 Aloha. I'm Marcia Joyner and we are navigating the journey. Navigating the journey has been and will be about the journey of life and how we navigate through the journey of life and how to talk about and express our wishes about how we live and how we live out this world and being open to talking about it. And of course part of talking about it and especially when you get to be my age is Medicare and how we take care of Medicare and ourselves and our elders and so we are going to talk to my dear dear friend and of course you all know I only talk to dear friends and this is Martha Copeland. Martha is the expert and I say that unequivocally unabashedly the expert in Medicare and Medicaid and she has honors and awards for all the work she does and how she assists people in Medicare and Medicaid. Martha welcome again. Thank you so much Marcia those are very kind words and well she is I you know I didn't make that up you can't spend what is it 20 years in this industry you know you can't make that stuff up that's who she is yes so tell us about Martha incredible background. Well I love Medicare so I always start with that because I do love it but I actually had a career on Wall Street before I relocated to Hawaii and became this person who has a passion about Medicare. So what did you do on Wall Street? On Wall Street I was in several management positions I was a vice president with Morgan Stanley and I was in charge of invest individual retirement accounts tax shelters limited partnerships and mutual funds so I traveled all over the country vetting organizations that we worked with who had product for our our clientele. Wow and then so you leave this million dollar paycheck to come to Hawaii and and my beautiful apartment in Manhattan yes I really really miss and my family and friends of course yeah but yes I left to come here and I started at Bishop Trust Company I was a trust investment officer and assistant vice president and did that for a while before I got into the insurance field and eventually found my way to what I do now which is work with people who are transitioning to Medicare. Were you Edward Jones? Yes I also worked at Edwards for a while. I want to be sure I got it right because that's how I met you. Oh okay. When my mother was her last year of life we opened an account with you for her. Oh okay. Yes so that was a long long time ago. Yes long long time ago. Okay well thank you for that. So I was trying to remember was it Edward Jones? I think it was it. Yes okay yes so then from Edward Jones you go into Medicare. Right well from Edward Jones I was I went I was independent and I started to actually do a radio show on financial planning and money management and that went really really well but I started to find out that people who had saved all their lives and envisioned a life on the beach or traveling through Europe would often be saddled with healthcare expenses that they were not planned prepared for. Oh boy. Yes that's most of it. So it was very intriguing. So I had an opportunity to work with a local insurance company here and work with the Medicare population and Medicaid population and I just fell in love with helping people navigate the Medicare system because there's a few things that you need to be aware of so you don't miss very critical enrollment periods you need to understand eligibility and you want to avoid penalties so I just fell in love with it and love helping people. So you have your own business now doing Medicare and Medicaid? Yes I do but what I am most excited about is as part of my community service I work with people who need more or less to really have an understanding of Medicare I call it Medicare Answers in Minutes and I just love providing that information to people who need help navigating the system because if you only turn 65 once if you're qualifying due to age. So now real quick tell us the difference in Medicare and Medicaid because most people don't know the difference. Right I enjoy sharing that answer to that. I say Medicaid is for people who you know were maybe not expecting to have their income drop or fall or maybe they just have low income and Medicaid provides aid to you to help you with this insurance when you need it because of low income. Medicare cares for you because the whole time from your working years Medicare taxes so security taxes have been deducted from your paycheck or if you're married from a spouse's paycheck so Medicare will care for you when you meet eligibility requirements either due to age or disability. So Medicaid is unexpected sort of a safety net provides aid to you for insurance and Medicare you've been paying into the system so this is something that will care for you in terms of your insurance needs as you age. So Medicaid is paid by the state. Right Medicaid for people who fall below the federal poverty levels and Medicare is a program that we paid into. Okay so that's that's the difference. All right now that we hopefully get that one straight. Okay now you brought us some slides that will help us navigate this whole thing called Medicare. Can we get the slides to see what we have? Yes. Yes so these are just some common questions that people often ask at least once a year is Medicare going away? That's a big question. Will benefits be cut? How might any changes impact their Medicare costs and lastly what changes are being considered to guarantee sustainability of the Medicare system and Medicare insurance? So I enjoy taking a step back and and really looking at well what is Medicare costing you know whoever's paying for it. So I just brought a couple slides to just give you an idea of what the costs are. Let's see the next slide then. Wow. The aging of the population I don't know if you've heard the statistic but according to the US Census Bureau nationally 10,000 people a day are turning 65 and that's expected to continue until a year 2020. Yes 10,000 people a day having that 65th birthday. And we're right at 2020. We're just about there. So what's the next level after 2020? Well I don't have the statistics beyond that but we're expected the numbers still to continue to be high but what I show in this graph that is from the Kaiser Foundation is the aging of the population and the rising health care costs are contributing to the growth in Medicare spending because a lot of people are concerned will it go away? Will the benefits be cut? And I thought it would be important to show the reason that we're having this situation is because of the aging of the population. So in 2010 and I believe this graph is from 2015 or 16 but when we look at 2010 there were 40.3 million people over the age of 65 and if you look at 2050 we're expecting that to double and we're expecting over 86.7 million people to be over the age of 65. So that'll be a lot of people who need Medicare insurance and need to have those services taken care of. I think now help me with this if that's the aging population it means that we are not paying into the system. Is that what that means? Well yes you often hear a statistic when the program first started there was like one person collecting for every 33 that we're actually having deductions from pay and now we hear that it's more like one is for every three that are for every one that's collecting there's only like three putting in the system. So yes as the population continues the age we will have fewer and fewer people who are adding to the program. Yes so there's more people taking out than there are people putting in. That's the trend. Oh my so what's the next slide? Yeah we have another slide and what this slide shows is exactly what does the Medicare spending look like. So it was 15% of our federal budget in 2016 and if you take a look at the slide if you could see it I believe our defense spending is 15% so think about that. Medicare spending from our budget is 15% which is the same as defense and we were expecting it to grow of course as the aging population continues to you know apply for their Medicare benefits. So social security here is that what comes out of the budget? Yes social security there's social security spending because of course that takes care of those monthly cash benefits that many people qualify for so the Medicare is separate because that's the insurance. So yes the social security spending was showing 24% in 2016. So if you are disabled but you're not getting Medicare is that what that means? No people can be disabled and get social security disability payments in their 25th month of disability they may qualify for Medicare also some conditions you qualify for Medicare immediately so you could have social security disability and Medicare as well. So those come out of separate parts? Correct. Okay. Yeah interesting is it? Yeah I guess okay do we have a next slide? Right and in the next slide I just thought I'd do something that would just give folks an idea of how much comes from the the Treasury how much comes from individual paying into the system based on the part of Medicare. So with Medicare there's different parts there's part A which takes care of you when you're in the hospital there's part B which takes care of doctor visits lab work x-rays things like that and there's also part D which is the part of Medicare that takes care of our prescription drug expenses. So the total spending and I believe this graph is from 2015 the total spending was like 644.4 billion so I do hear people complaining about their part B premium that they have to pay but I tell them well the expenses are kind of high so it's good when you can pay something that keeps this very valuable benefit sustainable but what is also unknown sometimes if your income is below a certain level then the state generally you know each state is different but the state may pick up your part B premium but this is a breakdown of how much is coming from the Treasury how much is coming from payroll taxes and how much comes from the individual who may need to pay their own part B or part D premium to have this Medicare insurance. So I thought it was good to just give that breakdown of the payroll taxes what comes from general revenues and the portion that comes from the actual beneficiary so many people are very surprised when it comes time for Medicare that they have to pay pay something yeah well listen we need to go to break and we will be back in 60 seconds so stay tuned. Aloha this is Winston Welch I am your host of Out and About where every other week Mondays at 3 we explore a variety of topics in our city state nation and world and events organizations the people that fuel them it's a really interesting show we welcome you to tune in and we welcome your suggestions for shows you got a lot of them out there and we have an awesome studio here where we can get your ideas out as well so I look forward to you tuning in every other week where we've got some great guests and great topics you're going to learn a lot you're going to come away inspired like I do so I'll see you every other week here at 3 o'clock on Monday afternoon Aloha Aloha I'm Wendy Lowe and I'm coming to you every other Tuesday at 2 o'clock live from Think Tech Hawaii and on our show we talk about taking your health back and what does that mean it means mind body and soul anything you can do that makes your body healthier and happier is what we're going to be talking about whether it's spiritual health mental health fascia health beautiful smile health whatever it means let's take healthy back Aloha Aloha and I'm Marcia and we're back and we are talking to my dear dear friend Martha Copeland and Martha is a genius to remember all of these facts and figures that's a genius and but the big thing with most of us with Medicare with or without Medicare prescription drugs yes that is huge I mean I have heard of people needing a prescription regularly that's a thousand dollars yes so what are we doing about prescription drugs well Marcia that's a really good question because that's one of the proposed changes to Medicare there is an attempt to work with the pharmaceutical companies and have Medicare negotiate the drug prices so hopefully they would would be lower to the Medicare beneficiary I have calls from people all the time who need assistance with more affordable prices for their drug and I recently had an individual who had a prescription from the doctor that they very much needed this prescription or they end up in the emergency room Marcia was two thousand seven hundred and five dollars for a 30-day supply so every 30 days you would have to come up with another two thousand seven hundred and five dollars so the first thing is okay what what drug insurance do you have we were able to contact this individual's insurance company and they said they would make an exception and cover it at what's called a tier four level so this individual's co-pay would have been seven hundred dollars per month isn't that great from twenty seven hundred he said Martha he said seven hundred dollars is too much so in the interim this person ended up in the hospital twice because they could not afford their medication so as a last resort I helped this individual reach out to the pharmaceutical company and they were able to qualify for a program through this pharmaceutical company and this person was able to get a three month supply for zero dollars zero thank you so there are programs available to assist you but you have to know you have because there's one and it says AstraZeneca may help but it was the may help right it is a may help right it says if you can't afford this prescription AstraZeneca may help exactly but it may is a big word because in many cases if you're on any type of a government program sometimes they don't help so you really need to know what programs are available to you that may help if you have a medication that you need to take or you could end up in the hospital or even worse so I really enjoy helping people navigate the system and find these programs and then I consider it a win we cheer and we get all excited whenever we can do that and I've been you know able to help many many people with this many people oh my gosh the thought I don't take any medication so thank you god yes but the idea that a thousand a month my goodness yes and that was only one medication that's just one medication right and again some people think when you qualify for Medicare that all of your copays and cost sharing would be zero so they don't realize that you need to plan when you're in retirement you're on a fixed income you need to understand you may have some cost sharing for some of your major major medical services and your prescription drugs as well so many people are not prepared for the health care expenses in retirement I had no idea we retired but I had no idea because like I said I haven't had the need I guess is what it's about to oops a thousand dollars a month wow exactly and then some people don't understand that I had no idea I'm one of those and she does not understand yet another issue beyond the prescription drugs a lot of people don't understand that Medicare is for medically necessary services services so I just had a family from New Jersey that contacted me because one of the family members felt her loved one was being discharged from the hospital prematurely and this person said Martha I keep showing their Medicare insurance cards and they're telling me my loved one has to leave or it's two thousand dollars per day so I was able to look into the case investigate and talk to some professionals they gave me permission authorization to do so and it turns out that this individual no longer needed any medically necessary care they needed what's called activities of daily living they needed help you know preparing food eating dressing bathing getting you know up from the bed and so on so that's not considered medically necessary so your Medicare insurance is not going to cover things that are not medically necessary unless you know there's some additional benefits with the plan but it's very important that people understand a lot of the expense that they did not anticipate was when your loved one no longer needs what's medically necessary but what they really need is long-term care which are activities of daily living it's a long-term care is those insurance you buy separately correct correct but people will show the Medicare card not knowing the difference between medically necessary services that are Medicare covered and approved versus activities of daily living okay now speaking of Medicare if you excuse me if let's say you get sick and you didn't know anything about Medicare mm-hmm and you at least when you left your job they told you you needed to you were 65 you needed to sign on mm-hmm then you get sick and now you get a bill and you wonder why am I getting a bill what what am I getting a bill for right I have people in that situation where they are not aware of the enrollment periods so they're very accustomed to seeing advertising mass advertising about Medicare between October to December of each year so they think they need to wait until October so in many times they may leave a job they had employer coverage that ends and they're waiting for October but they don't have to and they end up missing critical deadlines to pick up their Medicare Part A and Part B so that they can pick up a private plan but they miss that deadline and then they could be subject to you know penalties for as long as they have Medicare in the future and I had a gentleman actually in that situation and he did end up in the hospital and he ended up with a very very significant bill because he had no employer coverage he never picked up his Medicare A and B he ended up in the hospital with no insurance he was a hundred percent out of pocket for the services that he was provided so he called me and he said can you come meet me at the hospital and I'm like meet you at the hospital what's wrong he said I just found out that I'm 67 I was supposed to sign up for my Medicare Part A and Part B I never did so I'm a hundred percent out of pocket for this emergency so now he has a heart attack exactly exactly well I'm hoping the fact that I did run down with my iPad and assist him uh it worked out he still had a hundred and fifty thousand dollar bill he had to pay but he was happy because he could afford more so and he recovered from his situation his episode of illness but I like I said oh all right and imagine that yeah a hundred thousand dollars yes and no coverage and no coverage no coverage he thought it was automatic I thought it was automatic well and that's one of the issues yeah when people are collecting their social security cash payments prior to um their qualifying age for Medicare which is 65 uh if it's due to age but any age if it's a disability you may qualify but they're waiting for the card because their friend got a card and they don't know that if they did not choose to get their cash benefits maybe they're working waiting for full retirement age at 66 or 67 then they will have to contact social security administration and get the ball rolling so many times they don't know that they're waiting for the card to come they overlook it they end up in the hospital you're 100 out of pocket if you have no coverage that's scary yes that is really scary yes so Medicare is very important uh to learn about you need to understand eligibility enrollment you need to understand penalties that can be with you for life and you need to understand you don't just wait between October and December to learn about Medicare because tell me now how do people can people call you I mean we're talking about you but can people call you or write to you how do they reach you well I do a radio show and people generally just call me and they'll have a question or two and I'm more than happy to assist them with that so yeah people do call me so what is where is the radio station um the radio station I'm on am 690 the answer and people can hear me on Sundays at 9 30 or Saturdays from noon to 12 30 I think so they can just call the station they call the station and they provide my number they provide you is there a number we can yeah my number is 808 230 3379 808 230 3379 and people can call me and I answer general questions I generally you know push them back to a social security administration when it's necessary or Medicare but the worst thing I find happens to people sometimes is they're calling Medicare when they need to start the process with the social security administration so I make sure that I'm guiding people towards the resources that are available sometimes people just don't know where to look because the last thing is to say Martha said I want people to get it straight from the horse's mouth so they need to work with social security administration or Medicare but the problem is of course you have the contacts but you don't know what it's like to try to call social security and get them up that's impossible trying to call them on the phone is impossible so you don't know that because you have the inside track well what I will say is don't call on Monday at eight o'clock call on a Tuesday afternoon okay one we're just about out of time we one last time give us a telephone number or email where we can contact you sure my telephone number is eight zero eight two three zero three three seven nine good and is there a telephone email yes I have an email it's get to aloha at gmail.com get to the number two yes aloha at gmail.com great well my dear it's always a pleasure spending time with you and we look forward to you coming back and we will see you next time