Medicare 2027 Plan Changes: Coverage Gaps, Drug Coverage & Senior Medicare Tips (Episode 8, Part 2)

Medicare decisions can affect your prescription costs, access to doctors and protection from unexpected expenses. In Part 2 of Senior PrimeTime’s Medicare 2027 conversation, host Bonnie Keith is joined by Medicare professionals Doris Ford of Ford Benefits Group and Elka Soussana of Simpler Horizons Insurance Solutions to discuss questions older adults and families may want to consider as they review their coverage.

The conversation explores ways to compare prescription prices, including discount programs and the Medicare Prescription Payment Plan, and why it’s important to understand how any drug-cost option works with your current coverage. Doris and Elka also discuss questions about GLP-1 medications, retiree health plans and what to check before making a change.

You’ll also hear about Medicare Advantage and Medicare Supplement plans, including how provider networks can affect access to doctors and what to ask if your doctor is no longer in network. The guests explain situations that may allow exceptions for out-of-network care and discuss the differences between Medicare Advantage and Medigap coverage.

The episode also covers the GUIDE program and respite support for people living with dementia and their caregivers, the limits of Medicare coverage for custodial and long-term care, and why patient advocacy can matter. As the Annual Enrollment Period approaches, the guests discuss reviewing plan notices, checking whether coverage is changing, and learning about protections such as the Medicare Supplement Birthday Rule, guaranteed-issue rights and trial rights. These protections can vary by state and by individual circumstances.

Finally, Bonnie, Doris and Elka look at expenses Medicare may not cover, including long-term care, dental, vision and hearing services, and why some people explore separate policies for needs such as critical illness, accidents or final expenses.

Senior PrimeTime is presented by the Foundation for Senior Services, a 501(c)(3) public charity that provides older adults and families with education, options and resources to help them choose quality care and support and preserve independence. The Foundation is led by CEO Joyce Robertson.

Guests:
Doris Ford — Ford Benefits Group
fordbenefitsgroup.com

Elka Soussana — Simpler Horizons Insurance Solutions
simplerhorizons.com

Hosted by Bonnie Keith
Senior PrimeTime: Real People, Real Conversations.

Foundation for Senior Services:

foundationforseniorservices.org

Chapters

00:00 Part 2: Prescription drug discount cards
00:35 Drug costs and the monthly payment option
02:21 Discount websites, negotiated prices, and GLP-1 discussion
04:39 Retiree coverage and prescription plan caution
05:19 Out-of-network care exceptions
06:52 Keeping your doctor when plans change
07:35 Medicare Advantage vs. Supplement: the bus-and-car analogy
10:17 GUIDE program, dementia, and respite care
12:58 Custodial care, patient advocacy, and Medicare gaps
14:31 What does Medigap mean?
16:08 Medicare phone lines and local help
17:24 Unsolicited calls and fraud warnings
18:33 Annual Enrollment Period and reviewing plan changes
20:05 Medicare Supplement birthday rule
22:24 The 15% rule and plan benefit reductions
24:10 Guaranteed-issue options and the Medicare Advantage trial right
25:52 Why individual Medicare situations differ
27:03 Long-term care, final expenses, and critical illness coverage
29:05 Accident and critical illness policy examples
31:22 Dental, vision, hearing, and extra benefits

Senior PrimeTime is brought to you by the Foundation for Senior Services and hosted by Bonnie Keith.
Each episode features conversations that help seniors and their families live with purpose, vitality, and confidence in Act Three.

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Learn more:
FoundationForSeniorServices.org