
that answers, It'll be someone else right answering the phone.
So it's it's you mentioned how sophisticated they are AI,
(16:46):
and I would imagine now with AI and voice cloning,
you know, they can get people's voices and call Medicare
and try to trick Medicare right into into something, you know,
maybe saying I lost I lost my card, I need
another one, but oh I've moved, you need to send
(17:09):
it here. You know, I'm kind of thinking off the
top of my head. But and that's something very simple.
I'm sure scammers have already thought about it, so I'm
not trying to give them any ideas. But but yeah,
I mean, it's the AI part of it is just
and they they could you know, they can get voice
(17:30):
recordings of people at Medicare too.
Speaker 4 (17:35):
Yeah, it's crazy accomplish. Yeah, I mean AI is great
in a lot of ways, but then absolutely can be
very scary and a lot of other ways. I think
the yeah, the big point you hit on too. So, yeah,
if someone calls you representing a certain uh agency company, whatever, bank,
(17:56):
and they provide you the phone number, you don't don't
write that phone number down right right exactly. You go
go online and make and look at Medicare's numbers one
hundred Medicare or you can figure out your phone number,
or you just go Medicare dot gov and you just
contact us, or you'll google it and you call that
phone number. You don't call exactly use the information this
because that's exactly the way they get you. Maybe don't
(18:17):
get that get you that phone call, but you write
down that phone number, not really kind of thinking it through,
because they're catching you, you know, while you're making breakfast,
or they're catching you at the wrong times.
Speaker 3 (18:26):
They're not exactly or they're you know, scaring you that
something's wrong with your Medicare account.
Speaker 2 (18:30):
You might lose it, right.
Speaker 4 (18:32):
You're not clearly because they got you with that fear tactic.
Speaker 2 (18:37):
Yep. Absolutely.
Speaker 3 (18:38):
So I actually was doing some research this morning and
found this one website that said the top three Medicare
scams in twenty twenty five, and the first one is
the fake Medicare representative call. So obviously they pretend to
be Medicare agents. They claim there's issues, they're issuing new cards,
(18:59):
or need to verify your information, and it's always seems urgent.
So we're sending you a new Medicare card. We just
need your Medicare number and date of birth to confirm, right.
So that's another that's fishing, trying to get your information
and there it is right there. So how to avoid it,
use a call blocker app or service and report the
(19:21):
call to one eight hundred Medicare. So let me ask
you about the impersonation. Then you, as a Medicare agent,
if someone gave you permission to talk to them about Medicare,
you have to wait until October first before you can
do that.
Speaker 2 (19:41):
Is that how that works?
Speaker 4 (19:43):
For?
Speaker 1 (19:45):
So?
Speaker 4 (19:46):
Correct? So that would be like for obviously we'll have
I'll have my book of business. Yeah, so we'll have
current clients right that are currently in their Medicare plans, right,
So I'm obviously can help them year around. So we're
specifically for that plan you know, in the in say
two thousand and if it's September twenty twenty five, you know,
(20:07):
I can answer questions. I can do everything with that
current plan year. But if we're talking if I am
doing anything that's soliciting for the plan year for twenty
twenty six plans, that's correct that that can't be done
until October first, and that's when the plans are released,
so information on changes to the plans happens then, and
(20:28):
then we still can't accept applications until fifteen seven, So
that's just when the conversations and appointments can begin on
October first before that, and that's that window, and then
obviously it goes through potentially past January. But yeah, you're
correct in that, so that there's another telltale sign. If
(20:49):
someone is reaching out to you in September about plan
information at the end of September, you know, even before
October seventh, trying to enroll you, one of two things
is happening. It could be a scam or they're certainly
not in compliance.
Speaker 2 (21:06):
Right, So for in.
Speaker 4 (21:09):
Medicare, every annually. I have to do a fraud I
do fraud training. I do compliance training annually for Medicare,
So not just once, I have to do it every
year before that that window of October. So I generally
do my training in August, try to get it done
in August, like maybe I'll have left over the beating September,
(21:30):
get it done early. But yeah, every year, so agents know,
all should know all this stuff. I mean, it's beaten
into us year after year, these types of trainings over
and over again. And we have to get a nine
percent pass rate on the on the fraud and abuse training.
So you have to you have to know.
Speaker 2 (21:46):
Your stuff, okay, and you know that's what that is.
Speaker 3 (21:50):
One of the things we talk about is you know,
year round, you might be getting phone calls, emails, stuff
in the mail wanting to talk to you about about Medicare.
And so it's like if they're cond but especially I
would imagine probably July, August, September, July maybe the calls
start ramping up, but for sure August and September they
(22:11):
start ramping up even more. And if they're saying, oh,
we've got this great new plan, we think you qualify
for they have no idea what the what the new
plans are because, as you said, they don't come out
till October first. And one of the tips we tell
people is, you know, you might hear about new plans
from your friends or family members that are going through
(22:33):
the same process, right or it could be someone cold
calls you and you think they're legit and you're listening
to it. But we tell them, don't ever, ever, ever
make a change with someone that's not your agent. You know,
you go directly to your agent if you found if
somebody gave you this information and say, listen, I heard
(22:53):
about this new plan, would this work for me? Because
your agent knows your whole situation. I give an example,
and hopefully i'm correct in this, is that like somebody
might try to convince you to add a policy or
change a policy saying you're going to save all this
money in doctor's visits or you know, medical cost but
(23:15):
then come to find out you're paying more than what
you saved in prescription costs or in other costs. And
so always go to your agent because they know your
whole health situation and you know, yes, that plan might
have saved you money in the medical cost, but your
agent's going to go You're going to be paying so
(23:36):
much more in prescription cost it's not worth it, right,
Or it could be that your agent's like, yep, you
were on my list a call, this plan is going
to be great for you. Let's talk about getting it
put in place. But we just highly stress to them, always, always,
always go back to your agent. Yeah, because I hear
a lot from agents that they find out that, you know,
(24:00):
some of their clients will have switched without coming and
talking to them first. And I'm sure whoever it is
that's talking to them is telling them, oh, you don't
need to tell your agent, it's fine. They get notified.
This happens all the time, you know.
Speaker 4 (24:15):
Yeah, I mean, like you said, I think you're you're bombarded,
especially when you're turning safety five with all this information
and you're just harassed constantly. But yeah, during that window
coming up to open enrollment, a big one is these
medicare advantage plans they will push out and that's a
lot of them, maybe could be smart ones, ones you
(24:36):
haven't heard of, newer to the market potentially, and yeah,
they pushed big time. They're if they're not supplying all
the information that they should about the plans, and they're
you know, trying to get you signed up, you know,
as fast as possible. I mean that, Yeah, you want
to have some caution there. And sure, this is the
(24:58):
same thing with your neighbor, you know what, especially your
neighbor might not necessarily.
Speaker 2 (25:01):
Be everybody's situation is different, Yeah.
Speaker 4 (25:04):
Of course, And there's a lot of choices on the
market too. So yeah, one thing like a dental benefit
on Plan A might be amazing a little bit higher
on one, but that doesn't necessarily mean it's all the
other parts of that plan are going to you know,
fit perfectly for you, just because you're getting a thousand
dollars more in a dental benefit or something like.
Speaker 3 (25:24):
That, right, Yeah, yeah, So, and I guess there are
going to be people out there that don't work with
a Medicare agent. So that's another question, is if they
don't have a Medicare agent, an annual enrollment comes up,
do they just have to call the one eight hundred
Medicare and start talking to somebody there to find out
(25:47):
if they should make a change. I mean, is that
their only other option other than finding a Medicare agent.
Speaker 4 (25:55):
Just like in I guess the wealth management field, there's
there's self directed people. And if you feel, you know,
confident that you know what you're doing and you're shopping
and you have a system in place where you know
you're confident or you're happy with the things are going,
there's there's nothing wrong with that. Of course, I think
there's no harm in using a broker. There's no cost
(26:17):
to you for that. You have another person to run
ideas past. You know, if they're operating from a fiduciary standpoint,
they're looking out for your best interests. I don't have
any incentive to pick one plan over another. Eye contract
with all the major ones, so I don't I don't
get extra incentives from United Healthcare that I do from
Etna or something like that. So I'm looking out for
(26:40):
your best interests. So I think there's a lot of
value with using a broker. Now, if you if you
use like an agent that's specific with Humanity or United
health Care, they're only going to show you human or
United health Care products. I'm not saying that might wouldn't
be the best option for you. Maybe it would be
the best option for you, but you don't know that,
and that agent's not going to tell you one where
or the other because they're pushing you know, their.
Speaker 2 (27:02):
Specific products right that they work with.
Speaker 4 (27:05):
Correct, Yeah, but yeah, So to sign up, I mean,
you can sign up directly through the carrier. So if
you want, if you are self directed, you signed up
yourself through you know, at United Healthcare ARP Medicare Advantage
plan and it's open enrollment, and you know there's gonna
be changes every year, so you know, you can go
on United Healthcare's website and you can look at yourself
(27:27):
at the different changes and what options that they have,
and you can make a change directly through them if
you're not utilizing a broker. They have phone numbers as well.
You can do it over the phone with their agents
at at now or United Healthcare. Typically Medicare dot gov
will Medicare provides information on the plans through the marketplace
(27:52):
you can sign up, which is a separate Under sixty
five stuff, but through through Medicare dot gov. I believe
they're they're normally information wise. You're not you need to
go to the carrier to directly sign up for the
carrier's products. So we're utilizing you know, Social Security and
Medicare dot gov mainly to get our Part A and
Part B coverage. But they have information on their different
(28:16):
plans on their website.
Speaker 3 (28:18):
Okay, this uh sounds like if you're going to do
this on your own, you're you need to invest a
lot of time to do a lot of research to
figure out what's the best plan for you. So if
I were looking at it, which I will be in
(28:39):
five years, four and a half years, I'm going to
use a broker.
Speaker 2 (28:46):
I'm going to use a Medicare agent.
Speaker 3 (28:49):
Because they already know, right, like someone like you that
works with I mean, I can get information for someone
that works directly with United or with ARP or with
or whoever. But I think I would want to work
with someone who is contracted with all the carriers to
(29:11):
be able to see which plan would actually work best
for me. And there's there's different So there's Part A,
there's Part B. I've heard about Part D. Is there
a Part C? Or did they skip C?
Speaker 4 (29:25):
They that's called the I think they refer to that
as the alphabet Medicare alphabet soup because they have all
these different letters in there, and no one well I
shouldn't say no one knows what they mean. But they
could be confusing, right for first, when you're looking into
medicare for the first time. So Part A is your
hospital coverage, and there's some other stuff in there, but
(29:45):
you mainly think of it as your hospital coverage. When
you are working throughout your career or your spouse is working,
you'll see in your pit and you look at your paycheck.
Speaker 2 (29:55):
And you have Medicare taken out, and they have.
Speaker 4 (29:57):
Medicare taken out. It's going to Part A to fund
Part A. So for most people, if you have ten
years of work experience, your spouse has ten years of
work experience, you automatically are covered on Part A at
no additional costs because you've been paying into that system.
Now Part B there is a cost for that, and
it can be linked to your income, and they use
(30:20):
a two year look back, so we look at your
tax returns two years prior essentially, so say your say
your taxes are pretty high, or say you've made a
lot of money the two years that you're just retired.
Now you might pay a little bit more. Some people,
if your lower income, you pay a little bit less
or even nothing on Part B. But generally for most people,
(30:42):
you know you're it's the standard rate. Is was it
one ninety one something like around that ballpark this year
for Medicare Part B, and that's your outpatient services. When
you go to your PCP, you go to your specialist
care covers, so you have Part A and Part B.
You get those by signing up through Social Security and
(31:06):
that gets you your Part A Part B. You get
your Medicare card with your effective dates when you do that,
and that's what you need in order to sign up
for either a supplement plan or an advantage plan. And
it makes sense to go one of those routes, two routes,
because otherwise you're on the hook for deductibles and co
insurance and things like that. If you sign up for
an advantage plan, you know a lot of those deductibles
(31:30):
go away. There's generally zero deductible for anything, maybe very
low on specific plans. Supplements, they're going to go away too.
There might be some co insurance. With an advantage plan.
On the supplement side, you're you're more or less paying
a monthly premium and your hospital, your outpatient all that
(31:53):
stuff is more or less going to be there's different plans,
but it's when to be covered and you're just essentially
using your you're paying your premium monthly. But don't want
to get too into the weeds with all this stuff.
This is the first This is kind of the first part.
The first things I start with with a new client
that's newly eligible to Medicare is going over these basics
(32:13):
and trying to figure out what is going to be
the best route for them. That's the first question you
need to answers. Is Medicare advantage a better route for me?
Or is Medicare supplement a better route for me? It's
generally going to be one of those two, and not
just your standard Medicare A and A and B. Now,
so that's A and B. Parts C is another It
(32:33):
is Medicare advantage. So it's just another word for an
A Medicare advantage. So not everyone has Part C because
you may have Part B Part A and Part B
and a supplement plan. If you're going that route, you
don't have an advantage plan. You can't have both one
or the other. And then Part D is your prescription
drug coverage. So A, B, C, D would be the
alphabet soup of Medicare.
Speaker 3 (32:55):
Wow, I don't know why they just didn't call it
this is your medical coverage, this is your hospital coverage,
this is your advantage, and this is prescriptions. But it's
it just it sounds confusing. And was it last year
during open and annual enrollment that there was a ton
(33:15):
of changes in Medicare or was it a couple of
years ago.
Speaker 4 (33:19):
I think the biggest recent change that just is affecting
things for all carriers and plans starting in twenty twenty
six or I guess it really this past year actually
few and twenty five would be the Inflation Reduction Act. Okay,
so that was put in place to protect consumers from
(33:44):
from larger expenses in terms specifically on prescription medication coverage okay,
deductible or not deductibles. Out of pocket maxes could could
be seven thousand dollars plus, you know if you're on
these very expensive medicaid. So that's been lowered by a lot.
I mean it's down to like two thousand or less,
(34:05):
so that's going to be like cap at the match
you will pay for prescriptions. Insulin costs was lowered, and
that's that's been a hot spot.
Speaker 2 (34:14):
Yeah, that's the last couple of years.
Speaker 4 (34:15):
Yeah, yeah, yeah, I mean you talked a lot about it, right, right,
that the costs like actually making insulin, it's not expensive,
but they're charging so much an insulince. So you know,
that's been a hot spot for our government officials attacking.
So they've that was one of the things they've attacked,
the prescription medications, the insulin lowering costs for consumers. So
that's a good thing overall for consumers. But if we
(34:37):
look at the flip side of thing, if these insurance
carriers are margins changed, right, they're making less now if
they were making more, So they have to tweak their
plans and make changes. So we see you know potentially
you know, uh Co Insurance maybe going up a little
bit on certain things or you know, different things than
(34:58):
the plan have to change because they have to make
their margins work in their company. They don't like I
when you look at I guess you'll see in the
news or Unite Healthcare how much money that they've made.
And but they're just a huge company. Like their margins
from individual to individual aren't like huge amounts. They're not
making you know, all this tons of money off you
because one person might be in the hospital and you
(35:19):
know they're throwing out fifteen thousand dollars.
Speaker 2 (35:22):
Check what's the economies of scale? Right? Corect it.
Speaker 3 (35:27):
You know, the profit that you make off of one
consumer is x, but when you multiply that by millions
of customers, then I mean that's your profits are a
lot more exactly. Yep, yeah, yeah, I was going to
look back to this article that to see what these
(35:50):
other scams. So another one is fake Medicaary equipment or
coverage claims. Well, we talked about this. They submit false
claims for medical vices or services you never received, and
it says to make sure you keep a record of
your legitimate Medicare appointments and compare them again against your statements.
Speaker 2 (36:13):
Did I miss number?
Speaker 3 (36:14):
Oh here's a bogused Medicare refund offers. They promise a
Medicare refund or reimbursement. To receive it, they say you
must verify your identity by providing your sole security number
or bank details.
Speaker 2 (36:27):
That's where they get you.
Speaker 4 (36:29):
I haven't that one, and obviously that refund does not exist.
But right, yeah, it's surprising in the slightest Yeah, well.
Speaker 3 (36:36):
Right, because then that's a way to say that you know,
they could actually get into if you allow them into
your system and you know, you're accessing your bank account.
It's kind of the same thing with the tech support scams.
They've evolved over the years, and they started doing subscription refunds, right,
and then they're you're seeing that. And in fact, I
(36:58):
talk to a lady about this recently. She was actually
putting the five hundred dollars in and she said, I
only put two zeros, but a third zero came up
like five thousand dollars.
Speaker 2 (37:09):
She goes, I don't know.
Speaker 3 (37:10):
And he obviously whoever it was, had control of her system.
And then they're like, oh, my gosh, I'm going to
get fired, blah blah blah, and you know you need
to give the money back. And so that's another way
that scammers evolve, right, And they're not making enough money
off their original medicare scams, so they tweak it a
little bit and try to catch people off guard.
Speaker 4 (37:35):
That's amazing. I mean these are huge operations too. I've
I've seen some of them in years ago. I mean
they have massive call centers, yep, rows and rows of
people that are doing this, and I mean the money
involved is insane.
Speaker 2 (37:52):
Oh, it's really insist.
Speaker 4 (37:55):
They really are they're very smart at times, it's scary.
Speaker 2 (38:00):
Yeah.
Speaker 3 (38:01):
They this article that I was reading, it says in
twenty twenty four, the Medicare Part D, so the prescription
program alone saw an estimated improper payment rate of three
point seven percent, which totaled three point five eight billion
in losses. And that was just with the Part D program.
Speaker 4 (38:26):
Yeah, yeah, I mentioned my dad. Yeah, he obviously worked
in that field for some time. There was a company
out of Florida. Yeah. I mean they were doing massive
amounts of specifically doing.
Speaker 2 (38:42):
The fraudulent billings.
Speaker 4 (38:44):
Fraudulent buildings with like a pharmacy, and they had a network.
I mean, this is how sophisticated stuff is. I mean
they had a fake pharmacy in Florida, this whole network
of like none of this like actually existed, but it
like if Medicare, you know, from their side of the
house or from other people, it looked like it actually
did because they were doing Yeah, they had shell companies
(39:05):
and they were billing. They were doing all this billing.
They're doing things correctly. It was coming from the pharmacy
was going to this carrier was you know we're there. Yeah,
I mean hundreds of millions of dollars.
Speaker 2 (39:14):
Yeah, yeah, it's it's just crazy.
Speaker 3 (39:18):
So, I mean, if you can consider the money lost
in Part A, B, and C, you know, we're in
the hundreds of billions of dollars, if you know, not
close to a trillion dollar and and so do you
do you think they're just going to say, oh, this
isn't making enough money. You know, I'm going to go
find something else to do. Now they're making all of
(39:40):
this money, and this is and we only know based
on what people report, right, And I mean, unless they
they find the group that's doing it.
Speaker 2 (39:52):
But I'm sure I shouldn't say. I'm sure.
Speaker 3 (39:56):
My guess is that they're not keeping records of exactly
who they scammed and how much they got out of them.
Speaker 2 (40:03):
But I don't know, you know, maybe they are, maybe.
Speaker 3 (40:05):
They're maybe they're detailed like that.
Speaker 2 (40:07):
But uh so, I think.
Speaker 3 (40:09):
The the dollars lost is just so it's it's so
much more than what we actually know.
Speaker 4 (40:17):
Oh is more because they haven't caught the ones that
are still working, right.
Speaker 2 (40:22):
Oh, exactly right.
Speaker 3 (40:25):
So we're gonna wrap up, but I want to put
some tips out there that people can use to stay safe.
And you had mentioned a website Medicare dot gov. But
I had also found there's one called Healthcare dot gov.
Are you familiar with that website?
Speaker 4 (40:42):
Yeah? Yeah, I hope they're there, should be, maybe there's
Medicare stuff on there. I specifically utilize healthcare dot gov
for the market Blaze plan, so the under if you're
under sixty five, okay, the the ACE that go buy
again in a few different names, but it the A
C A, so the Affordable Care Act plans. They'll also
(41:03):
call them the marketplace plans, and it's also a reference
as Obamacare plans. So those are the all the individual
and family plans for are under sixty five. Individuals and
families that you know, maybe self employed don't have a
group plan that they can get into or not Medicare
eligible yet. So that's so that maybe there's some some
(41:27):
Medicare information on there as well, but uh, usually that's
going to be directed towards the marketplace stuff, and then
Medicare dot gov will be the Medicare stuff. There is
a a newsletter I get you can, so if you
go to Medicare dot gov, you can sign up for
a newsletter there and they'll push out a lot of
good information. If they're going around and signed newsletter. They'll
(41:47):
say they'll they'll show you. They'll send information aby the
scam that they found that is going around and nice
steps you can do, and other information about Medicare. So
I highly recommend signing up for that newsplayer just via email.
I mean maybe they can send it to your paper,
to your house as well. But I get a via
email because you can go to Medicare dot sign up
for those, and there's a different newsletter options ARP probably
(42:12):
has a lot of good information I get. I get
some stuff from there. Good company, and I'm sure there's
there's others too, you know, the cares and whatnot, whatnot.
Speaker 3 (42:21):
Yeah, that deals specifically, I know, Uh. In our our newsletter,
we're gonna because it is annual enrollment, we're putting stuff
out about Medicare, and which is why I wanted to
do this podcast now, because it's the early part of
annual enrollment. So I think some other tips are going
to be if you're not using an agent, which in
(42:43):
my opinion, I highly suggest you use an agent. If
you don't have one, talk to your family and friends
and find out who they use. If you know they're
trusted person and all of that, But if you still
just want to do it on your own, just make
sure you research and research and make sure you understand
all four parts and how they operate and understand what
(43:06):
each of them offers you so you can make an
educated and formed decision as to what's going to work
best for you. And then always monitor your statements. I'm
guessing Medicare sends out. I don't know if it's monthly,
weekly or or you know, bi weekly, but they're going
(43:28):
to send you statements that are going to list all
of your charges.
Speaker 4 (43:34):
And sign up for Medicare dot gov. You know, have
a have an account on there you can okay electronically,
you'll get other information from your career as well. Okay,
up for their electronics stuff where you can get in
your system and see you know, up to date stuff.
You know, who knows if you're getting everything in the
mail or if maybe you signed up or your broker
(43:55):
signed you up for electronic only statements, So make sure
you know you're logging in there, you know, make sure
that they're not in your spam, you know, and your
if you signed up for them electronically.
Speaker 3 (44:07):
Yeah, and then Social Security had changed their processes they
weren't as of the end of September, they were no
longer going to be mailing checks. Everybody had to go
on s s A dot gov and make sure they
had an account set up and you could do the
direct deposit or there was another and I don't remember
(44:32):
exactly what it was. It was some sort of card
or something that you could get each month that would
have your benefits on it.
Speaker 2 (44:41):
You'd have to go on there and look at it.
Speaker 3 (44:43):
But is so signing setting up an account at medicare
dot gov is going to be very helpful because you
could always go on if you happen to not find
your you know, your Medicare statements, or you lose you
could always go on there and look at your statements
and look at your charges, and you can see the
(45:06):
charges before you actually get your statements, I would imagine.
And then I'm sure they have a button you can
push push to report fraudulent charges as well. But you know,
like you mentioned the different carriers like ATNA and United Healthcare,
whoever your carrier is, you know, get on their website.
I'm sure they do newsletters as well that they'll send
out information and you'll get information on new updates that
(45:28):
they have as well.
Speaker 4 (45:31):
Yeah, and you know I should clarify. I guess you know.
Medicare is never going to send you a check or
the game was. But there are certain there are certain
plans through carriers, advantage plans where you can get money
to use for over the counter prescriptions and things like that.
(45:53):
But that will be a car that they send you,
so you know they're not going to contact them and
get a check center or anything like that. But they'll
send you either the same card that you use for everything,
or separate card that you can use for a certain
prescription or over the counter medications and other things. So
(46:13):
there are plans that do exist. So if you hear
something like that, like I get my neighbor says I
get extra benefits, like I get one hundred and fifty
bucks on my card every quarter, that does exist. So
I just want to clarify that.
Speaker 3 (46:26):
For certain things. Right, But you're not, like you said,
you're not going to get a check in the mail
for a refund. No, not for Medicare right from Medicare
right like you, some people normally got SOID security checks
in the mail every month. They're doing away with it.
They've done away with it. Everybody by the end of
September needed to have signed up for their online account
(46:50):
if they haven't already. So anything else too, yeah, yeah,
anything else that you think would be beneficial.
Speaker 4 (47:00):
For the tips, I think we hit on a lot.
I think you hit on a lot.
Speaker 2 (47:10):
I mean we hit on the timelines.
Speaker 3 (47:12):
And you know about if you're still working, you know
you're and you have credible coverage, you will get a
letter from your carrier or your HR person to prove
that so you won't get penalized. But to start planning
early if you know when you're going to retire, because
the processing times could take a while to get signed up.
(47:32):
And I mean most people, most people, I think, know
when they're going to retire. Sometimes, you know, a company
might force you into early retirement or into retirements you
might not have too much notice.
Speaker 4 (47:44):
I mean I have clients their company gets bought out
by another company exactly all the employees.
Speaker 2 (47:49):
Happens all the time, has right, Yeah, But.
Speaker 4 (47:53):
Most people like you said, no, they're okay, I'm going
to retire six months right, Yeah, that's one of our.
Speaker 2 (48:01):
Start planning early. So all right, Well, thanks Steve.
Speaker 3 (48:04):
Lots of great information and I'm at I'm going to
sign up for Medicare's newsletters because I don't want to
have to go searching the internet on you know, the
new scams that are out there. I'd like to hear it,
you know, right from them as to what they're seeing.
So I'm definitely going to sign up for that. Yeah,
all right, thanks again, Steve, really appreciate your time with this. Joyce,
(48:28):
all right, take care, all right, everyone, So we uh
a lot of information here about Medicare. Steve's very knowledgeable
and uh, there's a lot. We're in the Phoenix, Arizona area.
There is a lot of great Medicare agents out here
in Phoenix. I'm sure there's a lot of great Medicare
agents wherever you live. If you don't have one, in
(48:52):
my opinion, I would suggest you use one. It's not
going to cost you anything at least to have a
review done to make sure you have the best policy
for you or policies. Talk to your friends and family
and find out if they have a trusted Medicare agent
that they use, and and and talk to that person
(49:13):
and watch your Medicare statements and uh, excuse me, report
any fraudulent charges to whoever your carrier is, and and
get your Medicare account sign uh established online as well.
All right, so don't forget Get on our website, Roseadvocacy
dot org. You'll find our social media links bottom of
(49:35):
the homepage. Sign up for our newsletters. Uh you can
get one via email and or in the mail and
uh hit the subscribe button so you don't ever miss
an episode. And next week we are going to be
talking to we have a guest. We're going to be
talking to her about scam experience that she had, so
(49:58):
you're going to want to tune in for that.
Speaker 2 (49:59):
Thank you everyone.
Speaker 1 (50:02):
Well that's all the knowledge for this episode. Tune in
every Tuesday at eight am Pacific time on KFOURHD Radio
at KFORAHD dot com as Joyce explores a variety of knowledge.
So you have the power to make scam protection your
healthy habit. And until then, feel free to reach out
to Joyce and let's talk about scams.
This program is designed to provide general information with regards
to the subject matters covered. This information is given with
the understanding that neither the hosts, guests, sponsors, or station
are engaged in rendering any specific and personal medical, financial, legal, counseling,
professional service, or any advice. You should seek the services
(00:23):
of competent professionals before applying or trying any suggested ideas.
The information contained in this podcast is intended for informational
purposes only and is not a substitute for individual professional
legal advice. The podcast information was carefully compiled from vetted
sources and references. However, Rose Resources outreach to safeguard the
(00:45):
elderly cannot guarantee that you will not fall victim to
a scam. Let's talk about scams. It's the must listen
show for anyone who wants to protect themselves and their
loved ones from scams. Every Tuesday at am Pacific time
on K four HD Radio, Joyce Petrowski, founder of Rose,
(01:06):
and her guests will provide valuable insights and practical tips
on how to recognize and protect yourself from scams. And
now here is your host, Joyce Petrowski.
Speaker 2 (01:19):
Hi, everybody, welcome, back.
Speaker 3 (01:21):
I trust you enjoyed last week's show with Brian talking
about the urgency and why we need the scam prevention
through education out there to educate everybody on how to
recognize a scam and prevent yourself from falling victim to it.
(01:42):
Today it is we are in the annual open enrollment
for Medicare, and so we are going to be talking
to Steve Slatnik about he's a Medicare agent and about
some different Medicare scams and how you can protect yourself.
But first, don't forget to go to the website Roseadvocacy
(02:03):
dot Org. On the homepage you'll find our social media
links and scroll down to the bottom you can sign
up for our mailed and or emailed newsletter. You're gonna
want to hit subscribe so you don't miss an episode,
and you can also find all the episodes on YouTube.
But also are Let's talk about Scams dot com website.
Speaker 2 (02:22):
So now let's bring Steven so we can get going.
Speaker 4 (02:27):
Hi Steve, Hi Joyce, thanks for having me.
Speaker 2 (02:30):
Thanks, how you doing.
Speaker 4 (02:33):
I'm doing great this morning. Like you said, it's open enrollment,
so this is my busy time of the year, but
things are going well.
Speaker 2 (02:40):
Good, good, good.
Speaker 3 (02:41):
Could you just take a minute and let everyone know
your background and what it is you do.
Speaker 4 (02:48):
Sure. Yeah, I've worked in the financial services industry for
about fifteen years. For the past over five years now,
I've had my own insurance agencies and independent insurance agency.
It's called Panga Insurance Services, and I'm an independent insurance broker.
I specialize in health insurance and Medicare, so I work
(03:08):
with a lot of seniors. And you don't necessarily have
to be sixty five plus to have eligible for Medicare,
but many of my clients, of course, are the majority
of people in Medicare are sixty five plus, so I
work with a lot of our seniors and Medicare eligibles.
Speaker 2 (03:28):
All right, well, very good.
Speaker 3 (03:31):
So annual enrollment started October fifteenth, Is that right?
Speaker 2 (03:37):
About a week ago?
Speaker 4 (03:38):
Correct? Yeah? And depending on what plan you have, I mean,
if you have an advantage plan or if you have
a supplement plan, they make it as confusing as possible,
of course, but open enrollment can be a little bit different.
But really for most people, if you want a January
first effective date, so if you're making any changes in
open enrollment, that will be done from Octo over fifteenth
(04:01):
to December seventh is our window.
Speaker 2 (04:04):
And those changes take effect January first.
Speaker 4 (04:07):
That's correct, okay.
Speaker 2 (04:09):
And is there some other.
Speaker 3 (04:13):
Enrollment period that starts in January and runs for a
few months.
Speaker 4 (04:20):
And that would be specific to if you had a
Medicare advantage plan, so you do have a little bit
of a buffer there. So if you're signing up for
a Medicare advantage plan in January, or you have even
a little bit after that, it could it would then
take effect the first of the following month. So if
you make a change in your Medicare advantage plan in January,
that change would be effective for February first, for instance.
(04:42):
But that's a specific to the Medicare advantage only for.
Speaker 2 (04:46):
That window, okay, all right, And then.
Speaker 3 (04:51):
I also want to clarify that my understanding of when
you have to sign up you have a window to
first when you first sign up for Medicare, and that's
the three months before the month you turn sixty five,
the month you turn sixty five, and three months after
that that's your seventh month window.
Speaker 4 (05:10):
That's correct. The biggest I guess question or uh, what
people don't always get right though, is if you are working,
still working in your over sixty five, you don't have
to sign up for Medicare if you have what's called
(05:31):
credible coverage, and that normally means you have a large
employer of twenty five plus employees. You'll get a letter
every year saying that this is credible coverage. My prescription
drug coverage is credible coverage, my health insurance is credible coverage.
If you have if you get that letter every year,
you work with a large employer, you have health insurance,
(05:53):
and say this employer UH covers your health insurance one
hundred percent, it might make sense you just keep that
and you don't necessarily have to sign up for Medicare
when you're sixty five. In that seven month window that
you referred to, you then can have what's called a
special election period, so when you decide to retire or
(06:15):
you lose coverage, there's some other instances where you can
have that. You can then can sign up for Medicare
and be sixty seven years old, sixty eight years old,
so you your age of turning sixty five no longer
matters because you had credible coverage insurance this whole time,
and you will not be penalized. So that's the Okay,
one of the big things I think people just information wise,
(06:36):
providing information wise that I do out there a lot,
because a lot of people are still working a little
bit later past sixty five, you know, ten years ago,
twenty years ago, that might have not been in a case,
but I think, I mean, I get a lot of
people that are in their sixties that are still working,
and we hold off on getting them medicare, especially if
their plan is one hundred percent covering their insurance. So
(06:59):
no pointing that you know, part be pretty much you know,
almost two hundred dollars now every month.
Speaker 3 (07:07):
So and you can is it your current employer that's
offering that coverage for you? Is it their responsibility to
send you that letter?
Speaker 4 (07:17):
The insurance carrier, the insurance carrier, one of the two. Yeah,
normally the insurance carrier takes we'll provide that that's part
of their responsibility. Okay, So it'll normally directly come from them,
but you know, depending on how the plan is set up,
you know, maybe the HR, it.
Speaker 3 (07:34):
Could go to the HR of the company and then
the HR distributes it to all the people that it
applies to. So that's interesting I didn't know that part
about it.
Speaker 4 (07:44):
One.
Speaker 2 (07:44):
Yeah, yeah, and so, and.
Speaker 3 (07:50):
You mentioned you won't get penalized because you have the
credible coverage.
Speaker 2 (07:54):
So is there a time limit.
Speaker 3 (07:56):
Let's say let's say I'm sixty seven and I am
still working and I have credible coverage, I have the
letter to back it up, and then I decide to retire.
Do I have a certain time limit before then I
need to sign up for Medicare?
Speaker 4 (08:16):
Correct? Yeah, you don't have that seven month window. I
believe it's a sixty day window in that case. Okay,
Now the other thing is now when we're applying for
Part B and these Medicare programs, processing takes a little
bit of time. So if you know you are, my
recommendation is if I know I'm sixty seven, I'm sixty eight.
(08:39):
I held off on doing anything with Medicare and going
in there. Signing up through Social Security is where you
sign up for Medicare Part and B. Sometimes you're automatically
sign up for Part A. But say you're sixty seven,
you have not yet signed up for Medicare Part A
Part B. You know you're retiring in September. We want
(08:59):
to be pro active in that sense and and be
signing up for Part B, you know, a month or
two ahead of time, because processing times are based on
how busy they get over there. So sometimes it's a
couple sometimes it's three weeks processing. Other times it's been
much longer. So make sure we're doing that early. Used
to they used to let you in the Social Security system,
they used to let you pick your effective date, like
(09:21):
so I could an individual could go in there and say,
I want my Part B to be effective September one,
and they're doing this month in advance. They don't Maybe
maybe if you go in person they would allow that,
but when you're at least online, they're no longer like
giving you that option. So they're just kind of processing
it as quickly as they can, and then it's becoming
(09:41):
effective you know, the first of the next month. But again,
you know, sometimes that can take over a month or
two months, you know, and in certain instances, right and
going on with the THAL shutdown right now, I could
be a basic if you're you're looking at medicare right now, man,
you know, get on that as soon as possible.
Speaker 3 (09:59):
I bet they're not right, yeah, And you mentioned you
know you might be able to pick your starting date.
If you go to Soil Security in person, that's you
better plan a whole day, because I know I had
to do that. My mom passed away almost six years
ago and I had to go down to SOL Security
because we had an issue and it required a manager
(10:21):
that I had to sit and go through everything with.
And I made an appointment, and I thought, oh wow, okay,
this is great.
Speaker 2 (10:28):
I can make an appointment.
Speaker 3 (10:29):
And all that did was get me through the first line,
and then you have to go to the second line,
and that could be really long, and then you check
in at the second line, and I still waited two
and a half hours before I could see somebody. So
it was literally like a four to five hour you
know timeslot, and everybody's busy, you know, like I say,
(10:52):
you don't set aside time to talk to the irs
or the sole security here or anything.
Speaker 2 (10:56):
But all right, so that's interesting. So scams.
Speaker 3 (11:04):
Have you seen or heard from your clients or maybe
read anything about some current Medicare scams that are going on.
Speaker 4 (11:15):
Yeah, you know, my dad actually worked in this field
as an attorney for quite some time. He's retired now,
but he worked on like government scams which would include
the Medicare and Medicaid system. And so this is huge
amounts of money, right that they absolutely into these programs.
(11:37):
So there's a lot of incentive right for fraudden because
there's I mean we're talking millions plus.
Speaker 2 (11:43):
Right right, more Yeah, billions.
Speaker 4 (11:46):
I mean there's hundreds of million dollar scams constantly going
on where they are people are.
Speaker 2 (11:55):
Billing frauduling charges right, quaduling.
Speaker 4 (11:59):
Charges and using people's information, whether they know it or not,
to run up these charges.
Speaker 2 (12:07):
So that's a that's I have a question there with that.
Speaker 3 (12:11):
You know, That's one of the things we warn people
about in our presentations is you really need to monitor
your Medicare statements because if you find fraudulent charges, then
what's the best thing for them to do. Go directly
to their Medicare agent about it, or go directly to
(12:32):
the Medicare government office.
Speaker 4 (12:35):
Yeah, I go go. Medic recommends that you go directly
to them. I can assist in a lot of different ways.
I mean I so obviously my my expertise is more
along the lines of the whole I can help you
sign up with Medicare.
Speaker 2 (12:50):
I can getting people on the right plan.
Speaker 4 (12:52):
I get you people on the right plan. I analyze
different prescription drug plans and things like that, but yeah,
I can. I can certainly point you in the right direction.
But in terms of managing that, yeah, directly through medicare.
Contact them as soon as possible. Contact your carrier as well.
Most people ninety nine point nine percent of people are
going to have their medicare connected to either an advantage
(13:13):
plan or supplement plan. So you want to contact you know,
your supplement or advantage carrier as well so that they're aware.
And these carriers might pick up on it, you know,
even before you and be the ones that are notifying
you of chargers that just don't look right to them.
Speaker 2 (13:29):
Yeah, all right. Yeah.
Speaker 3 (13:31):
I had a lady once tell me, you know, she
was monitoring her statements and there was like ten thousand
dollars in catheters and she's like, I've never used a catheter, so,
you know, and it happens, right, and there might be
some little charges that get slipped through in the beginning,
right that kind of like credit cards. Sometimes they'll charge
(13:51):
a little bit just to make sure the card's active
and it's working, and then here comes all the other charges.
Speaker 4 (13:57):
They're just so sophisticated. These days are easy to miss
this I second guest, My you know some emails as
you know a business owner as you as well, Joyce.
I mean we get these constantly through the through email,
through the phone. They're just so sophisticated. Now, one thing
Medicare recommends that you do if you know, if you
(14:18):
have someone calling you directly. First of all, Medicare is
not going to call you directly, it says, I believe
on the website. It says like, very very rarely in
certain specific instances is someone from Medicare going to actually
call you. So there's a lot of scams out there.
Medicare is contacting you and they need and they're trying
to you know, verify your information. So here ID number
(14:39):
this and that and then you're going to know more
on that subject. But yeah, in very rare circumstances are
they are they doing this. So what they recommend you
do is if someone calls you and they're bringing up
a concern fraudulent charges or wherever they're however they're trying
to get to you and your information, you say, okay,
thank you, you know, I'm going to hang up now,
and then you call the Medicare phone number and then
(15:01):
say this is so and so I got I just
was received a phone call from someone claiming that they
were Medicare representative. And then that's you know, the best way,
and you know that's how we have to do it
as well. On certain scams that like come directly at
me that aren't Medicare related, it could be something else.
Speaker 2 (15:18):
Oh yeah, absolutely.
Speaker 3 (15:19):
In fact, I am during the presentation yesterday, I did
out in the West Valley, you know, and this lady
was talking to me about I think it was the
irs or no, I'm sorry it was it was her
bank maybe that called her, right, and they weren't trying
to sell something. It was they were talking to her
(15:42):
about are you really writing these checks? Could be the
same thing, right, if they're pretending to be a Medicare agent.
You know, we think there might be fraudulent activity on
your account, but I need to verify you, right, And
and I said in that instance, by you saying no,
I wasn't writing those checks, you're not giving out any information.
(16:04):
But your next thing you say is if you want
to be nice and say thank you, I'll get I'll
go to the bank myself and hang out or just
hang up, right, and then verify by calling Medicare or
calling the bank with their you know, you have their
phone number, going down in person and checking things out.
They're going to try to give whoever's on the other
(16:25):
end of the line is going to try to give
you a phone number. Oh, I have the bank's number,
I have Medicare's number, let me give it to you.
It's just going to reroute you right back into that
group that they're in, right, and it won't be them
that answers, It'll be someone else right answering the phone.
So it's it's you mentioned how sophisticated they are AI,
(16:46):
and I would imagine now with AI and voice cloning,
you know, they can get people's voices and call Medicare
and try to trick Medicare right into into something, you know,
maybe saying I lost I lost my card, I need
another one, but oh I've moved, you need to send
(17:09):
it here. You know, I'm kind of thinking off the
top of my head. But and that's something very simple.
I'm sure scammers have already thought about it, so I'm
not trying to give them any ideas. But but yeah,
I mean, it's the AI part of it is just
and they they could you know, they can get voice
(17:30):
recordings of people at Medicare too.
Speaker 4 (17:35):
Yeah, it's crazy accomplish. Yeah, I mean AI is great
in a lot of ways, but then absolutely can be
very scary and a lot of other ways. I think
the yeah, the big point you hit on too. So, yeah,
if someone calls you representing a certain uh agency company, whatever, bank,
(17:56):
and they provide you the phone number, you don't don't
write that phone number down right right exactly. You go
go online and make and look at Medicare's numbers one
hundred Medicare or you can figure out your phone number,
or you just go Medicare dot gov and you just
contact us, or you'll google it and you call that
phone number. You don't call exactly use the information this
because that's exactly the way they get you. Maybe don't
(18:17):
get that get you that phone call, but you write
down that phone number, not really kind of thinking it through,
because they're catching you, you know, while you're making breakfast,
or they're catching you at the wrong times.
Speaker 3 (18:26):
They're not exactly or they're you know, scaring you that
something's wrong with your Medicare account.
Speaker 2 (18:30):
You might lose it, right.
Speaker 4 (18:32):
You're not clearly because they got you with that fear tactic.
Speaker 2 (18:37):
Yep. Absolutely.
Speaker 3 (18:38):
So I actually was doing some research this morning and
found this one website that said the top three Medicare
scams in twenty twenty five, and the first one is
the fake Medicare representative call. So obviously they pretend to
be Medicare agents. They claim there's issues, they're issuing new cards,
(18:59):
or need to verify your information, and it's always seems urgent.
So we're sending you a new Medicare card. We just
need your Medicare number and date of birth to confirm, right.
So that's another that's fishing, trying to get your information
and there it is right there. So how to avoid it,
use a call blocker app or service and report the
(19:21):
call to one eight hundred Medicare. So let me ask
you about the impersonation. Then you, as a Medicare agent,
if someone gave you permission to talk to them about Medicare,
you have to wait until October first before you can
do that.
Speaker 2 (19:41):
Is that how that works?
Speaker 4 (19:43):
For?
Speaker 1 (19:45):
So?
Speaker 4 (19:46):
Correct? So that would be like for obviously we'll have
I'll have my book of business. Yeah, so we'll have
current clients right that are currently in their Medicare plans, right,
So I'm obviously can help them year around. So we're
specifically for that plan you know, in the in say
two thousand and if it's September twenty twenty five, you know,
(20:07):
I can answer questions. I can do everything with that
current plan year. But if we're talking if I am
doing anything that's soliciting for the plan year for twenty
twenty six plans, that's correct that that can't be done
until October first, and that's when the plans are released,
so information on changes to the plans happens then, and
(20:28):
then we still can't accept applications until fifteen seven, So
that's just when the conversations and appointments can begin on
October first before that, and that's that window, and then
obviously it goes through potentially past January. But yeah, you're
correct in that, so that there's another telltale sign. If
(20:49):
someone is reaching out to you in September about plan
information at the end of September, you know, even before
October seventh, trying to enroll you, one of two things
is happening. It could be a scam or they're certainly
not in compliance.
Speaker 2 (21:06):
Right, So for in.
Speaker 4 (21:09):
Medicare, every annually. I have to do a fraud I
do fraud training. I do compliance training annually for Medicare,
So not just once, I have to do it every
year before that that window of October. So I generally
do my training in August, try to get it done
in August, like maybe I'll have left over the beating September,
(21:30):
get it done early. But yeah, every year, so agents know,
all should know all this stuff. I mean, it's beaten
into us year after year, these types of trainings over
and over again. And we have to get a nine
percent pass rate on the on the fraud and abuse training.
So you have to you have to know.
Speaker 2 (21:46):
Your stuff, okay, and you know that's what that is.
Speaker 3 (21:50):
One of the things we talk about is you know,
year round, you might be getting phone calls, emails, stuff
in the mail wanting to talk to you about about Medicare.
And so it's like if they're cond but especially I
would imagine probably July, August, September, July maybe the calls
start ramping up, but for sure August and September they
(22:11):
start ramping up even more. And if they're saying, oh,
we've got this great new plan, we think you qualify
for they have no idea what the what the new
plans are because, as you said, they don't come out
till October first. And one of the tips we tell
people is, you know, you might hear about new plans
from your friends or family members that are going through
(22:33):
the same process, right or it could be someone cold
calls you and you think they're legit and you're listening
to it. But we tell them, don't ever, ever, ever
make a change with someone that's not your agent. You know,
you go directly to your agent if you found if
somebody gave you this information and say, listen, I heard
(22:53):
about this new plan, would this work for me? Because
your agent knows your whole situation. I give an example,
and hopefully i'm correct in this, is that like somebody
might try to convince you to add a policy or
change a policy saying you're going to save all this
money in doctor's visits or you know, medical cost but
(23:15):
then come to find out you're paying more than what
you saved in prescription costs or in other costs. And
so always go to your agent because they know your
whole health situation and you know, yes, that plan might
have saved you money in the medical cost, but your
agent's going to go You're going to be paying so
(23:36):
much more in prescription cost it's not worth it, right,
Or it could be that your agent's like, yep, you
were on my list a call, this plan is going
to be great for you. Let's talk about getting it
put in place. But we just highly stress to them, always, always,
always go back to your agent. Yeah, because I hear
a lot from agents that they find out that, you know,
(24:00):
some of their clients will have switched without coming and
talking to them first. And I'm sure whoever it is
that's talking to them is telling them, oh, you don't
need to tell your agent, it's fine. They get notified.
This happens all the time, you know.
Speaker 4 (24:15):
Yeah, I mean, like you said, I think you're you're bombarded,
especially when you're turning safety five with all this information
and you're just harassed constantly. But yeah, during that window
coming up to open enrollment, a big one is these
medicare advantage plans they will push out and that's a
lot of them, maybe could be smart ones, ones you
(24:36):
haven't heard of, newer to the market potentially, and yeah,
they pushed big time. They're if they're not supplying all
the information that they should about the plans, and they're
you know, trying to get you signed up, you know,
as fast as possible. I mean that, Yeah, you want
to have some caution there. And sure, this is the
(24:58):
same thing with your neighbor, you know what, especially your
neighbor might not necessarily.
Speaker 2 (25:01):
Be everybody's situation is different, Yeah.
Speaker 4 (25:04):
Of course, And there's a lot of choices on the
market too. So yeah, one thing like a dental benefit
on Plan A might be amazing a little bit higher
on one, but that doesn't necessarily mean it's all the
other parts of that plan are going to you know,
fit perfectly for you, just because you're getting a thousand
dollars more in a dental benefit or something like.
Speaker 3 (25:24):
That, right, Yeah, yeah, So, and I guess there are
going to be people out there that don't work with
a Medicare agent. So that's another question, is if they
don't have a Medicare agent, an annual enrollment comes up,
do they just have to call the one eight hundred
Medicare and start talking to somebody there to find out
(25:47):
if they should make a change. I mean, is that
their only other option other than finding a Medicare agent.
Speaker 4 (25:55):
Just like in I guess the wealth management field, there's
there's self directed people. And if you feel, you know,
confident that you know what you're doing and you're shopping
and you have a system in place where you know
you're confident or you're happy with the things are going,
there's there's nothing wrong with that. Of course, I think
there's no harm in using a broker. There's no cost
(26:17):
to you for that. You have another person to run
ideas past. You know, if they're operating from a fiduciary standpoint,
they're looking out for your best interests. I don't have
any incentive to pick one plan over another. Eye contract
with all the major ones, so I don't I don't
get extra incentives from United Healthcare that I do from
Etna or something like that. So I'm looking out for
(26:40):
your best interests. So I think there's a lot of
value with using a broker. Now, if you if you
use like an agent that's specific with Humanity or United
health Care, they're only going to show you human or
United health Care products. I'm not saying that might wouldn't
be the best option for you. Maybe it would be
the best option for you, but you don't know that,
and that agent's not going to tell you one where
or the other because they're pushing you know, their.
Speaker 2 (27:02):
Specific products right that they work with.
Speaker 4 (27:05):
Correct, Yeah, but yeah, So to sign up, I mean,
you can sign up directly through the carrier. So if
you want, if you are self directed, you signed up
yourself through you know, at United Healthcare ARP Medicare Advantage
plan and it's open enrollment, and you know there's gonna
be changes every year, so you know, you can go
on United Healthcare's website and you can look at yourself
(27:27):
at the different changes and what options that they have,
and you can make a change directly through them if
you're not utilizing a broker. They have phone numbers as well.
You can do it over the phone with their agents
at at now or United Healthcare. Typically Medicare dot gov
will Medicare provides information on the plans through the marketplace
(27:52):
you can sign up, which is a separate Under sixty
five stuff, but through through Medicare dot gov. I believe
they're they're normally information wise. You're not you need to
go to the carrier to directly sign up for the
carrier's products. So we're utilizing you know, Social Security and
Medicare dot gov mainly to get our Part A and
Part B coverage. But they have information on their different
(28:16):
plans on their website.
Speaker 3 (28:18):
Okay, this uh sounds like if you're going to do
this on your own, you're you need to invest a
lot of time to do a lot of research to
figure out what's the best plan for you. So if
I were looking at it, which I will be in
(28:39):
five years, four and a half years, I'm going to
use a broker.
Speaker 2 (28:46):
I'm going to use a Medicare agent.
Speaker 3 (28:49):
Because they already know, right, like someone like you that
works with I mean, I can get information for someone
that works directly with United or with ARP or with
or whoever. But I think I would want to work
with someone who is contracted with all the carriers to
(29:11):
be able to see which plan would actually work best
for me. And there's there's different So there's Part A,
there's Part B. I've heard about Part D. Is there
a Part C? Or did they skip C?
Speaker 4 (29:25):
They that's called the I think they refer to that
as the alphabet Medicare alphabet soup because they have all
these different letters in there, and no one well I
shouldn't say no one knows what they mean. But they
could be confusing, right for first, when you're looking into
medicare for the first time. So Part A is your
hospital coverage, and there's some other stuff in there, but
(29:45):
you mainly think of it as your hospital coverage. When
you are working throughout your career or your spouse is working,
you'll see in your pit and you look at your paycheck.
Speaker 2 (29:55):
And you have Medicare taken out, and they have.
Speaker 4 (29:57):
Medicare taken out. It's going to Part A to fund
Part A. So for most people, if you have ten
years of work experience, your spouse has ten years of
work experience, you automatically are covered on Part A at
no additional costs because you've been paying into that system.
Now Part B there is a cost for that, and
it can be linked to your income, and they use
(30:20):
a two year look back, so we look at your
tax returns two years prior essentially, so say your say
your taxes are pretty high, or say you've made a
lot of money the two years that you're just retired.
Now you might pay a little bit more. Some people,
if your lower income, you pay a little bit less
or even nothing on Part B. But generally for most people,
(30:42):
you know you're it's the standard rate. Is was it
one ninety one something like around that ballpark this year
for Medicare Part B, and that's your outpatient services. When
you go to your PCP, you go to your specialist
care covers, so you have Part A and Part B.
You get those by signing up through Social Security and
(31:06):
that gets you your Part A Part B. You get
your Medicare card with your effective dates when you do that,
and that's what you need in order to sign up
for either a supplement plan or an advantage plan. And
it makes sense to go one of those routes, two routes,
because otherwise you're on the hook for deductibles and co
insurance and things like that. If you sign up for
an advantage plan, you know a lot of those deductibles
(31:30):
go away. There's generally zero deductible for anything, maybe very
low on specific plans. Supplements, they're going to go away too.
There might be some co insurance. With an advantage plan.
On the supplement side, you're you're more or less paying
a monthly premium and your hospital, your outpatient all that
(31:53):
stuff is more or less going to be there's different plans,
but it's when to be covered and you're just essentially
using your you're paying your premium monthly. But don't want
to get too into the weeds with all this stuff.
This is the first This is kind of the first part.
The first things I start with with a new client
that's newly eligible to Medicare is going over these basics
(32:13):
and trying to figure out what is going to be
the best route for them. That's the first question you
need to answers. Is Medicare advantage a better route for me?
Or is Medicare supplement a better route for me? It's
generally going to be one of those two, and not
just your standard Medicare A and A and B. Now,
so that's A and B. Parts C is another It
(32:33):
is Medicare advantage. So it's just another word for an
A Medicare advantage. So not everyone has Part C because
you may have Part B Part A and Part B
and a supplement plan. If you're going that route, you
don't have an advantage plan. You can't have both one
or the other. And then Part D is your prescription
drug coverage. So A, B, C, D would be the
alphabet soup of Medicare.
Speaker 3 (32:55):
Wow, I don't know why they just didn't call it
this is your medical coverage, this is your hospital coverage,
this is your advantage, and this is prescriptions. But it's
it just it sounds confusing. And was it last year
during open and annual enrollment that there was a ton
(33:15):
of changes in Medicare or was it a couple of
years ago.
Speaker 4 (33:19):
I think the biggest recent change that just is affecting
things for all carriers and plans starting in twenty twenty
six or I guess it really this past year actually
few and twenty five would be the Inflation Reduction Act. Okay,
so that was put in place to protect consumers from
(33:44):
from larger expenses in terms specifically on prescription medication coverage okay,
deductible or not deductibles. Out of pocket maxes could could
be seven thousand dollars plus, you know if you're on
these very expensive medicaid. So that's been lowered by a lot.
I mean it's down to like two thousand or less,
(34:05):
so that's going to be like cap at the match
you will pay for prescriptions. Insulin costs was lowered, and
that's that's been a hot spot.
Speaker 2 (34:14):
Yeah, that's the last couple of years.
Speaker 4 (34:15):
Yeah, yeah, yeah, I mean you talked a lot about it, right, right,
that the costs like actually making insulin, it's not expensive,
but they're charging so much an insulince. So you know,
that's been a hot spot for our government officials attacking.
So they've that was one of the things they've attacked,
the prescription medications, the insulin lowering costs for consumers. So
that's a good thing overall for consumers. But if we
(34:37):
look at the flip side of thing, if these insurance
carriers are margins changed, right, they're making less now if
they were making more, So they have to tweak their
plans and make changes. So we see you know potentially
you know, uh Co Insurance maybe going up a little
bit on certain things or you know, different things than
(34:58):
the plan have to change because they have to make
their margins work in their company. They don't like I
when you look at I guess you'll see in the
news or Unite Healthcare how much money that they've made.
And but they're just a huge company. Like their margins
from individual to individual aren't like huge amounts. They're not
making you know, all this tons of money off you
because one person might be in the hospital and you
(35:19):
know they're throwing out fifteen thousand dollars.
Speaker 2 (35:22):
Check what's the economies of scale? Right? Corect it.
Speaker 3 (35:27):
You know, the profit that you make off of one
consumer is x, but when you multiply that by millions
of customers, then I mean that's your profits are a
lot more exactly. Yep, yeah, yeah, I was going to
look back to this article that to see what these
(35:50):
other scams. So another one is fake Medicaary equipment or
coverage claims. Well, we talked about this. They submit false
claims for medical vices or services you never received, and
it says to make sure you keep a record of
your legitimate Medicare appointments and compare them again against your statements.
Speaker 2 (36:13):
Did I miss number?
Speaker 3 (36:14):
Oh here's a bogused Medicare refund offers. They promise a
Medicare refund or reimbursement. To receive it, they say you
must verify your identity by providing your sole security number
or bank details.
Speaker 2 (36:27):
That's where they get you.
Speaker 4 (36:29):
I haven't that one, and obviously that refund does not exist.
But right, yeah, it's surprising in the slightest Yeah, well.
Speaker 3 (36:36):
Right, because then that's a way to say that you know,
they could actually get into if you allow them into
your system and you know, you're accessing your bank account.
It's kind of the same thing with the tech support scams.
They've evolved over the years, and they started doing subscription refunds, right,
and then they're you're seeing that. And in fact, I
(36:58):
talk to a lady about this recently. She was actually
putting the five hundred dollars in and she said, I
only put two zeros, but a third zero came up
like five thousand dollars.
Speaker 2 (37:09):
She goes, I don't know.
Speaker 3 (37:10):
And he obviously whoever it was, had control of her system.
And then they're like, oh, my gosh, I'm going to
get fired, blah blah blah, and you know you need
to give the money back. And so that's another way
that scammers evolve, right, And they're not making enough money
off their original medicare scams, so they tweak it a
little bit and try to catch people off guard.
Speaker 4 (37:35):
That's amazing. I mean these are huge operations too. I've
I've seen some of them in years ago. I mean
they have massive call centers, yep, rows and rows of
people that are doing this, and I mean the money
involved is insane.
Speaker 2 (37:52):
Oh, it's really insist.
Speaker 4 (37:55):
They really are they're very smart at times, it's scary.
Speaker 2 (38:00):
Yeah.
Speaker 3 (38:01):
They this article that I was reading, it says in
twenty twenty four, the Medicare Part D, so the prescription
program alone saw an estimated improper payment rate of three
point seven percent, which totaled three point five eight billion
in losses. And that was just with the Part D program.
Speaker 4 (38:26):
Yeah, yeah, I mentioned my dad. Yeah, he obviously worked
in that field for some time. There was a company
out of Florida. Yeah. I mean they were doing massive
amounts of specifically doing.
Speaker 2 (38:42):
The fraudulent billings.
Speaker 4 (38:44):
Fraudulent buildings with like a pharmacy, and they had a network.
I mean, this is how sophisticated stuff is. I mean
they had a fake pharmacy in Florida, this whole network
of like none of this like actually existed, but it
like if Medicare, you know, from their side of the
house or from other people, it looked like it actually
did because they were doing Yeah, they had shell companies
(39:05):
and they were billing. They were doing all this billing.
They're doing things correctly. It was coming from the pharmacy
was going to this carrier was you know we're there. Yeah,
I mean hundreds of millions of dollars.
Speaker 2 (39:14):
Yeah, yeah, it's it's just crazy.
Speaker 3 (39:18):
So, I mean, if you can consider the money lost
in Part A, B, and C, you know, we're in
the hundreds of billions of dollars, if you know, not
close to a trillion dollar and and so do you
do you think they're just going to say, oh, this
isn't making enough money. You know, I'm going to go
find something else to do. Now they're making all of
(39:40):
this money, and this is and we only know based
on what people report, right, And I mean, unless they
they find the group that's doing it.
Speaker 2 (39:52):
But I'm sure I shouldn't say. I'm sure.
Speaker 3 (39:56):
My guess is that they're not keeping records of exactly
who they scammed and how much they got out of them.
Speaker 2 (40:03):
But I don't know, you know, maybe they are, maybe.
Speaker 3 (40:05):
They're maybe they're detailed like that.
Speaker 2 (40:07):
But uh so, I think.
Speaker 3 (40:09):
The the dollars lost is just so it's it's so
much more than what we actually know.
Speaker 4 (40:17):
Oh is more because they haven't caught the ones that
are still working, right.
Speaker 2 (40:22):
Oh, exactly right.
Speaker 3 (40:25):
So we're gonna wrap up, but I want to put
some tips out there that people can use to stay safe.
And you had mentioned a website Medicare dot gov. But
I had also found there's one called Healthcare dot gov.
Are you familiar with that website?
Speaker 4 (40:42):
Yeah? Yeah, I hope they're there, should be, maybe there's
Medicare stuff on there. I specifically utilize healthcare dot gov
for the market Blaze plan, so the under if you're
under sixty five, okay, the the ACE that go buy
again in a few different names, but it the A
C A, so the Affordable Care Act plans. They'll also
(41:03):
call them the marketplace plans, and it's also a reference
as Obamacare plans. So those are the all the individual
and family plans for are under sixty five. Individuals and
families that you know, maybe self employed don't have a
group plan that they can get into or not Medicare
eligible yet. So that's so that maybe there's some some
(41:27):
Medicare information on there as well, but uh, usually that's
going to be directed towards the marketplace stuff, and then
Medicare dot gov will be the Medicare stuff. There is
a a newsletter I get you can, so if you
go to Medicare dot gov, you can sign up for
a newsletter there and they'll push out a lot of
good information. If they're going around and signed newsletter. They'll
(41:47):
say they'll they'll show you. They'll send information aby the
scam that they found that is going around and nice
steps you can do, and other information about Medicare. So
I highly recommend signing up for that newsplayer just via email.
I mean maybe they can send it to your paper,
to your house as well. But I get a via
email because you can go to Medicare dot sign up
for those, and there's a different newsletter options ARP probably
(42:12):
has a lot of good information I get. I get
some stuff from there. Good company, and I'm sure there's
there's others too, you know, the cares and whatnot, whatnot.
Speaker 3 (42:21):
Yeah, that deals specifically, I know, Uh. In our our newsletter,
we're gonna because it is annual enrollment, we're putting stuff
out about Medicare, and which is why I wanted to
do this podcast now, because it's the early part of
annual enrollment. So I think some other tips are going
to be if you're not using an agent, which in
(42:43):
my opinion, I highly suggest you use an agent. If
you don't have one, talk to your family and friends
and find out who they use. If you know they're
trusted person and all of that, But if you still
just want to do it on your own, just make
sure you research and research and make sure you understand
all four parts and how they operate and understand what
(43:06):
each of them offers you so you can make an
educated and formed decision as to what's going to work
best for you. And then always monitor your statements. I'm
guessing Medicare sends out. I don't know if it's monthly,
weekly or or you know, bi weekly, but they're going
(43:28):
to send you statements that are going to list all
of your charges.
Speaker 4 (43:34):
And sign up for Medicare dot gov. You know, have
a have an account on there you can okay electronically,
you'll get other information from your career as well. Okay,
up for their electronics stuff where you can get in
your system and see you know, up to date stuff.
You know, who knows if you're getting everything in the
mail or if maybe you signed up or your broker
(43:55):
signed you up for electronic only statements, So make sure
you know you're logging in there, you know, make sure
that they're not in your spam, you know, and your
if you signed up for them electronically.
Speaker 3 (44:07):
Yeah, and then Social Security had changed their processes they
weren't as of the end of September, they were no
longer going to be mailing checks. Everybody had to go
on s s A dot gov and make sure they
had an account set up and you could do the
direct deposit or there was another and I don't remember
(44:32):
exactly what it was. It was some sort of card
or something that you could get each month that would
have your benefits on it.
Speaker 2 (44:41):
You'd have to go on there and look at it.
Speaker 3 (44:43):
But is so signing setting up an account at medicare
dot gov is going to be very helpful because you
could always go on if you happen to not find
your you know, your Medicare statements, or you lose you
could always go on there and look at your statements
and look at your charges, and you can see the
(45:06):
charges before you actually get your statements, I would imagine.
And then I'm sure they have a button you can
push push to report fraudulent charges as well. But you know,
like you mentioned the different carriers like ATNA and United Healthcare,
whoever your carrier is, you know, get on their website.
I'm sure they do newsletters as well that they'll send
out information and you'll get information on new updates that
(45:28):
they have as well.
Speaker 4 (45:31):
Yeah, and you know I should clarify. I guess you know.
Medicare is never going to send you a check or
the game was. But there are certain there are certain
plans through carriers, advantage plans where you can get money
to use for over the counter prescriptions and things like that.
(45:53):
But that will be a car that they send you,
so you know they're not going to contact them and
get a check center or anything like that. But they'll
send you either the same card that you use for everything,
or separate card that you can use for a certain
prescription or over the counter medications and other things. So
(46:13):
there are plans that do exist. So if you hear
something like that, like I get my neighbor says I
get extra benefits, like I get one hundred and fifty
bucks on my card every quarter, that does exist. So
I just want to clarify that.
Speaker 3 (46:26):
For certain things. Right, But you're not, like you said,
you're not going to get a check in the mail
for a refund. No, not for Medicare right from Medicare
right like you, some people normally got SOID security checks
in the mail every month. They're doing away with it.
They've done away with it. Everybody by the end of
September needed to have signed up for their online account
(46:50):
if they haven't already. So anything else too, yeah, yeah,
anything else that you think would be beneficial.
Speaker 4 (47:00):
For the tips, I think we hit on a lot.
I think you hit on a lot.
Speaker 2 (47:10):
I mean we hit on the timelines.
Speaker 3 (47:12):
And you know about if you're still working, you know
you're and you have credible coverage, you will get a
letter from your carrier or your HR person to prove
that so you won't get penalized. But to start planning
early if you know when you're going to retire, because
the processing times could take a while to get signed up.
(47:32):
And I mean most people, most people, I think, know
when they're going to retire. Sometimes, you know, a company
might force you into early retirement or into retirements you
might not have too much notice.
Speaker 4 (47:44):
I mean I have clients their company gets bought out
by another company exactly all the employees.
Speaker 2 (47:49):
Happens all the time, has right, Yeah, But.
Speaker 4 (47:53):
Most people like you said, no, they're okay, I'm going
to retire six months right, Yeah, that's one of our.
Speaker 2 (48:01):
Start planning early. So all right, Well, thanks Steve.
Speaker 3 (48:04):
Lots of great information and I'm at I'm going to
sign up for Medicare's newsletters because I don't want to
have to go searching the internet on you know, the
new scams that are out there. I'd like to hear it,
you know, right from them as to what they're seeing.
So I'm definitely going to sign up for that. Yeah,
all right, thanks again, Steve, really appreciate your time with this. Joyce,
(48:28):
all right, take care, all right, everyone, So we uh
a lot of information here about Medicare. Steve's very knowledgeable
and uh, there's a lot. We're in the Phoenix, Arizona area.
There is a lot of great Medicare agents out here
in Phoenix. I'm sure there's a lot of great Medicare
agents wherever you live. If you don't have one, in
(48:52):
my opinion, I would suggest you use one. It's not
going to cost you anything at least to have a
review done to make sure you have the best policy
for you or policies. Talk to your friends and family
and find out if they have a trusted Medicare agent
that they use, and and and talk to that person
(49:13):
and watch your Medicare statements and uh, excuse me, report
any fraudulent charges to whoever your carrier is, and and
get your Medicare account sign uh established online as well.
All right, so don't forget Get on our website, Roseadvocacy
dot org. You'll find our social media links bottom of
(49:35):
the homepage. Sign up for our newsletters. Uh you can
get one via email and or in the mail and
uh hit the subscribe button so you don't ever miss
an episode. And next week we are going to be
talking to we have a guest. We're going to be
talking to her about scam experience that she had, so
(49:58):
you're going to want to tune in for that.
Speaker 2 (49:59):
Thank you everyone.
Speaker 1 (50:02):
Well that's all the knowledge for this episode. Tune in
every Tuesday at eight am Pacific time on KFOURHD Radio
at KFORAHD dot com as Joyce explores a variety of knowledge.
So you have the power to make scam protection your
healthy habit. And until then, feel free to reach out
to Joyce and let's talk about scams.
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