Health Insurance 101
Whether you are under 65 and shopping for plans outside of your employer—or as a self-employed business owner—or you’re retired and looking to better understand Medicare, this webinar will help you make sense of your options.
We cover:
Why working with an agent is at no cost to you
The differences between Bronze, Silver, Gold, and HSA plans
Marketplace vs. off-Marketplace options and how tax credits work
Medicare basics, including Parts A & B and the two main paths: Medigap vs. Advantage plans
Ancillary coverage such as dental, vision, travel, and final expense plans
You may be surprised to learn that the advice of a knowledgeable agent can be invaluable—and working with one never costs more than going it alone.
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Well, we are recording, so we can always, uh, get
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that information to those folks.
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So thanks for joining us.
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Uh, again, this, the goal of this is
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to be pretty consumer friendly and interactive.
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Uh, we will have the q and a.
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If you scroll down the bottom, if you're not familiar
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with Zoom, you can click on the q and a.
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You can ask any questions.
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We will, uh, at the end as well
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as throughout take questions.
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We can even open you up to, if you wanna just physically,
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you know, verbally ask your question.
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Um, I wanna introduce our speaker, Paul Miner.
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Paul's been in the health insurance business
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exclusively for five years.
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Uh, and what's unique about
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that is this is, this is all he does.
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He eats, sleeps, breathes health insurance.
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Um, I've known Paul maybe, what, a year and a half Paul?
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Mm-hmm. And he was referred to us by one
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of our best clients of 20 plus years.
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I said, no, we, we got a health person.
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They do a pretty good job. I'm, I'm not really interested.
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I met with Paul. I think as you'll find him,
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he's incredibly knowledgeable.
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He's incredibly straightforward.
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He's not a sales guy, he's just gonna tell you what it is.
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So he's probably worked with 25 or more of our clients, um,
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and he doesn't get anything
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special and we don't get anything special.
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He just, he does a good job.
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Um, and so I asked him if he would kind of cover, you know,
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one of the areas that we really don't
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focus on, which is health insurance.
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Um, you, you know, any advisor in my opinion, um, you know,
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they've got their expertise and they've got their gaps.
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And this is certainly a gap for us.
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So it's good to have an expert.
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Um, is he'll talk about, you know, he is a resource
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that really is, uh, it sounds good
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to be true, but, but free of charge.
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So, uh, I wanted to introduce him.
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I'm gonna let him sort of run with this.
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But again, questions, please.
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We're here to make this material for all
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of you to make it beneficial.
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I know we've got a gamut of people.
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Some of you are, are already retired, some
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of you are on the younger side.
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Um, young is a relative term,
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but, uh, please feel free to ask those questions.
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So with that, Paul, why don't you go ahead and,
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and uh, take it away.
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Alright, thank you so much.
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It's so good to be here
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and I've been looking forward to this day
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for quite some time now, let me put this up on my screen
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so you don't have to keep staring at me.
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Uh, so I am Paul Miner, a local independent insurance agent.
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And, uh, like I said, I'm excited to be here
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and to go over insurance options.
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If you have questions at any time, feel free to pop in,
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put it in the chat, put it in the q
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and a, um, open up your microphone, whatever it is.
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Uh, it's definitely not an interruption.
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We'll also have a q and a time at the end
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and we will discuss things too.
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So if you'd rather do it that way, that's fine also.
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Um, so,
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and I also wanna appreciate very much appreciate, uh,
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DOS Financial for inviting me in here.
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I do meet with a lot of different financial companies
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and I can tell you dos is very special to me.
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And no, I don't say that to everybody,
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but, uh, I appreciate what he has going on
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and I appreciate his, uh, uh, being so personal
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with his clients and you just don't see that everywhere.
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So, back to health insurance, we're gonna give, uh, this is
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what we're going to cover today.
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We're gonna go over the agenda.
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You can see where, um, maybe something
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of most interest to you will appear.
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We'll first cover, why would you even use an agent?
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What in the world would I use Paul Miner for?
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We'll, we'll look at that
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and then we'll look at under 65 insurance.
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Then we'll look at Medicare itself, the two parts
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and what to do with it, how to sign up,
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how to pay for it, all those things.
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We'll take a look at Medicare insurance, the two paths
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because you want something to go along with your Medicare.
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And then we'll also take a look at ancillary plans
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before we make our final stop as the Q and a.
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So let me get started here. Why use an agent?
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And the biggest reason is it doesn't cost anything.
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And my, my favorite price is free.
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And the thing is you think, okay, well if you're free
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and you usually get what you pay for,
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then why would I use you?
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Well, it's because of the way the insurance industry works.
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It's the same plan, the same price, the same benefits
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and everything, whether you go straight to a carrier
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or whether you use an independent agent like me.
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So we get a small commission from the insurance company
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and it's the same no matter what we sell or what it is.
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And so that helps us to look at your particular needs
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and find something that's perfect for you.
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Also, when you call a carrier, you are gonna be able
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to learn about only the one carrier's plan.
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And so I deal with over a dozen companies.
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So whatever company seems to be best for your situation,
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then that's what we want to go with.
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And the expertise of working
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with all these different companies,
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all these different plans,
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and then especially if there is an issue,
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how do you get it resolved?
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That's what I'm here for.
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So maybe a better question is why wouldn't you use an agent?
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Put yourself on easy mode and use an independent agent.
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Alright, so I want to touch on the under 65 plan types.
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And they use metals.
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So obviously the greater the metal than
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what they would call is the better the plan
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with some caveats.
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The bronze plan is a very low premium plan,
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high deductible plan and higher copay plan.
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So if you are just looking for something to have,
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just in case there's an emergency bronze plan would be it.
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They also have silver plans, medium premium,
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medium deductible, medium type copays.
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So maybe you have some greater needs
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or you're expecting more frequent use,
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then the silver plan may be the way to go.
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With a gold plan, you have a higher premium,
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a much lower deductible and lower copays.
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So if you are definitely a big user
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or something like that, you may want to go with a gold plan.
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Now I left this HSA plan.
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Ryan and I were talking before about changes
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in the under 65.
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We'll also Medicare, but especially under 65
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there are a lot of changes.
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And earlier in the year, I let my clients know, hey,
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the one big beautiful bill uh, passed.
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And so these are the changes.
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Well, not all those changes are gonna happen.
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There's been court cases, there's,
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I mean there's just so many things.
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So until we get the final numbers, I don't,
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it's just too hard to talk about all the changes.
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But the HSA is one big change.
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While it's separate this year, next year, all bronze plans
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plans or maybe 98% of them will be HSA eligible.
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And the HSA allows you to put, uh,
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money into the HSA untaxed.
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It allows you to use HSA fund, uh, funds
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for medical expenses without being taxed.
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And while it's in the HSA, it will grow without being taxed.
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So that is a big boon for these under 65 plans.
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There's two places you can get an under 65 plan.
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You can go off marketplace and that would be full price.
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So we have H-M-O-H-M-O point
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of service plans or um, we also have PPOs.
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And so basically the greater the network as we move
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to the right on the screen, the better the network,
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the higher the premium though.
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So keep that in mind.
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Generally we do a lot of work on the front end
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to check your network, what providers you need,
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what prescriptions you're on, all those kind of things.
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And then maybe we want to tailor the type
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of network you need to that this would be a good path.
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If you have a very high income,
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the on marketplace, you can get real time savings.
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So what they do is they will take your income from this year
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or your projected income for this year
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and they will set those rates based on their formula.
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And so if you can save a couple hundred dollars a month
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or $500 a month
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or a thousand dollars a month,
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then it could really be worth it to go on the marketplace.
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And again, it's based on income for current year.
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They don't look at previous years.
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So a lot of times people look at this option when they are
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retiring early, but they don't qualify for Medicare yet.
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And honestly,
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that is the number one thing preventing people from retiring
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earlier than they do is the cost of medical insurance.
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But when you know it's based on when you, uh, the, you know,
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the current year, then a lot
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of times you're not making the same kind of income.
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So you might get a much sweeter deal than
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what you thought you could
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because of the income you made in the previous year.
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Hey Paul? Yes. Uh, just quick question on that.
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So let's say somebody works January to June and mm-hmm.
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You know, they're making X and they retire in June.
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Is is that gonna be based on the income they've,
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they've earned, you know, year to date
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or like now going forward if they're not making any income?
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Uh, how, how does that work?
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That's a great question
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and it is based on the entire year income.
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So even if you sign quit in November
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and sign up to get something just for December,
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it's still based on the whole year.
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So it is probably much less still if you
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only work a half a year.
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And then the rest of it is, is um, you know,
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some lower income,
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maybe you're collecting a pension or something like that.
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But yes, it is the full year's income. Thank
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You.
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And uh, again, same thing with the other.
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The better the network, the higher the premium
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and this path, if you're eligible for tax credits,
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it's almost always worth it.
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And I'll give you an example for this year
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and we'll see what happens next year.
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All of this stuff is being played out in real time.
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Uh, you know, and I've said to a number of people, like
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with Trump, um, hate him, love him, doesn't matter to me.
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The somehow the way he's set up things can change
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and they can change in a hurry.
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And trying to keep up with all of this
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or make predictions is a little tough.
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And so when we see the actual plans for next year,
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we'll give exact details,
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but like this year you can have a couple making $150,000 a
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year and depending on age can still qualify for a five, six,
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$700 a month tax credit.
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So it could really be worth it to go on the marketplace.
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We'll look at all those factors.
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Um, also wanted to take a quick look about choosing
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between group or individual coverage.
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And so obviously if you're working for someone,
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then the group policy may be the best for you.
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But we have found recently as we think outside the box,
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that there are some real opportunities for savings.
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I'll give you an example with, uh, several people
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that have owned their own business
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and just within the last couple of years I've helped
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multiple people in these two categories, for example,
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because like how much does a farmer really make?
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We don't know, but we see what they put on their taxes.
248
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And with lawn care I've had, um,
249
00:12:11.795 --> 00:12:13.705
small business owners owning their lawn care
250
00:12:13.705 --> 00:12:15.745
that assign themselves a salary as well.
251
00:12:16.915 --> 00:12:20.285
Well, marketplace coverage is based off of income
252
00:12:20.585 --> 00:12:23.565
and so that's whatever's gonna wind up on your tax returns.
253
00:12:24.065 --> 00:12:27.565
And so I had these people in these categories that were able
254
00:12:27.565 --> 00:12:29.525
to get half the price
255
00:12:30.265 --> 00:12:34.765
or less on an individual coverage plan than they could
256
00:12:35.425 --> 00:12:37.525
on their group insurance.
257
00:12:38.185 --> 00:12:40.965
So saw some real good savings in here.
258
00:12:41.965 --> 00:12:43.585
And so if you have a small business
259
00:12:43.585 --> 00:12:44.705
where you can assign a salary,
260
00:12:45.655 --> 00:12:47.305
this could be a big deal for you.
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00:12:47.845 --> 00:12:50.465
And the cool thing is you can contact me,
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00:12:50.855 --> 00:12:52.225
give me a little information
263
00:12:52.685 --> 00:12:55.825
and I'll let you know say, Hey, this is what it looks like.
264
00:12:55.965 --> 00:12:57.665
How does that compare to what you have?
265
00:12:57.885 --> 00:12:58.945
Is this a better deal?
266
00:13:00.825 --> 00:13:03.155
Also, if you're an employer, I've had a number
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of people do this where,
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and especially bear in mind, when you have someone
269
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as they age, they get more expensive on the health
270
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insurance, their rates are more expensive
271
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and util usually their utilization is higher as well.
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And so I've had employers that will give a stipend
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to someone who does not, uh, chooses not
274
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to get their insurance.
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And that stipend could cover the cost
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of their Medicare plan.
277
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And so you have a much lower cost as an employer
278
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and oftentimes the, uh, your employee
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has a better plan and their costs are lower too.
280
00:13:45.835 --> 00:13:50.015
So there's a lot of ways to kind of, uh, look at things
281
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outside the box and see some serious savings.
282
00:13:54.665 --> 00:13:57.235
There's also the icra, the individual coverage,
283
00:13:57.235 --> 00:13:59.075
health reimbursement arrangement.
284
00:13:59.415 --> 00:14:01.035
And that's a little more complicated,
285
00:14:01.375 --> 00:14:03.435
but that's a possibility as an employer.
286
00:14:03.665 --> 00:14:08.435
Also, if you want some more fixed costs on income,
287
00:14:08.455 --> 00:14:10.915
but still, uh, or I'm sorry, on what you give
288
00:14:10.915 --> 00:14:11.915
to your employees,
289
00:14:12.415 --> 00:14:14.675
but uh, give them, uh, the ability
290
00:14:14.855 --> 00:14:16.395
of a little more flexibility.
291
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Uh, now we'll move to Medicare.
292
00:14:21.285 --> 00:14:23.345
So this is gonna be the meat and potatoes here.
293
00:14:24.165 --> 00:14:26.785
Uh, uh, this is a government program that helps
294
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with your medical costs.
295
00:14:28.365 --> 00:14:31.705
You've paid into it all of your lives or most of your lives.
296
00:14:32.445 --> 00:14:36.025
And so hopefully it's gonna be soon time to utilize that.
297
00:14:37.605 --> 00:14:40.445
Medicare does not cover some things. I'll go over those.
298
00:14:41.105 --> 00:14:43.395
Uh, dental care vision
299
00:14:43.895 --> 00:14:48.235
and when I mean vision, I mean routine eye, getting eyewear,
300
00:14:48.235 --> 00:14:50.515
contact lenses, glasses, those kind of things.
301
00:14:50.955 --> 00:14:52.765
Obviously it would cover if you needed
302
00:14:53.285 --> 00:14:55.445
cataract surgery or something like that.
303
00:14:56.975 --> 00:14:59.155
It does not cover hearing aids and exams.
304
00:14:59.855 --> 00:15:01.915
It does not cover weight loss medications.
305
00:15:02.065 --> 00:15:04.555
This has been a big thing recently
306
00:15:05.535 --> 00:15:08.395
and uh, it does not cover medical costs
307
00:15:08.585 --> 00:15:10.075
outside the United States.
308
00:15:11.055 --> 00:15:13.035
So those are some things it does not cover
309
00:15:13.215 --> 00:15:15.675
and that's why Medicare itself is great.
310
00:15:16.655 --> 00:15:20.035
But you want something else to be grouped with that.
311
00:15:20.815 --> 00:15:23.315
So here's the two parts of Medicare part a
312
00:15:24.265 --> 00:15:28.115
part A $0 a month when you turn 65,
313
00:15:29.255 --> 00:15:30.435
if you are,
314
00:15:30.785 --> 00:15:33.955
even if you're gonna stay on your group insurance, you want
315
00:15:33.955 --> 00:15:37.315
to get Part A because it doesn't cost you anything
316
00:15:38.375 --> 00:15:41.235
and it may not be a huge benefit to you,
317
00:15:41.535 --> 00:15:43.155
but it definitely won't hurt you.
318
00:15:43.775 --> 00:15:45.515
It covers hospitalization,
319
00:15:46.855 --> 00:15:50.195
it covers skilled nursing facilities for the first 20 days.
320
00:15:50.855 --> 00:15:52.315
It covers hospice care.
321
00:15:53.495 --> 00:15:55.875
Um, and there is for this year
322
00:15:56.025 --> 00:15:58.715
that $1,700 roughly deductible.
323
00:16:00.015 --> 00:16:03.195
So, but again, it costs $0 a month.
324
00:16:03.775 --> 00:16:07.515
It does not trigger any special election periods.
325
00:16:08.215 --> 00:16:11.635
So you almost always want to sign up
326
00:16:11.655 --> 00:16:14.915
for part A no matter what you're doing with your insurance.
327
00:16:17.795 --> 00:16:19.815
The second part is part B.
328
00:16:21.165 --> 00:16:25.655
Part B is $185 or more per month.
329
00:16:26.555 --> 00:16:28.055
It is income based.
330
00:16:28.835 --> 00:16:32.215
So when you do well, the government rewards you
331
00:16:32.515 --> 00:16:35.255
by charging you more for the exact same thing.
332
00:16:36.155 --> 00:16:39.835
So yeah, I'm, I'm laughing so I don't cry,
333
00:16:40.055 --> 00:16:41.235
but that's the way it works.
334
00:16:41.535 --> 00:16:46.395
Yes, so if you're a really high earner, you can pay as much
335
00:16:46.475 --> 00:16:47.795
as $600 a month
336
00:16:48.295 --> 00:16:52.795
and you receive these income related adjustments, um,
337
00:16:54.115 --> 00:16:56.695
uh, you know, to again to pay for part B,
338
00:16:56.705 --> 00:16:58.455
which is the same thing everyone else gets,
339
00:16:58.955 --> 00:17:02.855
but once they go back two years in taxes for your income.
340
00:17:03.395 --> 00:17:08.015
So a lot of times after you've been retired a year
341
00:17:08.015 --> 00:17:10.455
or two, that cost settles back down
342
00:17:10.755 --> 00:17:15.335
and you're not paying that extra amount above 180 5.
343
00:17:15.985 --> 00:17:17.415
We'll see what it is next year.
344
00:17:17.915 --> 00:17:19.775
The projection is 2 0 6,
345
00:17:20.075 --> 00:17:22.255
but I have not seen that officially yet.
346
00:17:24.755 --> 00:17:29.305
Part B covers doctor visits, diagnostic tests,
347
00:17:30.435 --> 00:17:33.405
outpatient care, preventive care.
348
00:17:34.645 --> 00:17:39.305
And how it covers is it will pay for 80% of those things
349
00:17:40.585 --> 00:17:45.405
and with a $257 yearly deductible, that's this year,
350
00:17:45.555 --> 00:17:47.725
next year is gonna be in the two eighties.
351
00:17:48.825 --> 00:17:51.045
So not huge deductible at all.
352
00:17:51.635 --> 00:17:55.575
However, if you're keeping group insurance,
353
00:17:57.075 --> 00:18:00.455
you probably don't want to sign up for part B
354
00:18:00.725 --> 00:18:04.535
because part B does trigger special election periods
355
00:18:04.535 --> 00:18:07.015
that you can't get back later on.
356
00:18:08.405 --> 00:18:09.425
And I'll talk about
357
00:18:09.425 --> 00:18:11.745
that a little bit more when we talk about the insurance
358
00:18:11.745 --> 00:18:13.265
portion of Medicare.
359
00:18:15.065 --> 00:18:19.325
And again, if anyone has a question, pop in at any time.
360
00:18:24.995 --> 00:18:26.655
So one, when you have,
361
00:18:26.755 --> 00:18:28.295
and I'll talk about sign up in just a minute,
362
00:18:28.295 --> 00:18:30.695
but when you have the two paths, uh,
363
00:18:30.715 --> 00:18:33.735
or the two parts of Medicare, then you want
364
00:18:33.735 --> 00:18:35.335
to look at which path
365
00:18:35.355 --> 00:18:37.695
of Medicare insurance you want to go with.
366
00:18:38.365 --> 00:18:40.415
There's not a right path and a wrong path,
367
00:18:40.795 --> 00:18:43.695
but there is a path that fits your needs better
368
00:18:43.955 --> 00:18:45.535
and that's what we explore.
369
00:18:46.565 --> 00:18:49.975
There's a Medicare supplement, also known as a Medigap plan.
370
00:18:51.355 --> 00:18:55.735
It has a great network for those of you that have struggled
371
00:18:55.735 --> 00:18:56.855
with networks before
372
00:18:57.315 --> 00:19:01.335
and making sure your doctor is in, you all have
373
00:19:01.335 --> 00:19:04.575
to do virtually nothing on a Medigap plan
374
00:19:04.805 --> 00:19:07.695
because if a provider takes Medicare
375
00:19:08.455 --> 00:19:09.575
anywhere in the United States
376
00:19:09.835 --> 00:19:11.335
and the outlying territories,
377
00:19:12.295 --> 00:19:14.025
then they take your Medigap plan.
378
00:19:14.485 --> 00:19:16.305
So that makes it super easy.
379
00:19:16.805 --> 00:19:18.225
Now it is still a network
380
00:19:18.455 --> 00:19:22.025
because you may have a provider that doesn't take Medicare,
381
00:19:22.885 --> 00:19:25.345
but that is an incredibly small amount
382
00:19:25.345 --> 00:19:27.225
of providers in the United States.
383
00:19:27.965 --> 00:19:31.985
So this is kind of the, a Medicare supplement
384
00:19:32.885 --> 00:19:36.625
is the health insurance equivalent of easy mode.
385
00:19:38.635 --> 00:19:42.735
And how it works is you pay upfront in terms of premiums
386
00:19:44.115 --> 00:19:45.575
and then you have your deductible,
387
00:19:45.905 --> 00:19:50.415
which is $257 this year it's two 80 something next
388
00:19:50.415 --> 00:19:51.535
year is what we're looking at.
389
00:19:52.475 --> 00:19:55.985
And then you would pay zero for your medical needs.
390
00:19:57.065 --> 00:20:01.605
So it's very static cost for medical,
391
00:20:02.855 --> 00:20:04.025
very easy to use.
392
00:20:04.525 --> 00:20:06.345
If Medicare approves it, your
393
00:20:06.915 --> 00:20:08.905
supplement approve approves it.
394
00:20:09.455 --> 00:20:12.425
There's no prior approvals, prior authorizations,
395
00:20:12.575 --> 00:20:16.025
well there's just a couple but you almost never see them.
396
00:20:16.805 --> 00:20:19.105
And so super easy to use.
397
00:20:20.875 --> 00:20:25.075
However, you need more than just a supplement.
398
00:20:25.335 --> 00:20:26.875
At the very least you need
399
00:20:26.875 --> 00:20:29.195
to add prescription drug plan to that.
400
00:20:30.575 --> 00:20:33.355
And prescription drug plans can run anywhere from zero
401
00:20:33.415 --> 00:20:34.875
to $120 a month.
402
00:20:35.255 --> 00:20:37.035
And again, this depends on your needs.
403
00:20:37.495 --> 00:20:40.795
We have the majority of our clients on $0 a month
404
00:20:41.075 --> 00:20:44.115
prescription drug plans, so there's probably a good
405
00:20:44.115 --> 00:20:45.395
opportunity for you there.
406
00:20:45.935 --> 00:20:48.005
But we look at all the prescriptions
407
00:20:48.105 --> 00:20:51.365
and we figure out what's the best, uh, one
408
00:20:51.465 --> 00:20:52.845
for your situation.
409
00:20:53.865 --> 00:20:57.085
And this year they have a $590 deductible.
410
00:20:57.585 --> 00:20:59.845
And most of the time that is only
411
00:21:00.065 --> 00:21:02.325
for name brand drugs and above.
412
00:21:03.255 --> 00:21:04.985
Next year that'll go to six 15.
413
00:21:05.765 --> 00:21:09.505
So again, most of our clients don't see the deductible
414
00:21:09.505 --> 00:21:11.665
because they stay on generic drugs.
415
00:21:13.645 --> 00:21:15.945
And you probably want to pair some sort
416
00:21:15.945 --> 00:21:17.665
of dental plan with this as well.
417
00:21:18.165 --> 00:21:21.065
And possibly dental, vision, dental, vision and hearing.
418
00:21:22.275 --> 00:21:25.935
And that can run anywhere from 35 to $60 a month.
419
00:21:29.985 --> 00:21:34.045
Hey Paul, we do have a, uh, a listener question. I dunno.
420
00:21:34.145 --> 00:21:36.925
Oh, sorry I missed q&a. Yeah, that's what we're here for.
421
00:21:40.055 --> 00:21:42.315
Let me see. Do you want me
422
00:21:42.315 --> 00:21:43.395
to read it or do you wanna click it?
423
00:21:43.395 --> 00:21:45.115
That would be great. 'cause all I'm seeing is
424
00:21:45.115 --> 00:21:47.075
my full screen, I'm afraid. That's
425
00:21:47.075 --> 00:21:48.075
Okay. So
426
00:21:48.075 --> 00:21:48.955
the question is,
427
00:21:49.175 --> 00:21:53.715
if you have kept prior employer group insurance instead
428
00:21:53.715 --> 00:21:56.755
of Medicare, can you get any of the gap insurance?
429
00:22:00.775 --> 00:22:04.775
So in order to get well,
430
00:22:04.775 --> 00:22:06.775
and there's a couple scenarios running through my head here.
431
00:22:07.355 --> 00:22:10.735
So let's say you are 75
432
00:22:11.035 --> 00:22:14.575
and you've been on group insurance this whole time, as long
433
00:22:14.575 --> 00:22:19.175
as it's considered creditable coverage, which if it wasn't,
434
00:22:19.175 --> 00:22:21.775
they would be sending you letters every single year saying
435
00:22:21.805 --> 00:22:23.175
it's not creditable coverage.
436
00:22:24.005 --> 00:22:26.935
Then whenever you leave the
437
00:22:26.995 --> 00:22:29.055
or you can sign up for part B
438
00:22:29.635 --> 00:22:32.015
or at any time you probably have part A already
439
00:22:33.535 --> 00:22:35.155
or you can sign up for both of 'em at any time.
440
00:22:35.665 --> 00:22:38.395
When you sign up for part B for the first time
441
00:22:39.215 --> 00:22:40.755
and you're already 65
442
00:22:40.775 --> 00:22:45.395
or older, you have this open enrollment period where
443
00:22:46.265 --> 00:22:49.835
they will take you in a Medigap plan at preferred rates
444
00:22:50.065 --> 00:22:51.515
with no questions asked.
445
00:22:53.655 --> 00:22:58.305
If you are, there's almost never a time
446
00:22:58.455 --> 00:23:01.825
when you would want to have both a group plan
447
00:23:01.925 --> 00:23:03.665
and a supplement just
448
00:23:03.665 --> 00:23:05.785
because it wouldn't be cost effective for you.
449
00:23:06.645 --> 00:23:07.785
So I wasn't sure if that
450
00:23:07.785 --> 00:23:09.065
was one of the things you were asking.
451
00:23:09.725 --> 00:23:11.465
Did I hit that or is there something else?
452
00:23:16.195 --> 00:23:18.335
And let me see if I can pull up that. Yeah,
453
00:23:18.335 --> 00:23:19.375
That that was the question.
454
00:23:19.375 --> 00:23:21.655
We'll see if, uh, if it's not, maybe they can,
455
00:23:21.655 --> 00:23:23.935
they can enter more and we can, we can circle back to it.
456
00:23:25.045 --> 00:23:27.025
Uh, while, while we're on that, just, uh,
457
00:23:27.025 --> 00:23:29.425
so when you mentioned like the prescriptions, right, a lot
458
00:23:29.425 --> 00:23:30.625
of people have mul prescriptions.
459
00:23:31.205 --> 00:23:33.865
Do you have like a program that you can put those into
460
00:23:33.865 --> 00:23:35.745
and it'll kind of say, okay, if you didn't have insurance,
461
00:23:35.745 --> 00:23:36.985
this is what it would be to kind
462
00:23:36.985 --> 00:23:38.745
of help them understand the cost
463
00:23:38.765 --> 00:23:40.465
of, you know, with and without?
464
00:23:41.685 --> 00:23:42.825
Yes, that's a great question
465
00:23:42.885 --> 00:23:44.385
and that is exactly what we do.
466
00:23:44.565 --> 00:23:46.445
So I, I capture all that information.
467
00:23:46.805 --> 00:23:48.045
I will run through a couple
468
00:23:48.045 --> 00:23:50.205
of different checkers just in case there's an error
469
00:23:50.205 --> 00:23:52.245
and then I kind of go back with a third as well
470
00:23:52.625 --> 00:23:55.125
and I will give an estimate for what the costs
471
00:23:55.225 --> 00:23:58.645
of those medications are going to be for the entire year.
472
00:23:59.425 --> 00:24:02.045
And uh, that way we can compare different plans
473
00:24:02.385 --> 00:24:04.605
and we can compare with what you're doing right now.
474
00:24:04.865 --> 00:24:06.655
Yes, thank you.
475
00:24:11.485 --> 00:24:14.735
Alright, so then we have advantage plans,
476
00:24:16.105 --> 00:24:18.115
this also known as Part C.
477
00:24:18.975 --> 00:24:21.555
And with these you have a very strong network.
478
00:24:22.655 --> 00:24:26.035
Um, oftentimes you're gonna find a stronger network in
479
00:24:26.515 --> 00:24:29.635
Medicare than you do definitely on the individual under 65
480
00:24:30.055 --> 00:24:32.555
and oftentimes better than the group
481
00:24:32.555 --> 00:24:34.075
insurance plans that you have.
482
00:24:34.785 --> 00:24:36.515
Some of these carriers like Blue Cross
483
00:24:36.535 --> 00:24:39.035
and Priority Health especially, they'll say somewhere
484
00:24:39.035 --> 00:24:41.195
between 92 and 94%
485
00:24:41.415 --> 00:24:43.355
of primary care physicians are in network.
486
00:24:43.905 --> 00:24:45.755
They have this huge number of specialists,
487
00:24:46.245 --> 00:24:48.835
every hospital in Michigan, those kind of things.
488
00:24:49.335 --> 00:24:50.835
And in network when you travel,
489
00:24:51.415 --> 00:24:55.475
but still not as much as a Medigap plan.
490
00:24:57.495 --> 00:25:02.145
Many of these plans are $0 a month in premium with a $0
491
00:25:02.365 --> 00:25:03.625
or low deductible.
492
00:25:04.125 --> 00:25:06.465
And I think that's attractive to some people as well.
493
00:25:06.805 --> 00:25:09.065
And then you pay copays when you use it.
494
00:25:09.765 --> 00:25:13.825
So in that sense it functions similar to a group plan.
495
00:25:14.865 --> 00:25:18.235
They also include a prescription drug plan, some
496
00:25:18.235 --> 00:25:20.475
with no deductible, some with deductibles,
497
00:25:21.135 --> 00:25:25.595
and they include things like vision and dental and hearing
498
00:25:25.815 --> 00:25:28.355
and over the counter and gym memberships
499
00:25:28.815 --> 00:25:31.315
and those kind of extra perks that you see.
500
00:25:31.695 --> 00:25:35.755
And that's why I dubbed those the all in one plan.
501
00:25:37.615 --> 00:25:39.995
And again, there's not a right path and a wrong path,
502
00:25:40.415 --> 00:25:43.995
but there is a path that you will see yourself on
503
00:25:44.135 --> 00:25:45.435
as we investigate it.
504
00:25:49.095 --> 00:25:53.865
Uh, here is, oh, here are some notes
505
00:25:53.865 --> 00:25:55.465
for drug plans for 2026.
506
00:25:56.285 --> 00:25:58.065
You may not be familiar with this year,
507
00:25:58.205 --> 00:26:01.705
but we had a $2,000 max out of pocket for drugs
508
00:26:01.975 --> 00:26:04.905
that are on the formula of your prescription drug plan.
509
00:26:05.725 --> 00:26:09.985
So next year that's going to $2,100, not a big increase.
510
00:26:10.575 --> 00:26:13.105
This has been a huge boon for people
511
00:26:13.105 --> 00:26:15.105
that have had very expensive drugs.
512
00:26:15.575 --> 00:26:18.265
I'll give you an example. I have a couple of clients
513
00:26:18.335 --> 00:26:19.905
that are on these drugs
514
00:26:19.905 --> 00:26:22.145
that cost a hundred thousand dollars a year.
515
00:26:23.335 --> 00:26:26.225
Well, with a $2,100 max out of pocket,
516
00:26:26.615 --> 00:26:28.145
that is a really big savings.
517
00:26:29.005 --> 00:26:32.105
So they will pay for their drugs month one
518
00:26:32.245 --> 00:26:33.985
and then they'll pay zero for the drugs
519
00:26:34.045 --> 00:26:35.065
for the rest of the year.
520
00:26:36.065 --> 00:26:37.605
If you're not on an expensive drug,
521
00:26:37.955 --> 00:26:39.765
then this's probably not a big value to you,
522
00:26:39.985 --> 00:26:42.605
but it is nice that you don't have to sell your house
523
00:26:42.805 --> 00:26:43.965
to pay for prescriptions.
524
00:26:45.605 --> 00:26:48.475
Again, there's up to a $615 deductible,
525
00:26:48.655 --> 00:26:51.235
but usually we see that on the more expensive drugs
526
00:26:51.665 --> 00:26:52.795
name brand and above.
527
00:26:53.575 --> 00:26:56.955
And then they also have a program to smooth these out.
528
00:26:57.535 --> 00:26:59.435
So like when I told you about the client
529
00:26:59.435 --> 00:27:03.355
who paid $2,000 right at the front, they could smooth
530
00:27:03.355 --> 00:27:05.315
that out over 12 months using the
531
00:27:05.515 --> 00:27:06.955
Medicare prescription payment plan.
532
00:27:09.645 --> 00:27:12.185
Uh, I already said that, so we'll skip through there.
533
00:27:12.615 --> 00:27:14.145
Here we go. Do I have to sign up
534
00:27:14.145 --> 00:27:15.785
for Medicare when I turn 65?
535
00:27:16.325 --> 00:27:21.225
Not necessarily Part A. Always, almost always, yes.
536
00:27:21.885 --> 00:27:23.265
And feel free to talk to me.
537
00:27:23.565 --> 00:27:27.065
Um, I give free advice as well, uh, if you want that,
538
00:27:27.165 --> 00:27:29.385
but almost always I would say yes.
539
00:27:29.695 --> 00:27:31.505
Part B, well it depends.
540
00:27:31.845 --> 00:27:34.105
If your group plan is creditable coverage
541
00:27:34.285 --> 00:27:37.545
and you're gonna stay on group, then there's no need
542
00:27:37.685 --> 00:27:38.825
to sign up for that.
543
00:27:40.445 --> 00:27:44.385
Um, if your group plan is not as good as a Medicare plan,
544
00:27:44.855 --> 00:27:47.465
then maybe you do want to sign up for that
545
00:27:47.525 --> 00:27:49.665
and switch to a Medicare plan.
546
00:27:50.625 --> 00:27:52.845
So again, we can take a look at that.
547
00:27:52.865 --> 00:27:54.685
If you have any questions, let me know
548
00:27:54.825 --> 00:27:58.325
and we'll take a look at that, when to sign up. Hey Paul,
549
00:27:58.325 --> 00:27:59.325
We do have another question.
550
00:27:59.385 --> 00:28:02.965
Oh, um, I know that your office is in Portage, Michigan,
551
00:28:03.145 --> 00:28:04.205
but uh, we have a question.
552
00:28:04.585 --> 00:28:07.005
Um, if you work with people who live in Indiana,
553
00:28:07.955 --> 00:28:10.335
That's a great que and I'm, I gotta figure out how to flip
554
00:28:10.335 --> 00:28:11.535
between answered and open.
555
00:28:11.815 --> 00:28:16.545
I see you now. Okay, so, um, yes, as a matter of fact,
556
00:28:16.865 --> 00:28:20.425
I am licensed in Indiana, in Florida, in Pennsylvania,
557
00:28:20.475 --> 00:28:21.945
South Carolina and North Carolina.
558
00:28:23.225 --> 00:28:24.585
I do most of mine in Michigan,
559
00:28:24.885 --> 00:28:27.585
but uh, there's been many people who they just want me
560
00:28:27.585 --> 00:28:28.905
to follow them as they move.
561
00:28:28.965 --> 00:28:31.625
And so I've picked up some licenses in other states as well.
562
00:28:31.625 --> 00:28:34.495
Mm-hmm. Yeah, Indiana's fun
563
00:28:35.035 --> 00:28:38.535
and being, uh, right now still living in three rivers
564
00:28:38.535 --> 00:28:41.295
before my move, I'm actually as close to Indiana
565
00:28:41.475 --> 00:28:42.535
as I am to my office.
566
00:28:46.765 --> 00:28:50.145
Uh, all right, so part B,
567
00:28:50.165 --> 00:28:52.145
the biggest thing is if you're gonna stay on group
568
00:28:52.165 --> 00:28:54.945
and it's creditable, you probably don't wanna sign up
569
00:28:54.945 --> 00:28:58.105
for part B because again, it does trigger special
570
00:28:58.665 --> 00:29:00.425
election periods, especially
571
00:29:00.615 --> 00:29:04.265
because of the supplement with a supplement
572
00:29:05.325 --> 00:29:07.515
after you've had part B for six months.
573
00:29:08.385 --> 00:29:10.805
If you wanna change supplements, you have to go
574
00:29:10.805 --> 00:29:11.845
through medical underwriting
575
00:29:12.625 --> 00:29:14.925
or you want to pick up a supplement and haven't had one
576
00:29:14.925 --> 00:29:16.965
before, you have to go through medical underwriting.
577
00:29:17.585 --> 00:29:19.365
So if you're healthy, that's no big deal,
578
00:29:19.705 --> 00:29:22.895
but if you're not, you may never have a chance
579
00:29:22.915 --> 00:29:24.175
to get a Medigap plan
580
00:29:24.485 --> 00:29:26.535
because you've missed your open enrollment.
581
00:29:26.875 --> 00:29:29.215
So that's why part B is the particular one.
582
00:29:32.495 --> 00:29:33.995
So when to sign up for Medicare,
583
00:29:34.515 --> 00:29:35.475
I think I'm taking too long,
584
00:29:35.495 --> 00:29:36.595
so I'm trying to get through here.
585
00:29:37.255 --> 00:29:41.325
So sorry. Uh, if you're already taking social security
586
00:29:41.505 --> 00:29:42.845
before age 65
587
00:29:43.145 --> 00:29:45.965
or you you have signed up to take it at 65,
588
00:29:46.515 --> 00:29:49.845
then you will automatically be enrolled in parts A and B.
589
00:29:50.465 --> 00:29:54.125
And if you don't want part B, then you can mail
590
00:29:54.125 --> 00:29:56.765
that form back and they'll stop the part B.
591
00:29:57.585 --> 00:29:59.085
So that's kind of the easy mode
592
00:29:59.305 --> 00:30:01.725
for signing up if you're taking social security,
593
00:30:02.385 --> 00:30:04.605
if you are not taking social security,
594
00:30:05.505 --> 00:30:07.845
you can do the signup three months
595
00:30:08.055 --> 00:30:09.565
prior to your birth month.
596
00:30:11.235 --> 00:30:14.615
And I do recommend the earlier the better if you know the
597
00:30:14.615 --> 00:30:16.175
date of when you want it to start,
598
00:30:16.965 --> 00:30:19.535
because they say they can take as much
599
00:30:19.535 --> 00:30:21.175
as 60 days to process it.
600
00:30:21.565 --> 00:30:25.735
They almost never do. But I think the earlier the better.
601
00:30:27.595 --> 00:30:30.895
Here's an example. If you turn 65 on December 23rd,
602
00:30:31.115 --> 00:30:33.295
and this is another question sometimes people have,
603
00:30:33.875 --> 00:30:38.295
you can have a December one start date if your birthday is
604
00:30:38.415 --> 00:30:41.735
even December 31st, you have a December one start date.
605
00:30:42.155 --> 00:30:45.575
And so you can sign up September 1st for
606
00:30:45.805 --> 00:30:47.175
that December start date,
607
00:30:52.285 --> 00:30:55.465
how to sign up the absolute best way.
608
00:30:56.405 --> 00:30:57.425
609
00:30:58.005 --> 00:31:00.625
You probably already have an account if you've been keeping
610
00:31:00.645 --> 00:31:03.025
an eye on how they're recording your income
611
00:31:03.125 --> 00:31:04.785
for your social security payment.
612
00:31:06.125 --> 00:31:07.825
So that's the fastest way,
613
00:31:07.925 --> 00:31:09.785
that's the way they want you to do it.
614
00:31:10.645 --> 00:31:13.065
You do have to have your ssa.gov account,
615
00:31:13.075 --> 00:31:14.985
which takes a little bit of time to set up,
616
00:31:15.325 --> 00:31:17.145
but you'll need it eventually anyway.
617
00:31:18.795 --> 00:31:22.655
You can also do it in person at the Social security office.
618
00:31:23.235 --> 00:31:28.015
But here in Kalamazoo they've had appointments 60 days out
619
00:31:28.355 --> 00:31:30.895
and so you'd really have to get an appointment,
620
00:31:31.915 --> 00:31:33.495
um, well in advance.
621
00:31:34.115 --> 00:31:36.535
And uh, because it takes so long to get in there,
622
00:31:37.765 --> 00:31:41.455
they may take some walk-ins, but it depends on the day
623
00:31:41.675 --> 00:31:42.935
and how busy they are.
624
00:31:43.675 --> 00:31:46.055
So ssa.gov, that's the way to go.
625
00:31:46.415 --> 00:31:48.735
I can also help with that if you'd like help with it.
626
00:31:49.125 --> 00:31:51.415
There's sometimes people will feel super comfortable
627
00:31:51.415 --> 00:31:53.295
with it, that's fantastic and sometimes they don't.
628
00:31:53.395 --> 00:31:54.615
And we've done it together.
629
00:31:57.585 --> 00:32:01.065
Medicare plan versus a group plan. Hey, let's compare.
630
00:32:01.485 --> 00:32:03.865
If you're wondering whether your group plan would be better
631
00:32:03.865 --> 00:32:06.825
for you based on what you're paying than a Medicare plan,
632
00:32:07.565 --> 00:32:08.865
let me compare those for you.
633
00:32:09.495 --> 00:32:11.825
Send me a copy of your group plan details
634
00:32:12.205 --> 00:32:13.705
and we will get it figured out.
635
00:32:15.245 --> 00:32:16.335
Ancillary plans,
636
00:32:17.155 --> 00:32:19.655
we have things like hospital indemnity plans.
637
00:32:20.115 --> 00:32:23.095
Um, I guess I call this the Medicare equivalent
638
00:32:23.395 --> 00:32:24.855
to, uh, Aflac.
639
00:32:25.805 --> 00:32:26.985
So you can get cash
640
00:32:27.245 --> 00:32:29.785
to help cover your costs if you're hospitalized.
641
00:32:29.885 --> 00:32:33.905
For example, cancer diagnosis plans where you get a lump sum
642
00:32:34.085 --> 00:32:36.625
to deal with if you're diagnosed with cancer.
643
00:32:36.885 --> 00:32:38.705
And that kind of helps smooth things out
644
00:32:38.845 --> 00:32:40.045
as you navigate that.
645
00:32:40.695 --> 00:32:44.845
Short-term. Home healthcare, this is a big deal nowadays.
646
00:32:45.105 --> 00:32:48.925
People want to be able to recover at home
647
00:32:49.145 --> 00:32:51.965
or stay at home as long as possible
648
00:32:52.305 --> 00:32:54.325
before moving to say a nursing home
649
00:32:54.345 --> 00:32:56.565
or even a long-term rehab facility.
650
00:32:56.945 --> 00:32:58.765
So if you have that option
651
00:32:58.825 --> 00:33:02.005
and you have this short term healthcare, that's a,
652
00:33:02.005 --> 00:33:03.125
that's a really big deal.
653
00:33:03.185 --> 00:33:05.005
So it's becoming a super popular item.
654
00:33:05.145 --> 00:33:07.625
Now, also have travel plans.
655
00:33:07.695 --> 00:33:09.385
What if you're leaving the United States
656
00:33:09.885 --> 00:33:12.145
and you want medical coverage outside the United States?
657
00:33:12.655 --> 00:33:16.105
Even a 65-year-old can get a million dollars worth
658
00:33:16.305 --> 00:33:20.025
of coverage with no deductible for as little as eight
659
00:33:20.045 --> 00:33:21.225
or $9 a month.
660
00:33:21.805 --> 00:33:23.945
So super easy to sign up for
661
00:33:24.085 --> 00:33:26.945
and can give you a lot of peace of mind if you're traveling.
662
00:33:28.475 --> 00:33:32.605
Also final expense, which is kinda like a very, uh,
663
00:33:32.735 --> 00:33:34.765
small life insurance policy,
664
00:33:35.225 --> 00:33:37.965
but enough to help cover your funeral
665
00:33:38.405 --> 00:33:39.485
expenses, things like that.
666
00:33:40.065 --> 00:33:43.405
And so that's kind of a big thing nowadays as well if you,
667
00:33:43.465 --> 00:33:44.605
if you have a need for that.
668
00:33:45.025 --> 00:33:46.205
And there's lots more.
669
00:33:46.685 --> 00:33:49.205
I mean, you know, an insurance agent can always sell you
670
00:33:49.205 --> 00:33:50.485
just about anything that you want.
671
00:33:50.885 --> 00:33:54.085
I don't wanna sell you anything that you don't want.
672
00:33:54.525 --> 00:33:56.845
I don't want to sell you anything that you don't need.
673
00:33:57.145 --> 00:34:01.325
But I do want to at least let you know what is available
674
00:34:01.865 --> 00:34:05.125
in case that is something that you think would be beneficial
675
00:34:05.265 --> 00:34:07.205
for your particular situation.
676
00:34:09.585 --> 00:34:11.795
Also, here's, uh, some of the companies that I work with.
677
00:34:11.955 --> 00:34:13.235
I thought I'd throw 'em up there.
678
00:34:13.535 --> 00:34:17.355
So we see all the major ones, especially in our area.
679
00:34:17.725 --> 00:34:20.715
There are some that rise to the top in certain situations,
680
00:34:21.255 --> 00:34:24.035
but again, I always want to provide choices
681
00:34:24.255 --> 00:34:25.515
and that's why I take the time
682
00:34:25.515 --> 00:34:28.715
and effort to stay certified with all of these companies.
683
00:34:30.835 --> 00:34:33.405
Your situation I've given highlights.
684
00:34:33.865 --> 00:34:37.205
But if you want to examine your unique situation,
685
00:34:37.525 --> 00:34:39.125
I am always willing to talk.
686
00:34:39.225 --> 00:34:40.445
You can probably tell 'cause
687
00:34:40.445 --> 00:34:41.525
I've been talking this whole time.
688
00:34:42.505 --> 00:34:45.085
So yes, reach out, um,
689
00:34:45.265 --> 00:34:47.045
and I'll take a look at everything you have
690
00:34:47.145 --> 00:34:48.325
and see what your options are.
691
00:34:48.595 --> 00:34:51.485
Sometimes what you're on is the best. Great.
692
00:34:51.985 --> 00:34:54.325
At least now you're not worried like, oh,
693
00:34:54.745 --> 00:34:56.085
was I missing out on something else?
694
00:34:56.275 --> 00:34:58.125
Nope. Now you know, what you have is the best
695
00:34:58.125 --> 00:35:01.205
for you right now, or if something is better,
696
00:35:01.305 --> 00:35:03.045
you have the opportunity to get something better.
697
00:35:03.305 --> 00:35:05.365
So that's why I love conversations.
698
00:35:08.065 --> 00:35:11.285
Yes, almost always if you move to another part of Michigan,
699
00:35:11.495 --> 00:35:13.005
plans will go with you.
700
00:35:14.345 --> 00:35:17.085
The only time they don't is if they are specific
701
00:35:17.145 --> 00:35:18.725
to certain regions.
702
00:35:19.355 --> 00:35:21.285
When it comes to the Medicare world though,
703
00:35:21.665 --> 00:35:25.845
it will almost always travel with you with the under 65.
704
00:35:26.225 --> 00:35:29.125
You can, it's an easy switch with, you can stay
705
00:35:29.125 --> 00:35:32.045
with the same company, but like a slightly different plan
706
00:35:32.045 --> 00:35:33.645
because those are more regional based.
707
00:35:34.735 --> 00:35:35.875
But it's very easy to do
708
00:35:35.875 --> 00:35:37.085
and I can help you with that as well.
709
00:35:38.715 --> 00:35:41.645
There's my information and my crazy picture.
710
00:35:41.805 --> 00:35:44.205
I need a better picture. I need a stunt double
711
00:35:44.435 --> 00:35:45.965
that is more handsome than me.
712
00:35:47.265 --> 00:35:50.845
Um, I even through, I know it's a crazy QR code, uh,
713
00:35:51.025 --> 00:35:53.805
but if you ever wanted to submit your information to me
714
00:35:53.865 --> 00:35:55.525
and say, Hey Paul, reach out to me.
715
00:35:55.745 --> 00:35:59.925
You know, you can always scan that QR code, submit some
716
00:35:59.925 --> 00:36:02.765
of your information, and I can get back to you.
717
00:36:02.885 --> 00:36:06.245
I can do an analysis for you, all of that kind of stuff.
718
00:36:06.865 --> 00:36:09.565
But there's also my number and my email address.
719
00:36:09.985 --> 00:36:12.005
And again, I love conversations.
720
00:36:12.245 --> 00:36:13.525
I love when people reach out
721
00:36:13.545 --> 00:36:16.125
and I will reach right back out to you.
722
00:36:16.345 --> 00:36:18.685
That's the whole point of having a local agent is
723
00:36:18.685 --> 00:36:20.245
to being able to contact someone
724
00:36:20.345 --> 00:36:22.005
and talk with them when you need something.
725
00:36:24.305 --> 00:36:27.885
And then if we have any other questions, we've got a q and a
726
00:36:27.985 --> 00:36:30.325
or I have a few answers, uh, questions
727
00:36:30.325 --> 00:36:32.445
and answers on my own too if no one has a question.
728
00:36:34.555 --> 00:36:36.415
Thanks Paul. I I've got a couple
729
00:36:36.475 --> 00:36:38.255
and then there maybe some more filter in.
730
00:36:38.355 --> 00:36:41.895
Um, yeah, so I, I was wondering, like we call our, some
731
00:36:41.895 --> 00:36:43.415
of our clients the snowbirds, right?
732
00:36:43.415 --> 00:36:45.855
So they maybe wanna go to Arizona or Florida in the winter.
733
00:36:46.355 --> 00:36:48.575
Um, how do you evaluate those networks?
734
00:36:48.635 --> 00:36:50.095
You know, do you, do you look at it ahead
735
00:36:50.095 --> 00:36:53.255
or is the coverage, if they're buying a Michigan based plan,
736
00:36:53.335 --> 00:36:54.575
I guess how does that all work?
737
00:36:55.685 --> 00:36:58.985
That's a great question. With the under 65, um,
738
00:36:59.565 --> 00:37:01.545
we would want, uh, either a travel plan
739
00:37:01.545 --> 00:37:04.385
or a PPO plan that would be the best to travel with.
740
00:37:04.445 --> 00:37:06.465
But most of that question is probably Medicare.
741
00:37:06.805 --> 00:37:10.745
And Medicare has great networks in state and out of state,
742
00:37:11.205 --> 00:37:14.865
and so you have companies like Blue Cross, UnitedHealthcare,
743
00:37:15.605 --> 00:37:17.825
Humana, they have networks everywhere.
744
00:37:17.965 --> 00:37:19.985
So you use that network wherever you travel.
745
00:37:20.285 --> 00:37:23.145
No big deal at all. You have companies like Priority Health
746
00:37:23.735 --> 00:37:26.705
that say, um, you know, if the, if you're outside
747
00:37:26.705 --> 00:37:28.385
of Michigan and they take Medicare,
748
00:37:28.735 --> 00:37:30.545
then you'll pay in-network rates.
749
00:37:31.045 --> 00:37:33.545
So virtually everything has a great travel plan.
750
00:37:33.545 --> 00:37:35.585
And then if you're on a Medigap plan, of course
751
00:37:36.415 --> 00:37:38.665
it's all 50 states, all US territories,
752
00:37:38.665 --> 00:37:39.865
whoever takes Medicare.
753
00:37:40.045 --> 00:37:42.305
So super easy to travel with those plans.
754
00:37:43.185 --> 00:37:45.235
Okay, great. Um, another question.
755
00:37:45.335 --> 00:37:47.835
Um, so you know, I have group coverage
756
00:37:47.945 --> 00:37:49.035
from a previous employer.
757
00:37:49.565 --> 00:37:52.155
We've maintained the premium, it's gone up significantly.
758
00:37:52.375 --> 00:37:54.835
It probably goes up 15 ish percent a year.
759
00:37:55.655 --> 00:37:57.155
You know, how often should people,
760
00:37:57.275 --> 00:37:59.075
I know there's people in this situa, should they, you know,
761
00:37:59.075 --> 00:38:00.115
go to somebody like you
762
00:38:00.115 --> 00:38:01.715
and say, all right, look, I've got this group plan,
763
00:38:01.745 --> 00:38:03.395
it's good, but the rate keeps going up.
764
00:38:03.895 --> 00:38:05.435
Um, you know, is that a, is
765
00:38:05.435 --> 00:38:07.155
that a every other year, every few years?
766
00:38:07.415 --> 00:38:09.555
Is there, you know, any standard for that?
767
00:38:11.695 --> 00:38:14.595
Ooh, yeah. Used to be probably every few years.
768
00:38:15.175 --> 00:38:18.795
Um, it just depends on the significance of the changes.
769
00:38:19.975 --> 00:38:23.275
So, uh, yeah, that's a good question.
770
00:38:23.515 --> 00:38:26.995
I would say, uh, naturally I would say probably every other
771
00:38:27.025 --> 00:38:29.355
year if you just wanna double check
772
00:38:29.695 --> 00:38:32.875
and see what's, what else is out there compared to
773
00:38:32.875 --> 00:38:34.515
what you have, I'd say every other year. Yeah.
774
00:38:35.475 --> 00:38:37.165
Okay. I'm gonna fire one more
775
00:38:37.265 --> 00:38:38.925
and then maybe people will have some more questions.
776
00:38:38.985 --> 00:38:41.045
So, uh, look, nobody on this call works
777
00:38:41.045 --> 00:38:43.045
for a health insurance insurance company,
778
00:38:43.425 --> 00:38:44.685
so we'll get a little candid here.
779
00:38:44.685 --> 00:38:46.325
The loaded question, um,
780
00:38:46.865 --> 00:38:49.205
health insurance carriers overall, right?
781
00:38:49.305 --> 00:38:50.885
Not the highest levels of satisfaction.
782
00:38:50.885 --> 00:38:52.045
It can be very frustrating.
783
00:38:52.615 --> 00:38:54.565
We've been on this end of it where you're, you know,
784
00:38:54.565 --> 00:38:55.765
you think something should be covered and
785
00:38:55.765 --> 00:38:56.885
it's not, or this or that.
786
00:38:57.625 --> 00:38:59.685
In your experience, if you're willing to comment,
787
00:39:00.105 --> 00:39:02.005
and again, everybody maybe has good
788
00:39:02.005 --> 00:39:03.325
or bad experience with different carriers,
789
00:39:03.665 --> 00:39:05.005
do you find there is a,
790
00:39:05.585 --> 00:39:07.725
any significant service in the coverage
791
00:39:07.725 --> 00:39:10.365
and the service between all those big carriers?
792
00:39:10.825 --> 00:39:13.525
Or do you think, you know, it's, it's each person kind
793
00:39:13.525 --> 00:39:14.565
of has a different experience?
794
00:39:17.155 --> 00:39:20.255
Um, yeah, gr great question.
795
00:39:20.495 --> 00:39:23.215
I think they're all ac acceptable in some ways,
796
00:39:23.755 --> 00:39:24.775
but I do think,
797
00:39:25.755 --> 00:39:27.855
and uh, I probably shouldn't call out too many names,
798
00:39:27.855 --> 00:39:31.575
which I have, but, but yes, there, I, there are,
799
00:39:32.105 --> 00:39:34.335
there is one particular company in Michigan
800
00:39:34.365 --> 00:39:36.055
that always rises to the top
801
00:39:36.635 --> 00:39:38.295
and we'll say this, objectively speaking,
802
00:39:38.875 --> 00:39:41.575
if you look at these customer satisfaction surveys,
803
00:39:41.765 --> 00:39:43.015
even across the nation,
804
00:39:43.815 --> 00:39:46.735
priority health always reigns right near the top
805
00:39:47.115 --> 00:39:50.175
and they rank best in Michigan in customer satisfaction.
806
00:39:50.515 --> 00:39:51.775
And that can be a big deal.
807
00:39:52.085 --> 00:39:54.375
That does not mean that you'll have a problem
808
00:39:54.565 --> 00:39:55.695
with the other carriers.
809
00:39:55.795 --> 00:39:56.935
You may never have a problem,
810
00:39:57.875 --> 00:40:01.455
but those customer satisfaction consistently
811
00:40:01.455 --> 00:40:02.655
every year is a big deal.
812
00:40:03.225 --> 00:40:05.485
That's a great answer. This next question just came in
813
00:40:05.485 --> 00:40:06.845
this, this is great 'cause I was gonna ask this.
814
00:40:06.865 --> 00:40:09.565
So this question is, what about long-term care insurance?
815
00:40:09.745 --> 00:40:11.285
Is that one of the ancillary plans?
816
00:40:11.355 --> 00:40:13.125
Will it cover short-term care at home?
817
00:40:13.385 --> 00:40:16.365
And I'll just add, um, you know, we, we
818
00:40:17.025 --> 00:40:19.445
use long-term care insurance all the time.
819
00:40:20.205 --> 00:40:21.485
I have never heard of, uh,
820
00:40:21.485 --> 00:40:24.085
this short-term home care until today.
821
00:40:24.105 --> 00:40:25.765
So maybe you could just talk a little bit about that,
822
00:40:25.865 --> 00:40:27.805
the timelines, how it works, et cetera.
823
00:40:28.385 --> 00:40:30.845
Mm-hmm. Yeah, both good questions.
824
00:40:31.025 --> 00:40:35.525
So long-term care I have just started getting into,
825
00:40:35.985 --> 00:40:39.245
so I'm, I'm not that knowledgeable on that.
826
00:40:39.965 --> 00:40:42.245
I guess I've been so busy with the other health insurance
827
00:40:42.245 --> 00:40:46.085
portions anyway, but I am working on that.
828
00:40:47.185 --> 00:40:51.205
Um, and in some cases you can use it for short term.
829
00:40:51.425 --> 00:40:53.445
It depends on what your plan says.
830
00:40:54.035 --> 00:40:57.965
Usually if you have one that you've already had enforced
831
00:40:57.985 --> 00:41:00.045
for many years, it's gonna have many different,
832
00:41:00.045 --> 00:41:02.525
different rules than anything you would get nowadays.
833
00:41:03.665 --> 00:41:06.605
Um, the, so I'm sorry. I'm sorry.
834
00:41:06.865 --> 00:41:08.245
No, you're, you're, you're ask me again in a
835
00:41:08.245 --> 00:41:09.805
few months I'll have a better answer. Well,
836
00:41:09.805 --> 00:41:10.805
I asked the question wrong. I
837
00:41:10.805 --> 00:41:11.885
can speak to long-term care.
838
00:41:11.885 --> 00:41:15.085
Almost every long-term care policy I've ever seen typically
839
00:41:15.145 --> 00:41:17.605
has a minimum of a 60 day waiting period.
840
00:41:17.905 --> 00:41:19.245
So short term it's to,
841
00:41:19.245 --> 00:41:20.485
and the reason they do that is when
842
00:41:20.485 --> 00:41:21.485
to keep the premiums down.
843
00:41:21.945 --> 00:41:24.885
And two, because Medicare typically covers the first 20 days
844
00:41:25.225 --> 00:41:28.085
and what is it, days 21 through 90, they cover a portion,
845
00:41:28.665 --> 00:41:31.205
but I believe a three day hospital stay is required.
846
00:41:31.785 --> 00:41:34.365
Um, so long-term care is generally gonna be longer.
847
00:41:34.925 --> 00:41:36.845
I think the follow up, maybe you could follow up
848
00:41:36.845 --> 00:41:38.645
and we could email everyone who's interested.
849
00:41:39.105 --> 00:41:41.725
Is this, this short-term care at home that you mentioned?
850
00:41:42.345 --> 00:41:44.005
I'd be very interested to learn about that
851
00:41:44.005 --> 00:41:45.405
because like I said, that
852
00:41:45.405 --> 00:41:47.285
that long-term care is not going to cover.
853
00:41:47.865 --> 00:41:50.325
Um, typically it's a 90 day elimination period.
854
00:41:50.395 --> 00:41:51.645
Some plans are even longer.
855
00:41:53.085 --> 00:41:55.055
Yeah, no, you, you asked it well
856
00:41:55.115 --> 00:41:56.975
and I was on the one and the move to the other.
857
00:41:57.475 --> 00:41:59.615
So yeah, the short-term care, that's it.
858
00:41:59.615 --> 00:42:02.495
And so basically it's geared towards six months or less.
859
00:42:03.355 --> 00:42:05.615
And um, there's several carriers
860
00:42:05.615 --> 00:42:07.175
that have a good product in this market.
861
00:42:07.645 --> 00:42:10.575
It's gonna be much less expensive than the long-term care
862
00:42:10.575 --> 00:42:13.615
because you're not looking for three years of coverage
863
00:42:13.615 --> 00:42:15.695
or four years of coverage or five years, you're looking
864
00:42:15.715 --> 00:42:18.055
for these short increments of coverage.
865
00:42:18.795 --> 00:42:22.575
And so a lot of plans, for example, let's say you have to go
866
00:42:22.575 --> 00:42:24.295
to Mary Free bed, something like that
867
00:42:24.315 --> 00:42:26.575
for this long-term rehabilitation, there's a lot
868
00:42:26.575 --> 00:42:28.015
of insurance coverage that will cover you
869
00:42:28.015 --> 00:42:30.015
for 20 days and no more.
870
00:42:30.325 --> 00:42:31.695
Well, there's short, but you're like,
871
00:42:32.355 --> 00:42:33.495
so where do I have to go?
872
00:42:33.675 --> 00:42:37.175
You know, and a short-term plan can give you that same care,
873
00:42:37.315 --> 00:42:39.335
but in the house where you have people coming over
874
00:42:39.355 --> 00:42:40.895
and attending to your medical needs
875
00:42:41.595 --> 00:42:44.535
and uh, so that's where it's been a really nice product
876
00:42:44.635 --> 00:42:48.295
to be able to keep people at home during
877
00:42:48.295 --> 00:42:49.735
that same type of recovery.
878
00:42:50.745 --> 00:42:53.805
Uh, but again, yeah, six months or less during that frame.
879
00:42:54.805 --> 00:42:56.915
Great. And then I'll just read this last question came in.
880
00:42:56.915 --> 00:42:59.715
You might see it, uh, when you've kept group insurance from
881
00:42:59.715 --> 00:43:01.395
a previous employer, is there a penalty
882
00:43:01.545 --> 00:43:04.435
that may be prohibitive if you decide to go to Medicare?
883
00:43:06.485 --> 00:43:08.905
Not if it is creditable coverage.
884
00:43:09.845 --> 00:43:13.105
So, uh, if it is coverage that is equivalent
885
00:43:13.525 --> 00:43:17.825
or better than Medicare would provide, hey, if you came off
886
00:43:17.825 --> 00:43:21.465
that group coverage at age 89, you would sign up
887
00:43:21.465 --> 00:43:22.745
for Medicare with no penalties.
888
00:43:23.685 --> 00:43:28.465
If it is not creditable, then you could face some penalties
889
00:43:28.605 --> 00:43:30.505
for both part B and part D.
890
00:43:31.005 --> 00:43:32.985
But again, employers or,
891
00:43:33.045 --> 00:43:37.465
or that that offer a non-editable plan are required
892
00:43:37.565 --> 00:43:40.545
by law to send you a letter each year stating
893
00:43:40.545 --> 00:43:42.105
that this plan is not creditable.
894
00:43:42.325 --> 00:43:44.345
So if you have not received that letter,
895
00:43:44.655 --> 00:43:47.865
then you probably have a creditable plan can sign up
896
00:43:47.865 --> 00:43:50.345
for Medicare anytime you leave group
897
00:43:50.705 --> 00:43:51.945
coverage with no penalty.
898
00:43:53.425 --> 00:43:55.915
Okay. Great. Thank you. Do you wanna go back maybe just
899
00:43:55.915 --> 00:43:57.155
to your contact information?
900
00:43:57.155 --> 00:43:59.355
And again, anyone feel free to reach out to Paul directly.
901
00:43:59.735 --> 00:44:02.635
Uh, we did record this if you would like a copy
902
00:44:02.855 --> 00:44:04.035
or if you have, you know,
903
00:44:04.035 --> 00:44:05.475
further questions we can get you in touch
904
00:44:05.475 --> 00:44:07.115
with Paul, uh, health insurance.
905
00:44:07.215 --> 00:44:08.915
You know, any questions you ask me,
906
00:44:08.975 --> 00:44:10.515
I'm probably gonna forward 'em right onto Paul.
907
00:44:10.655 --> 00:44:13.635
So he really is a, a very open and easy to talk to
908
00:44:13.655 --> 00:44:15.275
and he, he won't push you into anything.
909
00:44:15.815 --> 00:44:18.235
Um, with that, Paul, did you have any other comments
910
00:44:18.495 --> 00:44:19.555
or, I don't know,
911
00:44:19.555 --> 00:44:21.955
maybe frequently asked questions you wanted to mention?
912
00:44:22.055 --> 00:44:24.075
You did finish ahead, so good work.
913
00:44:24.615 --> 00:44:26.275
Oh, I did. Okay. I thought I was trying
914
00:44:26.275 --> 00:44:27.795
to get done in like 35 minutes.
915
00:44:28.035 --> 00:44:32.915
I was really rushing. So I, you know, a couple of things
916
00:44:33.135 --> 00:44:36.515
and sometimes people ask, Hey, if I, if I get on this plan,
917
00:44:36.655 --> 00:44:37.795
am I locked in forever?
918
00:44:38.125 --> 00:44:41.195
Especially in the Medicare world? And the answer is no.
919
00:44:41.375 --> 00:44:44.235
You can change every single year when it comes
920
00:44:44.295 --> 00:44:47.315
to a prescription drug plan or an advantage plan.
921
00:44:47.695 --> 00:44:51.795
You change during this October 15th through December 7th.
922
00:44:52.375 --> 00:44:54.515
And so in January you come up with a new plan.
923
00:44:54.665 --> 00:44:56.875
Most of the time people don't switch, there's no need to,
924
00:44:57.215 --> 00:44:58.995
but if something drastically changes,
925
00:44:59.655 --> 00:45:01.755
we may have a better fit for you.
926
00:45:02.135 --> 00:45:04.595
And then you have that possibility when it comes
927
00:45:04.595 --> 00:45:07.715
to a supplement, you have to go
928
00:45:07.915 --> 00:45:08.955
through medical underwriting.
929
00:45:09.615 --> 00:45:10.835
So sometimes you do that
930
00:45:11.095 --> 00:45:13.075
for a better rate or something like that.
931
00:45:13.655 --> 00:45:16.435
But I would walk you through all of that if you ever wanted
932
00:45:16.435 --> 00:45:17.635
to switch your supplement.
933
00:45:20.045 --> 00:45:22.595
Thank you. Um, I, I've had this one also.
934
00:45:22.775 --> 00:45:26.755
Uh, HSA, when you become Medicare eligible, what happens
935
00:45:26.775 --> 00:45:27.835
to your HSA?
936
00:45:29.245 --> 00:45:33.095
Well, if you're on Medicare, you cannot contribute
937
00:45:33.115 --> 00:45:37.615
to your HSA, but you can still spend your HSA money.
938
00:45:38.825 --> 00:45:43.465
So, um, uh, that makes it easy
939
00:45:43.465 --> 00:45:44.705
for all of your copays,
940
00:45:44.705 --> 00:45:46.745
for your deductibles, for whatever it is.
941
00:45:47.125 --> 00:45:48.625
And even like cough, coughing,
942
00:45:48.625 --> 00:45:50.185
cold meds, those kind of things.
943
00:45:50.245 --> 00:45:51.945
You can use your HSA money on that.
944
00:45:52.005 --> 00:45:53.545
You just can't keep contributing.
945
00:45:55.925 --> 00:45:57.185
Uh, let's see here.
946
00:45:57.385 --> 00:46:01.745
I I did have, there's some common, um, what do I call it?
947
00:46:02.305 --> 00:46:03.665
Medicare mistakes that people make.
948
00:46:04.165 --> 00:46:06.425
And the number one self-admitted
949
00:46:06.945 --> 00:46:09.265
Medicare mistake is lack of research.
950
00:46:10.245 --> 00:46:12.185
Not checking out all of your options
951
00:46:12.565 --> 00:46:14.705
or seeing exactly
952
00:46:14.845 --> 00:46:17.665
how your situation fits the option that you've picked.
953
00:46:18.245 --> 00:46:20.065
And that's where I come in
954
00:46:20.135 --> 00:46:22.945
because I check all that stuff exhaustively.
955
00:46:23.605 --> 00:46:27.025
And this is not a plug,
956
00:46:27.045 --> 00:46:30.225
but I'm saying this is how important it is for me.
957
00:46:30.725 --> 00:46:32.145
So all of my current clients,
958
00:46:32.525 --> 00:46:35.945
I'm currently gathering their most updated information
959
00:46:36.445 --> 00:46:38.865
and I will check every single client.
960
00:46:40.075 --> 00:46:41.725
They will probably stay on their plan,
961
00:46:42.145 --> 00:46:46.005
but if a plan changes in some way that's not beneficial
962
00:46:46.065 --> 00:46:47.845
to them, I will know
963
00:46:48.385 --> 00:46:51.485
and I will say, Hey, looks like this one might kind
964
00:46:51.485 --> 00:46:53.685
of catch you off guard and be more expensive.
965
00:46:54.585 --> 00:46:57.525
Here's another option and then we'll discuss it.
966
00:46:58.065 --> 00:46:59.565
But I do all of that checking
967
00:46:59.665 --> 00:47:02.365
and I continue to do all of that checking as well.
968
00:47:03.035 --> 00:47:07.955
Very important. Um, let's see here.
969
00:47:11.285 --> 00:47:13.085
I I got one, one great point I'll make
970
00:47:13.085 --> 00:47:15.365
because you, you gave them the, the social security website.
971
00:47:15.465 --> 00:47:19.245
So, um, again, if they, if they wanted to explore,
972
00:47:19.325 --> 00:47:20.925
I made this mistake a few years ago when we were
973
00:47:20.925 --> 00:47:23.725
transitioning, um, our operation
974
00:47:23.825 --> 00:47:26.125
and I tried to go to healthcare.gov.
975
00:47:26.475 --> 00:47:29.085
Okay. And I, and I typed something a little off.
976
00:47:30.035 --> 00:47:32.205
There's a lot of sites that try to replicate that.
977
00:47:32.205 --> 00:47:33.885
And next thing I know I was getting emails
978
00:47:33.985 --> 00:47:36.085
and phone calls from everybody and their brother.
979
00:47:36.265 --> 00:47:39.485
So, uh, again, it's important work with somebody who knows
980
00:47:39.485 --> 00:47:40.525
what they're doing, or if you're trying to go
981
00:47:40.525 --> 00:47:43.565
to healthcare.gov, make sure you're on the right site.
982
00:47:43.845 --> 00:47:45.725
'cause otherwise you are just gonna get inundated
983
00:47:46.185 --> 00:47:48.245
and not all those folks calling are,
984
00:47:48.245 --> 00:47:49.685
are looking out for your best interests.
985
00:47:50.725 --> 00:47:52.185
Oh, well said. You're right.
986
00:47:52.205 --> 00:47:53.505
And I've heard that several times.
987
00:47:54.135 --> 00:47:57.625
They have one question online and all of a sudden everyone
988
00:47:57.625 --> 00:47:59.025
and their brother is calling them
989
00:47:59.445 --> 00:48:00.745
and they want to change phone numbers.
990
00:48:01.005 --> 00:48:02.005
Yes. I get it.
991
00:48:03.145 --> 00:48:05.875
Alright, well again Paul, we really appreciate your time.
992
00:48:05.875 --> 00:48:06.995
This has been very helpful.
993
00:48:07.365 --> 00:48:09.995
Again, thank thank you to all of you who've joined, Paul.
994
00:48:10.105 --> 00:48:11.435
Just the fact that everybody
995
00:48:11.435 --> 00:48:14.355
that started is still on it says you did a great job.
996
00:48:14.515 --> 00:48:16.795
I know you can't see anyone's faces, but uh, um,
997
00:48:16.935 --> 00:48:19.195
or at least they're all very, very, uh, um,
998
00:48:20.045 --> 00:48:21.515
respectful to the end.
999
00:48:21.575 --> 00:48:22.675
So thanks for joining.
1000
00:48:22.935 --> 00:48:24.435
Any follow up questions, feel free
1001
00:48:24.435 --> 00:48:25.635
to reach out to any of us.
1002
00:48:26.055 --> 00:48:27.275
Uh, I hope we all have a great day.
1003
00:48:27.275 --> 00:48:29.755
Oh, we did get one more, so, oh, thank you.
1004
00:48:29.785 --> 00:48:31.995
Well you're very welcome. Thanks for joining.
1005
00:48:32.225 --> 00:48:34.555
Alright, Paul, any final thoughts before we wrap up?
1006
00:48:35.735 --> 00:48:38.475
Uh, just, again, I just wanna say the, the same thing
1007
00:48:38.475 --> 00:48:42.875
as Ryan iterated that, uh, I'm happy to help in any way
1008
00:48:43.375 --> 00:48:45.435
and helping does not necessarily mean
1009
00:48:45.435 --> 00:48:46.715
that I'm gonna sell something.
1010
00:48:47.155 --> 00:48:51.395
I can give you peace of mind either way, and I love that
1011
00:48:51.535 --> 00:48:52.995
and I'm always willing to talk.
1012
00:48:53.375 --> 00:48:56.315
No pressure and we'll figure out your situation.
1013
00:48:57.565 --> 00:49:00.055
Well said. Okay, well everybody have a great day.
1014
00:49:00.355 --> 00:49:02.535
Uh, we're here to help you
1015
00:49:02.915 --> 00:49:05.535
and uh, thanks for tuning in. Be well, take care.
1016
00:49:05.985 --> 00:49:08.085
Thank you so much. Bye-bye.