Understand the confusing world of Medicare [Interview][Transcript]

Presenter: Neal
Guest: Danielle Kunkle
Guest Bio: Danielle Kunkle is the co-owner of Boomer Benefits, an agency that specializes in Medicare-related insurance products nationwide. She is the immediate past-president of the Fort Worth Association of Health Underwriters and currently sits on the board of the state association as its quarterly magazine editor.

Segment Overview : Danielle Kunkle discusses the tools available for healthcare professional and consumers to begin to understand the confusing world of Medicare


TRANSCRIPTION

HPR – Health Professional Radio

Neal: Hello! You’re listening to Health Professional Radio. Welcome! I’m your host Neal Howard. Our guest in studio today is Danielle Kunkle. She’s a medical insurance expert, author and speaker. Her agency, Boomer Benefits is an award winning top national producer for major insurance companies like Bluecross, Blueshields, Cigna and Aetna – she’s a license insurance agent in over 40 states and has personally helped thousands of Medicare beneficiaries with their enrolment and much, much more. How are you doing today Danielle?

Danielle: I’m terrific! Thank you for having me.

N: Thank you for lending us some of your time with the healthcare reform that’s going on. Medicare, it was already confusing. And I’m sure that it is a much more so now. As a Medicare expert, what is it that makes Medicare so confusing, I mean it’s not like it’s the tax code or even the affordable healthcare act, you know, Medicare has been around for a lot of years but why it’s still so confusing after all this time?

 

D: That’s a great question. What we find normally is that so many people have been trotted insurance throughout their lives by employer group and in this kind of insurance, normally, your HR department gets benefits for the company and then present them to you as an employee and you may have one or two choices, perhaps there’s a PPL option or an HMO option. Or the company has a plan with two different deductibles and may be you pay a little bit more out of your pay check for one or the other, and when you get to age 65, you come into Medicare and Medicare itself has four different parts that you’re trying to learn and manage and then you can set insurance that alongside of it that has literally limitless options. There are ten different Medigap plans, there are scores of Medicare damage plans, then we have Part D carriers and so what makes it so confusing is it you go from a pretty simple choice every year that you’re used to, to kind of being thrown into this system that works differently than anything you’ve ever had before. First you gotta learn the basic Medicare and then the insurance on top of it. So it can be very confusing just for people that understand how the basic part of Medicare works. And then once they that get down, they have to tackle the supplemental insurance and this makes for confused individuals when they turn 65.

N: Are there any factors that would you might consider to be the overall biggest challenge for new Medicare beneficiaries who are learning about Medicare and all this different parts and all this different options?

D: Yeah. I really find that they don’t have a good understanding of the amount of full citations that they’re getting so they’re not sure which pieces of communication that they received that are actually part of the government program that they need to pay attention to as supposed to scores and scores of insurance companies soliciting them knowing that when they turn 65 they’re gonna have an open enrolment window to join a Medicare supplement. So the biggest challenge is first deciding, OK what benefits are already mine based on the federal government program and what do those benefits pay then what don’t they pay that I need to look into additional insurance for. So just identifying the basic Medicare pieces so that you can learn what else you need to have covered is really the first uphill battle that they face.

N: With the affordable care act I mean you can go online and get the entire act, read it, you know, if you’re, if you don’t get sleepy, you know, follow through it, you can do the same thing with the tax code. There’s thousands of pages, each of those documents when it comes to Medicare, is there anything that exists out there to help people, another thousand-page document or are there other tools that exist to make it a little bit easier?

D: There some tools and actually Medicare sends out a handbook that you’ll receive a few months before you turn 65 and then you will receive one annually in the mail thereafter. And this handbook has well over a hundred pages in it and it explains the different parts of Medicare, what Medicare covers and what it doesn’t and talks about a different benefit classes, so it’ll explain about preventive care and what’s all included in that, what things are not included in Medicare. And the tricky part about that is, again, they’ve come from, you know, a nice little benefit summary that might be two or three pages that they get from an employer group to this big booklet that they have to read through, and as you mentioned, you know, you kinda get sleepy when trying to read tax codes or legislation and then the Medicare book kind of reads like that. Some of the language has terminologies that people just aren’t used to, things like deductibles and co-insurance and parts and beneficiaries; these are all terms that they’re trying to learn. So online, you can go and there are numerous websites out there, typically these are sites that are actually designed by insurance companies, Medicare also have that site , Medicare.gov and then lots of insurance agencies, like my own, will also has basics Medicare education over there, so you will find in today’s day and age we’re so much luckier because we can go right online and if we’re a visual learner, we can read at Medicare.gov, if we are an audio learner there’s all sorts of interviews and podcasts and videos too online at Medicare sites that can help you with getting that terminology down and once you get that terms understood, it becomes much easier to understand how the pieces work together.

N: Now, as the co-founder of Boomer Benefits, I’m assuming the name is geared toward, you know, the baby boomers, the people that are approaching this age bracket. Now, what is your agency do in addition to some of these other options that are out there. What is your agency do to help the process be a little bit easier for folks?

D: What we have is an agency that has grown from working with individual health insurance plan to almost hundred percent Medicare based and that happened because we were helping people with insurance back in 2005, 2006 and they would repetitively ask about their parents, hey do you know anything about Medicare, can we talk about my parents, I don’t understand them trying to help them understand Medicare and we got so many questions like that. And we actually went out learn to the Medicare, got appointed to work with these products and so, what’s in really need about that working with the baby boomer generation is they are so open to being educated and they just want someone to give that to them straight up. So what we can do is, we have an opportunity to, of course, to work with them on insurance products but really what we do, we call this all the time, Medicare 101; that’s what we start with. When you get a new person we’ll say, Ok let’s spend 25-30 minutes on the phone or in person for a local client here in Fortworth, let’s talk about what Medicare covers, what it doesn’t, and we give them the basics. And that education is really the foundation and that they need before they can even make any type of educated choice about their insurance benefits and then we can also identify what risk tolerance they have, and this helps us with determining what type of supplemental coverage is best and suits their individual needs, budget and what helps them sleep well at night.

N: Now, our healthcare professionals obviously are dealing with people who are really confused about Medicare, all of these different parts, they’re not sure whether or not their physician can participate in Medicare or not or even accept it. When it comes to participation, you know, doctors have faced with a lot of choices about which Medicare networks to participate in. What are some of the things that the healthcare professionals should consider before deciding whether or not to participate in Medicare?

D: I think that a lot of it has to do with their patient-base, and if you have a good group of people in that baby-boom generation that are approaching Medicare age, then being a Medicare participating provider is the natural transition ’cause what you’ll find is that when people are getting ready to turn 65, their number one concern about going on Medicare is whether or not they’re gonna lose their doctor. And so, I find that if your position that is proactive with that, we work with some like that, that actually communicate to their patients in the years that their 64 or heading ready into 65 about this is what we participate in here we do accept Medicare, we work with Medicare and Medigap, whether or not they participate in any of the networks for Medicare advantage and that is so important because people, your general consumers, they don’t understand the differences between the contracts that healthcare professional might have for PPO, HMO, Medicare itself, and so if you can communicate ahead of time to your patient based and have that information out there, letting them know, these are the different types of Medicare program to participate in. That is almost solely the thing that people based their insurance on when they end up choosing finally a plan, I would say that’s one of the top two reasons they pick is based on what their doctor takes and we also find a lot of times, they don’t know the proper questions to ask to find out what their doctor’s office participates in. And so help your professionals because sometimes lose patients because so glad they’ve enrol in a Medicare advantage plan and never think to ask their doctors if he participates, then they’re locked into this plan for year at a time. So if this providers could do a little proactive approach upfront and say, “Hey, here’s a little plan for you to work with,” you’ll find that you can keep those patients probably for life on Medicare ’cause they’re very resistant to losing their trust to providers.

N: Some really great information! You’ve been listening to Health Professional Radio. I’m your host Neal Howard, our guest in studio today has been Danielle Kunkle; Medicare insurance expert, author and speaker. And we’ve been here talking about some of the obstacles in the way when you’re trying to understand Medicare and all of the different correspondence that you’re gonna receive once you hit the age of 65 and before you’re gonna be faced with options and choices, there are about a year down the road. It’s been great having you here with us today Danielle.

D: Thank you! I’m so glad to be here.

N: And I’m hoping you’ll come back and speak with us some more in the future.

D: You bet!

N: Alright. Audio of this program is available at HPR.FM and also at healthprofessionalradio.com.au and you can subscribe to our podcast on iTunes.