In this episode, we are joined by Josh Kinzel from Seniority Benefit Group to discuss key changes and updates for Medicare Open Enrollment 2024, highlighting how these alterations might impact current and prospective enrollees.

Josh Kinzel brings 18 years of experience, with a focus on Medicare for the past 16 years. He assists individuals with the often intimidating and multifaceted choice of Medicare plans, alleviating concerns without any charge for services.

Open Enrollment for Medicare runs from October 15th to December 7th each year. The discussion underscores the complexity of Medicare and the crucial nature of informed decision-making. Fidelity Investments estimates retirees' lifetime healthcare costs can exceed $160,000, making a thorough understanding of Medicare essential.

A significant part of the episode is the reassurance that clients feel when working with local services familiar with area doctors and hospitals. The familiarity brings a level of comfort that can be very reassuring. Regarding premiums, there is uncertainty about the monthly Medicare premium, with a slight increase projected, reflecting typical stability during election years.

Several impactful changes include the Inflation Reduction Act that aims to cap annual prescription drug costs at $2,000 by the next year and the Extra Help Program, which offers income-based assistance for drug costs to those earning below $23,000 (individual) or $31,000 (married couple). This program plans to eliminate premiums and deductibles while limiting drug charges significantly. This financial support could benefit millions of individuals.

Medicare can now negotiate prices for certain drugs, akin to the Veterans Commission, starting with 10 approved drugs. This negotiation process is expected to lead to significant cost reductions, such as capping out-of-pocket costs at $2,000 and slashing insulin prices to $35 per month.

Updates to Medicare Advantage Plans were highlighted as they require mid-year updates to clients starting in 2025 to promote better utilization of available benefits like exercise programs, grocery benefits, and gym memberships, including the popular SilverSneakers program. Expansion in mental health and dementia care programs is also covered, offering support for older adults and caregivers. Additionally, expanded access to 24/7 mental health and dementia care support aims to help patients stay at home longer.

Medicare's unique parts are outlined: Part A covers hospitalization often with no cost for those who've worked 40 quarters, and Part B covers outpatient services with a 2024 premium of $174.70, typically accounting for 80% of medical claims.

Key Moments

00:00 Helping with Medicare choices free of charge.

03:48 Internship led to unexpected 18-year insurance career.

08:47 Original Medicare covers approximately 80% of costs.

11:06 Medicare Advantage Plan: lower premiums, network-based, copays.

12:51 Providing guidance, not direct answers for health.

17:56 Income-based aid available for qualifying individuals/couples.

21:16 Insulin capped at $35; ten drugs negotiated.

24:58 Using SilverSneakers online; mental health services available.

28:22 Donut hole removed from drug plan stages.

30:48 Flexible payment plans; insurance premiums stable next year.

33:51 Pharmacists now allowed to lower prescription costs.

36:42 Advantage plans effective but understand trade-offs.

41:28 Original Medicare approvals often get rubber-stamped.

42:41 Medicare Advantage's benefits and drawbacks warrant discussion.

48:41 Help individuals, especially in small companies, access Medicare.

49:22 We help employers with Medicare-related questions.

53:09 Attend free workshops for Medicare education.