The Retirement Power Hour
The Retirement Power Hour
Medicare Hot Topics with Joanne Giardini-Russell
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There are 11,000 Baby Boomers turning 65 everyday. Many of them share the same Medicare questions, like:
- Do I need to enroll at age 65?
- What if I work past age 65?
- What coverage is best for me?
- Should I get a Medicare Supplement or Medicare Advantage plan?
- What does Medicare cover?
- Does my income impact my premium? If so, how?
On this episode, Joe Allaria is joined by Medicare expert Joanne Giardini-Russell, CEO of Giardini Medicare, to touch on all of the above.
About Our Guest
Joanne Giardini-Russell is the Founder and CEO of Giardini Medicare, located in Brighton, Michigan. Joanne has spent decades in the insurance industry and has dedicated most of her career to educating her clients about Medicare. She is well-known for her outreach efforts and, most recently, her Tik Tok fame, as she continues to be a leading voice on all issues surrounding Medicare.
Show Resources
- Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 65
- Form L564: Request for Employment Information
- Form SSA-44: IRMAA Appeal (to reduce or eliminate Medicare surcharges if your income has dropped)
To submit a listener question, visit our website at https://www.retirementpowerhourpodcast.com/contact/ and enter the details of your question.
Disclaimer: All material discussed on this podcast is for educational purposes only and should not be construed as individual tax, legal, or investment advice. Investing involves risk of loss and investors should be prepared to bear potential losses. Past performance may not be indicative of future results. Joe Allaria is an Investment Adviser Representative of CarsonAllaria Wealth Management, a Registered Investment Advisory firm. Information discussed on this podcast may be derived from third parties that are believed to be reliable, but CarsonAllaria Wealth Management does not control or guarantee the accuracy or timeliness of such information and disclaims all liability for damages resulting from such sources. Any references to third parties are provided as a convenience and do not constitute an endorsement.
Welcome to the Retirement Power Hour Podcast, where you'll hear direct financial insights from financial planner, writer, and consultant Joe Allaria, as he and his guests uncover key wealth management strategies to help listeners invest wiser and retire better. Now, here's your host, Joe Allaria.
Joe AllariaWelcome everybody to the Retirement Power Hour. My name is Joe Allaria , and this is episode eight. You know, every week, just about, I get questions about Medicare. And we've been doing listener questions on the show before we do our main interviews, but because I received so many questions on Medicare, we're going to jump right into the interview this week and answer those Medicare questions like do I need to enroll? Am I eligible? Should I get a Medicare supplement or a Medicare Advantage plan? And much, much more. And for that, I'm going to be having Joanne Giardini Russell. Joanne is one of the leading Medicare experts in the country. Joanne is the president, owner of Giardini Medicare, located in Brighton, Michigan. And I followed her, I've noticed her on different platforms, and she has shown and proven her knowledge in the area of Medicare. She's been in the insurance industry for decades and does a fantastic job educating her clients and the general public on these important issues surrounding Medicare. So you're going to want to share this with anyone that you know that might be on Medicare or getting ready to get on Medicare in the near future, because I even learned things in this interview that we're going to share with you today. So with that, I hope you enjoy this show, this episode, where I'm going to be interviewing Joanne Giardini Russell about all things Medicare. Enjoy. Joanne, welcome to the show.
Joanne Giardini RussellHi, thanks, Joe. Thanks for having me here.
Joe AllariaSo excited, Joanne, to talk about today's topic, which is Medicare, which is something that our clients and many baby boomers out there turning 65 every day. Is there still 10,000 every day turning 65? 11. 11,000.
Joanne Giardini RussellGot up to 11,000. Yeah.
Joe AllariaAll right. All right. So so many people having to deal with Medicare. Nobody teaches anybody about Medicare, aside from what you do and what we're trying to do, but you don't learn it in school. You don't, employers don't really cover much about this. So people end up turning 65, having no idea what Medicare is, what it does, how it works, what their options are. And that's what we're trying to help with today is that those people that are, you know, approaching 65, or maybe even over 65 that are already on Medicare, hopefully we can give them some good information today and insights. You've kind of built your career in the insurance industry. And then from reading your bio, it looks like you've been involved in a lot of different areas of the industry. So before we started talking about Medicare, I was just curious, how did you actually end up specializing in Medicare?
Joanne Giardini RussellYeah, super long story short. So I'm 57. I came out of Michigan State years and years ago. And at 22, I went into medical malpractice. So I started there. And then eventually I just, it was in every single type of insurance, home, auto, disability, everything. Hooked up with a financial firm. I was doing insurance kind of cases with them. Actually, kind of went into my little bit of financial field, not doing what you do, but I had licenses and all that garbage and I don't like that side of the world. But my oldest son, Cameron, who works with me today and runs the agency with me, he needed a job out of college. And so I threw him at these Medicare people that were actually trying to get me to sell Medicare at the time. This was years ago. And I'm like, no, no, it's too crazy. I'm not going there. I don't want anything to do with Medicare. I didn't know anything about it. And then he's very intelligent. He came right back to me immediately and he said, Do you know how confusing this stuff is? And I was really intrigued. I'm like, what do you mean? Again, I had been around these firms that nobody was talking about Medicare. So I'm like, you've got this thing that this kid is already identifying as super crazy, confusing, and stressful, but nobody's helping people with it. Like, that's really bizarre. And so our whole thing has really grown from that. And then it was, we were all in the whole entire family at dinner time where we were talking Medicare. Talk about the biggest geeks at the dinner table, just my poor husband was surrounded by Medicare talk. But it was sort of fascinating. We just built the agency based on that. So that is what we do. So we only 100% do Medicare. That's it.
Joe AllariaYeah. I tell clients, I'll never be your accountant, I'll never be your attorney, and I'll never be your Medicare specialist. Just too much, you know, we know enough to be dangerous. And that's probably that's why we don't do it ourselves, is because if you make a wrong choice, it can be dangerous.
Joanne Giardini RussellAbsolutely. Absolutely.
Joe AllariaSo I want to get your take on a few of these things. You know, we've hosted some webinars on the basics of Medicare, Medicare supplements versus advantage. We won't go all into the very basics. Anyone listening can go to our website, Carsonalaria.com, and sort of listen or you know and read some of the material we have there, or go to your website as well to learn the basics. But we're gonna skip forward and talk about Medicare supplements versus advantage. And as someone that spends every day dealing with various Medicare related issues, I wanted to get your take on how those nearing 65 or those that are older than 65 should evaluate supplements versus advantage. And my first question is is one truly better than the other? And that's such a loaded question, but I'll just leave it with that. Is one better than the other?
Joanne Giardini RussellYou know, it's loaded, but it's not loaded because I'm gonna say yes. And a lot of people won't just say yes, but is one better than the other? Technically, yes. So a true supplement follows original Medicare. So what everyone needs to understand is again, go back to those websites and just realize what A and B is. A and B is the government. That's your starting point. So whatever you pick after that, whether you do a supplement or you do Medicare Advantage, you have to have A and B in place and you're gonna pay for those. That's a moot point. So you pay more for a supplement every month and it follows original Medicare and it pays all your bills. So you're buying a contract to pay your bills. That's it. So let's just throw out $125 on average for a 65-year-old. You're paying $125 a month, month in, month out, yeah, to pay your bills. Medicare Advantage. 65% of those plans can be zero premium. Is it free on the surface? Yes. But will you have co-pays and things like that? It's all based on usage. But when you get back to better, you know, the supplement's going to pay all the bills. Is the Medicare Advantage? No. Every single person that we talk to, I know what they want. They want a Medicare Advantage plan, free dental built-in. They want it to be a supplement and they want it to cost zero.
Joe AllariaBecause it has some of the bells and whistles and shiny objects.
Joanne Giardini RussellGot some great perks.
Joe AllariaThey're not bad. I mean silver sneakers, the memberships to the gym, like maybe some dental over-the-counter benefits, you know, a couple hundred a year, you know?
Joanne Giardini RussellYeah.
Joe AllariaYou can spend your however much per quarter and just stock up on like band-aids and you know, uh clients. You know, I've got some clients that they really like doing that. And then other people that are on maybe a more of a fixed income, they like that zero premium. So I maybe went too far too quick, but just really reviewing part A is hospital coverage, right? Part B is medical, medical physician services. And like you said, you get that. That's Medicare. Would you say, is it right to say folks out there should sort of consider that like an 80% covers 80% of what their cost would be, but there's still that 20%, which is where you need to fill that gap with a supplement or an advantage plan. Is that yeah, most of it so it's it's 80 right?
Joanne Giardini RussellIf you have original Medicare just A and B, you're gonna pay for that coverage, but you have an 80-20 plan and you don't have coverage for the 20 unless you purchase that supplement. The people with Medicare Advantage, they unfortunately they still pay for part B, but they think they're still enrolled in the original Medicare system and they're not. So those folks are truly don't look to Medicare to handle your bills, look to your carrier. Maybe it's Anthem, maybe you're not a healthcare, maybe Humana, whatever. Look to that carrier to pay your bills. So it's a different, and that goes back to the whole thing of you know, is one better than the other technically if you're sick? Sure. But does it mean it's better for everyone to buy it? No. It really comes down to usage, you know, what you want out of your health insurance. Some people have no problems with networks. So there's not that one's bad or good, it's just understand. And that's what we'll talk really laced throughout this entire conversation is just understand what you're buying.
Joe AllariaYeah, exactly. And I I shared with you, and I'll share with the audience that when I first got into the financial industry, actually, I did sell some Medicare supplements. So that was one of the first things I ever learned in the industry a long time ago. But they're actually, I would argue, Medicare supplements are very easy to understand because every plan across every company, plan N, plan G, whatever, they all have to be the same. They're standardized. So it doesn't matter if you're United Healthcare or Mutual of Omaha or whoever, a plan G is a plan G is a plan G is a plan G. Right. They're the same. Your benefits won't vary. So that's that actually makes it very easy. So the two things you're looking at for Medicare supplements are just price and carrier.
Joanne Giardini RussellI would say really carrier, we focus on carriers a lot, carrier stability, right? Because you got a lot of new players that come into the scene that, you know, they entice agents to sell their product because they're giving extra money and bonuses and all that. However, they can be gone in two years, you don't know, or they can have a 30% rate increase in two years. So you got to be careful. And we're gonna talk about pre-existing conditions later, but that's a big factor. So we don't play that game. We stick with solid carriers across the country. We want stability, we don't want the complaints, you don't want the hassle. But looping back to to when you talk about the ease, yes, you're looking at just price, but maybe perks, maybe some do have a gym membership because the carriers can throw some things in if they want to. But the plans are standardized, so yeah, so you're really not looking at very much. And then the other thing that makes Medicare supplements so easy is that it follows original Medicare. So if you have a knee replacement, the government's paying 80% of the knee, and the 20% is covered by your supplement. It's just very easy. You can go to any doctor in the country that takes Medicare. Very easy.
Joe AllariaAdministratively, I think. Would you say it's easier? And I'm kind of leading into the next question on do you find that you have a personal preference?
Joanne Giardini RussellI do because it's Medigap. So when people are sick, we routinely hear, well, a couple things. We either don't hear from them, you know, it's like, oh, I didn't tell you I got lung cancer two years ago. We don't hear if we don't hear from them for two years and they have their coverage, that is telling you how great it's working. They're very thankful when they have the good coverage. So that is huge. You know, if they have lung cancer with a Medicare Advantage plan, they're, you know, dealing with a network. Maybe they can't go to this cancer center, maybe they can't go here. Maybe, you know, chemo and radiation is a 20% copay. That's pretty darn pricey. So maybe they hit their max out of pocket of five grand that year and they're not super happy. But thank God they have the plan. One of the great and powerful things with Medicare Advantage is it has a max out of pocket. That's actually a great thing.
Joe AllariaWe've never recommended one way or the other. I think every situation's different, it's unique. You do need to look at where you live, what state you're in. You said that you're your network, are you traveling, how healthy are you? There's a lot of things. There's a ton. But you know, I would say that, like you're saying, Medicare supplements, they're very straightforward. They're very simple. It's good coverage. You don't deal with the networks. You do have to pay a premium.
Joanne Giardini RussellYou have to be okay with paying more money on a monthly basis.
Joe AllariaOn a monthly basis. You know, advantage, you're super healthy, you might have zero premium, you might never pay anything, not for several years. It works more like I think, like your coverage when you're working. When someone says, Hey Joe, can you take a look at my health insurance options, which we do for our clients, and give me your thoughts on what you think. You know, I don't think I've ever looked at two that are the same. You know, they're very different. And that's what makes it really hard to compare. On the flip side, it's really easy to compare supplements. So it doesn't mean that advantage plans are bad. I don't think it just means that you really gotta dig in and understand to take your words what you're buying.
Joanne Giardini RussellThere's a lot of moving parts. My coverage right now, I pay $807 a month for garbage, garbage coverage in Michigan. But I will say I never use it, you know, knock on wood. I can't remember the last time I really paid for much other, you know, $100 maybe for an ophthalmology visit. But all insurance is great until you need it, right? That's kind of the essence of what we do also. But if I had my choice and I could be on this, you know, Medicare Advantage plan now at my age, which I can't, I would take a zero premium. But I also know what's around the corner regarding pre-existing conditions. So I probably wouldn't take it. So that's just me. But I'm willing to pay for healthcare. You have to kind of pull back and see what it is that you value about insurance. It is insurance at the end of the day. It's all insurance, you know. So everybody wants to have everything for free. But when the house burns down, what kind of coverage do you want? And I always kind of liken it to musical chairs. If the event happens and you do get sick, what plan do you want to be sitting in and what makes you feel good and sleep better at night? You can extend it to beyond just the plan. Maybe it's the family too, because the family can be impacted by this sounds crazy. It can be impacted by the person's choice. Maybe they have a Medicare Advantage plan that says they can't go to the skilled nursing facility two miles from their house. They have to go to one 30 miles away, or maybe they can't even get into the skilled nursing facility because the plan said no. Those are different rules and considerations. And then all of a sudden that affects everybody. The kids are scrambling. Well, how do we help dad? Because he can't get in there, or he's, you know, half an hour away. So there's a lot to it that people don't see on the surface. They see zero and they see or an expense for Medicap. They see, you know what I mean? They see two different things. And so we have to break down those conversations because it really just, you know, you want stress reduction.
Joe AllariaAnd like when you're saying zero premium, again, we're talking about those Medicare Advantage plans that are out there. Some of them, many of them, they don't make you pay a monthly premium. Your supplement, if you chose a supplement, you do pay a monthly premium. Your supplement, that's I don't want to say it's all you pay, but let's say you get a plan G, you pay your premium, and there's a part B annual deductible of a couple hundred dollars, depending on when you're watching this, that you'd have to potentially cover. And then prescriptions aside, not talking about those right now. We're just talking about hospitalization and medical services. Once you pay your premium and the part B deductible, you don't pay anything else. Now, on the advantage side, again, you're not paying a premium and you have a max out of pocket, like you've referenced. So that's a really good number to understand. It's if you go with advantage or if you're looking at advantage, what is the max out of pocket? And I would just assume that that's your premium. If it's way more than what you could pay for a supplement, I'm not sure that makes a lot of sense. You know, if it's we've had them where they've been kind of close and the person's healthy and doesn't see the doctor much, and they're thinking, well, geez, worst case scenario is I'm gonna pay this, whatever, $3,000. I don't even go to the diet, see the doctor one time a year. So chances are I'll probably pay $50. Right. Okay, that could make sense. Right. You might come out ahead on that one. But since you brought this up, I'm gonna jump to this question. I want to ask about pre-existing conditions. When folks are transitioning to Medicare, are they guaranteed coverage?
Joanne Giardini RussellSo, what happens with Medicare is when somebody is 65 and enrolled in part B for the very first time, that's when a six-month window kicks in. So some people, this window starts at 65, some people it starts at 68. Let's say they're retiring, they're coming to us saying, Hey, now I want my part B to start. We help them get all that done, but their part B is starting when they're 68, 67, whatever the age they are. So it confuses people when that window is. But it's six months. The whole key is that you have a six-month window when you first start to go to any agent in the country saying, Hey, I want a plan G with ABC insurance company. Don't ask me any medical questions, you know. And you might have cancer, you might have lupus, you might have ALS, you might have a kidney transplant two weeks ago. They cannot deny you.
Joe AllariaSix months from when you leave your group coverage.
Joanne Giardini RussellPotentially, when you start part B. It all gets triggered on part B coverage, yes. And is that you have to be 65 or older and starting part B.
Joe AllariaIs that six months before? Like, how does that work? Does it straddle the time when you start part B? Is it six months before, six months after?
Joanne Giardini RussellIt's just the start date. So I have somebody who emailed me this morning that she started her part B May 1st. Okay. And I haven't talked to her. We haven't done a supplement yet, but she's got chronic conditions, so she knows she wants a supplement, but she she's got six months from May 1st. So I literally always count on my fingers May, June, July, August, September, October. So October here, she has literally till November 1st. I can put an application in with any carrier with a November 1st, the latest start date for her to not be triggered any questions about her history. Because in her case, she will not qualify for a supplement. So that's where you need to be careful. So if you're coming in with illnesses like that, you want to know this right away for sure.
Joe AllariaSo you said she has pre-existing conditions, she would not qualify for a supplement, but she can get a supplement if she does it in this window.
Joanne Giardini RussellYes.
Joe AllariaBut if she waits or wants to change coverage later, then you have to answer health questions. And then in her case, she would not be approved. She can get one now, right? But she'll probably not be able to change to a different supplement down the road.
Joanne Giardini RussellRight. All bets are off later. And that to me is the whole gotcha moment to Medicare. That's how I describe it. And this in this, here's a little story to go along with that, because a lot of people don't know this gotcha piece, and that is the gotcha piece because they don't know about that six-month window. But somebody called last fall, and she had called Medicare, 1-800 Medicare, and she got a plan with them a couple of years ago. She was 67 last fall. She called and she said that at age 65, that's how she found her plan. She got an Aetna PPO down south someplace, and she said, it's working pretty well. I don't have a lot out of pocket at zero premium. I've been pretty happy with the coverage. She said, but I just sort of feel like, you know, I had this in a polyp removed and I had this. And I she's just starting to have little things happen. So she said, as I age, I just think I'm better off with Medigap or supplement like my friend has. So that's how she called us. And so I said, Great, makes total sense, right? Let's start talking about your health history. She said, Well, I thought I could just get one because I'm calling between October 15th and December 7th. That's when the annual stuff starts. And I said, Well, no, you have to answer medical questions because you've been in that plan for a couple of years. Talking through her medical. She had heart issues that will not allow her to purchase a Medicare supplement. She had no idea. So the downside, a couple downsides, she called Medicare. Medicare doesn't tell you about Medicare supplements. They enroll you in Medicare Advantage plans. They don't talk about Medicare supplements. They do not, correct? So yeah. Wow.
Joe AllariaI didn't know that.
Joanne Giardini RussellYeah, there's largely a shift because the government would prefer everybody in be a Medicare Advantage plans. They pay the Medicare Advantage plans across the country to run those plans because what it does is it takes the risk off of Medicare, right?
Speaker 2Oh yeah, for sure. Right.
Joanne Giardini RussellRight. So they don't discuss those. So that's how she ended up with that. So it's really just a bummer. Then that's that was her only how would she know?
Joe AllariaLike I said, and it's not necessarily a bad thing. And that's one of my next questions is that's a major difference between these two options of should I get a supplement or should I get an advantage plan? Anyone can get a supplement if you get it at the right window. Right. You said six months after you start part B. So that's that's good. No, I've six months after I start part B. I'm assuming that's if you're working, you're retired. Anything. But anytime you want to change a supplement, go from supplement to supplement, or I guess I should say go from advantage plan to supplement. Anytime you want to go to a new supplement, you're gonna have to answer health questions after that six months forever.
Joanne Giardini RussellRight.
Joe AllariaSo the difference is advantageous, you don't have to do that.
Joanne Giardini RussellCorrect. And so that's where the industry advertises that whole open enrollment time. They call it you can change. A lot of people will just say agents will even say, Well, you can just change your plan next year if you don't like it. And I'm sure that was what she kind of heard with Medicare when she called in for that plan. They said, Well, if you don't like the Zetna plan, you can change next year. The consumer hears they have carte blanche to go get what they want, and then it's not true, right? So just imagine being the consumer that you just didn't know it was available to you, and you would have picked it, maybe, right? It's just not fair. It really isn't fair.
Joe AllariaThere's a couple windows. There's the October 15th, right, to December 7th. And tell us just what you can do during that. My understanding, I thought there was another, there used to be another window that was at the beginning of the year, January or March. Maybe tell us first what that first window, what you can do during that one.
Joanne Giardini RussellThat's an important window too, because October 15th to December 7th, like you said, you can change your Medicare Advantage plans because if you really have one and you didn't like it, or maybe your doctor doesn't take it anymore, or something like that happens, you can change your plans. What happens is every September, everybody needs to understand that with Medicare Advantage and with prescription drug plans, it's super important to pay attention to your mail in the month of September. In September, all the plans are legally required to give you their changes and tell you what's going on, what this is going to happen with your plan. This drug isn't covered, this is your premiums changing, whatever's going on with your plan. That's your time to really look at your plan, right? And then if you want to make a change, fine. During that window, make the change. And the new plan will kick in December 1st. If you hear this and you decide you, I didn't know that about Medicare Advantage, I'd prefer to get Medigap and I'm still you know healthy, then you apply during that same window too, and you would start January 1st.
Joe AllariaI might not have understood that. So if you're on an advantage plan and you want to go to a supplement, you have to do it in that window as well.
Joanne Giardini RussellYes. Yes, that's your window. Otherwise, there's also another window, January, February, March, which allows us to take people off of an advantage plan and go back to a supplement as well and get a drug plan. You can't change drug plans in January, February, March. So you've got all these crazy timing windows, you know, with that just makes no sense to me.
Joe AllariaI'm sitting here thinking, okay, let me mention something that we may not have touched on, but if you want to go from supplement to supplement, you can do that any time of the year.
Speaker 2Yes. Right.
Joe AllariaSo you can do supplement to supplement any time during the year.
Speaker 2Right.
Joe AllariaDoesn't matter. Okay. So that's one thing, right? Right. We said if you want to go from uh supplement to an advantage plan, then that has to be October to January.
Joanne Giardini RussellWell, October, but then you have January, February, March that opens up again.
Joe AllariaSo it's it's so you can go from supplement to advantage plan the beginning there. But if you want to go from advantage to supplement, though, it has to be the end of the No, because that one we can do January, February, March.
Joanne Giardini RussellWe can extend it. So kind of think October till March. It's not super advertised. It's good, it's just crazy.
Joe AllariaI didn't send this to you ahead of time, but I was just curious. What are these periods called, actually? So you've got the October to December is called. What is the name of that enrollment?
Joanne Giardini RussellActually, the annual election period. It's not open enrollment, which is what throws people off. Open means implies you can do whatever you want, right? It's the annual election period. AEP is what we call it.
Joe AllariaAnd what's January through March?
Joanne Giardini RussellThat is a Medicare Advantage disenrollment period, January, February, March. So you can only do a couple of things there. If the government ever wants everyone in Medicare Advantage, why didn't it give you this big window to get out of it, potentially?
Speaker 2Yeah. Right.
Joanne Giardini RussellAnd then you've got other things. So I don't want to ignore two, but I don't want to dive into it either. But there's things called trial rights. So maybe you at age 65 went to Medicare Advantage and you learned that you didn't like it, then you can get out. So there's all these different nuances, which just really go means to just find somebody that knows Medicare. Exactly. There's so much to this. You know, you don't have 10 hours a day to do Medicare.
Joe AllariaI've had that thought a few times just as we've been talking. It's like, I'm sure if you're out there listening, you're you're wondering, what in the heck?
Joanne Giardini RussellYou know, what is she talking about?
Joe AllariaIf your head's not spinning yet, it probably will. I would say there's no reason that it needs to be this complicated, but it is. It's silly. It's not Joanne's fault, it's not my fault. It's just that's just how it is. Shouldn't be, but it is. And so one thing you mentioned, though I want to just make sure people hear is that if you do choose advantage, you have, I think it's a 12-month window, correct? Yeah, to change your mind and go on a supplement guarantee issue. Is that right?
Joanne Giardini RussellYes, but you have to make sure that that trial rights, you're very close. You have to make sure you've done that at age 65. If you are an employer coverage, and this happened recently to a guy who came to us, he was on employer coverage and at age 68, he left employer coverage, went right to Medicare Advantage. He thought he had trial rights to come back in 12 months. He does not. The only time you get trial rights like that is when you go right directly to it at age 65. Okay. So that makes it who right, who's gonna know that? He argued and he called Medicare, and it's not possible.
Joe AllariaAnd again, I would say, yeah, I feel like he's right. I mean, why would that be? But I'm on his side. I think he should have been able to.
Joanne Giardini RussellMe too, but he can't. So I told him, I said, go call the carrier. If they'll give it to you, that's great. But I will not put it through because it's wrong, you know. So and he called and they said, No, we won't do that.
Joe AllariaSo supplement advantage, you know, supplements, like we said, they're they're more flexible in when you can change. So that maybe you know gives them a point in their on their side. Yeah, if you're keeping score here. You supplements you can change whenever you want. You do have to answer health questions. Advantage, you can't change whenever you want, but you don't have to answer the health questions, right? Are there any health questions you have to answer to be insured under a medical?
Joanne Giardini RussellNo, there used to be end stage renal disease, but they took that off a couple years ago. So there's nothing absolutely new.
Joe AllariaI was gonna ask about that because I thought that was the one, but learn something new today. I mean, uh, this isn't wasn't the first thing, but one of the problems that you kind of just mentioned is people sometimes continue to work. People have different situations. Not everybody retires at 65. Some people are before, some people will continue working. I know that one of the major issues or questions that we get is do I need to enroll? There are penalties for maybe not enrolling in part A, Part B, certain things. So I know because I've researched this enough that you won't be able to answer that fully because of all the situations. But can you just shed some light on do people need to enroll at 65?
Joanne Giardini RussellYeah, and that's my favorite question, actually, because I start every webinar seminar with that whole concept of do you even need to enroll? Just because you're 64 and a half and approaching 65, our big question for us, and that's our job, is to figure out do you need to do it? And the answer is no. There's a really great fact sheet with the government from CMS, and it says deciding whether or not to enroll in Medicare at age 65. That means deciding whether or not. That doesn't mean automatically do it. It's like just stop and read and look well logically. So that's all we really do. So we come in and just say, okay, if you're working and it's a large employer, which is over 20 employees, you're on their group plan, you like your insurance, maybe your spouse is on the plan, you're gonna work a couple more years, you're not contributing to an HSA. If all those factors fit you, go ahead and enroll in part A of Medicare only. Do not do part B, and then come see us when you need part B. However, let's say in that a little equation, you are working, it's a large employer. I mean, you are funding your HSA and you love your HSA and you don't want to give it up. Well, then don't do anything with Medicare. That's it. Don't do anything. The only time you're automatically going to be signed up in Medicare is if you're taking and collecting your social security benefits prior to age 65. Those people will automatically be enrolled into Medicare, both A and B, but it doesn't mean they have to keep part B. So, same kind of assessment. Well, I'm on my husband's plan, I don't need part B. Well, then turn the little card over, sign it, and give it back, and it goes away and you don't pay for it. So we try and make it that simple. I know it sounds a little silly and I'm trying to be basic, but that's how it should be. It's like you have a basic half dozen questions. That's the most important thing is to triage that situation. And every person should be doing that at 64 and a half and going through the little triage conversation. We get people calling and say, Well, turn to 65 this month, and I'm doing an HSA, blah, blah, blah. And the last person I talked to, I said, Well, don't do anything. And she's like, shoot. And she already did. She already enrolled. I'm like, Well, why are you calling two weeks before? Right.
Joe AllariaYeah, she wanted to hear that she did the right thing. But she didn't.
Joanne Giardini RussellI said, Well, if you want to do right to say, then you just did the wrong thing. She said, But HR told me to do it. And I said, Well, HR's wrong and you shouldn't have done that. So she was able to unwind it, but she caused all this stress for herself where all she had to do was call us two months prior to when she did. So just don't wait. I know you're all paranoid. I know you don't know who to call and all that kind of stuff, but you only hurt yourself.
Joe AllariaAs far as the penalties, I want to make sure I'm I have my understanding on this correct. So for most people, it's not for everybody, but for most people, part A is free.
Speaker 2Correct.
Joe AllariaIf you have enough work credits, quarters, yep. Part A is free. Therefore, there's never any penalty for not enrolling or enrolling late in part A, correct? Correct. Right. Okay. Right. But part B, you do have to pay for, regardless of your, you know, your uh how many quarters you have, there is a penalty for enrolling late in part B. Can be. There can be. So you want to talk a little bit about that.
Joanne Giardini RussellMaybe this is a the industry is driven on this part B penalty thing, and oh my gosh, you got to do something. It's like the scare tactic to get you to sign up for Medicare, and you don't need to. So only four percent of the people in the country are affected by a Part B late enrollment penalty. So when you think about it logically, so what happens is if you're 65 and you're working and you don't need Part B, you're gonna defer that. Again, certain parameters apply, so always check with somebody. But if it becomes that you don't need it, then fast forward three years. You know, let's pretend there's Ford Motor Company in my backyard. Somebody is working there at age 68, they come to us and say, Okay, now I'm gonna retire. Did you get part B? No, I didn't. I don't I didn't need it. You're right, you didn't need it. Great. So what we do is there's a form called an L564. That form is fantastic. I can send it to you so you can have that on hand. That form goes back to HR at Ford and all they do is sign off that Joe Smith has had Ford coverage since he was 65 years old. That goes to Social Security with Joe. When he signs up for part B, he says, Hey, my Ford insurance is ending in August, so I need my Medicare to start in September. And then it gets all hooked up and there is no penalty. So again, that form is what verifies that he's had coverage. Now, if Joe retired at 65 and did absolutely nothing for coverage for three years just because he was living in a cave and didn't need health insurance and he just did nothing. Then he decides he wakes up at age 68 and says, Oh my gosh, I need Medicare. He's gonna get a penalty because he had zero coverage for three years. That's a late enrollment penalty situation. But again, when you think logically, nobody calls us and says, Hey, I'm gonna retire in three months. Can I get my coverage together in a year and a half from now? And then have a penalty because they have a gap, right? They're worried about their coverage.
Joe AllariaWhat about people that work for small employers that are gonna work past 65? I just read it on Medicare.gov. You know, that's where we just shared any information we put out or event we've done, it's always from Medicare.gov. And it Medicare.gov, I think, from what I read in the past, says that if you have 20 or more, then you can defer part B. But if you don't have 20 or more, then even if you keep working, you have to sign up for part B.
Joanne Giardini RussellWell, and the reason is it's different, yes, and that is true. So if it's an under 20 situation, you got a small CPA firm with eight people, right? And that person's turning 65. The reason they have to sign up for part A and B in that case is because on the day that the person turns 65, this gets extra confusing, Medicare becomes primary insurance for them. Whatever company they have at work, they can still stay on their employer coverage and they will not get a penalty, but they have to so it's a different issue. It's a claims issue, more so than a late enrollment penalty. Because again, Medicare is primary insurance. If they don't have primary insurance in place, if they just ignore it, and actually, here's another great example because the stories tend to really teach the most. We had somebody was it was in that situation in January. She turned 65, she called Social Security and said, Hey, should I enroll in Medicare? They asked her, You're still working. She said yes. They didn't ask how many employees. Big problem. So she there were three as all. She did not do part B of Medicare. She did the free part A and she did not do part B. Unfortunately, she has an oncologist, she has cancer, she had scans, she had all this stuff going in January, February, March, April this year. She called us in May because she got bills for $20,000 that we're racking up because her insurance company. Now again, remember, she stayed on her group insurance. She thinks she's fine because she called Social Security. They said you're still working, you're on group insurance. The group insurance carrier, rightly so, said, Well, we're not covering those claims because you should have been on Medicare in January, Part B. You were not, and then therefore you're going to pay 20 grand. We were able to fix her from you know May, June onward, but we can't go backwards and fix those claims. So that's the danger to the small employer situation. So you can see it's not a late enrollment penalty situation. She's not getting a late enrollment penalty. And that's what people worry about.
Joe AllariaShe doesn't get a late enrollment penalty.
Joanne Giardini RussellShe's enrolled.
Joe AllariaYeah.
Joanne Giardini RussellSo I mean now she is, but no, she would not get a late enrollment penalty because she has qualified coverage. So it's it's very hard to understand the difference there. A lot of agents even goof that up. She has coverage, she has employer coverage, she's fine. She would never, even if she never went and got part B for two years, she would not have a late enrollment penalty because she has qualified worker coverage.
Joe AllariaSo if she didn't have employer coverage, she didn't have part B, then she would have the late enrollment penalty.
Joanne Giardini RussellThe key is if you didn't have employer coverage. If she had just bought her own coverage in the marketplace and stayed on it for two or three years because she wanted to, then she's gonna get a late enrollment penalty.
Joe AllariaThat is uh probably a big misconception, then because it is. You know, again, Medicare.gov's not really clear about this, but it says 10% for every year that you didn't sign up that you could have signed up for life. Correct, which is true.
Joanne Giardini RussellIf you had marketplace or if you kept on Cobra for 36 months, but those things don't really happen very often. They really don't. No. So it's there's all these little nuances that get tough. Yeah.
Joe AllariaYeah, they don't happen very often. Gosh, we're running out of time. There's so many different questions I want to get to. This is all very, very helpful, good information. Let me try to hit a couple quick ones. We're talking about enrollment. There's a seven-month window to enroll in Medicare. Is it best to do it early?
Joanne Giardini RussellIf you know you need Medicare, again, go back to that question. Do I need to? If I need to do it, like if you know you have if you have marketplace coverage and you absolutely need to go to Medicare next, then absolutely just file early.
Joe AllariaDoes it affect the effective date of your part A, part B, or prescription drug coverage if you don't do it?
Joanne Giardini RussellIt does. And so if you wait until after, like I've got someone right now, she's turning 65 in September and she wants to retire at the end of the year. And so, well, don't do anything without talking to us because if she files in October, November, and December, it's she's still in her seven-month window. She thinks she's fine. It's gonna have a delayed start date for her root part B. And she doesn't really understand that. So we have to really plan out when we want it to start. She's just thinking it'll just start. So be very careful if you're trying to start it a certain month and you're in your back date.
Joe AllariaThey don't backdate your part B start date, even if you're in the seven-month window. Or your drug coverage for that matter, I'm assuming.
Joanne Giardini RussellWell, drug coverage you can get as soon as you have part A. So part A, they always start with the month you turn 65. So they would backdate that part, but they don't do part B, which is could cause you problems. So it's another goofy social security rule.
Joe AllariaSo at this point, we've already said it, but you know, don't think you have to memorize all this stuff.
Joanne Giardini RussellRight.
Joe AllariaIf you're getting ready to turn 65, you know, and you're listening, obviously, you know, if you're a client of ours, you're in our area, give us a call. What we're gonna do is we're gonna connect you with Joanne or someone like Joanne, who's you know, licensed in the state of Illinois who or Missouri or wherever we're at here, and we're gonna talk through your situation. I definitely know this is way too much to digest. These are the issues, these are the questions. So what else are we gonna talk about, right, Joanne? So we'll keep going here. A couple other quick ones, you know, because I think I've seen some of your material on this, so I have an idea what you're gonna say. But one of the places people go to get information about Medicare is the Social Security Office. Is that a good place to do that to get information?
Joanne Giardini RussellHorrible, horrible, horrible, horrible. I had someone this week that literally went to sign up for their Part B and then they came out dejected. They called and they said, Well, they told us that we have a one-month gap and we're getting a penalty, and she can't have Medicare next year. And said, You know what? They are absolutely incorrect. I'll send you the information. I will send you their policy manual, and you can go show the person tomorrow when you have to go back in they're wrong. So they went back in literally yesterday, sent me a tax staff or that was so easy, he's done. So they do that bad advice, yeah. Or they'll process wrong. So you just don't want to take them on the surface. You don't want to listen to HR, you don't want to listen to you don't want to listen to your friends and family. Honestly, you don't I don't mean not listen. Listen, write down the questions that you have related to what all these people are saying, and then go find somebody qualified that can give you the answers. And if you need to ask five agents, go ask five agents.
Joe AllariaBy the way, that goes for social security advice too. Yes. We tell people don't rely on social security. And you would think, well, it's a social security office. Well, don't rely on the social security office because I've had multiple instances where they give wrong information. So it goes for Medicare, Social Security, that goes for investing too. Don't rely on um on me.
Joanne Giardini RussellDon't rely on me.
Joe AllariaDon't rely on your neighbor, your family members, you know, your coworkers to give you investment advice because I can tell you the vast majority of the time where I've heard about cases where that's happening, it's not good advice. And they don't know your situation. I can't give, not to get on a tangent, I can't give any investment advice when I don't know your financial situation. There's no one mutual fund or stock that's just great for everybody, everyone's in different positions. So, anyway, rounding out the discussion, I want to just briefly hit on this subject of Irma and what it is and how it works. And again, people probably aren't aware, most people aren't aware. This is something we we help with and target and make sure. But can you just share what is Irma?
Joanne Giardini RussellGreat that you pay attention to it because a lot of advisors don't. So a lot of people come to us and they start with their Medicare and we'd say, Well, do you know how much your medic, your part B is going to cost you? And they're floored because we even asked the question. We're like, you know, they're like, No. Well, it's based on income. And when you file this year in 2022, they're gonna look at your 2020 tax return as a couple, both of you. And if your modified adjusted gross is in, you know, whatever range it is, there's six different levels. You know, the base rate is $170.10. And if you're under $191,000, I think it is this year, it's $170. If you're in the top tier, if your income is over $750,000, which is high, you're gonna pay $578 a month for the same insurance. All right. So this is just tiered.
Joe AllariaSame coverage, same exact coverage.
Joanne Giardini RussellIdentical coverage, right? You're just paying more than your friend because you have higher income. And it's not net worth, it's income. So people are shocked by that. So high net worth people are absolutely floored by that. And they also think when I say $578, they think that's per a couple. And it's like, no, that's per person per month. So all of a sudden they add a supplement and drug coverage and all that garbage, they're at $800, $850 a month, and they are shocked that it's as high as it is. So again, they have high income. So it's fortunate for them for that piece. But that's where you have the ability to, though, if you do retire, let's say you retire and your income goes from here down to here, you file a form called an SS44 and you request that they redetermine that number. And that just means, hey, I retired. I don't have the same money I had a couple of years ago. Can you give me a lower rate? And they will definitely do that. So you have that, you can do that for a couple situations with retirement, death of a spouse, maybe a divorce, maybe you sold rental property that was giving you income, things like that.
Joe AllariaSo who do you file that with?
Joanne Giardini RussellSocial Security, Social Security Office.
Joe AllariaIs that what year's income is used? So someone's turning 65. This is very common. You know, people retire. Let's just say they retire at 65 and they go on Medicare. They've been working, but now they're not. So what year income is used to determine your premium or your surcharge if there is one?
Joanne Giardini Russell2022. So right now they'd be looking at this current year's income. So if you're retiring now and you're gonna be, you know, $80,000 less than you were two years ago, right? Two years ago, they're gonna look at your 2020 tax return. That's what Social Security is pulling. And they're sending you a letter saying, hey, you made this much in 2020. Based on that, this is your Medicare premium. And if you look at that premium and say, well, I don't make that much anymore, that's a valid situation where you can go send that form in.
Joe AllariaDo you think that a lot of people just get charged surcharges and they have lower income and they just nothing ever happens? I mean, does it ever get corrected if they don't file the form and they pay too much and then they file their taxes? Do they get some money back?
Joanne Giardini RussellNo, not in the current year. But what'll happen is they're every year. So 2023, as soon as January hits next year, they're gonna look at 2021 income. So it's gonna keep rolling. So eventually it'll flatten out because their new reality is gonna kind of come through. But be proactive, go get your money now. Now we've seen some people get paid back even till January if they file it you know late.
Joe AllariaSo let's say that um I didn't file the form and I went two years on an artificially high income paid Irma surcharges and all that. Again, if I never file the form, am I ever getting that money back?
Joanne Giardini RussellNo, pretty much no. No. You can some people can file in June and go, it'll go back to January, but you can't just say, Well, I didn't know that from five years ago, and I want my money back, they're not gonna give it to you.
Joe AllariaI think that's important. I think I think that probably happens to more people than than they realize because they don't they just well, here's what they're telling me it's gonna cost, and I'm just gonna pay it, even though Yeah, and they gripe and they complain and they gripe and all that, but they could a lot of them could fix it.
Joanne Giardini RussellWe've seen people go from the top tier to the bottom tier, you know, selling a business. If you sell a business this year and on paper it's five million dollars for the sale, then you show a sale uh document, one page, just show one or two pages most, and you send that in as your proof. And just, you know, because you know, Joe has me living off of 150 grand, even though I got a five million dollar sale, they will exclude that and you'll go from 578 down to 170. That's huge.
Joe AllariaReally?
Joanne Giardini RussellYeah, huge. So think of how you're structuring your business sale. Are you doing it over five years? Are you doing it in one year, right? Because then you can easily argue the one year. But I talked to someone recently who sold a business, but they also have some rental property as part of the it's a lease going on, and that's producing $550,000 a year for five years. They just stuck themselves in the the income category, the higher ones, because how they structured the sale of the business.
Joe AllariaSo if it's a sale of a business in this year, they sell a business this year, that income from that sale can be excluded. Yep.
Joanne Giardini RussellGood to do that. Just show the one-page sale document. We did it recently with someone sold a marina. So show the document, and they were gonna be living off of 150 or 130 grand, you know, with reality. Right. Totally got it reduced. And now they'll have to do it again next year because when they look back, it's gonna be in that one year, you know, that keeps creeping up. But so what? You just kind of you do the same paperwork next year.
Joe AllariaAll right. Well, my last question here is uh is my favorite one. I know one of your favorite people in the world is Joe Namath. Uh Joe Namath, famous quarterback from decades ago, uh National Football League, NFL quarterback. I'm sure everyone listening kind of knows who.
Joanne Giardini RussellYeah, everybody sees him on TV.
Joe AllariaI say that a little sarcastically because I know that in your world, he's not one of your favorite people. So why not? What's wrong with Joe Namath? Why is he on your bad list?
Joanne Giardini RussellYou know, and now it's Jimmy Walker and Joe Namath, and there's a whole bunch of them out there too. My own husband. So my husband uh enrolled in Medicare last fall, and he literally walked in one day and he said, Do you know who Jimmy Walker is? I'm like, oh my gosh, I'm gonna die because you know, he's watching the Medicare commercials. So they're all advertising that just, you know, make sure you're getting what you're owed, you're what you deserve, what you know, call us, call us. The call centers have given really a bad rap and a bad name to insurance agents, even like us. And it's very problematic, so problematic, actually, that very recently in the last couple of weeks, CMS, which is Medicare, has come out and said that all agents like our agency and and every single agent that's going out there needs to record every single client call, correspond everything. We have to call a client to say happy birthday, it has to be recorded inbound, outbound, because of the call centers like the Joe Namath situation, because they had so many people that got sucked into those plans that were not appropriate for them, and they figured it out within a month or two and they disenrolled. So they had so many complaints that are coming down on the entire industry saying we have to record everything. So that's all it was. It's just robocalls and callers, and there's a lot of money in Medicare sales, you know. So if you can just sign a bunch of people up and don't think it's ever gonna matter, that's kind of how they operate, which is really bad. Just don't deal with those people, unfortunately. There's local agents in every single place. There's the National Association of Health Underwriters. They have, you know, you can find an agent through them. You can that's you know a way to find a qualified one, but always ask for a referral, just like going to Joe and saying, Hey, who do you refer? You know, if you want someone at your house, great. That's not a good fit for us because we're not gonna be at your house. We're in Michigan. So it just really gives the industry a bad mark. He's paid. Joe Namath does not have those plants he for his own healthcare. He's got a true supplement from the NFL. He's he's got fabulous coverage. He doesn't have what he's offering.
Joe AllariaYou you know that for a fact, too. He doesn't even have planned coverage. Wow.
Joanne Giardini RussellHe's got a supplement provided by the NFL. Exactly. He's got great coverage.
Joe AllariaSo these are call centers. That's your issue with it, is it's just the call center, people get bad information.
Joanne Giardini RussellYeah. So when my husband, so when he came in asking about Jimmy Walker, I had my husband call and I transcribed the phone call. I recorded it. It was funny as I'll get out. The girl on the phone, she was not bad or malicious or anything like that. She was just untrained. She told him that she said nobody and nobody in the entire country pays more than $170 for Medicare. She insisted over and over again. And he's like, Well, I think I'm paying more than that. She said, No, no, no, nobody. She was floored. So they just aren't trained. She didn't do anything bad, but he didn't qualify for the programs. A lot of them, too, are they marketing to you that are on Medicaid and Medicare, two programs. If you're Medicaid low income and Medicare over 65, you might qualify for Joe Namut's plan. The problem is it's just they don't say that on the commercial because and we used it. It was great because I used that as uh an email to all of our clients. We took a we did a big email. We know that every time, every year this stuff happens, my clients are sitting there thinking, I am the only idiot on the planet paying for a supplement and good insurance. Everyone's getting everything for free. I get that. That's fine. So let's just readdress it every year. And like, you know, you number one, you don't qualify, you don't have Medicaid, you're not, there's just it's so misleading. And it just makes us all look like bozo insurance agents. So it's not very pleasant for us.
Joe AllariaI've seen, you know, I've seen some of your thoughts put out on those type of commercials and the celebrities, and I get it. But the thing is, clients are just bombarded. Advertisements, mailings, commercials, they don't know. How would you really know? That brings us back to talk to someone, obviously, you know, Joanne, sitting here talking to you. If anyone's listening, they should be able to easily tell, you know what you're talking about. You've been doing this a long time. There are people like you out there, and reach out to us. You know, we like I said, one of our main roles, one of our services, you can, it's on our website, you know, professional coordination. We are the the quarterback, the coordinator of the team, the financial team, we'll connect you with someone like Joanne. Absolutely or Joanne herself and her team, and we'll get you to the right coverage. Because that's what we want, you know, that's what you want, I'm sure, Joanne, too. And we're here to educate, we're here to help, you know, dispel some of the myths and the rumors. And hopefully you learned something today. Those that are out there listening, if you have questions about Medicare, again, you can reach out to us. You can go to Joanne's website at GmedicareTeam.com.
Joanne Giardini RussellYeah, just GmedicareTeam.com.
Joe AllariaGmedicare team.com. And I will put obviously this information in the show notes so that anyone can go back and listen. And I'll put some of the things that you reference in there too, Joanne. But just reach out, set a time, talk about your situation. Even if you're 63, 64. I mean, if you have questions, we're happy to get you the answers whenever is good for you and whenever you're thinking about it. Uh I don't think it's too early to start getting some answers, start planning, doing some legwork, getting prepped. I don't think it's too early to start doing that if you're a couple years before 65 or or whatever your situation may be. So, Joanne, thank you again so much for coming on today. I would hope to maybe we can have you back, keep my fingers crossed, but uh hopefully we can have you back sometime.
Joanne Giardini RussellOh, I'd love to. It's like you can see it can go on for hours. And I know, sorry everybody, it is like drinking from a fire hose. Everyone says you just there's just so much. And so, but yeah, I'm happy to come back, happy to fly in and do some more with you. But yeah, just get help and don't be afraid of agents. We're not all bad.
Joe AllariaNo, not at all. I thought this was great. There are uh a lot of good solutions out there, folks. So, anyway, again, thank you to Joanne for her time. Thank you all for listening. Take care. Hey everyone, Joe Allaria here. I hope you enjoyed today's episode and I hope you learned something about Medicare. I know I did, but if you still have questions about your own personal situation and what approach is best for you when it comes to Medicare, or maybe even just what approach is best when it comes to your own retirement planning, you can go to retirement powerhour podcast.com and you can connect with us. You can schedule a 15-minute phone call directly on our website, and we can help you and answer your individualized questions. Also, if you have a question you'd like to submit for the show, do that on the website, retirement powerhour podcast.com. And please do me a favor and share this episode with anybody that you know that is 65 or is going to turn 65 in the near future because I think they're going to learn something and I think they'll be able to take something away from this episode. But with that, I hope you can join us next time on another episode of Retirement Power Hour Podcast, where we help listeners invest wiser and retire better. Take care.
SpeakerThank you for listening to the Retirement Power Hour Podcast. All material discussed on this podcast is for educational purposes only and should not be construed as individual tax, legal, or investment advice. Investing involves risk of loss, and investors should be prepared to bear potential losses. Past performance may not be indicative of future results. Joe Allaria A is an investment advisor representative of Carson Allaria Wealth Management, a registered investment advisory firm. Information discussed on this podcast may be derived from third parties that are believed to be reliable, but Carson Allaria wealth management does not control or guarantee the accuracy or timeliness of such information and disclaims all liability for damages resulting from such sources. Any references to third parties are provided as a convenience and do not constitute an endorsement.