Inside Marcy's Mind
Having hosted the Aging aint for Sissie's podcast for two years, I wanted to expand what I could discuss. This podcast will touch on the fun of aging and whatever has crossed my mind! Please join me as I walk through life! #retirement #travel #fun #aginggracefully Link in my bio! Listen now!
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Inside Marcy's Mind
Medicare Insights and Chicago Moments with a Nostalgic Twist
Discover key insights into the world of Medicare with the Medicare Diva herself, Neta Wenrick, as she unveils crucial updates on prescription plans that will impact seniors nationwide. You'll learn about the elimination of the notorious "donut hole" and how a new annual cap on out-of-pocket expenses will reshape your Medicare experience. Along with these changes, explore the importance of consulting with Medicare agents to ensure your medications remain on the correct formularies, and find out about a fresh payment plan option to manage high copays over time.
Join me on a personal journey as I navigate a week filled with new responsibilities and joyful reconnections, all against the backdrop of vibrant Chicago life. A delightful encounter with a fan at St. James and the enduring charm of the city remind me of the unique experiences urban living offers. Amidst these reflections, I share my decision to incorporate beloved music from my past podcast, "Aging A for Sissies," into the current show, adding a nostalgic twist to our discussions.
And for a sweet finish, indulge in a fun exploration of candy corn, a Halloween staple that has delighted taste buds since the 1880s. Learn about this iconic treat's storied past and its surprising popularity, evidenced by the staggering amount consumed each year. Whether you're a candy corn enthusiast or not, this segment offers a light-hearted escape within our episode rich with essential Medicare knowledge and personal stories.
Hello and welcome to Inside Marci's Mind. My name is Marci Backus and I am your host. Well, that music cut off rather abruptly today. See if I can fix that in editing. I totally forgot about my pot. I didn't even realize it was Wednesday today and thank God, I already have a fabulous interview with the Medicare diva all in the in the book, so that I can filter that right in, because, honestly, sometimes I forget what day it is. And today is Wednesday and I promised you an episode every Wednesday and that's what you shall get. So sit back, grab a coffee, grab an iced tea, grab water, whatever you need. Sit back, I'll tell you a little bit about my week and then we're going to dive into Nita Wenrick, the Medicare diva, and there are some big changes coming to Medicare. So if you're on Medicare, if you're going on Medicare, if you have friends or family on Medicare, listen up so you can help them out. Tell them to listen to the episode. All right, family on Medicare, listen up so you can help them out. Tell them to listen to the episode. Hey then, what a week.
Speaker 1:You know, I think I shared with you all that the priest Lisa at our cathedral had asked me to be the head of or lead the stewardship committee group, and I said, yes, lead the stewardship committee group. And I said yes, I said yes, I said yes. Do I regret that a little bit? Yes, am I grateful to it a little bit? Yes, two things can be true. You know, when I retired, one of the things I was so happy was to not have emails, not to have to look at things, just not to have so many deadlines. And, holy cow, I've been on hours of Zoom meetings. I have, oh yeah. The good thing is is this is just the stewardship season and this too will pass. But man, oh man, I have been knocked out of my retirement rather harshly, but very grateful and enjoying it at the same time. Again, two things can be true.
Speaker 1:It's been a crazy week, though. As you know, my oldest child has gone no contact and received contact last week from said child. Said child is ready and has removed themselves from a very, very, very toxic relationship to not only them but to the entire family. So just keep us in your prayers and your thoughts. I won't share any more on that. It's an ongoing thing, but having that on top of all of this has been quite some something. But as a mom and I don't, I'm going to get emotional, sorry To know that your child is safe is the greatest feeling you can have, and right now my child is safe. A lot of work ahead, and that's okay, because with God all things are possible. That's all I want to say on that. And then let's talk about this week.
Speaker 1:Lots and lots of things went on with stewardship. I had to speak in front of all three services. It's been a while since I've done public speaking. I guess this is public speaking, but I speak from my heart. I spoke from my heart but I had to write things down so that I made sure I hit all points, and that's a little more nerve wracking for me. I'm better off just winging it in front of people, but it went well.
Speaker 1:One of the most interesting things was that I was going to the grocery store this week and I was waiting at the elevator. Yes, I have an elevator into my grocery store. Welcome to city living and I love it. So I was in the park I parked. This was going to be a big grocery shop, just FYI. And when you big grocery shop and you live in the city, you need your car because you can't carry it home.
Speaker 1:So it was a big grocery shop and I was standing there and as I walked into the elevator area there was a man on his holding his phone and we looked at each other and I always smile. I mean, that's, you know, the least you can do in a city and is smile at everyone. So we smiled, we nodded to each other and I was waiting and he said excuse me, and I said yes. He said did you speak at St James this weekend? And I said I certainly did. He said well, I was there and I'm hoping to come back and I it made me feel good. It made me feel good that maybe the words I spoke made someone want to come back. It made me happy that someone in the city recognized me and said something and we were able to have a little deeper conversation. I don't know, it was just kind of cool. City living is something that you don't understand until you do it, and especially in a very friendly city like the city of Chicago. It is a very friendly city as far as cities go, but living here and living in your neighborhood is just like living in. It's actually better than living in a neighborhood, in the suburbs, because we all walk around, we greet each other, we see our friends. It's an interesting thing and that just brought it home to me again.
Speaker 1:I did do my interview this week with our Medicare diva, nita Wenrick, and I'm going to share that with you. There are a lot of things coming up in in Medicare changes, especially in prescriptions, so you want to listen whether you're on it, you're going on it, you have people on it. You need to listen to this and you need to share this episode with those that it affects. I would appreciate that. Let's see what else. Oh, have you enjoyed me going back to my old music from Aging A for Sissies? I personally love that music. I am going to keep it. I'm going to keep it even though this is inside Marcy's mind. We all know this is inside Marcy's mind, but I'm keeping my old music from my old podcast because I truly love it.
Speaker 1:And you know, I think that you know I had a busy week, had a lot of Zoom calls, three hours, four hours of Zooming emails a bit of a nightmare for me. But again, stretching those spiritual wings and giving of myself is something I've always done. I know this isn't forever, because our season dies down. We've made a lot of great changes on the heels of what was done greatly last year by lay leadership, and we have added more. And with that said, I am going to turn you over to our Medicare diva, nita Wenrich. All right? Well, we have, as I promised you, our Medicare diva, nita Wenrich, is with us and we have. We have something really big to talk about, it sounds like. So I'm going to read it exactly as she wrote it to me what is the Inflation Reduction Act of 2022? So that was two years after COVID and how does it affect Medicare in 2025 and beyond? Yeah, tell us, nita, tell us.
Speaker 2:How does this?
Speaker 1:happen.
Speaker 2:Yeah, I'm kind of interested in this. Good morning, good morning, okay, so OK. So the Inflation Reduction Act that President Biden signed into law in August of 2022. I'm sorry that keeps stinging. It was designed to help meet some climate goals, but also they added some things to help vulnerable populations, medicaid and specifically Medicare. So that's where I come into this, and so the ways it's helping Medicare is lowering drug costs, which they started actually with the $35 insulin cap on insulin for seniors and expanded benefits, and then trying to get a handle on prescription drug prices, which is kind of the crazy part of Medicare.
Speaker 1:Wouldn't that be nice if they could do that for all.
Speaker 2:Yes, yes. Well, we're starting with the seniors. I'll take it, we'll see what we're going to do. So the way it's changing for 2025, you've probably been hearing that people's out-of-pocket costs for prescription drug plans. It's going to be capped at $2,000 for the year. So people are going well, that's still a lot of money. So the way we explain it, that darn donut hole is going away.
Speaker 1:Oh, the donut hole is leaving. Okay, those of you that know the donut hole know the donut hole. Those that don't, don't need to know it, because it's not going to affect you anymore.
Speaker 2:So that's going away. Because what that did is, you know, about halfway through the year it threw people into this huge donut hole where they were paying a lot for their prescriptions and then, after they got out of that, they were paying nothing. So that's going away, okay. So the way that it's going to be working with a $2,000 prescription cap is the it's not necessarily what you are paying for your prescription. So say, you're on and I've just been running some numbers you're on Ozempic and maybe on your plan it's costing you $100. The actual retail cost of Ozempic is closer to $1,000. So what we look at is what we call the true out of pocket the troop. What we look at is what we call the true out of pocket the troop, and that includes the retail cost, your copay and the deductible, which this year is five hundred and ninety dollars. So once you reach that two thousand dollars, then you will go into catastrophic coverage and you will not pay anything else.
Speaker 1:OK, so the donut hole, I see, has disappeared. Yeah, so from this to that.
Speaker 2:Yeah, they're kind of. They've kind of just moved it a little bit so and it's not nearly as much. So I have somebody that one of their medications it's going to cost them like $600 the first month, but it's like the retail cost is $2,300. So after January, bam, they're going to be in that zero copay.
Speaker 1:That's great, that's amazing, that is. That is a difference, you know. Sometimes you feel like the government says they're going to do things and you're like, yeah, great, and you don't really feel it, but this seems like something people are going to feel immediately, in a good way.
Speaker 2:Yeah, the caveat in all this is and why you need to talk to a Medicare agent. Even if your medication was on the formulary last year, it may or may not be this year. So you need to make sure they're running numbers and making sure all your prescriptions are on the formularies Because, say, you're on a prescription that last year was covered, it's $600. If it's not on the formulary, you'll be paying that six hundred dollars, but it does not count toward that two thousand dollars. Oh, I know, that's the yeah.
Speaker 1:There always is something right.
Speaker 2:There is something. So yeah, but I mean, the thing is we can look in and I can generally find a plan that has it on the formulary. However, there are some medications that it's not on anybody's formulary, so then we have to go to a plan B and try to figure out something else. But that's kind of how it's working. So that's why this year more than ever, and even if you're on an advantage plan, even if you're on one of the HMO plans, their formularies are generally a little cheaper and more stable. But they've changed too.
Speaker 2:So make sure that you speak with somebody you know to get them to run your medication, so that you don't go to the you know pharmacy on January and be shocked. We don't want that. So that's kind of what's happening. The other thing is that you know somebody may have a $600 copay in January and that's a lot of money, even though they're going to hit that cap pretty early on. Still, $600 is a lot. So Medicare has instituted a payment plan. So and it doesn't matter if it's a prescription drug plan or if it is a an advantage plan Say, you've got a $600 copay just in January, you can apply to spread that out over the whole year.
Speaker 1:That's really important People. Did you hear that? So if you hit, let's say, one of your medications again, is that that cap, that 600 or you know, there you can apply to spread that out over the year.
Speaker 2:Good information, really good, and there's no, um, you know no interest or anything. Um, this is the first year they've done that. You don't pay it to the government, you pay it directly to your carrier. So if you have, you know, humana or Anthem or whoever you have, you you make a deal with them, with their member services, to make those payments over the year.
Speaker 1:So really good information that, yeah, that we really is helpful. Yeah, yeah, for sure, we're really happy about that.
Speaker 2:So, um, that's the changes, like I said, um some, and the placement of some of the drugs on the formularies. Maybe they were a preferred brand last year. Now they're considered a specialty drug. So you and the percentage of what you're going to pay is more. So you just want to make sure your medications are all in line. You know, and get someone to change that if you need to change it.
Speaker 1:Okay, so how long? So this is a good question, then. How long do people have to look at their plans and make a change?
Speaker 2:So we start we're in kind of pre-annual enrollment now. So I'm talking with my clients and looking at their plans and a lot of them we don't have to make any changes, so they're just going back in my files, files. But there's some people that we are going to have to make a change to their plan, so they're going in another pile because I can't make changes until starting october 15th. So we have from october 15th to december 7th to make changes, which then, um, get started in january. So okay.
Speaker 1:So people should not only look at the formulary for Medicare, but if you're on an advantage plan, look at your advantage Cause actually I was just talking to Craig this morning I still have another year and three months or four months closer.
Speaker 1:I am, and I I've never wanted to age so fast in my life. I personally just had to go buy a plan off of Cobra. I was on Cobra for two years from Craig's company and I just had to thirteen hundred dollars a month and it's not even like, it's not even the goal. I'm a gold plan, I'm not even a platinum plan. Like, it's just sad, sad, sad. So I do want to get older fast and then stop. But we were talking about it this morning. Want to get older fast and then stop. But we were talking about it this morning. He said, yeah, he got his devoted as his advantage plan. And he said, yeah, there were some changes, so we're going to take a look at that. So you can this is a question then for you you can change your advantage plan every year also, if you wanted to. Yeah, absolutely.
Speaker 2:And another thing that I came into play this year here in Southern California is generally going from an advantage plan back to a supplement. The Medigap plan is difficult. You usually have to go through underwriting and it can be kind of not so great. However, if you have a plan that is going away and we have a couple in Southern California going away, that opens up what we call a guaranteed issue scenario for you. So I've got some people that I'm going to be able to put on a med sup. We'll call them med sup, a supplement plan, a Medigap plan that I normally would not be able to do that for, but because they it's they're leaving, it's going away, those plans are disappearing.
Speaker 2:The other thing is, if your plan has gone up more than 15 percent your premium or you know some major part of your plan, that also opens up a guaranteed issue.
Speaker 1:Those are some important things to hear. Situation those are some important things to hear. If your price has gone up on your advantage, plan 15% or more or it's going away, it opens the door. So you don't have to have underwriting or anything. You can switch plans.
Speaker 2:Yeah, we call it a guaranteed issue, so just like when you're aging into Medicare, you're guaranteed issue. This opens that up for us. That's kind of Aging into Medicare, you're guaranteed issue. This opens that up for us. That's kind of we kind of all went, ah, because yeah, no, those are, these are all good things and you know, if you don't know, you don't know.
Speaker 1:And we've talked about this before and I want everybody to understand People like NIDA and the people that do what NIDA does. The Medicare experts is what they are. They don't cost you anything. Nita does not cost you a thing and her information is on my website, which is inside Marci's mindcom. Her information is always there for you to get and if you, if she can't help you where you live, she can help you find someone that will. And again, you guys, this is not costing you anything. So if you're sitting there with a hundred windows open on your computer and you're shuffling through things and you're looking at medications, and you're trying to do this on your own foolish, foolish, foolish, foolish, foolish because there's people out there that can help you and that are professionals at it and that know everything. Nina knows everything, everything. She knows it all. So you know. I really encourage you to look in your area. If you're, what states do you work in, nina?
Speaker 2:you know what you kind of cut out on me there.
Speaker 1:So what states do you work?
Speaker 2:in. I'm licensed in california, arizona, nevada, idaho, oregon and hawaii look at you, go girl.
Speaker 1:You're all over the place so if you're anywhere west and if, if you need something this way, nita can send you in the right direction yeah, I have 700 agents all over the state.
Speaker 1:Yes, and again, if you're trying to do this on your own, since when is government stuff ever easy? It's never. It's never easy. It's hard, and to have an expert help you that it's not going to come out of your pocket is really important. I think you know it's just, it's just too hard. Everybody's trying to figure it out and I think that to talk to it's just, it's just too hard. Everybody's trying to figure it out and I think that to talk to someone like you is really important. Yeah, is there anything else we need to know?
Speaker 2:No, that's the basics. Ok, there are some changes, like I said, in your advantage plans. Some of them are being merged and sometimes they will what we call crosswalk people to a new plan. So just, you get what's called an ANOC, an annual notice of change. So look through that. I know a lot of people toss it, but look through it and if you have any questions about the changes in your plan, you know contact somebody and say, hey, is there something that you know? Maybe you had chiropractic and that's going away? Is there another plan that I can get that has that? Well, you know, there are plans that are specific for people that have diabetes or end-stage renal disease or COPD, or there's some now for dementia.
Speaker 2:When new plans out here, at least there are plans for people that are on Medicare and Medicaid together that work, you know, give you extra benefit. There's all kinds of plans. So if your situation have changed, you've been diagnosed with a chronic illness. You know, find out. Maybe I have some people that last year they weren't diagnosed with diabetes. This year they've been diagnosed and so we're looking at a plan specifically for diagnosed with diabetes. This year they've been diagnosed and so we're looking at a plan specifically for people with diabetes because they get a little better benefit. Some extra things that a regular plan I'll tell you those advantage.
Speaker 2:Plans have got benefits out the zoo yeah, you can get groceries sometimes and and we have one coming they'll do pest control and if you um, they'll do. If you're in the hospital, they'll come in and check on your dog. You know there's all kinds of great plans, so you know we have on Craig's.
Speaker 1:One of the things is it can go towards groceries, it can go towards your rent, it can go towards anything, and I figured out how to put that. It's. I think it's $65 a month and I've figured out how to put it towards our electric bill every month. So it just goes, I, I, I click a couple buttons and off it goes and it makes a payment to the electric bill and you know it. Just, it's, that's how we choose to use that money and and it's great.
Speaker 1:And then we have the over the counter benefit, which is I didn't I don't think last quarter I even used the whole benefit Cause I mean, we, we didn't need it at any more things. Um, I just put in an order. Today there's so many things and so look at those plans. I encourage people to see what they have to offer and and use it. And I'll tell you the other thing I know Craig's advantage plan Anytime he's called. The people have been so helpful. I, he had an issue and he had to call the nurse and the nurse helped and they called in a prescription and were able to help just over the phone. So, um, yeah, I, every time we've called or we've had a question. I can't believe how kind and helpful everybody is, yeah.
Speaker 2:The member services mostly are really excellent.
Speaker 1:So yep, well, we found that, so all right. Well, we appreciate your updates. For Medicare, it sounds like you're going to have a very busy month with all kinds of things to do.
Speaker 2:Yeah, I'm already busy. One more thing I want to mention. Absolutely, we've been hearing too part of this was that Medicare was going to be negotiating with prescription drug plans, and so they are doing that. And again, we're not sure quite what that's going to mean, but they are. This will go into effect next in 2026. Ok, so I'm not till 2026. But they're. They are negotiating, like with Sorelto and Eloquist and some of the big brand name drugs, so we'll see what that means. We're not sure um how that's going to play into everything. And again, you know they, the plans, don't have to have all these medications on their formularies. So we'll see where that goes. But that's for next 2026. I'm not even thinking about that yet. Yeah, yeah, that'll affect me in june. I'll be thinking about that because that's when we start to get ready for the next year.
Speaker 1:So yeah, so January 2026 is when I finally get my, and then I'm going to stop aging, then I'm done.
Speaker 2:I get on.
Speaker 1:Medicare, and then I'm it's over.
Speaker 2:You can start in November of 2025 to look at the plans.
Speaker 1:Yeah, oh, OK. Well, that's my expert telling me what to do. I love it.
Speaker 2:You've got three months ahead and three months behind your birthday, so that's right.
Speaker 1:I had forgotten about that. So that's good information, everybody. If you're turning 65, you've got three months before and three months after to start figuring it out, so call those experts around you. So, all right around you. So All right. Well, thank you so much, nita. Until the next time.
Speaker 2:Thank you so much. I appreciate it no problem.
Speaker 1:All right. Well, I hope you enjoyed our interview and got some information that you needed. Today's fun fact is about candy corn. Now, I am one of the controversial lovers of candy corn. My mother was a lover of candy corn and I love those pumpkins, but they're the the candy corn kind of pumpkins but they're a little too much for me a good candy corn. I've already gone through a bag. This season I intend on going through another bag. But here's our candy corn fun fact. It was invented in the 1880s by George Renninger. Candy corn is one of the most oldest Halloween candies still eaten today. If all the candy corn purchased during Halloween were laid end to end, they would circle the earth 4.25 times. So for people that say they hate it, they sure buy a lot of it, and it is the oldest candy still eaten at Halloween time. So there's your fun fact for the week. Go out there and do something positive.
