00:00:01:02 - 00:00:25:20 Unknown For those of you just joining, I am recording this. My name is Cathy Ray, I'm with Q source. And this is our quarterly learning session. This was identified by our community coalitions across the state as a hot topic for those of us working in health care around discharges when it comes from folks moving from the hospital, acute 00:00:25:20 - 00:00:46:10 Unknown care to other level of care settings. We've had some conversations across the state about insurance barriers and understanding the different insurances that are out there. If you just a couple of housekeeping things, if you wouldn't mind just muting your phones until the end, we will have a Q&A available at the end. 00:00:48:22 - 00:01:14:23 Unknown So this is this is a community focused conversation. It is sponsored by our Indiana Q Source, community coalitions and our partners. Our topic and our goal today was identified again across the state, and we have an objective. We are hoping that you will learn how the state health insurance program, which is known as SCHIP, empowers, educates and 00:01:14:23 - 00:01:33:13 Unknown assists the Medicare eligible individuals, their families and their caregivers through objective outreach, through counseling and training to make informed health insurance decisions that optimize access to care and benefits. So we are very lucky today to have our subject matter. 00:01:33:13 - 00:01:58:28 Unknown Expert Megan Rogers is joining us. She has worked 16 years in social services field in Michigan. She's a graduate from Bethel College with a double major in sociology and criminal justice. She has four years experience working at the local community mental health centers, ten years working with Area Agency on aging real services with the aged and disabled 00:01:58:28 - 00:02:21:26 Unknown population. She currently is the Northwest Indiana region volunteer supervisor and has vast knowledge of the aged and disabled TBI and BDD waivers, nursing home assessments and approvals and person centered care, where each her position has required her to learn extensive knowledge of Medicare and Medicaid. 00:02:22:14 - 00:02:37:10 Unknown So she is our subject matter expert today. We're very thankful to have you join us and answer some of our questions when it comes to understanding Medicare. So I understand you've got some slides you'd like to share with us, and then I'll just turn it over to you. 00:02:37:24 - 00:03:05:20 Unknown Perfect. Thank you. Cathy, thank you for inviting me to do this today. I'm very excited. While these slides come up because I know it takes it a hot minute, when Cathy first approached me with this, she did talk about the need in health care, the frustration that they hear from families when it comes to insurance issues and 00:03:05:21 - 00:03:24:10 Unknown discharges to home or from nursing homes to hospitals or the other way around. And that is one subject with Medicare and working with people that honestly, I just love. That is something that is my passion when it comes to working with Medicare beneficiaries. 00:03:24:21 - 00:03:42:29 Unknown My parents are in nursing homes. I've dealt with grandparents being in the nursing homes and Medicare and Medicaid and the transition and working with different clients in and out of nursing homes and the battles that are at play there. 00:03:42:29 - 00:04:05:12 Unknown So we're going to talk about mainly what SCHIP is, who we are, how we got started, who are volunteers. What is the process? Who? What are we help with? What are the types of things? And I like to say, if it's involving Medicare, we can help you with it now. 00:04:05:12 - 00:04:23:10 Unknown It may not be the help you want. We may not be able to give you the answer you want, but we're going to be able to give you the accurate facts, the rules and regulations to make sure that you have the accurate information on how you need to proceed. 00:04:24:00 - 00:04:48:07 Unknown And then towards the end, I'm going to be sharing some case studies on actual individuals that we helped. one of the stories is a client that I am still actively working with. I've been working with them for a few months now, and it involves insurance barriers from hospital to nursing homes and specialty hospitals. 00:04:48:16 - 00:05:08:21 Unknown So I thought that was a great case study to talk about. Since you mentioned that was one of the biggest frustrations they're hearing, Kathy. Can you see my screen? Yes, I can. Perfect. Just wanted to make sure. So first of all, let's talk about SCHIP. 00:05:08:21 - 00:05:33:20 Unknown So SCHIP stands for the State Health Insurance Assistance Program. And our goal is to be the trusted, unbiased one on one counseling and assistance program in the state for Medicare needs. So SCHIP is a free and impartial counseling program that is important. 00:05:33:21 - 00:05:52:02 Unknown I've had clients after counseling sessions pull out their wallets. How much do I owe you? You owe me nothing. They ask, Well, what insurance company are you tied to? We're not. People are free to go to insurance brokers or insurance agents if they wish. 00:05:52:23 - 00:06:19:16 Unknown But the benefit of going with SCHIP is we again are in partial and free. We are going to be looking for plans that. Tie in to what is important to the individual for their health care needs, how they want their health care provided to them, their medication that they're on, what are the best programs for them based 00:06:19:16 - 00:06:38:03 Unknown on the medication? What is the cheapest? And what services in their area, what provides at the pharmacy they pervert prefer to go to? We are part of the ACO, the administration on community living and we are housed within the Indiana Department of Insurance. 00:06:38:03 - 00:06:57:29 Unknown We are grant funded. This is a federal network. So there is a SCHIP program in every state. It may be called something else. Florida is called Shine, which is fitting since it's the Sunshine State. Again, we're not affiliated with an insurance company or agency. 00:06:58:20 - 00:07:23:14 Unknown We don't sell insurance. Now we can help enroll you and your party and your advantage. And we're going to talk more about what we do. one on one in just a couple slides. We are primarily staffed by volunteer counselors or agencies who have their staff members go through counseling training, which we will also talk about as well 00:07:24:12 - 00:07:50:17 Unknown . So a little bit on the history of ship, so in 1990 ships were created under the Omnibus Budget Act and that morphed into going with the Centers of Medicare and Medicaid Services to make grants for states to establish and maintain health insurance advisory service programs for Medicare individuals. 00:07:51:12 - 00:08:12:05 Unknown There is a lot to know about Medicare. There is a lot, so this has been a useful service. Not one person in the state, I like to say, knows everything about Medicare, including the ship staff, including the Medicare individuals themselves, the Medicare one 800 number. 00:08:13:06 - 00:08:33:17 Unknown So we work as a team to make sure that we are up to date on Medicare and we work with each other if we get a case that is complicated or we don't know much about that situation to try to figure out what is the best for Jill in 2014. 00:08:34:09 - 00:08:56:12 Unknown Ship was transferred from CMS to the ACL, and that's where we are today in September of next year. We will be celebrating 30 years in Indiana. So what is our mission? Our mission is to empower, educate and assist those that are eligible for Medicare. 00:08:57:01 - 00:09:13:23 Unknown Their family members that might be helping them and their caregivers. And we do this through objective outreach, counseling and training. We want to help these individuals make informed health insurance decision that optimize their access to care and benefits. 00:09:14:09 - 00:09:39:03 Unknown Our vision is to be known and trusted community resource for medical information. And yes, our primary focus is Medicare. But we also have to know how Medicare coordinates with other insurance. Retiree benefits Medicaid. The federal benefits veterans benefits marketplace Cobra. 00:09:39:09 - 00:09:59:29 Unknown So we do have some understanding with all of those as well, mainly primarily how it coordinates or doesn't coordinate with Medicare. What is our role, what's going to happen when you have questions about Medicare, is it appropriate to contact ship? 00:10:00:25 - 00:10:16:17 Unknown And like I like to say, if it's involving Medicare, then yes, it's going to be appropriate, but here are some scenarios. So we will provide educational materials and brochures. We've got brochures on, you know, are you new to Medicare? 00:10:16:18 - 00:10:36:05 Unknown Are you on Medicare? Because of disability, mental health and Medicare preventative measures or preventative services you can get under Medicare? A wide range of brochures that you can hand out to your client, to your patients or to have for yourself. 00:10:37:03 - 00:11:00:05 Unknown We also have fliers and booklets on how to make decisions. You know, do I want a supplement? Do I want an advantage plan? We're going to help you understand Medicare. It can be very overwhelming to determine. Either you're new to Medicare or your old Medicare, it doesn't matter. 00:11:00:05 - 00:11:20:27 Unknown It can still be confusing, and we can help you understand the different parts of Medicare, your asset duration and what might be the best route for you. Now we do not recommend, we do not encourage, but we're going to give you the facts and help you make that informed decision. 00:11:21:16 - 00:11:44:28 Unknown We can help you organize your records. I've worked with some clients who don't understand their mail that they get. They get very, very overwhelmed with their mail and what is through mail that they need to keep on Social Security, Medicaid, Medicare, the government and what is junk. 00:11:45:06 - 00:12:08:23 Unknown And when you are going on Medicare. Or during the special enrollment periods, open enrollment, which is coming up. Your mailbox can get flooded with fliers on, Oh, choose us, take us, oh, we give you all this free stuff and we can help individuals organize what they need to keep up. 00:12:09:00 - 00:12:32:14 Unknown Get rid of documents that they shouldn't help them with pointers on what is junk mail and what is important mail. We're going to talk about this in a couple slides, but one of the outreach presentations that we do is we do Facebook lives Medicare Mondays, and on the 30th of this month, we will be doing a special 00:12:32:14 - 00:12:49:00 Unknown junk mail presentation. So we're going to help individuals on our Facebook Live determine what is important mail and what is junk mail as far as Medicare. And these are presentations that we can provide to the public as well. 00:12:49:01 - 00:13:09:20 Unknown I've got a couple at some assisted livings coming up as well, where we can help you determine your Medicare claims. How were they filed? How can you repeal? Looking for clues on your claims? Was this fraud? Was this a mis billing that they put in the wrong code? 00:13:10:05 - 00:13:24:24 Unknown And for the medical professionals, when they code, it can have effects on what you pay as your copay. So you want to be careful with that and watch that you're getting bills that you don't think you should be getting. 00:13:26:06 - 00:13:45:26 Unknown We help teach you to assess your needs to make informed decisions about your health care policies help you determine what might be the better policy for you based on your situation. We're going to inform you of your rights as someone with Medicare or any type of health insurance. 00:13:47:10 - 00:14:12:28 Unknown Shows you how to evaluate your prescriptions, your supplement, your long term insurances that are out there. We will also refer you to appropriate agents that can help you with other needs. And if you're on social services, you know that when someone starts talking to you, you're starting to build rapport and they're going to start asking you questions 00:14:12:28 - 00:14:32:14 Unknown about other situations. So we provide resources and training to our volunteers and counselors to give them a pointer on, Hey, if this situation happens or they start talking to you about this, you can refer them to their counsel on aging adult protective services, the area agency on aging. 00:14:33:21 - 00:14:49:17 Unknown Maybe they need a power attorney, maybe Medicaid. So we refer to other agencies as well, and we love to do our outreach. We love to speak either in person or virtually like today to get the word out about shit. 00:14:50:02 - 00:15:23:19 Unknown I've done church groups. We play a mean game of Medicare bingo. I've done presentations to human resources with employees that are about to retire pretty much anywhere we can speak to. So again, we do four presentations, we will go to food pantries, give information on ship we've done on clothes, you know, like good rail pharmacies will set 00:15:23:19 - 00:15:45:04 Unknown out to. We do boost at health fairs, Medicare Bingo. And these are just a couple of slides because I wanted to show you some of the outreach we have been doing, especially in the time of COVID. So when COVID hit last year, we weren't able to do a lot of our face to face presentations, but we still 00:15:45:04 - 00:16:01:24 Unknown wanted to get the word out. So a couple of my coworkers, they started doing Medicare Mondays and we have what you should know Wednesdays. So this is August Flight August's flier. We don't have September out yet, so I can't share that. 00:16:02:11 - 00:16:18:09 Unknown But our web pages on here, so feel free to go and like us and you'll get alerts on these. And that's that. We have we have many different topics that we talk about. We go on site to some of our ship sites throughout the state. 00:16:18:10 - 00:16:39:18 Unknown We bring in guest speakers to talk about other programs out there in the state of Indiana, and they're always at 10:00 Eastern. We do have them recorded so you can watch them all on our Facebook. And they we have a YouTube page that they're also on, and we have been at a lot of fairs this year. 00:16:40:08 - 00:16:58:11 Unknown We will be at the Marshall County Blueberry Festival in my neck of the word, so I'm very excited about that. We will probably have a posting with open up open enrollment events coming up on our Facebook page. So be looking for that and we're going to talk more about that at the end. 00:17:02:02 - 00:17:28:11 Unknown So who do we get to do all of this wonderful work that we do? We work primarily with volunteers or staff members at local agencies throughout the state to help provide ship services. These individuals are trained and certified to help Medicare beneficiaries, their families, caregivers, whoever is assisting that individual. 00:17:28:20 - 00:17:52:06 Unknown Again, we're going to inform them on the different parts of Medicare. Maybe what the best plan is for them, when they can enroll, when they can't enroll, all of that pertinent information that they need to know about. We're going to explain what these parts are, especially the supplemental insurance and how that works and how maybe that's different 00:17:52:06 - 00:18:17:20 Unknown from Advantage plans and what that will do for them. We will touch on long term care insurance or refer them to the Indiana Department of Insurance to help them with that. Referring to other agencies, we will also screen them for assistance programs, Medicare savings program and extra help for the individuals that might need some help paying for 00:18:17:20 - 00:18:40:14 Unknown their Medicare costs. Oh, who are these volunteers, so we have a lot of retired individuals, business people, teachers, doctors, nurses, Medicare beneficiaries themselves. We will have individuals go through a ship counseling appointment and afterwards they're like. I want to do what you're doing. 00:18:40:15 - 00:19:07:24 Unknown I want to give back. You have helped me so much understand my Medicare. I want to help someone too. So we do have Medicare beneficiaries that are SCHIP counselors. We also have some retired Social Security staff. I have three of my volunteers are Social Security retirees and one of our staff members. 00:19:08:18 - 00:19:34:23 Unknown Our Medicare specialist, John Williams, is actually also retired from the Social Security office. We have active social workers, active health care navigators who help with marketplace and Medicaid. Area agency on aging staff, nurses and medical billing staff. I have a wide range of expertize to help you. 00:19:36:15 - 00:19:58:03 Unknown How do you become a councilor so you want to go to our Web page, and I have a read page on one of the last slides and you want to submit an application? And once you submit that that will go to the call center in Indi and you will want to call them to do a background check 00:19:58:03 - 00:20:16:04 Unknown on you. We welcome all types of individuals to be councilors and volunteers for ship. Because we are impartial, we will not take anyone with an active insurance license, so we do a background check to make sure there's no active license hanging out there. 00:20:17:12 - 00:20:38:00 Unknown And that application will be sent to the area's volunteer supervisor, someone like me, depending on what county you're in and that volunteer supervisor will reach out to you. You will have an internal meeting. Talk more about what the role is and to make sure that it's a good fit for both parties. 00:20:38:00 - 00:20:56:21 Unknown We want the volunteer to enjoy their work and what they do, and Medicare is a lot. So we talk about that and make sure that both of us feel that it's a great fit. You're then going to be scheduled in a four day training on everything Medicare. 00:20:58:01 - 00:21:14:11 Unknown We have a director of training, Ben Hudson, and he manages most of our training. Some of the volunteer supervisors will also handle the training. I think that's a great way to build rapport with your volunteers in your area. 00:21:14:19 - 00:21:29:27 Unknown So if you are someone who is going to be volunteering in my area, you will most likely have your four day training with me. Right now, we are doing them via Zoom. But we've done them in person in the past before COVID. 00:21:30:07 - 00:21:49:29 Unknown We may go back to that at some point, but for now, they're still on Zoom after the initial training. We then do mentoring. You're either going to work with your volunteer supervisor or another seasoned counselor to. See, appointments, life in action. 00:21:50:15 - 00:22:09:07 Unknown And you're going to want to watch that trainee or trainer trainer do the counseling and then after you're both comfortable after a few sessions, you're going to switch. The trainee will be leaving the appointments with the supervision and support of the volunteer supervisor. 00:22:09:19 - 00:22:25:14 Unknown And what I like to say to my new counselors is when you start doing appointments by yourself, just know that you're by yourself physically there at the appointment. I am a text away and email away a phone call away. 00:22:25:29 - 00:22:40:11 Unknown We don't have to give an answer. Just to answer the question to the individual right, then, because we want to make sure that we're giving accurate information, it's perfectly appropriate to tell the individual. We'll call you back. That's a great question. 00:22:40:17 - 00:22:56:15 Unknown Let me look into it because I want to make sure I give you the correct facts and then ongoing requirements for our counselors is to do annual trainings each year. We call them spring and fall update trainings. They're about three hours. 00:22:57:05 - 00:23:17:03 Unknown We have been doing Zoom this year. In September and October. We're going to do a hybrid of about 30 or so in-person sessions throughout the state and then a couple Zoom offerings as well for those that are more comfortable with you or face to face or Zoom. 00:23:21:00 - 00:23:40:18 Unknown We have now this number changes daily because we are actively recruiting more volunteers, more sites. I actually have a new site this morning I met with it is coming on board, but we have give or take about 118 ship partners throughout the state. 00:23:41:08 - 00:24:06:07 Unknown And what that means is it's an organization like a hospital, an area agency on aging, a council on aging, senior apartments, libraries, assisted living health centers, food pantries, churches who the one this morning was YMCA in Warsaw, who want to provide the service to their community members. 00:24:07:00 - 00:24:37:25 Unknown So they become a ship partner, a ship site, and we go to that location and provide counseling either the volunteer supervisors, staff members from that organization or volunteers. We have about 400 Volunteer State right now. That's a mixture of two volunteers or counselors through an agency that have been trained to provide ship counseling. 00:24:38:15 - 00:25:05:05 Unknown We also have a call center in Indi at our India office, and we have two ladies right now manning that call center. We are hiring. So if you'd like information on that? Let me know. We on a day to day like this in August, we're probably getting 20, 30 calls a day if that during open enrollment, they 00:25:05:05 - 00:25:21:23 Unknown probably get over 100 a day at the call center. So they're either going to be helping the individual on the call or sending them information or getting them connected to a local council or in that individual service area. 00:25:25:28 - 00:25:48:20 Unknown So this is my favorite part of the presentation. We're going to talk about a few scenarios. What is it really like when you're contacting? On the ship, Councilor, let me know that they had a client that failed to check their prescription drug plan in the fall during open enrollment. 00:25:49:21 - 00:26:08:23 Unknown The plan that they had changed names, which happens from time to time and the cost of the prescriptions went from $14 a month to $67 a month. The individual contacted ship and asked if there was anything we could do to help her. 00:26:09:23 - 00:26:28:18 Unknown The counselor that helped them called Medicare and explained the Medicare that this was causing her financial hardship and that the same company she was with had a plan for $14.20. And the cost of her drugs were the same amount, but the premium was higher. 00:26:30:03 - 00:26:59:18 Unknown Medicare agreed to let her have a special enrollment period. Because the counselor was with ship. If. She had not called with a ship counselor. They were not have given her a special enrollment period. So this counselor told me ship has quit, and we do this counselor also reported that this actually happened a multiple of their clients where 00:26:59:18 - 00:27:20:26 Unknown they did not check their drug plans during open enrollment and they were increases that they didn't know about and it caused some issues. So this client or this counselor called Medicare with them and he, he or she was able to get four or five of their clients last year granted special enrollment periods outside of the open enrollment 00:27:20:26 - 00:27:50:28 Unknown period to make changes to better plans. Now, this scenario again was not mine, but I have worked with clients in the same scenario. This is one we get quite a bit. So Frank contacted a local ship site, saying he no longer understood the insurance he had while looking at his insurance cards. 00:27:50:29 - 00:28:07:28 Unknown We were able to determine that he had had a Medigap supplement. He had a supplement card in his wallet, but we also found an Advantage plan card. Now you can only have one or the other. You can't have both a supplement and an advantage plan. 00:28:08:22 - 00:28:23:17 Unknown Frank reported he had the supplement for many years and was just signed up for the Advantage plan. You said someone came to his house telling him about all this free stuff he could get and he got confused and he signed up for it. 00:28:23:18 - 00:28:45:02 Unknown And that was Advantage plan. We were able to help him keep the supplement and get him off of the Advantage plan because he did not want it. He did not understand it and he felt the supplement was the better option for him and we were able to do that without him losing his supplement because he had an 00:28:45:02 - 00:29:12:29 Unknown advantage plan. So that's something we can assist with to. Now, Jose is one that I did talk to. So Jose called us because he was he got a collections letter and it was for an old medical bill with a heart doctor, and he didn't understand it because as of now, he has Medicare and full Medicaid. 00:29:13:18 - 00:29:38:00 Unknown So he has his primary Medicare and Medicaid is secondary. And he didn't understand why he owed a medical bill because all of his bills have been paid by Medicare and Medicaid, and that is true. So I was able to help him call the doctor's office, and we spoke to the billing office to fill in the missing pieces 00:29:38:26 - 00:29:57:11 Unknown . We were able to determine from speaking to the billing specialist that while he had Medicaid for many, many years. At 1.2 years ago, when the spill happened, he was off of Medicaid. We don't know why, because it was so long ago. 00:29:58:01 - 00:30:13:23 Unknown But this is why he had this spill. The doctor's office was only able to bill Medicare because that's the only insurance he had, so he had a 20% co-pay. He doesn't remember getting a bill from the doctor's office, but it was two years ago. 00:30:14:00 - 00:30:36:10 Unknown So who knows? Now, while we were not able to get the amount saved from the collections agency, we were able to help him determine that it was an appropriate billing. Now again, he wasn't happy with the answer, and I said that at the beginning that sometimes clients may not be happy with the outcome. 00:30:36:20 - 00:30:53:20 Unknown Still, we may not be able to get them the help that they want, but we're able to make sure that they understand what is happening and that it is correct that it's happening, that it's the right thing that needs to be done. 00:30:53:22 - 00:31:08:16 Unknown You know, the rules and regulations are being followed. If we can help them appeal, we'll do that too. So this is a good example of we didn't give him the outcome that he wanted because he still owes the bill. 00:31:09:06 - 00:31:29:16 Unknown But we still met a need by ensuring that this was a correct. Now that he got. Because sometimes people get those and they're not correct. You know, they then searched. But all the doctor's office should have billed Medicaid and sometimes they don't. 00:31:29:22 - 00:31:54:11 Unknown And that was my goal from the beginning to make sure that all of his insurance was that he had was billed. So, Victor, Victor is the one that I mentioned at the very beginning. This is one I'm still working with, and it's a very in-depth pull at your heart strings situation. 00:31:54:28 - 00:32:19:17 Unknown So Victor got a hold of us, probably back. Actually, I think it was back in April. So Victor lives up in northern Indiana with his wife when he called me. The wife was in Indianapolis hospital on event. I think she had a stroke or heart attack or something that resulted in her being on event. 00:32:20:16 - 00:32:46:07 Unknown And he. Is fighting for his right tooth and nail. And he is not leaving any stone unturned. So he called me because she had an Advantage plan and she was still in the hospital. She had been there a couple of weeks, maybe longer. 00:32:47:07 - 00:33:14:25 Unknown And he wanted her and the doctor wanted her to go to an attack it. Oh. Long term acute care hospital, they or expertize in pet care. And the advance plan was denying him or deny her because they didn't think that she had a good enough chance to recover. 00:33:15:13 - 00:33:37:04 Unknown So they weren't going to pay for her to go. He was already appealing it, and he was told to call us because. On. Sorry, I lost my train of thought. He he was told to call us because we could get him to original Medicare or is ripe to original Medicare, and I had to break the news to 00:33:37:04 - 00:33:58:15 Unknown Victor that you can't make changes to your Medicare plans whenever you want. You can't just wake up on a Friday morning and say, OK, I don't want this anymore. I want to change. Well, that was hard for him, but I pulled up the list of all the special enrollment periods and we went through everything and we could 00:33:58:15 - 00:34:13:24 Unknown not find a reason that would allow her to move back to original Medicare. Now I told him that if she went into a nursing home, we would be able to do that. So he said, OK. He was frustrated but understood. 00:34:14:24 - 00:34:28:29 Unknown He called me about two weeks later and we had the same conversation again because someone told him at the hospital he could make the changes. So I had to tell him no. And if they want to call me from the hospital, that is fine. 00:34:28:29 - 00:34:40:21 Unknown We can talk about it again. Reminded him the minute she goes into her nursing home, you call me and we can change it if that's so what you want to do. Well, he'd been on my mind. Him and his wife. 00:34:40:26 - 00:34:59:05 Unknown But I hadn't heard from him again until. Middle of July. Riferisce still in the hospital. Now he called me to let me know she was in a nursing home. She got transferred to a nursing home two weeks before she called me. 00:34:59:21 - 00:35:17:05 Unknown She was back in the hospital, the ICU, because she developed pneumonia at the nursing home. It sounds like it was not a good situation at the nursing home, I said, well, we're in luck. Now, you didn't call me when she went into the nursing home, but she left the nursing home. 00:35:17:11 - 00:35:36:29 Unknown So we have a special enrollment period to move her now to original Medicare because he said they were still denying her to go to an Altec and she would not go back to her nursing home. Her experience was that bad and he wanted to get her home and they were still down in Indy and he was driving 00:35:36:29 - 00:35:56:17 Unknown there from northern Indiana for about every other day, said. And the hospital costs and the gas. And we talked, I explained, Hey, we can do original Medicare now. So we set up a time I wasn't able to talk to him that day. 00:35:57:21 - 00:36:15:02 Unknown But we set up a time to speak that Friday and get her stretched. And he called me at the best time because it was towards the last week of July. At this point? And the change would have gone in would go into effect the first of the following. 00:36:15:19 - 00:36:30:22 Unknown So explain that. Well, don't call me the next day and said, Well, hold on. We're going to pause here. We've appealed and the Advantage plan may actually pay for her to go to Altec now. I said, OK, I'm going to keep you on my calendar. 00:36:31:00 - 00:36:47:17 Unknown You just let me know. So but then the next day comes and he calls me and. They denied he didn't win the appeal. He was heartbroken. So I said we can meet on Friday. And he wanted to meet right then. 00:36:47:18 - 00:37:05:23 Unknown And I was in another meeting. And I explain Friday is the soonest. I mean, even if we met today, Victor, it wouldn't take effect till August the first. Now force is pulling at my heartstrings here because he's just so dedicated to his right. 00:37:06:05 - 00:37:25:13 Unknown So I did. What happened was that day we did. He sent me the list of medication. And after my meeting, before I drove home, I sat in my car on my laptop and I did a planned comparison to get her a drug plan, which would trigger her going back to original Medicare. 00:37:26:06 - 00:37:42:20 Unknown And off of the Advantage plan, I talked to him on my way home, on my Bluetooth, and he picked the plan. I enrolled her when I got home and I sent because he was very overwhelmed and he kept saying. 00:37:43:26 - 00:37:55:16 Unknown When am I going to get a new card, when am I going to get the information that says she's off of the advantage plan on and on original Medicare? Well, technically you've already got your original Medicare card, that red, white and blue card. 00:37:55:29 - 00:38:09:18 Unknown So there really isn't anything I can send you. You're going to get a new card for the prescriptions, but that will be a little bit. So I spent the time to send him a detailed email that explained the transition. 00:38:09:19 - 00:38:25:26 Unknown What we did, why we did it. What's going to happen? You know the hospitals and understand all of this August, the first, you know, the billing department should be able to see that she's on original Medicare and process the request to go to the Altec. 00:38:26:25 - 00:38:45:28 Unknown So you didn't get the email first, so he called me the next day in a panic. But he found it. And he called me. I think August. The third, she said, everything worked like I said she was back on original Medicare. 00:38:46:05 - 00:39:04:17 Unknown But now we've got a new problem, one that I did not think about. We were kind of focused on this one thing. She was out of her hospital benefit days on original Medicare because she has not gone home since April, so. 00:39:05:19 - 00:39:32:05 Unknown We talked about that he, the discharge planner, was able or the billing person was able to determine she has 40 lifetime reserve days left, so he called me the next day and said that was resolved. And he said at this moment she was in the ambulance being transported to the Altec in Porter County, so she is back 00:39:32:06 - 00:39:55:02 Unknown home closer to him in a hospital. But he is getting the training with the end and she's making wonderful progress. He talked to me about what do I do now when she goes home? So I was able with because of my past experience, I was able to help him with. 00:39:56:06 - 00:40:15:28 Unknown Getting connected with the area agency on aging to get possible in-home care and Medicaid set up for her when she comes home. So that's what I know today with Victor and his wife. I'm sure I will hear from him in the future, but that these are stories of what we can do with shit. 00:40:17:04 - 00:40:33:01 Unknown We help all kinds of individuals and all kinds of situations and. I like to say anyone with a ship is doing it because they want to help people and they want to make sure that their needs are met. 00:40:33:21 - 00:40:57:07 Unknown And that's one of the things that I love about ship and how we go above and beyond to help individuals understand and get their needs met timeline. So before I start crying, let's move forward. So while this is primarily to talk about ship and how we help you with the Medicare puzzle, I did want to talk about 00:40:57:07 - 00:41:16:27 Unknown some of the newer pieces to Medicare. So these are all within the past 21 year. Nothing new yet for next year. So the insulin costs have decreased. Some or most of you or all of you may know that insulin can be expensive. 00:41:17:24 - 00:41:45:07 Unknown And for Medicare individuals, it was the same 200 $300 a month for your insulin. Starting last fall for. Came out last fall, but I believe it started in 2021. Insulin costs decrease. So you are now going to pay $35 a month for your insulin, which is awesome. 00:41:46:15 - 00:42:08:02 Unknown And there's a whole wide range of insulin that is covered under this. I don't think all of the insulins out there are covered under this, and not all the plans cover the same insulins at this cost. But if you work with a ship counselor, we're going to make sure that we plug that into the system. 00:42:09:00 - 00:42:22:27 Unknown We use Medicare.gov, the plan finder, and we're going to make sure that we find you a plan that covers the insulin at $35. And if this one isn't covered with that, we may talk to you about talking to your doctor if you can switch. 00:42:25:25 - 00:42:49:25 Unknown So there are also now more options for those with end stage renal disease. Up till last year, the year before, those with end stage renal disease couldn't have an advantage plan. So last year, everyone that had end stage renal disease were sent a letter, especially if they had Medicaid. 00:42:50:03 - 00:43:13:08 Unknown And we were able to look to see if an advantage plan or a special needs plan with the Advantage plan was a good option for them. COVID 19 vaccine is covered as a preventative measure, preventative service under Medicare. 00:43:13:11 - 00:43:27:10 Unknown Now I like to talk about this. A lot of people really don't. I'm going to say care for lack of a better word, but that may not be the best word because no one is having to pay for the COVID vaccine right now. 00:43:27:23 - 00:43:49:23 Unknown No matter your age or your insurance, or if you have insurance or whatnot, but then down the road when things get, figure it out with it, there very well could be a cost. And if you have Medicare, that is going to be covered with no co-pay, it's a preventative service under Medicare. 00:43:54:12 - 00:44:17:16 Unknown This came out again within the last two years. So if you want a Medigap plan, up until recently, you had to be 65 or older to get a Medigap plan. Those who have Medicare because of Social Security disability and under 65, they were not able to get a Medigap plan. 00:44:18:11 - 00:44:42:00 Unknown Now they can, but there's still some exceptions. So if you are under 65 and have Medicare, you're only allowed to get one type of Medigap supplement. It's a plan a. You, the company is required to offer you a plan if you're under 65. 00:44:42:09 - 00:45:04:11 Unknown But when you try to get one, you may not be guaranteed that you're sold a plan and your premiums are probably going to be higher because you're disabled. So there's still some hiccups with the process, but if you are under 65, you are allowed now to try to at least get one. 00:45:04:12 - 00:45:33:23 Unknown So we're making some progress. I hope that is corrected a little bit more in the future. And because of COVID, there has been some loosening of the Medicare rules due to COVID 19. Couple of the big ones I listed here, there's there's pages of it, but for the for this presentation, I pointed out some of the bigger 00:45:33:23 - 00:45:53:13 Unknown ones. So one of the biggest one is the two midnight rule for nursing home placement. So generally, if you go to the hospital, you have to be inpatient status and you have to be there two minutes or three days for Medicare to approve you to go to a nursing home for rehab. 00:45:53:29 - 00:46:15:05 Unknown Because of COVID, we have been told that this rule is being raped. So individuals probably do not have to stay there the whole two minutes to get to a nursing home placement and transportation coverage normally. And honestly, it's the same with the hospital. 00:46:15:13 - 00:46:34:03 Unknown Medicare is going to cover the closest hospital to you and pay for the ambulance to go to the closest location, the closest hospital for you. But because of COVID and hospitals being full or diverting, you may have to go somewhere further. 00:46:34:16 - 00:46:50:27 Unknown So Medicare is paying for a transfer, your ambulance, your transportation to where you're being told you need to go and they will cover you at the hospital that you are sent to to, even if it's not the closest. 00:46:52:16 - 00:47:12:04 Unknown Another change in Medicare rules is you might be able to direct admit to a nursing home without going to the hospital. So if you go see your doctor and. You are sick and he realizes, well, I think maybe you have pneumonia. 00:47:13:06 - 00:47:34:01 Unknown Or. You fell, but it wasn't bad enough to go to the hospital, you're you don't want to go to the hospital. If the hospitals fall with COVID or on diversion, or the doctor doesn't feel that it's appropriate for you to go to the hospital because you might be higher risk to catch COVID. 00:47:34:01 - 00:47:51:17 Unknown If you go there, they should be able to work with your Medicare and the nurses home to get you directly admitted to the nursing home for rehab and care. And you can bypass the hospital now they have to determine that you're stable enough to just go to the nursing home instead of the hospital. 00:47:52:04 - 00:48:14:14 Unknown But that's one of the changes that has happened because of COVID. And the doctors in the hospitals and the nurses are going to be able to determine if you're able to have any of these exceptions, depending on the situation, your situation, the medical situation, the hospital you're at and the nursing home you want to go to. 00:48:17:16 - 00:48:35:22 Unknown So what is coming up in the world of ship open enrollment that is our busy season? Tax people have their busy season in the spring. We have ours in the fall. So October 15th to December seventh, that's national groups day to Pearl Harbor Day. 00:48:36:18 - 00:48:58:09 Unknown Anyone on Medicare can make changes to their Medicare plans. You can change to a different Part D plan. You can move back to original Medicare if you have an Advantage plan. You can change to a different Advantage plan, or you can get a Part D or Advantage plan for the first time. 00:48:58:19 - 00:49:19:10 Unknown And all of these changes will happen on January first. If you do make changes, we recommend that anyone with Medicare check in with a ship counselor during this time. You never know if the plan has these big premium changes or co-pay changes with medication. 00:49:19:20 - 00:49:39:19 Unknown Maybe you've changed medication throughout the year, and it's just a good time to verify if you are on the cheapest plan or the best plan for you or changes need to be made. I worked with a lady last year who thought she had a good plan and she did last year or the current year we were in 00:49:39:26 - 00:49:58:14 Unknown and she just wanted to check to see if there was something better out there for. And there was. I found her a plan that saved her about $3,000 a year. It was that cheaper for her. She just couldn't believe it, and she was just extremely excited. 00:49:59:00 - 00:50:13:11 Unknown And I've had other volunteer supervisors say they've saved clients that much, if not more. So it's a great thing to do just to check in if it's the cheapest. We don't have to do anything. You just let the plan that you have. 00:50:14:00 - 00:50:32:14 Unknown Stay there. You don't have to call them. You don't have to call Medicare. It will just continue on to the next year. So how can you get all this shit? So I have my name, phone number and email, if you want copies of these slides, feel free to email me. 00:50:32:26 - 00:50:50:25 Unknown You can also put your email in the chat box and I can get it to you as well. We have our ship office phone number in Indianapolis. We have our Indiana State Ship website. That's where you can go to submit a volunteer application. 00:50:51:16 - 00:51:06:09 Unknown That's where you can go to see all of our upcoming events throughout the state or all of our open enrollment events. I am almost completely booked every day from October 15th to December seventh. I have a few days open, but we're getting busy. 00:51:07:02 - 00:51:22:26 Unknown And then I have our national ship website in case you know of anyone outside of Indiana that could benefit from these kinds of services in another state. Now I cover the northwest region of Indiana, so I cover eleven counties. 00:51:23:08 - 00:51:50:27 Unknown I have Lake. Quarter. Port Saint Joe. Stark Newton, Jasper Plass, Guy, Kasi ASCO, Elkhart Marshall, I believe that's eleven. We're going to go with that. So I have some fellow volunteer supervisors throughout the state that have just as many, if not more, counties. 00:51:51:05 - 00:52:16:10 Unknown And I have them listed here by region. If you want to check with me if a certain counselor or volunteer supervisor has a certain county, feel free and I'll get you connected. Listed here. So now I am going to share my screen, I think, and see if anyone has questions. 00:52:23:20 - 00:52:49:14 Unknown Can make Cathy. So in your example, talking about Victor. Yeah. Just to clarify, once you used your lifetime reserve days, you don't get those back. Is that correct? OK. Yeah. And for her benefit periods to roll over, she would need to go home from the hospital and or and or the nursing home for 60 days. 00:52:50:02 - 00:53:09:02 Unknown Is that 60 day spell of wellness, they call it? I've never heard it that way, but it doesn't mean that it's not combat. Yeah, I think I think that was the term we used at one time. I'm not sure how to raise a hand, can you hear me? 00:53:09:13 - 00:53:25:29 Unknown Yes. Okay, this is Amy Miller. I have a question about premiums. I have a friend who's going to be 65. I don't know. Anyway, he's going to be 65 in the year and a half, maybe. Mm hmm. And how do you establish the price? 00:53:26:00 - 00:53:45:17 Unknown The rate. So I understand this is I know enough to be dangerous. So I understand that the price is established by. Somebody looking at your eye, your adjusted gross income from your tax returns for the previous two years. 00:53:45:24 - 00:54:10:21 Unknown Right, right. So in this case, this person in that two year period will not be one year. Last year was an anomaly. They had a capital gains that was unique because somebody passed away. OK, so it completely throws him into a completely high income bracket, which was a one time event. 00:54:11:06 - 00:54:30:21 Unknown OK, so normally he I believe they make under 150 as a couple. OK, well under 150. But that one year they went over to because of an inheritance. Wonderful question. So what that it is called that's called Burma. 00:54:31:02 - 00:54:48:28 Unknown So I don't have the couple amounts memorized, but if someone makes less than 87,000, then they are going to have the base premium for their Part B, which this year is 1:40 8:50 and it goes up every year. 00:54:49:20 - 00:55:04:26 Unknown So for this couple again, I don't have the full amount memorized, so I don't know if they would be in a higher bracket or not, but what they would if someone because again, Social Security looks at your taxes from two years. 00:55:04:26 - 00:55:28:17 Unknown Previous. So if I'm going to apply for for Medicare next month, they're going to look at my taxes from 2019. Well, two years is a lot. So what happens if I was married two years ago and my spouse passed away or we got divorced or he went out for a pack of smokes, never came back or I 00:55:28:18 - 00:55:47:00 Unknown had a higher job. But now I'm retired or I got laid off or in that circumstance, I got a one time payout for some reason. That individual just needs to contact Social Security and appeal it, and Social Security will look at their current taxes. 00:55:47:18 - 00:56:05:05 Unknown They will have an interview and talk about what the circumstance was and. From my experience, the appeals usually go very smoothly, so they shouldn't have to pay the higher amount. So would it be wise for this person to speak with a ship counselor about that? 00:56:05:24 - 00:56:33:21 Unknown Yes. OK. Again, anything Medicare related return to us. OK, I'll do that. OK. Thank you. You're welcome. Megan, it's Kathy again, for all those social workers and discharge planners other than reaching out to their ship counselor. Do you have any words of wisdom or any quick processes that they need to be aware of? 00:56:33:22 - 00:56:50:01 Unknown Maybe when it comes to those rapid discharges and then ups, then all of a sudden we're we're faced with an insurance issue and the family says, Whoa, wait, no, I'm want to do a b and C, and I don't know, are there any quick? 00:56:51:13 - 00:57:10:02 Unknown Type of process, steps they can take or just really reach out to the ship counselor at that point. I have two things so really reach out to your step counselor, know where your ship counselors are, build relationships with your volunteer supervisors, have us come out and do presentations. 00:57:10:03 - 00:57:29:23 Unknown We can do virtual presentations in person. The other thing I'll say is no, your special enrollment periods. No, when a person can make a change, that is going to help in some circumstance. I still encourage you to pull ship in in case we can find something else. 00:57:30:04 - 00:57:51:09 Unknown But like in my case with Victor, they kept telling him that his wife could just change to Medicare original Medicare whenever he wanted. And that's incorrect. And then you've got an individual who is overwhelmed, confused. He doesn't know if he can listen to ship or if we can listen to the discharge plan or the hospital. 00:57:51:24 - 00:58:13:23 Unknown So. Know your facts, do your research reach out to ship because Medicare is very overwhelming and we don't want to confuse individuals even more. So when it came down to your plan of action with getting with with getting on a prescription medication plan and you were. 00:58:14:05 - 00:58:27:23 Unknown Is that something social workers in the hospital can do? I mean, is that an option? Do they need to know those steps? Is that taking action in the moment? Is that possible? My recommendation would be to send them to ship. 00:58:28:08 - 00:58:44:15 Unknown OK, so a mistake isn't made, but technically, technically, anyone can go on medicare.gov and use plan finder. It is not a special ship tool. I mean, Medicare beneficiaries can do it themselves. We teach them how to do that. 00:58:44:21 - 00:59:00:24 Unknown That is part of what we do. But especially since you may not be that person, may not be in a special enrollment period and you may not be allowed to change plans in circumstances like that, it's probably best to involve ship. 00:59:03:17 - 00:59:20:05 Unknown And you know what, we can train hospital social workers and discharge planners to be set counselors. I have one in La Porte Hospital and she is a case manager at La Porte Hospital, North West Hospital, whatever it's called now. 00:59:20:11 - 00:59:34:02 Unknown And she does this with her individuals. So being a volunteer ship councilor, do they make trips to the hospital like twice a week on regular day so they can keep a presence in the hospital? Or how does that work? 00:59:35:00 - 00:59:54:01 Unknown I I can't speak for other volunteer supervisors. We're all a little bit different. I do make regular trips to all of my sites. It may not be every other week. I do have a presence with all of my volunteers. 00:59:54:01 - 01:00:18:17 Unknown I send them update emails, changes with Medicare, Medicaid, ship information. Sometimes they say I send too much. I try to limit it, but I also want to keep them informed. I also do from my region and I do a monthly email newsletter that gives training information on what you need to know. 01:00:18:18 - 01:00:39:16 Unknown Or did you know this or this was an interesting situation we had. This is how we handled it. Reminders to keep them honest, all on the same page, and we may have Zoom meetings. I also do a monthly know your options training for my ship volunteer, so we talk about other resources. 01:00:39:25 - 01:00:56:24 Unknown We've talked about pace, adult protective services, area agencies on aging, Medicaid, all of that fun stuff. And COVID has kind of changed how often I get out in person because each site is different, some of them are still closed. 01:00:57:08 - 01:01:14:14 Unknown Mm-Hmm. Let's see. We've got a couple of hands up, Elsie and Emmy. I don't think you me, I've already asked my question. OK, thank you. I think if you click the hand again, I think it'll go down. OK. 01:01:14:27 - 01:01:35:05 Unknown Sorry. No, you're fine. You're fine. We just got to figure out where to find the hand now that I have. Hi, my name is Elise. So I just wanted to. I know I might have missed this information because I came in a little bit late, but I just have a few questions regarding because we are community health 01:01:35:05 - 01:01:52:10 Unknown workers that work within the hospital. But we do outpatient services for our chronic health individuals, and they have a lot of the times you work with people who have Medicare, Medicaid, Medicare, we help apply them for the Medicare savings program, things like that. 01:01:52:24 - 01:02:05:21 Unknown So it would be nice to become a school counselor, and I saw that you were mentioning about that like midway through. Is there a cost? When I was able to get in, there is no cost screening and it's. 01:02:07:11 - 01:02:25:04 Unknown Okay. And it's all virtual online at this point. Yes. OK. And then what are the hours of the training? The four day training? Is it it's going to depend on who is doing it. If your volunteer supervisor is doing it, it might be different than what Ben is doing. 01:02:25:14 - 01:02:46:08 Unknown I believe Ben does 9:30 eastern to four eastern. I usually do it about ten to four eastern. What county are you located in? Saint Joseph? OK, so St Joseph like South Bend, Mishawaka. Uh-Huh. OK, that is my territory. 01:02:46:08 - 01:02:59:19 Unknown So you want to email me and we can set up a time to talk more about it? OK. Yeah, because that would be nice. Thank you. I appreciate that, and I think I have your email in the original. 01:03:01:29 - 01:03:19:15 Unknown Email that we received regarding the disappointment here, OK? And if you want to put yours in the chat box, that's fine too. I'll copy it and I can send you an email too. OK, thank you. You're welcome. So that brings up a great question. 01:03:19:16 - 01:03:35:14 Unknown I know we're running out of time, but do you know I went over? Sorry. No great information. Do you have a list of ship counselors for all of the regions from north to south? Good question. Not necessarily the counselors, but the sites. 01:03:35:24 - 01:03:53:00 Unknown So if you go on to a web site that is on the contact us side, you can go and click the search sites and you will see like little pins in the state of Indiana and you can hover over those and they will tell you who is a site it. 01:03:53:17 - 01:04:12:25 Unknown It might be a little outdated because again, we're moving. We're we're losing sites for multiple reasons. We're gaining sites for multiple reasons and updates. Take time. We can also send out its a brochure called Feeling Lost at Sea and it explains what ship does. 01:04:12:25 - 01:04:27:16 Unknown And we have a flier in there with all of our ship sites in Indiana. All right, perfect. Well, thank you, Megan. Thank you all for attending if if in fact you still have questions for her, please reach out to her. 01:04:27:16 - 01:04:45:24 Unknown Her contact information was, I think you had it up on the screen or it's in the chat, but thank you everyone for attending. And we want to just encourage all of you to reach out to her if you have questions specific to your organization and to your situations that you're dealing with. 01:04:46:11 - 01:04:51:19 Unknown All right. Thank you so much, Megan. We appreciate you very much. Thank you. Thank you, everyone for joining.