Medicare School Daily
The team at MedicareSchool.com led by Marvin Musick answers REAL Medicare questions from our callers, and help bring clarity to the VERY confusing Medicare System.
Medicare School Daily
Cancer - Medicare Advantage vs Supplemental Cost Examples | April 23rd, 2026
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A cancer diagnosis is hard enough — but the way your Medicare plan handles costs during something like this can be very different depending on the coverage you chose.
On today’s Medicare School Daily, we’re walking through real-world cost examples to show how expenses can play out under different Medicare options. This is where the differences between plans become very real — and often not what people expected.
We’ll break down how these situations unfold, what drives the costs, and what you should understand before making a decision about your coverage.
📞 We’ll also be taking live calls, so if you’ve got a question about your situation, call in and we’ll talk it through with you in real time.
Well, hello and uh good morning. Uh, my name is Marvin Music uh with MedicareSchool.com, and uh this is our daily program that we do every day from uh Monday to Thursday, uh 11 o'clock central time to noon. Um, and we call it Medicare School Daily. And uh honestly, this is uh something that I look forward to every day. I love doing this, and I hope that those of you uh that uh listen in are benefiting from it. I hope you're learning, and then also not just learning for yourself, but to learn uh for others, because uh Medicare is a big topic at our at our age, and so it's uh great if you can give some good advice uh to your friends and family members as well. Uh today I'm joined in our studio by uh one of our agents, had uh agent with me last couple days, and now another top one, Nick Oberly. Uh Nick's been with us for several years now and truly is a great agent setting people up but also taking care of them long term as well. And so glad uh you're to be a part of the show. Real quickly, Nick, just before I get going. I know you have two little ones. I do. Okay, well let's let's hear about them real quickly. We got a lot of grandmas and grandpas in the audience.
SPEAKER_00So that's right. Yes, they keep me busy. I got my uh three-year-old son, Rocco, and uh ten months old today, actually, my baby girl Josefina. So ten months old today.
SPEAKER_01Well, that's wonderful.
SPEAKER_00A lot going on. Green beauty dad.
SPEAKER_01When he you curr first came to us, you were not a dad. I was not. Exactly right. I think you were just getting married, as I recall.
SPEAKER_00So was engaged then, so yeah, been doing that.
SPEAKER_01Lots changed since uh you joined our company.
SPEAKER_00Yes, five years in June. Yeah.
SPEAKER_01Coming up on five years. That's wonderful. Well, uh, Nick knows a lot, he's a pro. We're gonna talk about uh a topic today, uh revolving cancer. Uh kind of kind of a topic, but uh the reality is um people have cancer. People get cancer. And so um, depending upon what type of Medicare plan people choose is really gonna depend on what their cancer care is going to look like. Correct. Um and so we're gonna talk about the details of that. I hope that uh uh things that we lend today will give you some insight if you ever get cancer. You know what's interesting about uh Medicare uh population, Nick. Right now, uh we know that this year 1.2 million people uh will be on Medicare that will be diagnosed with a first cancer diagnosis, first time. Uh, there'll be some repeats as well, which is very, very sad, but a lot of people get it, uh, which is unfortunate, but uh insurance uh can certainly help. And so we'll talk about uh the differences of that today. Okay, and then we're gonna take your call. So let me give you real quickly the number. We'd love for you uh to be on the show today. Call in. Uh there's uh uh a toll-free line here. You can call it as uh 833-824-2004. Again, one more time, 833-824-2004. So really, whatever is on your heart uh as it relates to Medicare, uh it relates to even our topic today, or a story and experience that you have that you want to share with us or ask a question, uh we'd be delighted to take your calls today. So call in, please. We'd love to hear from you. 833-824-2004. All right, Nick. So let's get into uh our topic today. Um uh kind of a sad one for me, just so you know my my dad uh passed away with cancer, lung cancer, um uh several years ago, but uh we experienced it for sure. So uh not only is it a terrible, terrible disease, but it can also be um gruesome when it comes to you know getting care. Um and so uh what I want to talk about is uh really the options. Uh we know that when people go on Medicare, they have three options. They can do A and B only, they can do A and B with a SOP, or they can do it, of course, A and B replaced by an advantage plan. So I don't want to spend any time talking about A and B only. Most people are not gonna do that. But I do think it's um very worthy to talk about uh the differences between what someone's cancer care is going to look like uh you know on a subinent plan versus a Medicare Advantage plan. And just let me just preface this. We are not here today to badmouth advantage plans. That's not my goal. I don't want to do that. Uh but we do have an obligation to make sure that you understand if you did get cancer, and I'm talking about you know, something serious, breast cancer, prostate cancer, colon cancer, lung cancer, you know, those kinds of very serious issues. What's your care going to look like? And Nick and I have been in this business long enough to to really know that. So Nick, let's go through. Let's uh why don't you share uh you know your thoughts uh in regards to the differences on these uh different types of coverages?
SPEAKER_00Absolutely. It's definitely uh an important subject to cover. As they say nowadays, one in two men will be diagnosed with cancer, one in three women. And as we get older, those chances only go up. So it's super important. That's what we really like to do here. It's super important to educate and know what is right when we're turning 65 or starting Medicare for the first time. It can be a one-time decision. Um when it comes to the differences in care, one is going to be a lot more comprehensive than the other. The Medicare supplement plans are going to be the more comprehensive coverage in terms of cancer treatment, radiation, chemo. Um what we really enjoy or what we really like about the Medicare supplement plans is uh as Mario said earlier, the doctor is the boss. They they get to do what they want to do, and that's super important when uh your doctor is the one making the calls. They're not waiting on your insurance company, Marvin, to approve or deny services you need. Or heaven forbid you need to go, he mentioned Sloan Kettering earlier, you need to go to the Mayo Clinic, MD Anderson, those are the best doctors in the world. With Medicare supplement plans, we have no networks. We're going anywhere that takes Medicare. So we have access to the best doctors in the world on those plans. Right.
SPEAKER_01Right. Yeah, it's almost really unlimited. Yes. We know not totally, but but almost 100% of all hospitals do. 99% of all doctors do. That's right. Yeah. So you're exactly right.
SPEAKER_00What else, Nick? It's the the peace of mind goes a long way. We're we're paying for it, you know, depending on where we are across the country. It could be $150 to $200 a month, maybe, to be on that Medicare supplement plan, but we are limiting our max out-of-pocket. Right. Like you mentioned earlier, our our max exposure, our annual deductible is $283. So a doctor office visit or two, we satisfy that deductible. And we have 100% coverage for our services for the remainder of the day.
SPEAKER_01Yeah, and let's talk about that. Let's say that uh well, let's just use me an example. I live in Missouri, which is a state that's kind of on the higher side uh for submodal plans. Uh I pay $212 a month for my plan G. Uh so that's $2,400 a year. My B deductible is $283. So I'm pushing what $2,700 max out of pocket, and that's it. Go to any doctor I want and would spend $2,700 for the total year. Right now, and we know there's of course what over $4,000 different advantage plans, so we can't uh uh you know be real, real specific, but I do know this stat, and that is that the average max out of pocket right now on an advantage plan is $5,900. That's right. That's average across the board. And so I know there's some that are lower for sure, and some certainly higher. Uh, but if we just looked at that uh alone, that's more than double uh that someone's gonna pay because you and I know, Nick, when people get uh cancer, they almost always max out.
SPEAKER_00That's right. Yeah.
SPEAKER_01I can't say always, but usually chemotherapy, radiation, surgery, all those kind of things are gonna probably force people to hit the max out of pocket.
SPEAKER_00That's correct. And the issue with that is it it resets on January 1. Yeah. So now we're hitting that 5,900. Again. Again, within the first couple months doing chemo radiation.
SPEAKER_01So hey, by the way, I've had a lady, I had a lady out of Windows County uh not long ago, actually, that that happened to. She gets cancer, breast cancer late in the year, uh, maxes out her plan was sixty, seven hundred dollars. She maxed out, treatment's still going on, uh uh advanced plan resets in January, another sixty, seven hundred dollars again. I mean literally thirteen four uh within just a matter of months. I'm sure you probably have similar situations.
SPEAKER_00I hear it. I hear it all the time. And as I mentioned earlier, that's why we really stress making the correct decision for your circumstance at 65 or when we're starting Medicare for the first time, because you know, your your client you had in Wyndock County can't get into a Medicare supplement plan. You know, 47 states out there say, Hey, you better be healthy enough to answer no to all 40 of these health questions. Exactly. Or you're stuck with your Medicare Advantage plan.
SPEAKER_01Exactly. Right.
SPEAKER_00That's the bad deal about it.
SPEAKER_01Well, I've had people that uh uh we really had a misunderstanding about uh switching plans, and so they are on an advantage plan, they're on it for three, four, five years, and then something terrible happens, and now they just want to go back to original Medicare, and you and I know that's not possible. No, unless you live in what, New York, Connecticut, Massachusetts. That's right. Uh those are the only three states. And so everywhere else. Um now that doesn't mean to say that people can never uh get a submental plan, but um, but I think most carriers right now, what are they looking for? Thirty-six months to be cancer-free, treatment-free before you can uh actually get on that plan. So it's gonna be a while.
SPEAKER_00Yeah, they are sure. They are extremely picky with their underwriting. They'll deny you if you're doing physical therapy. Yep, exactly. They do not want to be responsible for 20 percent of your medical bills if they don't have to.
SPEAKER_01Yeah, exactly right. Let's also talk about it because I think this is really, really important uh when it comes to the uh prior authorization process, uh, you know, what's involved with that. So kind of share uh with our audience uh some of those issues as well that can occur, you know, on the advantage plans.
SPEAKER_00Yeah, just w what do you say, Marvin? 70, 75 percent maybe of services on an advantage plan require that pre-approval. Exactly right. So you're letting I had a client actually a couple weeks ago said she's not comfortable with a business major making her health care decisions on those advantage plans. And that's how it works, you know. It's some guy at that insurance company behind the desk pulling the strings, getting to decide what's best for your health care, not the doctor. Right. I I hear it often, you know, people being denied. I had a client, they approved one of her cataracts, she needed to go back to do the other, and and they denied the second cataract surgery.
SPEAKER_01Oh wow.
SPEAKER_00Family members kicked out of skilled nursing facilities after a week or ten days. The insurance company decided, hey, we don't need to you don't need to be here anymore. That's our decision. So by the time we really need our insurance to step up, that's that's where that peace of mind lays with those Medicare supplement plans. It's gonna do what it's supposed to do. You you paid into it, you're paying for it, but there's no ifs, ands, or buts with those supplements. It's uh it's gonna do what it's supposed to do.
SPEAKER_01Yeah, I agree with you. I think the money that is spent is not wasted. That's right. Uh you're buying something that's high, high quality. It's insurance. Yeah. And the truth is, uh, we know there are some people that it just doesn't work. It's just not affordable. That's right. And there's no shame in that at all. Uh so that's when I think an advantage plan is certainly tons better than getting A and B only, for sure. 100%. And so when people can't afford it, or maybe just don't want to afford it. But I encourage people, and I know you do the same, you just can't look in the mirror today and say, I'm healthy, I have no problems. In fact, hey, uh brings me, I I brought a letter into the studio today. I thought this is very uh uh really uh appropriate for today's program. This guy writes to me, and and uh he's he's one of our company's clients, not mine personal, but he says, Hi, Marvin. Uh he says, two years ago, your team guided my wife and me to the, and they names the company, Medicare Supplemental Plan. Uh, when we took out the policies, we thought we were both in excellent health. Within those two years, Terry, his wife, had a heart attack, and I've had major surgery for prostate cancer. Our out-of pocket costs were less than $1,000 for each. Obviously, they had to meet the deductible. Rather than the tens of thousands of dollars, we'd be out of pocket with advantage plans. We invest a bit more each month than we'd have we would have had had we taken the advantage plan, but we have saved tens of thousands of dollars in doing so. All right, so that just those kind of things happen all the time.
SPEAKER_00All the time. Yeah. And no, I I have a close colleague that uh was diagnosed with prostate cancer, and uh right down the road, KC Neurology Clinic, yeah, they do a um they do a treatment called proton therapy. And there's only four or five, six locations across the country that do that. Luckily there's one right next to Topgolf down the road. And he was telling me he went to the front desk for his initial orientation, and the person at the front desk goes, What kind of insurance do you have? And he goes, I have a Medicare, I have a Medicare supplement plan. He goes, She shut the book, she goes, All right, you are eligible for the best kind of treatment because they cover proton therapy. A lot of the advantage plans do not. So if he had advantage, he would have had to settle for the second best kind of treatment, radiation, chema, whatever it would be. So he was able to get the best treatment out there for his condition, and it was because of his coverage.
SPEAKER_01So exactly right. That's good. All right. Well, that's that's truly neat. Uh well, folks, uh just keep in mind when you make this decision, uh, it's possible. And that and that's an interesting stat. One out of two men, one out of three ladies. Uh once you make it to 65, the probability of cancer uh certainly increases. And by the way, that's why we have to take care of ourselves. That's right. We need to exercise, need to you know, be healthy and all that. I know sometimes the cancer can't be avoided, even with those items for sure. Uh but it is uh just a serious reality. Hey, I just wanted to also just read this. I thought this is interesting because uh I made a statement recently uh on one of my one of my uh videos, and and it was this, and that is that Medicare Advantage plans are excellent uh when it comes to very simple routine care. And I believe that they are, okay? Uh but when it comes to more complex situations like cancer, as sometimes not so great. And I got this letter uh uh from a gentleman who is one of my clients, and here's what he said. He said I was, and this goes back a couple years, he says I was diagnosed with cancer in July. I began six weeks of daily radiation treatments and chemotherapy, weeks one and five. He said over 125,000 was billed to Medicare, and that was just the initial treatments. Since then, I have had, and here's the whole point, since then I have had multiple PET scans, CAT scans, MRIs, and visits with surgical oncologists, urologists, and follow-ups with oncology staff of the Sarah Cannon Cancer Center. Okay? And so he said, I've only had to pay my annual deductible and nothing more than that. And so uh and he goes on to talk about how that uh his budget was still tight, but he wanted to make sure he had the best insurance. He's glad uh that he did. And that's what happens. It's not just a simple, you know, couple doctor visits. So I mean uh the fact the average uh person that's being treated uh by uh or with cancer, they are going to see on average between five to eight different doctors. Okay? And that's gonna be, of course, ongoing uh you know, through treatments, and then afterwards, after you know they go into remission, they're still having to have follow-up. So the point is there's a tremendous amount of money that's gonna have to be spent. And so that's why it's so easy to max out on those advantage plans.
SPEAKER_00Yeah, that's right. It shows up out of the blue. You know, I've I've been reaching out to a lot of my clients I wrote four or five years ago, checking in on them. How's everything going? And oh, I never used my plan until last year, diagnosed with throat cancer, one of my clients. Oh wow. They just, you know, just tell me I'm just so grateful I I had this policy. And I go, that's why I do it. I don't want to have to worry about you. That's why we really recommend going with one of these products. So when the time comes, if the time comes, you don't have we don't we just we don't need to be adding additional stressors when that diagnosis comes down. And that's what the supplement plan is going to eliminate. We get to go to the doctors, we get to, or we want to go to, we're not fighting the insurance company to approve or deny our services and no out-of-pocket beside your small deductible once a year.
SPEAKER_01That's good. And also permanent. Can't ever lose that policy. It's yours. It's yours. They can't cancel because you got cancer at all. As long as you pay your premium, uh, we are good to go on that policy for life. So that's great. All right, I just want to add just one more thing as we think about you know uh coverage. We know there are or half of all people that are on uh Medicare today have advantage plans, and that those uh people are gonna get diagnosed with cancer and they're probably not gonna be able to switch their plan. And so it doesn't mean that if that's your situation, that you don't have good insurance because you do. Uh you're just simply gonna have to deal with some of the, you know, some of the hoops that you may have to jump through. But it's not like the advantage companies don't care about you. But when you enroll in those plans, they uh you have given them the right for pri prior authorizations. You do have a network and you're aware of all that. So what I would suggest doing, uh, since cancer is ongoing treatment, you want to make sure, number one, I'd sure like to be on a PPO. Uh the majority of plans, as you know, Nick, are HMOs this year, and that's gonna continue to grow. But there are still PPOs available. So if we're on an HMO, we have to stay in the network. We cannot go out, even with cancer. You can't. But every year we get the opportunity to switch uh advanced plans twice. So October 15th to December 7th, um uh as that approaches here in a few months. Um if you're on an HMO and you want to uh get on a PPO to give you more provider options, that could be a very good move. Or the first part of every year, we call this the Medic Medic uh Medicare Advantage OEP, open enrollment period. So if I'm on advantage plan January 1, I now have the first three months of the year where I can switch to a different advantage plan. And so my point is uh you have insurance, and it's not like you're gonna go broke. I mean, they they have a max out of pocket. Uh but if you're uh not satisfied with the network or you feel like you're getting a little bit more pushback, because frankly, some advantage plans are more difficult to deal with than others. Others uh you know not as bad. So if you feel like you're not getting what you want, then please uh make sure you switch those plans uh to get on a PPO plan or on a plan that um uh you know your doctor is going to accept and take. And so uh we're not all done doomsday about having cancer on advanced plans. We just know as we go into this decision, we want to make sure that we do know there is definitely gonna be a difference.
SPEAKER_00That's right. And you know, the PPOs, it's it's a give and take. You know, you're gonna get the more freedom a lot of the time. It usually comes with a higher max out-of-pocket. Right. Just depends on the area, though. You know, there's low max out-of-pockets here in the metro where we are that are PPOs and great networks. Always depends where you are. But yeah, it's super important that if we do go the Medicare Advantage plan route, that we do get a bit more freedom being on a PPO or access to doctors.
SPEAKER_01I would agree. Let's also address the fact that, and I want you to to to uh to speak to this, but uh as people are just you know new to Medicare, going on plans, and they realize I cannot afford an advantage plan. I mean, I can't afford a supplemental plan. I need to go on advantage, and that happens, okay. But but we do know as they approach 65 or approach retirement, they do have a way to offset some of those expenses that they can incur with cancer. Why don't you explain what you think could be a good uh a good solution for that? So again, we're talking about advantage, that's what we're taking, but we want to get something else to help.
SPEAKER_00Absolutely. And yeah, budget is always on the top of our mind. You know, when we're paying over $200 a month for Medicare, another $200 possibly for a supplement plan, that could be unaffordable, especially if we're on a fixed income. Uh the thing with the advantage plans, when they do have the higher max out of pockets, maybe five, six, seven thousand dollars, which there's really only a couple ways we're going to hit that, maybe a couple hospital stays or surgery, cancer, radiation, chemo, that's where we're going to be hitting that $60,000 or $6,000 max out of pocket, for example. What we really like to do for our clients uh that that go the Medicare Advantage route due to the budget is copay protection plans, a cancer policy. A lot of people have had these with AFLAC before, where we may pay them uh twenty, thirty dollars a month, and it's a ten thousand, fifteen thousand dollar benefit, where heaven forbid we are diagnosed with cancer, they get a check written to them uh for 10, 15, 20 grand, depending on the benefit that uh they elect. And that goes towards that max out-of pocket. So it helps relieve that expenses. And it's still not a supplement, but we are protecting ourselves from that high max out-of-pocket. That's good.
SPEAKER_01So that's really good. Now, when someone is approaching Medicare eligibility 65 or beyond, is there any kind of underwriting they have to go through in order to get those policies? What's that look like?
SPEAKER_00It depends on the carrier. There are some carriers that have what's called a guaranteed issue, even up to 79 years old for stuff like that. Um most carriers are going to say, hey, you better answer no to these health questions, right? You get a few that they may have to answer. Trevor Burrus, Jr. Usually for heart attack, cancer, stroke, stuff like that. It's you can't call me after the fact and ask for a uh cancer product. So uh but yeah, we we are usually going to have to medically qualify for it.
SPEAKER_01Okay. Or do you find the majority of people that we work with uh are actually getting those policies?
SPEAKER_00When we do Medicare Advantage plans, absolutely. It's just an extra layer of protection. Okay. Because, like you know, that comes that diagnosis can come out of the blue, and then we're hitting that out of pocket immediately in the first couple of months.
SPEAKER_01And my understanding is the check does go to the M, so that it's not it's not a claims process, it is prove you've had this diagnosis. That's right. File the claim and you get the check.
SPEAKER_00You go on vacation with it. Okay, we advise you to use it towards your medical treatments. But yeah, it is your money. Okay, it's your money to do what's great, please.
SPEAKER_01Yeah, if you're listening and you know you're gonna have to go with advantage because of the monthly budget, then uh get one of these plans critical illness plan, uh cancer plan, copay protection. All right. Uh we have uh Robert on the line from Indiana. Robert, it's great to have you on the show today, sir. Uh, how can we be of help?
SPEAKER_02Well, I uh I'm currently on uh disability, social security income, and uh received a letter in the mail uh that says uh in this package you'll find Medicare card in the booklet about your coverage. Your Medicare coverage will start in three months. Check your card for the exact date. Um automatically be enrolled in both Medicare part A and Part B. And what you'd like to do is for me to deny that coverage and stay with my current health care plan.
SPEAKER_01Can I deny that without penalty? Or do you have to accept it? Well, let me ask you this. So the the plan that you're covered by now that you like and want to stay on, is it a an employer-provided plan?
SPEAKER_02Yes, it's through my wife's employment.
SPEAKER_01Okay, very good. Okay, do you know if uh the um the the the employee side employer uh has to be 20 employees on the payroll? or more. So uh uh would that apply? Is it a large employer meeting? Okay, very good. So no doubt with that. All right. That sounds good. Okay, well I have uh Nick with me today in studio. So he's a pro. Nick, uh let's tackle it.
SPEAKER_00You I'm gonna let's start with you. Go ahead. Answer his question. Yeah so Robert um technically speaking sir you you do not need to take that Medicare uh here in three months. When did you say it it's starting? Is it June or July?
SPEAKER_02August first is what's on the card August first.
SPEAKER_00Yeah okay very good. So um yeah what Marvin was asking 20 or more 20 or more employees excuse me you check off that box. Wife is still working correct she's a current employee active employee yes gotcha like I was saying technically no you do not need to take that Medicare you can defer that part B. Now what we advise is maybe looking into Medicare options depending on how you're using that coverage and uh you know cost comparison um just depending on how that wife on how your wife's group plan is structured may make sense to move over to Medicare. It's always worth exploring that option and that's something of course we could help you out with here.
SPEAKER_01Yeah well let's do this Nick uh tell us about your wife's plan. What uh what is it that you like about it? What's the cost of it? Those kind of things. Share that with us if if you don't mind.
SPEAKER_02Yeah it's through United Healthcare and uh it it the we have a deductible of twenty five hundred dollars which we've already met for the year. So that's why I don't want to change over because we have no expenses at this time. So that's good.
SPEAKER_01Now what does it cost her to cover you Robert? It costs about $400 a month. Okay and that would be just for your portion yes. Okay okay that sounds good. Okay so let's let's talk I'm gonna I'm gonna of course I'm gonna address you and we'll kind of go back and forth here with Nick but um uh he said you you don't have to take B and that's exactly true. So we want everyone to know you to know and everyone to know that once you're receiving any form of Social Security benefits, whether that's retirement benefits, survivor benefits, spousal benefits, and in your case disability benefits, you have to stay enrolled in Part A. But you don't have to take Part P if we have a good employer provided plan uh that is better than the Medicare option. Now just so you know as I look at this really Medicare is a better option for you, however not for a while and now we understand what you're doing. You are saying hey we've already met our deductible and so we don't want to have to uh uh you know be out of pocket anything so what I would suggest doing is uh going ahead this year uh uh going ahead and disenrolling for Medicare Part B.
SPEAKER_00So Nick he got a card in the mail tell him how to do that please what you will do there should be instructions on that on that packet you received Robert I believe you just signed the back of the card send it back to Social Security. You'll get a new card in a few weeks with part A hospital only listed on that.
SPEAKER_01Yeah so and you said turn the card over uh and you'll you should see on the back um that it'll say I do not want medical insurance and that medical is part B. A it's called hospital B is called medical so just check the box, sign your name, mail the card back in just as he suggested, and then that you'll get a new card in probably a month or so I guess Nick and it will say Medicare Part A only. And then what I would do if I were in your position, because $400 a month is is definitely not crazy high, but it's also no bargain either, especially if you're gonna meet your deductible on an annual basis. Now you are going to be eligible I mean I know you are going on Medicare now in August but then you would have a 10-1 2018 date. Nick, do you know if in the State of Indiana if they offer med step plans for people below the age of 65? I know I'm putting you on the spot, I don't know.
SPEAKER_00Off of the top of my head I am not positive now I they will offer some sort of supplement plan but maybe that's where it's it's just questionable.
SPEAKER_01Here's what we're gonna do Robert I'm gonna suggest this. Why don't you um uh let me let me give you our number first off and uh call in fact just call in in a couple hours and ask for Nick he can take care of you. It would be awesome. But let me give you our our office number and I'm gonna tell you why. The number is 800 782676. Okay. 800 782676. So for you and everyone, here's what happens uh there are there are Federal laws and there are state laws. The Federal laws um uh say that insurance companies do not have to offer Medicare supponal plans to people that are uh below 65 meaning coming into Medicare because of disability which is your situation. In other words insurance companies do not have to offer those. However in many States they do uh now some states they offer them but they're not very good they are expensive all that so I I can't just you know we're we're brokered throughout the country so I I can't memorize every state rules but I do know that it could be very possible that we can look at the rates on submodal plans uh in the state of Indiana and if it's attractive and it could be I will tell you if you lived where our office is in Kansas or Missouri, it's a no-brainer. Correct it's it's it would be much better to be on Medicare. So I would stay on A only until the end of the year and then Nick can explain to you the process of bringing you into Medicare effective January 1 of 2027. Then you can pick up your Part B and then get a supplemental plan, uh drug plan and all that cost would probably be $4 or less and has a deductible of $283 instead of a deductible $2,500. So I think you're you're fine to do what you're planning on doing now for sure. Send the card back in and let's stay on that for the rest of the year, but then I would still look in the option of changing this um in January. And so and you can find that out now. I'm you don't have to make any decisions now, but I think it would be something I'd explore. Now it could be that uh you live in a state Texas would be a great example. There are no med subs in Texas below uh the age of 65. So if Indiana's like that then you're gonna just keep staying on your wife's plan. But if there's some available that are attractive then you know Nick will share that with you. Now I want to explain this to really you our our general audience too what happens is when a when a uh a state does not offer submetal plans uh then they only offer advantage plans. Uh though those would be available but sometimes those are not as attractive and so your wife's plan I would say probably would be better than that.
SPEAKER_00Correct would you agree Nick? I would agree especially Robert since you've already hit your max out of pocket there would be no sense in restarting a $6,700 max out of pocket on an advantage plan and restarting that on January 1. So Yeah.
SPEAKER_01And then I want you to explain to him what's going to happen October of 28 uh 2028, okay? A couple years down the road.
SPEAKER_00Explain that please Robert it's basically like you are turning or you are turning 65, but it's like you're starting Medicare for the very first time again when you do turn 65 will get you on Part B at that point in time or possibly earlier as Marvin was explaining. You get the pick of the litter when you turn 65.
SPEAKER_01Reset the clock yes sir reset the clock mean that you even if you can't do your B now with a submental plan, you'll be able to do so come October of 2018, because it's just like you didn't even have Medicare before. You do, but they allow you this second opportunity because of the different rules that are out there that could prohibit you from getting a SUP metal plan. Okay. And there'd be no underwriting. So just keep that in mind. So my suggestion sir is in an hour or so a couple hours here sometime today call and ask for Nick and uh if you if you can't get right to him he'll call you back for sure. And let's just see what would make sense for you in January. But right now, great plan, sir. Any other questions that you have for us today?
SPEAKER_02No that's exactly what I was hoping when I could do is just wait till January. So there's no penalty if I if I don't take it now?
SPEAKER_01Not at all sir. Not at all. Because frankly Medicare is glad you don't take it because they're not liable for you. So they make it very easy. And the key is because you're covered by an employer provided plan. If you weren't good we got a problem. We wouldn't but because you have that plan 20 or more employees you are good to go sir. Okay? All right perfect.
SPEAKER_05Yeah all right well sure sure good talking to you we appreciate you calling in today appreciate you Robert yes sir thanks for your help yes sir all right let's get to our next caller uh Mario from New Jersey glad to have you on the show today sir how can we be of help yes sir I just wanted to let you know what you guys are doing are great uh everything that you guys say it's it's true I ex I experienced it myself I've had uh in October August 2025 I had stomach cancer I went to MSK New York New York to MSK New York they remove half of my stomach lymph nodes I'm cancer free now I have Medicare part A and B and uh ARP United Healthcare until today it did not cost me one penny I also just been in the hospital for uh uh pneumonia uh covert I have COPD AFib franchiactasis I had my heart shocked a few times I'm on heavy duty medication for my heart um and Medicaid once I pay my deductible the plan Gm covered 100% my nebulizers I do a lot of nebulizers uh it's covered by part B all nebulizer stuff and then I do a 28 day on 28 off uh medicine that costs eleven thousand dollars for 28 days on a month and off 28 on 28 for ceremonies and Medicare is the greatest people should not should not listen to these zero things because that's all baloney I get calls every day every day oh you you have A and B you want to qualify you you could qualify for Medicare Advantage and said no leave me alone I hang up I said I have great insurance I don't need I just broke my hip I'm in a rehab facility they brought me from the hospital to rehab by ambulance everything is covered they picked me up by ambulance when I it's great great great people should listen to you should call you guys because you guys give great great great great advice all right you know yes it's true about the Plen G. Plen G goes up mine is 240 now and I've had it for about four or five years and I never goes up. I'm gonna talk to the senator of New Jersey see if they could do something about that. Because once you're sick, once you use the water it charge you more and more because I can't switch I try to switch to it You Manner or Aetna and they said no they turned me down.
SPEAKER_01Yeah too many you know yeah too many uh pre existing editions sure well Mario Yeah well we we appreciate the testimony and I'm grateful that you have wonderful coverage and and the truth is that there is I tell everybody I tell everybody about you guys to listen to this your school thing I even tell them you gotta go on YouTube and you gotta listen to those guys are great.
SPEAKER_05And I told a lady I used one of the members of the family that was doing that that's what I you know. But he told me I could choose you know I he it was up my decision to choose and I chose a A and B. Because the doctor is the boss not the insurance company. Exactly right sir.
SPEAKER_01Good good good way to put that uh very good way to put that yeah I'm also sounds like awesome people should listen to you.
SPEAKER_05Uh-huh yeah well uh I'm also grateful for you I was just gonna say I'm glad that you also get to benefit by that um uh max out of pocket on the on the drug plans that 2100 that's awesome that's awesome yeah I'm glad you and once my twenty like I'm low income my twenty one uh I I have New Jersey New Jersey Pad if people want to know that New Jersey Pad is for low income people Medicare takes over so Medicare even took uh New Jersey Pad took over care of my first twenty twenty one hundred dollars for the drug plans so since January my drug plan has been free wow zero copay is on all my drugs and I take a lot of drugs take multech for my heart I take cardiazam I take uh uh you know I get tested for cancer every three every month every three months to see if I'm cancer free uh I have COPD AFib so I get treated for that all the time I see a doctor every couple of months not even one penny everything is covered all my doctors all my uh nebulizer stuff all my medication yeah you know I do have a drink plan through wildcare you know yeah yeah because you have to have one well I will say this I'm glad you're definitely getting your money's worth uh out of that supplemental plan and I hope your cancer is doing well I mean with with the stomach issues yeah so far I'm doing good and I just had a couple of weeks ago I had skin cancer removed through my on my head um through uh a dermatologist no questions asked whatever the doctor says that doctor demands that's great okay I just you know people should listen to you guys you guys do a great great and I hope you get a lot of business if I need you guys I I definitely have your number programmed on my phone all right Mario well we'll send you your check later okay we appreciate the endorsement I'm teasing no no check I just I want other people to to to to realize you know those zero and dental and uh hundred a thousand dollars for counter stuff that's all yeah it's all good and when you get sick you you you're done you know exactly right I could I would have been dead already and and another question I'll let you go I had a friend that had cancer he went to Salon Cattering he had the advantage program three hundred dollars every time he gets he goes to see them he stopped going and he dies two months later yeah yeah boy that is he said he couldn't afford it he was gonna leave his wife bankrubbed you know yeah well that's that is a sad story well I'm glad you're doing well and uh uh we appreciate the opportunity to serve as your broker stay in touch and have a have a great rest of your day thanks for the call take care Mario thank you so much okay thanks for a great job you guys do bye see you bye all right we have uh next uh James uh calling us from Texas James glad to have you on today's show uh can we answer a question for you sir what's on your heart and mind yes um uh it's about the IRMA just I know you're limited on time so I want to be as respectful as possible for other callers um the the two questions I wanted to ask is number one is it permanent and number two could I just give you an approximate number so I know what I'm dealing with because I'm gonna be honest with you it scares the daylights out of me because I'm by myself.
SPEAKER_04Yeah yeah yeah Armas yeah Jimmy they're not permanent for sure uh so when you're giving yeah tell me about an amount are you talking about you want me to give you an amount or are you talking about um uh some income if I can I give you a fictitious amount of of my what do you call it of of my home you know just my um you want my monthly income or yearly income or approximately well well I I know that you're you're a single filer so uh the limit this year is $109,000 for the year.
SPEAKER_01So as long as we stay below the $109,000 we don't have an Irma. And so tell me about tell me about the home sale. What a what's your what what do you think your profit's going to be on that well I own my home um so hopefully all of it I just have a very small um uh HELOC um you know just for emergencies um um it's uh I I'm looking at a approximately nine hundred um so I just want to know the numbers because yeah you mean nine hundred thousand yeah uh yes sir okay okay so here's the way it's gonna work so what what did you would you originally pay for your home and and include some kind of an estimate for for any improvements I'm trying to get what you what your basis is nine hundred thousand less uh so what what you pay for it and what what improvements have you made to it and just you know just a ballpark a hundred thousand dollars improvements two hundred thousand dollars all that's gonna come into play Jim um i it was it was for sale for uh uh a half a million I purchased it with uh uh a few uh things that we put in it um just basically fans and lights uh uh that we wanted in the home and it ended up being the price was four sixty five and this was in May of 2019. Okay 465. So we're looking at a uh profit basically 435,000 you probably I don't know Jimmy if you'll have to sell through a realtor. Let's say you have to let's say you have to sell to a realtor and the real estate commission is six percent so that's going to be another 25 off. So let's just keep it simple. Let's say you've got about a $400,000 profit on that home. Okay so I I did nine hundred thousand I took four sixty five out that put us to four thirty five and then I just you know because you got commission and some closing costs so that puts us about four hundred grand. So because you're a single filer uh two hundred and fifty thousand of that will be excluded you will not have to pay taxes on the first two hundred and fifty thousand why because you've lived in the home uh for at least two years you've owned it you know uh you know for at least two of the last five years so you qualify uh for that exclusion so what's gonna happen Jimmy is that extra $150,000 then uh would be capital gains uh and that of that amount then is going to go on your uh tax return. So what that's what that means is if you sold the home this year in 2026, then come 2028 for that one year you are going to have an IRMA. Okay, I and again I don't know what the thresholds will be Jimmy but the time you take your uh you know your Social Security you take this $150,000 you're more than likely going to be just in that that first level of IRMA the first level and that means it's gonna cost you basically an extra probably about $100 more a month. Right now it's $95 for the Mer Medicare B and DERMAs at that next income level. Okay? So that's that's what's going to happen. You it we it will impact you if you sold this year it impacts you in 2028. You sell 2027 it'll impact you in 2029 but fortunately it'll only be one year worth of IRMA. So it's a good problem to have for sure have you heard anything about capital gains uh uh going up one of my friends told me that might be possible under this administration yeah have you heard I no I have not heard that I mean that seems a little bit contrary to the you know to the Trump philosophy but I can't say that won't happen uh but um yeah I again I I know that um uh I mean I think he he'd like to see tax rates come down so I'm not sure about about how ta you know uh the tax on capital gains but um we'll have to see on that hey Jimmy anything else at all sir that's on your heart today bes besides this um I think you covered the numbers and and the reason why I called in I heard that you guys were talking about Ermus so I said let me call in right now and ask these two questions but then I can watch the video and I and I can take notes doing that. So I really appreciate that Marvin all right hey good to talk to you I'm glad you called in Jimmy have a good rest of your day sir you too take care all right well Nick it has been a blessing. Thank you so much number one for being such a wonderful agent caring about people as you do but also the knowledge that you uh have as well I appreciate you sharing things uh with us today and so for uh those of you that need immediate help um uh give us a call today you can if you want I'm gonna give you the number and that number is 800-782-6676800 782-6676 uh that'll get you into our uh switch uh our receptions we have actually 15 on our reception team uh so you can tell them why you're calling they'll direct you to uh the appropriate department now for those of you that want to be on the show uh on Monday uh the program uh we're gonna be discussing and talking about or should say the topic is this should anyone uh give up their lifetime Medicare supplemental policy? Okay we have a couple enrollment periods every year so uh sometimes people consider that so we'll talk about that in detail uh on our program on Monday should anybody give up their lifetime Medicare supplemental policy so if you want to be on the show Monday please uh let us know we'd love to have it have you appreciated all the callers today that number is 833 824 2004. Again one more time 833 824 2004 give us a call we'll look forward to seeing you on Monday