Medicare Open Enrollment

Dr. Jim Applegate joins us to discuss Medicare Open Enrollment. 

Episode Transcript

Speaker 1 (00:01):
Listen up if you're eligible for Medicare or if you're
helping someone who is navigate the system. This is West
Michigan's Morning News. Steve Kelly, Bredakita, Lawrence Smith, doctor Jim Applegate,
former Family Position of the Year in the State of Michigan,
on the liveline. Doc, thanks for doing this today. Good morning,
So talk to us a little bit about Medicare. What

(00:21):
is it?

Speaker 2 (00:21):
First and foremost, well, Medicare is a program that's designed
to help seniors and there are about seventy million people
on this most of them over ninety five percent of
them are over sixty five years old. So it was
developed to help with a i cost of hospitalizations and

(00:42):
other medical care, which is just skyrocketed over the past decade.
And basically there are three parts to it. There's Part A,
which covers hospitalization, There's Part B, which cover things like
doctors and ambulances, and there's Part D which covers medication.
And there's costs in all if you buy into these programs.

(01:03):
There's costs in all of these. But the idea was
to help senior citizens defer the costs of medical care.
So the program itself. Doctors are in favor of It
allows us to do a lot of things that a
lot of people couldn't afford in their older years if
we didn't have Medicare.

Speaker 1 (01:26):
So SSA dot gov is a great website. Is are
there any things that are new that we should talk about?
And do you have to opt in roll over? I
mean some of that stuff can be so confusing.

Speaker 2 (01:43):
Can be overwhelming. So the thing you see advertised on
TV all the time are the Medicare advantage plants. They
are owned by insurance companies you know, Humanity United, and
they all have these Medicare it's the idea behind those
This is several minutes ago, a chunk of money and

(02:04):
you take care of all their medical costs. The advantage
of these programs like Medicaid that they cover a lot
of services without copays, that you don't have to have
a copaid to your doctor or to them. And then
you'll also see the advertiser. They'll do everything from you know,
shine your shoes to you know, comb your hair. The

(02:27):
way that they make their money is by denying and
delaying service system. We've all occurred or no have had
a procedure denied or delayed because they if the longer
they hold onto the money, the more money they make.
So the way that they make money is by basically

(02:48):
denying or they'll deny that. But from a doctor's perspective,
which is what I'm speaking from right now, that's what
they do. And so if you go to your doctor
and they say, well, we've got to get that pre
authorized on your you know, your insurance company, that's what
That's how they make their money is by denying and
delaying care. So if you're going to look at plans,

(03:10):
you need to, especially Medicare advantage plans, you need to
make sure that they are going to cover the doctors
and services you might need, especially if you're sick. If
you're sick, that is where all the rub is. And
in the free clinically of people they got their services
were denied by their Medicare advantage plan. So that's the

(03:31):
one caveat in all this. There are some tweaks that
they are making to the system of how much you
can pay out of pocket, how much your cope. So
that is all ongoing and those are actuaries that live
in DC that figure all that out. But you want
to make sure that whatever plan you have covers what

(03:55):
you need. And what your projected needs may be. I
personally only don't want to have somebody who sits in
a cubicle whether or not, and who I can have
surgery by, so I tend to go straight Medicare. I
have a friend who is perfectly healthy, not sick at

(04:16):
all once the easy plan, so they have a Medicare
advantage plan. So you really need to sit down with
your family, maybe your financial advisor, or maybe somebody who
knows the system really well to look at what plan
works for you. There are some government programs that may

(04:36):
help you look at all the different options, but you
really want to look deeply for what your needs are
and are predicted.

Speaker 1 (04:43):
To be min This is doctor Jim Applegate. Thanks for
your time this morning.

Speaker 2 (04:47):
My pleasure,