Open enrollment is coming up and as Steve O said, there are a lot of people out there who don’t know when it is, what their options are, and what happens if they miss it.

Our very own Bill Kohn was live on the air for a chat with Steve O and Rene on 880, the Biz to answer questions about this year’s Open Enrollment period.

You can listen below or read the highlights.

So, Bill, I was one of those people who didn’t know what to do. And I know there’s a lot of people out there like me, and if you miss this coming up enrollment period, you could have to go another year without health insurance. Am I right?

That’s crazy. Can I tell you something? I don’t even know why they set it up like that. So when is open enrollment now?

Great question. So there are two different open enrollments. For Medicare, open enrollment starts on October 15th and it ends on December 7th.

And if you miss that, what happens?

Well, you’re stuck with whatever you have right now and if you have nothing …

You’re stuck with nothing. SOL, basically. So what’s the other open enrollment? You’re talking about Medicaid?

No, there’s an open enrollment for people that are under 65, some people call that Obamacare, some people call it the Affordable Care Act. And that starts November 1st and ends on December 15th. So almost everybody in America has gotta make choices, one way or the other in the next couple of months.

So let me ask you something. Aside from the Medicare, if you have the insurance, do you have to … if you don’t tell them that you’re gonna renew, does automatically roll over? I’m saying like if you have Obamacare or anything like that, does it automatically just renew itself if you don’t let them know whether or not you’re changing the plan or keeping it?

So, on the Obamacare side, the answer is yes with a big caveat.

What’s the caveat?

It changes over but the IRS knows what your income is, they’ll make adjustments and all of the sudden you’ll be stuck with a plan that may cost several hundred dollars more or the plan may have changed and your doctors aren’t on it. So it’s worth checking in any case and making sure the information is correct, especially if you get a subsidy.

Or if you’ve got doctors or medicines that you wanna make sure are gonna be on the plan. And some areas, we’ve got a wide audience, there may be some new carriers and new plans to consider that you didn’t have last year.

Meaning coverage could be less expensive or have better benefits.

Bill, what does Medicare cover?

Well, Medicare is a plan that covers hospitalization, it covers your doctor bills, your tests, and your labs but there are different parts. Part A covers hospitals, Part B covers the doctor bills, there’s a Part D that covers medicines but that’s not through the government, that’s through private insurance companies. And there are gaps in each of those plans. So you may have significant out of pocket costs with just straight Medicare.

So basically, if you get Medicare, so you hit a certain age, you’re eligible for Medicare and so it’s still 65, if you hit 65 you’re eligible for Medicare. So basically you need a supplemental insurance policy as well. Because Medicare does not cover everything.

That is correct. That is absolutely correct.

So if they came to you and spoke to you, can you recommend what you think would be the best plan for somebody, like a supplemental plan?

Well CMS, which is the controlling government entity doesn’t allow us to use the word “best”, because really, to use the word best we’d have to use a rear view mirror, look in the rear view mirror, know what’s coming, if you will, and be able to see. But what we can do is we can make prudent recommendations among the plans.

There are different kinds of plans. Some are called supplement plans. Some of them are Medicare Advantage plans, and they serve very different audiences based on income, based on health, based on all different kinds of criteria. So it really is a very, very individual decision and what’s right for person A might not be correct at all for person B.

How do you make that determination, though? Based on medical needs?

Based on medical needs, based on your history, sometimes based on your family history, based on your income and based on what you want in health insurance. For some people, health insurance is secondary to certain dental benefits, which is more important to them for the next period of time.

I was gonna ask you about dental benefits because it’s really hard to get dental insurance. So does Medicare cover dental as well? I mean, obviously as you get older, things start deteriorating and teeth and everything else. So does Medicare cover that or you have to get a supplemental plan for that?

Many Medicare Advantage plans do cover dental as part of their basic benefit. Medicare supplemental plans, which are pure supplemental plans, do not. And Medicare by itself does not.

See, that’s why people need to call you up. There is such an educational process to this. Like I said, because of myself not knowing, I have to wait until July of next of year for, I guess it’s the Plan B for the doctors.

Right, general enrollment for B.

Yes. Now, I do have the pharmaceutical, which is good. But, gosh, if I had to have surgery now, it’s gonna have to be out of my pocket.

That’s correct.

That’s a really scary factor because people are not aware of that. I don’t know why we wouldn’t have, at least, two open enrollments. If somebody misses it. Because you thought you’d have to wait until you’re 65 to actually do the plan, to enroll in the plan. So he wasn’t even aware that there’s a certain time frame involved, an enrollment period. I didn’t know that.

So the fact that at 65 years old you went to go sign up and figured, okay, now I’m gonna get health insurance, that wasn’t the case.

Right. So the right thing for people to do is to talk to a professional, at least 90 days before you turn 65. That way you have a game plan in place and you know what you’re gonna do and when you need to do it.

So they need to call you … tell people how they can reach you to call your office.

My direct line is (954) 332-9768 and we’re located in White House Point.

Okay. But they don’t actually have to come to your office, they could speak to you over the phone, you could set something up with them and kinda walk them through the process. You would help them through the Medicare for them applying for the Medicare, and then also selecting the supplemental insurance, so you can help them through this whole entire process.

Absolutely.

You needed that. Why didn’t you find Bill prior to this? I’m telling you, a lot of people don’t even know this.

That’s why I got Bill because I learned my lesson and it’s a very costly one but I found out, Bill, there’s a lot of people like me out there.

I think you’re right. I think you’re right. We help quite a few people and we’re specific to the state of Florida. So we really try to focus and be experts in one thing and do it well.

Now, this is not just for Medicare, if somebody needs health insurance you can help them there also.

That’s correct.

Good for you, Bill. I’m so happy to hear that. Because that’s a big factor as well. A lot of people don’t know what’s available, especially now with the insurance and everything else. The Affordable Care Act (ACA) or Obamacare still going. People are not even aware of that. It’s not fully gone. So you could walk them through the process.

Let me just ask you something, because I know President Trump had said something about, now some insurances cross state lines, is that now something that is offered or not?

So now, and this is very, very recent. There are certain professions, let’s say, dentists, doctors, real estate people, various professionals, if they’re independent businesses, there are association plans that are now available here in the state of Florida.

Those generally are PPO plans. So people like that because that means wide access to doctors. And the only other real PPO plans that are offered right now come from Florida Blue and they’re quite expensive if you don’t get assistance from the government.

So the association plans may save people, if they qualify, hundreds and in some cases over $1,000 a month.

That’s a lot of money. So they could speak to you about that as well. That’s great.

I know, I love that. I think it’s an important topic. Because everybody needs healthcare and there’s a lot of people that weren’t even aware of these open enrollment periods.

If you have insurance, most people have to re-enroll, I just found that out through my insurance. So listen, I’m sure a lot of people need some direction, some information, you’ve gotta give Bill a call. Thanks for coming on the show with us today.

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