MMAP Regional Coordinator Bob Callery discusses the Public Health Emergency and its effect on Medicare and Medicaid benefits, what to expect when the PHE ends, and what to watch out for with the common scams we're now experiencing.
Brooke and Kitty provide the Calendar of Events for August with Caregiver programs and a Matter of Balance and a New to Medicare webinar for anyone starting Medicare.
MMAP Regional Coordinator Bob Callery discusses the Public Health Emergency and its effect on Medicare and Medicaid benefits, what to expect when the PHE ends, and what to watch out for with the common scams we're now experiencing.
Brooke and Kitty provide the Calendar of Events for August with Caregiver programs and a Matter of Balance and a New to Medicare webinar for anyone starting Medicare.
Good morning. This is Kitty Glomski along
Brooke:with my cohost Brooke Mainville
Kitty Glomski:from Region 9 Area Agency and Aging and another episode of Let's Talk About Aging. I'm here with Bob Callery from Region 8 Area Agency on Aging. Bob, the Public Health Emergency that we're dealing with right now we've had some news about it, haven't we?
Bob Callery:Yes. This is a issue that our program has been following along for quite a while because it impacts Medicare beneficiaries and individuals with Medicaid. Once the Health Emergency's up, there are gonna be some big changes for some people.
Kitty Glomski:Let's back up a step though. What is the Public Health Emergency?
Bob Callery:Public Health Emergency this was declared back in January of 2020 related to COVID. The Public Health Emergency was a program that was established to provide different benefits and protections for people during COVID. There were some different rules within Medicare that were altered. There were some policies within the Medicaid program that were altered so that people could maintain benefits, things of that nature.
Kitty Glomski:The thing I remember about it is that it eased the rules to prevent Medicaid beneficiaries from losing their healthcare coverage, and this is continued on since then. Hasn't it?
Bob Callery:That is correct. That is one of the big issues that has our attention right now is the Medicaid ongoing eligibility. Typically with Medicaid beneficiaries, every 12 month period they have to complete a redetermination. What that means, you gotta turn in your income and assets to make sure that you still meet the qualifications for the program. With the Public Health Emergency during pandemic that was suspended, so people have not had to do these. Anybody who was new to Medicaid within the last few years, they have not had to do one of these redeterminations yet. So it's gonna be a new process for those individuals having to gather all the documents, even identifying what the document is, understanding how to fill the paperwork out is gonna be new to them. Even individuals in our, long term Medicaid programs or Medicaid in general, who have done this multiple times, it's been a few years since they've had to do it. This is gonna be a, a refresher process. We anticipate within our program lots of people calling for help during this.
Kitty Glomski:Do you know how many people there are in Michigan that this is going to affect?
Bob Callery:Great question. State of Michigan MDHHS, Department of Health and Human Services, they've been having some presentations for partner organizations across the state, and they were sharing some of this data with everybody. I was not really shocked by it, but really intrigued by it. For people who have standard Medicaid, prior to pandemic, it was about 1.75 million. Within the last couple years that has ballooned to over 2 million individuals who have Medicaid. Our Healthy Michigan programs specifically, that's for people under the age of 65 who are not Medicare eligible that has steadily increased from about 600,000 to just under a million. These numbers are from this past March.
Kitty Glomski:I'm looking at my chart here. So you're talking about approximately 2 million people that have that type of Medicaid with Medicare.
Bob Callery:They are in that mix of the 2 million. So that 2 million doesn't represent all that population, but, but the dual eligible beneficiaries that our programs work with are in that mix of 2 million. So that population, since March or April of 2020, it's increased about 17%.
Kitty Glomski:That's a big increase. Well, I'm glad they found this type of healthcare because that was one thing that was the purpose of freezing these benefits in place was that everybody would have access to healthcare during the pandemic.
Bob Callery:Yeah. Access to healthcare, and the other issue too is with these redeterminations you have to turn in paperwork with that. You have to turn in bank statements and cash surrender-value statements from life insurance. You have all this other documentation that you have to go out and secure to turn in, and most of these organizations had shut down at the time and it was super difficult to get your hands on some of these things that you needed. There would've been tons of people canceled because of that.
Kitty Glomski:That's true. Then not being able to call somebody up on the telephone because their offices are closed are an obstacle as well, isn't it?
Bob Callery:Yep, absolutely.
Kitty Glomski:That's where our network comes in. That's the MMAP, Medicare Medicaid Assistance Program. Do you want to talk about that, Bob?
Bob Callery:Yeah. MMAP in general. So with MMAP people contact us, they call us We have a statewide phone number that people can call to answer Medicare questions. We're a volunteer program. We have amazing volunteers within our program. Lots of retired professionals that will give their time to help people understand their benefits with Medicare, help review plans, answer questions on billing issues and appeals, and all that associated Medicare topics. Another significant portion of what we do is helping those Medicare beneficiaries with Medicaid benefits. Screening for programs, helping people fill out applications when they get a determination notice back from the state. It's gonna tell'em if they were approved or not approved or, if they need to turn more documentation in. Our program, our volunteers have an understanding of all this, and so they're able to provide quality information, accurate information to people. So they can understand why they may or may not qualify for something. And, and we can help them through the application processes too.
Kitty Glomski:That's great. And that's what we do. So that when the pandemic does end and people are asked to re-certify, our counselors are going to be available. Aren't they?
Bob Callery:You betcha, and all the coordinators across the state for this program, we have been trying to gather up as much information, find out as much information. We have a lot of how I would say squeaky wheels across the state people who are constantly digging to find out information on when is the Health Emergency gonna end. When it does end, what are the processes gonna look like for people to reapply or do redetermination? Now that the State is finally rolling out some general information in preparation, because there's a general understanding that we anticipate this program to end soon. But we want to be prepared for when the Health Emergency ends and all of a sudden people start getting all these documents in the mail, all these applications or whatever it may be that we are ready. We have the knowledge and expertise to help people right from day one.
Kitty Glomski:We have sort of been on alert anticipating the Health Emergency to end. What have they told us is the procedure for that, Bob?
Bob Callery:The Health Emergency started back in beginning of 2020. There are 90 day extensions to this. So once you get towards the end of a 90 day period then the federal Department of Health and Human Service would sign the extension for this to go on. So at this point in time, on the federal end they anticipate that this program could be coming to an end that they're not gonna renew the program anymore. The current extension is going to come to an end in mid-July so if the extension is not completed by mid-July the federal Health Emergency is gonna come to an end on the last day of July/the 1st of August. The feds have promised the states that they will provide a 60-day notice that the Health Emergency is going to end. So if the Health Emergency was gonna end in July the feds were supposed to have told the states by mid May. That did not occur. As a result. Everybody is now under the understanding that the Health Emergency will be extended then for the August, September and October months. So the deadline then would be pushed back to mid-October.
Kitty Glomski:Of course, all of this depends upon whether COVID is not an active virus. It's really important for everybody to get their booster, and if you haven't gotten the shot, get one, because if COVID comes back, then it could mean that we are extended again.
Bob Callery:Yeah, that's correct. Based on the numbers the other side is with funding and other political issues that might be going on whether this should be extended or not too. So yeah, I mean, everything, all the indications that we have is that this is gonna be extended through mid-October. There's still a part in the back of my mind that says, you know, the feds, they still have to sign the extension in July. And there's no guarantee essentially of that. So this could all of a sudden come outta nowhere and really shock us in July. If this is not extended, then all of a sudden the state is having to jump right in. And that's my thinking is that that's why they have started the preparation process at the state level and started rolling this out to partners, providing information just in the minor probability that this Health Emergency's gonna end in July. then everybody's at least has some basic understanding. But we do anticipate this to go until October. If it does go until then then starting in November we would start to see redeterminations people having to submit their bank statements, income amounts, things of that nature.
Kitty Glomski:So let's talk about that process because it's not an immediate thing. DHS has said, they're going to send out a pre-letter notifying people that they're going to have to renew. Isn't that correct?
Bob Callery:Exactly. Yeah. Once the states are confident that the Health Emergency's gonna end, they have developed a form letter that's gonna go out to all current Medicaid beneficiaries. The purpose of that letter is just to provide them notice that says,"Hey, the Health Emergency's gonna be coming to an end, redetermination is gonna be starting back up. So just to be aware that this is gonna be happening and get ready and keep an eye out in your mailbox or email or whatever method that you have your contact with the State of Michigan that redeterminations will be starting to go out." The State's doing what they can to provide beneficiaries of these programs with knowledge and information.
Kitty Glomski:There's been a gap of time. People kind of get lax about reporting their telephone number change or an address change. So this is really important that you keep the Department of Health and Human Services updated and the Social Security Administration updated so that they can contact you when they need to send this information out. They are putting out requests that beneficiaries pay attention to this, aren't they?
Bob Callery:You betcha, especially for our Medicare population. A lot of our beneficiaries are like me I like doing stuff through the mail. You need to get official documentation mail it to me. Don't email it to me. I don't wanna go to a website, send it to me through the mail. Well, they're gonna send it to the whatever address they have on file at the State of Michigan. You wanna make sure that all that information is up to date because if the State sends it to a previous address, from their perspective, that is not their issue. If you don't get that paperwork turned back in, because it went to the old address that's not their issue. That was the beneficiary's responsibility to make sure that information was up to date. For people who have their Medicare Part B premium paid for through the Medicaid program, because they qualify based on lower income and their asset situation, they could see that benefit end, and that's gonna be costly. The Part B premium right now,$170.10. That is a huge amount of money that all the sudden could start to be taken out of Social Security benefit just because you've got to keep the address up to date with the State and the State send the paperwork to the wrong place.
Kitty Glomski:It's a good reason to pay attention to this because the benefits you're getting now, you have to prove that you still qualify. I tell people all the time, it's not up to the agency to automatically qualify you. It's up to you to prove to them that you do qualify. This is the process and part of this is your responsibility to keep your address current, your phone number updated. If you use email, you have to keep that all updated and report any changes to your household or your income to the Michigan Department of Health and Human Services. Isn't it?
Bob Callery:Bingo. You got it. That is correct.
Kitty Glomski:We're sitting here waiting for the next step, which is ending the pandemic and the Public Health Emergency.
Bob Callery:The only other thing is the big one, is gonna be Medicaid and redetermination. We anticipate probably close to half a million people that have qualified for Medicaid within the last few years that are no longer gonna qualify based on their income and assets. The other interesting part is for people once they age into Medicare or qualify for Medicare, the income limits for Medicaid benefits actually go down. So you could have people who at one point qualified for a full Medicaid benefit and now that they're simply eligible for Medicare, the income limit is gonna go down and so they might not qualify. The numbers on it may be up to 250,000 to 500,000 people that are no longer gonna qualify. For me, that's a concern. That's gonna be a big shock for some people. For people with traditional Medicare, some of the big rules that were changed: for an inpatient hospitalization under Medicare Part A if you needed some type of skilled rehab after that hospital stay, normally Medicare would require a three day stay as an inpatient under Part A. That rule has been waived this whole time. People who might not have normally been able to qualify for a skilled nursing benefit, they have been able to. The reasoning behind that is with COVID with the worry about hospital utilization, they wanted to try and get people in and out of the hospital as quickly as possible. So they would move people to skilled facilities. That's the reasoning for this suspension of that three day hospital stay rule but that's gonna come to an end. So then we we're back to the inpatient rules, the observation rules, all that's gonna apply. At home testing, right now there are lots of resources out there for that and Medicare covers at home testing at 100%. That's gonna end at the end of the Health Emergency so people could start seeing copays for some of their tests. If you have a Medicare Advantage Plan, they have provider networks. In order to get the lowest copay amount through your plan, you wanna stay in network. If you have to go to a hospital, that's within the plans network. Again, because of the concern about people becoming ill, they waive that rule. So you could go anywhere to any hospital, even if it was out of network and the Advantage Plans would charge you in network rate, so that rule's gonna go away. People are gonna have to be more mindful of their provider networks with their Advantage Plans. On the prescription side a lot of plans that would normally have 90 day or 30 day limits for medication(most of the time because of cost.) Now, these plans were allowed to offer 90 day supplies three month supplies. That way people didn't have to worry about going, seeing their doctor, getting approval for the medications as often, having to go to the pharmacy as often to get their medication. So for some of those medications where you were able to get a 90 day supply, that's going to possibly drop back down to a 30 day supply. So for some people that could be just a"now I gotta go to the pharmacy every month again." So look out for that. The other big thing was telehealth lots of expansion of telehealth services. For individuals in Advantage Plans and in our rural areas, rural communities, Medicare is still gonna provide ongoing coverage of telehealth. But people in our more urban areas like myself, I'm in the Grand Rapids area, in Kent county. Anybody who's in traditional Medicare down here in Grand Rapids, they could lose their telehealth benefit. So they're gonna have to go back to seeing the doctor in person. Some people really like that, other people I'm sure they're just as fine going back to the doctor's office. That benefit's gonna end. I don't know the official standing for your area in Northeast, Michigan especially like Alpena area, but I'm sure Medicare's still gonna carry on with the telehealth services in your area.
Kitty Glomski:This is the time of change. So we will be ready and help people regardless, and even if there are differences between the regions and we have rural populations where you have concentrated ones, so healthcare may be delivered somewhat differently. We'll look forward to seeing what those changes are.
Bob Callery:The big thing right now is getting the word out to people. As we talked, making sure addresses are updated, making people aware that redeterminations are gonna start soon, so just be ready and then letting people know that we have this great organization across the State of Michigan, and have great volunteers that love helping people providing information, connecting people with programs. People come to see us and they have that deer in the headlight look like,"I don't know what's going on. Please help me." And our volunteers are like, yes! we can!. They do an amazing job, a stellar job help people all through this maze of health insurance benefits.
Kitty Glomski:I can't sing the praises enough for our volunteers. They train constantly to be prepared for whatever changes happen each year. But with the pandemic, we have had a lot of changes that they've had to absorb and be able to explain to our beneficiaries so that they understand and understand what they need to do. It has been quite a challenge and we're prepared. Bob, we have that 800 number. Do you remember what it is?
Bob Callery:1-800-803-7174.
Kitty Glomski:That's one thing podcasting. You get used to rolling that off your tongue.
Bob Callery:And like me personally, I listen to lots of sports radio, and so hearing those guys and gals, when they're giving out the station number, I'm sure those phone numbers are in their heads all the time.
Kitty Glomski:Right, right. Anything else you'd like to add?
Bob Callery:We are already starting to get into the swing for fall Open Enrollment period. Every year we highly encourage people to review their plans. Beginning of October Medicare releases all the new drug plans The drug plans, they'll change their coverage, and Advantage Plans, they'll change their prescription coverage. They'll change copays and premiums and all their extra benefits. Even if you are happy and pleased with your plan, you always want to take a little bit of time to review those plans because you don't wanna be caught first of the year with all of a sudden my plan's not covering half my medications, it doesn't work at my pharmacy. What do I do? I don't like those calls when I have to tell people, come back and visit with us next fall. Yeah, take that little bit of time. Review the plan, feel confident that everything's gonna be okay if there's something better, that's your chance to change. So our volunteers, that's our busy time. We're, we're running around just help trying to help as many people as we can.
Kitty Glomski:You're right. Sometimes you have a change in prescriptions during the course of the year and you want to find out what those costs are going to be in your plan for next year, because plans change from year to year don't they?
Bob Callery:Yes they do. Yes, they do. That reminds me of one of the gals I used to meet with every year over in Baldwin, in Lake County. Every year she would flip back and forth between one plan one year, another plan the next year, she'd go back to the original plan. She did that for probably six years because one of the medications that she had lots of plans did not like covering that. So these plans would take turns providing coverage for that drug. We would just flip back and forth each year. So yeah, I'm glad she came in so we could figure that out for her, help her through that process.
Kitty Glomski:Ultimately you save money when you do this right?
Bob Callery:Big time. Yep. Yeah.
Kitty Glomski:And I always tell people too, that even if you come in and it takes 10 minutes to do a review, nothing's changed, your plan still covers, and we find out it's the best plan for you. You save the most money staying in your plan. You have peace of mind that it is the best plan for you.
Bob Callery:You betcha, plus because people get those phone calls nonstop every day. You know, Hey, come join our plan, all the commercials on TV. You know, you spent the time to review your plan. We've already done the comparison so you know, that you have what's gonna be best for your situation and all that other garbly goop that those people are sending you in the mail and on TV and those phone calls, you can ignore'em. You can't stop the calls other than unplugging your phone, but at least, you know that you are prepared and you can tell them no thank you.
Kitty Glomski:No thank you. I know we do have several people that call when they've made the decision to jump at one of those calls and they figure out real fast that it's not what it's cracked up to be. We are here to help you undo some of this too and some of it they're just scammers.
Bob Callery:We could go on forever on this. This is gonna be another one of your podcast topics on itself.
Kitty Glomski:I think so, I think we should have a group of us and just talk about the scams that we incur throughout our season, because if I could recommend one thing to people is just don't answer calls. Don't answer a call for anybody you don't know.
Bob Callery:Caller ID allows you to just see that number and now phone services are required to identify potential scams. So a lot of your cell phone companies it'll just pop up as potential scam or fraud. Yes, it's bothersome
Kitty Glomski:The technology has advanced so much. Last holiday season, Christmas, we got a telephone call from our phone number. My husband said, well, who's got our number. Spoofing. Mm-hmm Maybe I should answer that. And I said, no, no, no, no, no. That, you know, right away is a scammer. They changed the display to our own telephone number.
Bob Callery:100%. That is a scam right there. Yep. When it's your phone number that's pretty, pretty, pretty scary in what's going on, but the thing from our perspective is when you start seeing professional organizations, Social Security, State of Michigan. Things of that nature popping up on caller ID. Now you're getting into the real scary stuff. So just kind of prepping people, that those organizations they're not gonna call you.
Kitty Glomski:Never. They have your information, they don't need to call you. A scammer wants your ID. There's a lot of scams out there that they'll call and say, your account has been compromised. I need to send you a new card or I'm gonna send you a plastic card and it's cool with a chip. So you don't have to do anything. Those are all scams and so don't fall for it. Don't fall for it. Don't even answer it.
Bob Callery:Cause the results can be horrible.
Kitty Glomski:Well, Bob do you have anything else you'd like to add?
Bob Callery:We could talk all day about all kinds of stuff, but in terms of the the Federal Health Emergency, keep an eye on your mailbox and make sure your contact information is up to date with the state. If you need any help at all understanding documents, what those documents mean or understanding eligibility, we are in the process of getting our volunteers fully up to speed on all this information and they will be able to answer just about any question you try and toss at them. We're ready.
Kitty Glomski:Just give us a call and that phone number again?
Bob Callery:1-800-803-7174.
Kitty Glomski:You are right, Bob, thank you for joining us this morning. And we'll look forward to having you back again to talk on another topic with Let's Talk About Aging. Thank you.
Bob Callery:Sounds great, Kitty, sounds great.
Kitty Glomski:This is Kitty Glomski and Brooke Mainville,
Brooke:with
Kitty Glomski:the Calendar of Events for August. Brooke, tell us what you've got.
Brooke:I have a full calendar for everyone. We have a virtual Creating Confident Caregivers starting August 2nd going to September 13th. That's at 10:00 AM to noon. Creating Confident Caregivers is for dementia caregivers. We have a PATH for Chronic Pain. That's virtual starting August 26th and going to September 30th, from 1:00 to 3:00. If you're dealing with chronic pain issues, this is a workshop for you. We have a Matter of Balance that's in person up in Cheboygan. So Matter of Balance is a fall prevention workshop, and we talk about how to modify your house, how to talk to your doctors and family about falls, how to exercise so you maintain your mobility. That is in Cheboygan, August 3rd to September 21st from 9:30 to 11:30. We have some webinars that are taking place. Our first one is going to be August 12th and that is Navigating Family Dynamics and Caregiving. Dealing with a care recipient maybe isn't hard, but then you have your family, maybe the different dynamics involved with that is hard. So how do we go about navigating that? Navigating Family Dynamics and Caregiving is taking place August 12th from 1:00 to 2:00. Then on Friday, August 19th, we have a Healthy Living Webinar and that is Living With Chronic Pain. It's taking place Friday, August 19th from 1:00 to 2:00, it's Living with Chronic Pain., and this one is only a one-hour session. If you're able to do the six-week chronic pain PATH workshop, that's taking place August 26th. To register for the workshop, please contact me at 989-358-4616 again, that was 989-358-4616. Or go to our website at NEMCSA.org/ senior services, and you'll find all the online registrations for all the different items there as well. That's all I have for the calendar events. So I have two virtual workshops, one workshop in person in Cheboygan and two virtual webinars.
Kitty Glomski:Thank you, Brooke. With the Medicare Medicaid Assistance Program, we also have a New to Medicare virtual presentation on Wednesday, August 10th. That's the second Wednesday of August, and this is for anybody that is new to Medicare. If they're planning their retirement and they want to know how Medicare handles their benefits, or if you're disabled in starting Medicare, this presentation explains how Medicare works. Then afterwards you get to meet one on one with a counselor and talk about your personal situation. So mark August 10th, that's a Wednesday at 10 o'clock. To register, you can call 1-800-803-7174 or contact your local, senior center, your Commission or Council on Aging, and they can make the appointment for you. So anything else, Brooke? So this is Kitty Glomski and Brooke Mainville asking you to join us again next time on Let's Talk About Aging.
Carla:Podcast music provided by Groove Music, selection titled"Modern Logo," created by Vadym Kuznietsov and can be found at https://elements.envato.com/modern-logo-ZVHFBJ6 This Podcast was supported, in part, by grant number 90MPPG0039 from the US Administration for Community Living, Department of Health and Human Services, Washington, DC 20201. Let's Talk About Aging is a production of the Region 9 Area Agency on Aging, 2569 U.S. 23 South, Alpena, Michigan 49707.