Your Medigap Rate Just INCREASED - What Can You Do?

Medicare School Daily airs Monday–Thursday, 11 AM–12 PM CST.

Book a call-in slot for upcoming shows here: https://medicareschool.com/medicareschool-daily/

Call in directly to the show at: 833-824-4004

For immediate Medicare enrollment assistance, call our team at 800-782-6676

-

Rate increases catch a lot of people off guard, and the frustrating part is that most people do not know why it happened or what they can do about it. On today's Medicare School Daily we are getting into all of it.

We will talk through why Medigap rates increase, what is likely driving yours, and what your real options are moving forward. Things like how your plan is priced, whether switching carriers makes sense, and what underwriting could mean for you if you decide to shop your coverage.

If you just opened a rate increase notice or you have been watching your premium creep up over time, this is the conversation you need to hear.

We look forward to taking your calls!

Transcript

SPEAKER_05 0:03

Thank you for joining us here for Medicare School Daily. We're so happy that you're here. If you're confused by Medicare, if you're confused by Social Security, or if you just want to make sure that you are getting the most out of your Medicare benefits, you're in the right place. If you need help with your Medicare benefits at any time, uh, you can call in to our office 800-8782-6676, 800-782-6676, and you can talk to someone on our team. When you call in, you're going to be talking to someone that's been personally trained by my dad, Marvin Music, who's the nation's leading expert and educator on all things Medicare and Social Security related. So take advantage of that opportunity. If you want to call in today and get your question answered by Marvin personally, I encourage you to take advantage of that. The phone number for this uh call in is 833-824-2004. 833-824-2004. And when you call in, we're not going to try to sell you anything. There's nothing to buy. We just want to make sure that you get your questions answered so you know what you need to do. We run this show every single day from Monday to Thursday, 11 a.m. Central to noon, and we'd love to talk to you. So your Medigap rate just increased. What can you do?

SPEAKER_02 1:20

All right. Well, I think first off, let's uh make sure everyone's real clear on um why rates go up. Everything goes up, and that's because of inflation. Uh so if someone's on a Medicare supplemental plan, they ought to expect some type of a of a rate increase. And we do know that uh you may experience uh uh rate increases more frequently, more drastically than than others. So one of the things that matters uh to us and to you would be uh to make sure that you go with a company that uh has tended to be historically rate stable. Now, there's no way we can guarantee you how much they'll go up and how often, but it is uh possible for us to look back the last, usually, five to ten years and show you exactly how your company has adjusted. So I want to make sure everyone knows rates are going to go up. Uh even Medicare advantage plans uh go up because their max out-of-pockets raise. So uh inflation is a reality that you have to deal with. So that's the reason they go up. So how often? Well, the majority of uh Medicare Summental plans are going to raise your rate uh at the policy effective date. So if you start a policy uh July 1, you're gonna get a notice about 60 days before July 1 letting you know how much your uh policy is going to go up. Now, there is one carrier that doesn't do it uh at the anniversary date. They actually do it in the spring of the year, and that would be United Healthcare. They just decide that they're gonna do uh increases that way. Uh so if you're on a meds up plan right now, you can expect it to go up some uh amount on an annual basis. So as uh your rate adjusts upward, sometimes it gets to a place where you're uncomfortable with those premium increases. So you do have some options. Uh you're able to um uh uh move that uh uh plan you have to another company. You may not only move to another company, but also you may want to change plans. So uh right now I'm on a G plan. If I wanted to move, I could move to another company's G plan or I can move to an N plan. So go down a little bit of benefit, and that would allow you to save some money. Uh now sometimes uh we'll have people that want to move, but we can't improve your position, meaning everyone's going everyone's going up, and so it could be that you're still with uh the the right company and the right plan. Uh and so you can move like to like, uh, that's uh G to G, or maybe move to uh from a G to an N plant. Uh and so uh uh most people are gonna have to qualify to make a move like that. So if you live in a state where we have to go through underwriting, then we're gonna ask you some health questions, we're gonna check your medications. Uh but as long as you're generally healthy, uh we're typically able to find another carer that uh uh then can save you money. And people ask me all the time, Josh, uh would you move for how much money? Well, my my rule of thumb is if I could say $20, $25 a month, I'd be moving for sure. Uh if it's five or ten dollars, probably wouldn't worth not worth the hassle. But another reason that I would suggest you moving if we can save twenty to twenty-five dollars a month is because uh the group that you went in is beginning to get smaller. Uh people pass away, people get off the plans, and so that group uh is uh uh shrinking. And so the more that it shrinks, the less stable your rates will probably be. And so what we want to do is to give you the best opportunity to have stable rates. So let's save money, $20, $25 a month, sometimes $50 to $100 a month. Uh that's very possible. But we also are resetting the clock. Uh you may be 68 or 69 or 70 now. And so when we uh do a new plan, you're gonna go in primarily with probably healthier, younger people, maybe 65. And so it is worth your time uh to try to improve that position.

SPEAKER_05 4:43

All right. So uh I was out last month at the Medicare's conference, and I was standing in the back of the room. They people were talking about Medicare, the guys on the stage were talking about Medicare supplements and like what they're doing. And um there was a guy that I stood next to, he was with the uh the Department of Justice, and he was one of the guys that like kind of went down this whole skin graft thing. Do you know much about that? He's talking about the pre-authorizations? No, the the fraud that has existed in original Medicare. So he was telling me they've gone from $400 million of spending, $390 million of that Medicare would spend on skin grafts for like diabetic wounds and ulcers and all these things to $10 billion in 2024. And all of it's fraud, almost all of it. Right. Yeah.

SPEAKER_02 5:33

That's why they had the pre-authorizations on skin graphs. That's all I was saying. Exactly right. That's why they had to do it.

SPEAKER_05 5:38

But he it was just interesting talking to him because they kind of have to go in and investigate and figure out is this fraudulent or not. But I mean, things like that, I I kind of wanted to talk about like why med subs have gone up a little bit more lately than historically. So I'm assuming things like fraud, because Medicare is gonna pay their part and then the supplemental plan is gonna pay the difference. No supplemental plan is gonna go in and be like, oh, is this a fraudulent case or not? They're just gonna see Medicare paid, so we're gonna pay it. Right. Right. Which is one of the beauties if you have a Medicare supplement plan is that the insurance company isn't haggling over whether or not it has to cover it. If Medicare pays for it, then your Medicare supplement plan is gonna pay the difference. But like in this scenario, people abusing the system, you know, fraud has caused these Medicare supplement plan loss ratios to go up. Right. And a loss ratio is insurance jargon. It's basically like the amount of money that a Medicare supplement plan gets in in premiums from all of the people that are paying for this plan, minus the amount of money that they have to spend on claims, right? That's called that loss ratio. And for a long time, um, you know, they were running, they they they were spending 85 cents of every dollar, and that's kind of where they can maintain their operations at like a 15% profit margin. But I I just I'm just curious, like other than fraud, which has caused their spending to go up without any net benefit, like the consumer base isn't getting healthier because it's fraudulent, right? That's what's caused these Medicare supplements to kind of go up because they've increased their spending just to keep up with what's going on. So what else is there?

SPEAKER_02 7:20

Well, it would be uh just high use of plans. Uh we know that even though we've been uh out of COVID for a couple of years, uh uh there's there's been a lot of people who delayed uh procedures. There's people today, Josh, that uh are still working and have a high deductible plan at work, maybe five or six thousand dollars. So what they're doing is they're delaying uh getting those surgeries. And and the primary ones would be knee, hip, and rotator cuff surgeries. And so they they're on Medicare, been on Medicare for a month, and then they're in the operating room. And so, yeah.

SPEAKER_05 7:49

Well, we talked to Yeah, I think her name was Mary last week, and she was trying to decide do I put off surgery and do I not retire, or do I just go ahead and go to Medicare so I don't have to pay my $6,400 deductible to get the knee replacement or hip replacement. Exactly right.

SPEAKER_02 8:06

Yeah. So inflation, uh the fraud, uh, waste and abuse within the system, and then uh uh people delaying services.

SPEAKER_01 8:13

Trevor Burrus, Jr.

SPEAKER_05 8:13

Everybody blames it on COVID. I mean, we're four years past that. How is that a thing still? Well, I think you know we can all like point to this big pandemic that is causing Medicare supplements to go up. Yeah, rate increases.

SPEAKER_02 8:26

Yeah, rate increases this year would not be related to that. I'm saying when we we those that when we saw increases 22, 23, 24, uh it's still people are uh you know back to getting uh normal services. And so I don't think now it's that. I think it's primarily inflation, fraud, as you mentioned, and delay. Um I I would say, you know, when someone delays uh a knee replacement or hip replacement, uh, you know, those are those are expensive operations.

SPEAKER_05 8:52

What have you ever looked up a medical inflation chart? You probably have. I'm just curious like how that compares to just regular.

SPEAKER_02 9:00

Yeah. I I think the last time I looked at it was like 10 to 15 percent or something like that.

SPEAKER_05 9:04

So I want to go back to just everyone's options if your medsup has gone up. Um So you you said you said you could let's a lot of people are on a plan G. Right. Right? So if they're on a plan G and they want to go to another plan G. Yeah, right. It's great coverage. That's what I meant to do. The vast majority of people are on that. So what do they have to go through underwriting, or is it only if you switch plan letters?

SPEAKER_02 9:28

Unless they live in a birthday rule state and there's only about a dozen of those today, then yes, they're gonna have to go through underwriting. So when I was saying like to like, what I was simply saying is if you're on a G plan, you can move to another G plan. Okay. Uh and and you can have to go through underwriting. You will. Right.

SPEAKER_05 9:42

What if you go from G to N?

SPEAKER_02 9:44

Same thing. You're gonna have to, and unless again you live in a birthday rule state. Okay.

SPEAKER_05 9:48

Now there's what are the birthday rule states? Do you know?

SPEAKER_02 9:50

Well, yeah, I pretty much I do. Yeah. I mean California, Oregon, Washington, Idaho, Nevada, um, Oklahoma, Louisiana, uh, Missouri's anniversary rule, same king, same thing.

SPEAKER_05 10:00

Anniversary rule just means instead of on your around your birthday, it's the anniversary of the pause. Policy. Right. That's when you have this special time. Now, people in these states, you know, and it's kind of like touted like, oh, you know, this is a great thing. What ends up happening in these birthday rule states is overall, it's probably not a great thing. It can feel great for you perhaps individually, but you're going to pay more for your Medicare supplement compared to a lot of other regions that don't have this.

SPEAKER_02 10:29

Well, Josh, I'm a great example. Okay. I live in Missouri. It's not a birthday rule state, but it's anniversary rural state. My Submanital Plan G cost me $212 a month. Okay. Where we set today right across the state line. I mean, like like 12 miles away. 10 miles away. Well, but yeah, I mean, I I live almost on the state line, so but I live in Missouri. So we're in Kansas in our home office here, and uh that same plan would be at least sixty dollars a month cheaper. Trevor Burrus, Jr.

SPEAKER_05 10:52

Yeah. So this idea of like, oh, we want to and a lot of the It helps people that are unhealthy, uh, but it doesn't help the masses. Well, and so well, it becomes unstable. So yeah, it helps in the short term. Because what ends up happening in these birthday rule states, right, is the insurance carriers are being forced to take on business for people who want to switch. And generally that business is unhealthy, right? So they're picking up extra claims, and now that makes that whole medical loss ratio get out of whack. So we get notices pretty frequently from, hey, this carrier, so it uh what happens, this just happened in Indiana. Um, the uh the uh uh you know, they passed some legislation said, hey, we're gonna add this this rule, which you know everyone seems like excited about, and then carriers are like, oh, we don't want that business anymore. So they just like pull out of the state or they say, hey, we're gonna limit you know people's ability to get this. It's just I think at the end of the day, it becomes a not a net benefit. And I I was talking to um a guy that owns an insurance company a month or two ago, and he said the it's the advantage plan companies that are behind all of this lobbying at the state level to get these birthday rule issues passed. Why? Or not birthday rule, but guaranteed issue rules passed. Why? So that people they can pull out of a state, people get on these well, no, let where am I going with this? Um I had that train of thought and then it just totally lost. Why would they do that?

SPEAKER_02 12:19

Well, I guess they would do it because then people will go in on advantage plans knowing that they can get off whenever they want to. That's what it is. That's what it is.

SPEAKER_05 12:25

Okay, so let me go with that. Okay. So it's the advantage plan companies that are like lobbying to get these special rights for people so that they can get the unhealthy people off their plan. So they fake because an advantage plan, and again, they're not like the big bad wolf, but sometimes they can kind of be the big bad wolf in certain situations. And so they're they're saying, hey, let's let's lobby, let's make this opportunity for all of our sick people instead of saying on our plan, eating into our loss ratios, let's give them a special right to get on a Medicare supplement. And so they just end up hurting that system.

SPEAKER_02 13:00

That's right.

SPEAKER_05 13:01

The ones who are on med subs.

SPEAKER_02 13:02

Yeah, I think the main thing is, though, is that you have to realize you don't have to be perfectly healthy to qualify. Now, if you're in the midst of being treated for cancer, you're not gonna qualify. If you're a diabetic that it takes uh, you know, 100 units of insulin a day or you've had diabetic neuropathy or retinopathy, you're not gonna get approved. Exactly right. If you had a heart attack six months ago, you have a fib right now that you're being treated for, probably not gonna get you get you moved. Uh if you have rheumatoid arthritis, spinal stenosis, uh uh psorotic arthritis, there's lots of things that you're not gonna get approved. But but the majority of people um are are gonna see we can get them approved. And that's really our job to help you. Uh we know what the carers are looking for. Give me give you a great example. We have a carer right now, only one, that will ask you, are you on uh medications for depression? And have you taken those meds more than two years? If so, you say yes to that question, your decline. They're not gonna take you. Uh we'll have a carer that will will take uh someone that has um osteoporosis uh unless you've had a fracture. Okay, some won't even look at osteoporosis, period. And so that's our job uh for you is to find a carer uh that will approve you. And again, we don't make the final decision, but we we do uh we'll do what we refer to as field underwriting. We're gonna ask all those questions to try to match you with the care that we believe will say yes to the application.

SPEAKER_05 14:19

All right. So if you work with our agency, our company, MedicareSchool.com, again, we you it doesn't matter, you know, wherever you live in the United States, we can help you. And you are assigned a dedicated client care manager uh when you become a client of ours, and that person is there to walk through all of these scenarios with you. You've maybe been on, maybe you signed up two, three years ago, maybe you're listening to the show, you're a client of ours, and you're two or three years into your med sub, you say, Hey, let's see if there's a way to save some money. Call in, we'll get you to your dedicated client care manager, and that person will be able to shop all of these options for you, show you ways to save money. Maybe you're not, you know, you have never worked with us in the past and would like to work with us to switch your med sub. You don't have to wait until January 1st. A lot of people think, oh, I gotta wait until January 1st before I start or before I switch my Medicare supplement. There's no time period for doing this. You can do it whenever you want. And I would suggest doing it as soon as you get a rate increase notice if you're healthy.

SPEAKER_02 15:19

I think another thing to add to that, Josh, is that if someone uh feels like we can they want to do this and we can get we all feel good about the application, meaning we think we can get it approved, go for it. And the reason I'm suggesting you do that is because um uh there's no harm done even if you were to get denied. Now we're not gonna submit someone that's in the midst of cancer treatment, or you know, you just you have a uh a um uh defibrillator uh implanted or uh a pacemaker. We can't get those through. But if we feel good about it, there's no harm done. You're we're not canceling your present policy. Uh that's not gonna happen until we get approval. So once you get to the case, once you get your new cards.

SPEAKER_05 15:56

Yeah. That's when I always tell people to cancel.

SPEAKER_02 15:58

And then we're gonna cancel it. But there'll be no overlap either. So if we made an application today, uh we were gonna ask for an effective date probably often. Yeah, or yeah, June 1, maybe July 1. But there's plenty of time uh to make that happen. So we'll go through underwriting, we get approval, then you can cancel the old policy, and the new one goes into effect.

SPEAKER_05 16:15

And most carriers now do uh automatic approval. I mean, there's a few that don't. But they're going to, you know, you put in your social basically, and it runs uh medical information bureau check, it runs what's called a Milliman RX poll, and it just says like, what is this person's health conditions? Are there any red flags? If there's not, the application's approved instantly, you know right away.

SPEAKER_08 16:38

Right.

SPEAKER_05 16:38

Um that's about 60% of the time, and then about 40% of the time, uh, if it's not uh well about 20% is automatically approved, 60% goes through, then that other 20% has to go to a human underwriter, and underwriter is just a big term that's just somebody who's looking at your health situation with their set of eyes and saying, do we want to accept this person or not? And uh then they'll make that call. But for most people, you know, if you call in, we can probably tell you in 10 minutes if you are able to save money. Right. So phone number to call in if you would like to do this, um, or if you're new to Medicare, it's time to get set up. Advantage plan, supplemental plan, plan G, plan N, drug plan, anything you want, uh signing up for Medicare, signing up for Social Security, filling out Irma paperwork, all of those tricky government forms. Our team uh we'll do that for you. Happy to assist you, it's no cost. The phone number's 800-782-6676, 800-782-6676. Uh call in. You're gonna be connected to somebody who's right here in our office outside these studio doors. Um you're gonna be talking to someone who's trained by Marvin. We've uh helped uh 75,000, 80,000 people um enroll in Medicare so far, us and our team.

SPEAKER_02 17:54

And I think I want to add, Josh, you know, when we started this business, well, we started 17 years ago, but Medicare is 15 years ago, uh, we determined that we were going to do everything possible through the whole process. And so that's why we studied this out for you, so that you would understand, hey, you don't have to go through this alone. I am amazed at how many people get wrong information from Social Security offices, uh uh, you know, thinking it's going to be accurate. And sometimes it is, but sometimes it's not. And so what we will do for you is to make sure the A and B and the Social Security and all these other decisions you have to make, you have great advice, unbiased advice, so you can make great decisions.

SPEAKER_05 18:34

Okay, let's talk to Joel in Indiana. Joel, welcome to Medicare School Daily. What questions do you have, sir?

SPEAKER_03 18:41

Okay, uh, my the best known partner, Kelly, has her insurance through the Healthy Indiana plan. Now, because that's a government subsidized plan, if she turns 65 in February, will she be able to stay on that plan, or does we need to find a different plan?

SPEAKER_02 19:04

Okay, let me ask you this. I am assuming it is not an employer-provided plan. Is that correct?

SPEAKER_03 19:09

No, it's the state of Indiana. Oh, okay, like an affordable tariff. Yeah.

SPEAKER_02 19:13

Yeah, they have they have a state exchange.

SPEAKER_05 19:14

Okay, state exchange, okay.

SPEAKER_02 19:15

Exactly right. And so, Joe, what no? What she's gonna have to do, what you're gonna have to do, is uh she's going to have to go on Medicare because all the that's what she planned on doing. Yeah, exactly. And that's the right thing to do.

SPEAKER_03 19:29

So that that plan will wage sign of a plan then on Medicare.

SPEAKER_02 19:34

Exactly right. Now, Joe, is she on uh Social Security yet?

SPEAKER_03 19:39

No, no, she won't be going on social security. I think uh I've talked to you guys about that before, like three months before she turned 65.

SPEAKER_02 19:46

Okay, is that when she wants to start her Social Security at 65? Yes. Okay. Okay, good. Yeah, actually, you can do it four months uh if you're gonna uh tie it in with the Medicare and Social Security. And three months is fine. Yeah, four and three months is fine as well. I'm just saying to you, uh, when we're doing Medicare only, then uh we we can you can only do that uh three months prior to your birth month. But if it's a social security application, then uh you can do it actually four months in advance. Okay.

SPEAKER_05 20:13

However, that four if you start doing everything four months in advance, that would be November. You are right in the annual enrollment period, which means it's it's gonna be a disaster. Yeah. So you may you may wait until just right after that ends, December 7th or something, December 8th, to do it all. Because everything kind of slows down, take a little bit of time, enroll. Yeah.

SPEAKER_02 20:36

And and Josh, I agree with you. I think that's right. But let me say this I I think most people uh are are uncomfortable waiting. Sure. So if you're comfortable waiting, Josh's advice is is accurate. But if you don't, you don't feel good about it.

SPEAKER_05 20:49

She'll do it online, right? Yeah. The application. Yeah, she can. So then really, what's the first day of her window that opens up to do all that? Yeah, well, it be October 1. October 1. So here's what you could do, not to jump forward into like giving you advice and instructions right away, but you got to do my Medicare. So that's fine. So maybe you do it, maybe maybe it's like this. Go ahead and get her enrolled and apply for Social Security and Medicare it after October the 1st, then the card will come four or six weeks later. And then when it's time to set up the supplement, the advantage, all that, you know, you could wait till after December 8th if you want. Just take your time. Or do it right away. Just saying it's busy.

SPEAKER_02 21:30

Yeah, a lot of people think that because we're at that time we're going through the open enrollment season that you have to do it. But she's coming in because she's turning 65. So it has nothing to do with the October 15th to December 10th.

SPEAKER_05 21:40

December 7th deadline ain't gonna apply to her. Yes.

SPEAKER_01 21:44

All right, yeah.

SPEAKER_03 21:45

Thank you very much, guys. You're welcome, Joe. We appreciate the call. Nice talking to you. Okay, bye-bye.

SPEAKER_05 21:52

All right, let's talk to Susan in Illinois. Hello, Susan. Yes, hi hi, welcome to Medicare School.

SPEAKER_06 22:03

Um well recently I've been looking at my budget since a lot of things are more expensive these days and I was I was um getting curious about the um Medicare A and B and wondering why we have to pay for that when it seems like the advantage plans cover everything we need.

SPEAKER_02 22:26

Okay. Are you on uh assignmental plan right now, Susan?

SPEAKER_00 22:31

Yeah, I'm already on I'm already on um an advantage plan.

SPEAKER_06 22:34

I'm just curious.

SPEAKER_02 22:35

Okay, well, in order for you to have an advantage plan uh to qualify to enroll into one, you have to be enrolled in A and B. Uh that's the way the system works. And so uh the advantage plan is available to you only because you have A and B. So what's going to happen is A and B actually is not paying for any of your bills. They pay no doctors, no hospitals at all. Your advantage plan is responsible to do that. Well, how do they fund that? Well, uh they're getting about anywhere from $1,200 to $3,000 a month from the A and B system. That's how advantage uh plans are funded. So you're paying part of that, general revenue is paying part of that. Uh so that's the that's the way the system works. So the advantage plan has you covered, but again, they're getting their funding from the government, and uh uh and and again you're helping uh participate in that funding by paying your your Medicare B premium. Does that make sense to you?

SPEAKER_05 23:25

Yeah. So if you were to drop if you were to drop A and B, uh you would no longer be able to have that advantage plan. It would go away.

SPEAKER_02 23:34

Exactly right.

SPEAKER_05 23:34

That you would get a notice in the mail and it would say, hey, you've been disenrolled from this advantage plan because you no longer are enrolled in Part B.

SPEAKER_02 23:42

Yeah, that that insurance company is not paying that uh uh out out of the kindness of their heart. They're paying your bills because they're getting m money from Medicare, for which you know you're you're paying some of that through your Part B premium. Susan, any other questions that you have about that?

SPEAKER_06 24:01

Um not about that, no.

SPEAKER_02 24:03

Okay, anything else?

SPEAKER_06 24:05

Um, yeah, actually, um I'm moving out of state, and um I wanted to know what like what to expect and what step I need to take.

SPEAKER_02 24:13

Sure. And w when when are you planning uh to move and where are you moving to?

SPEAKER_06 24:19

Um just uh to Missouri in about a month.

SPEAKER_05 24:22

Okay, very good. You're moving from Illinois.

SPEAKER_06 24:25

Yeah.

SPEAKER_05 24:26

Okay. Uh is it just like uh just a few miles or do you do you know how far? Yeah. Where do you live?

SPEAKER_06 24:34

Uh just across the river. It's very close.

SPEAKER_02 24:36

Okay, so I understand. So uh what's going on? Let me ask you this first off. Uh are you right now on Medicaid as well or just Medicare only? Um Medicare only. Okay, okay. So uh can I assume that you're not going to apply for Medicaid whenever you get to Missouri? Would that be true?

SPEAKER_06 24:56

Um I might try again.

SPEAKER_02 24:58

Okay. Okay, so so let's do this. Let me answer your question if you decide to not apply for Medicaid, because there there are definitely options that they're they're different. So uh it sounds like to me you like an advantage plan, it's working for you. So what you're gonna do 30 days before you move, or actually 60 days, well, let me say it this way, 30 days before you move and up to 60 days after, you qualify to change your Medicare advantage plan. Uh so let's say your your move date is gonna be, you know, let's say you know, July 1. Uh then actually any time after uh June 1st, uh all the way through the end of August, you can move uh to a different advantage plan uh and because you qualify for what we refer to as a special enrollment period. And so it sounds like to me that's what you'd want to do. Now, if you know your zip code that you're going to move to, we actually can look up all the plans in advance. And we would be delighted to do that for you. Uh look up your doctors and your your hospital choices, all your medications, so that that that can be set up in advance so that when you move, uh everything's done. If you don't do it in advance, again, you still have that 60-day window um uh you know to be able to pick out that advanced plan that's gonna be in your your best interest.

SPEAKER_06 26:08

Okay.

SPEAKER_05 26:09

What m what advantage plan are you on right now?

SPEAKER_06 26:13

Um at an um um something enhanced or something like that?

SPEAKER_01 26:20

Yeah, yeah, and it has several plans. So uh that and that's why. Do you pay a monthly premium for that plan?

SPEAKER_05 26:28

Uh I think I've a very small like $37 a month.

SPEAKER_01 26:34

$37 a month?

SPEAKER_06 26:36

I think I get help from the state, so I don't I don't think I pay that much.

SPEAKER_02 26:40

Okay. Okay. So yeah. Then you you must be on Medicaid right now, then in Illinois. Would that be correct?

SPEAKER_06 26:48

No, I'm not on Medicaid.

SPEAKER_02 26:50

Okay. Okay, but the state's helping you with that premium.

SPEAKER_01 26:53

All right. No, no, no problem. Um Yeah, so it yeah, I think the advice is good. And when are you moving? She said the next 30 days.

SPEAKER_05 27:00

30 days, yeah. Yeah, if do you have our office number? Because you can call, chat with somebody on our team, and then they can say, okay, what are the plans that you're gonna need to switch to? And they can kind of advise you even on if you're gonna apply for Medicaid, if there are plans that coordinate really well with that and get you a bunch of extra benefits. Right.

SPEAKER_02 27:17

Yeah, because Susan, if you get just a traditional uh Medicare Advantage plan, there are several available in your area. But if you do end up being able to be eligible for Medicaid, then like Josh said, you'll be able to have several other options available to you that actually will be a little bit richer in benefits.

SPEAKER_06 27:35

Okay, yeah, I know how to get a hold of them.

SPEAKER_02 27:38

Okay. Sounds good. Okay, give us a call. We would love to help you.

SPEAKER_06 27:43

All right, I will.

SPEAKER_02 27:44

Okay, thanks for calling.

SPEAKER_06 27:46

Thank you.

SPEAKER_05 27:49

Okay, let's talk to uh Paula in Tennessee. Paula, can you hear us? Welcome to Medicare School Daily.

SPEAKER_07 27:56

I can. Hi, how are you?

SPEAKER_05 27:58

Good. What's your questions?

SPEAKER_07 28:00

My question is is I have been on SSDI and eligible for Medicare since I was 30 years old, but I did not get on it because my husband had um employee coverage, so I was eligible under that. Now my husband is looking at retiring. And when I got on the Medicare website, I am eligible for the Medigap called FG, all of them. And when I look at those, it's like an extra 600 or more dollars a month. But if I change my age to like 65, then it's only like a couple hundred dollars a month. So I'm wondering, you know, why is it more for somebody who's in their 50s than 65? And if I take the Medicare Advantage plan, which doesn't cost anything at this point, um when I turn 65, will I have to get medically, if I want to go on Medigap at that point at 65, do I have to get medically approved for that?

SPEAKER_08 29:12

Okay.

SPEAKER_07 29:12

And will it still cost a lot more at that point? Or is that something that ha does something else change when I turn 65?

SPEAKER_02 29:20

Okay. Well, you've got a couple great questions there, Paula. So first off, you ask why does it cost more? And the reason is because uh federal law says this that insurance companies do not have to make Medicare supplemental plans available to people that are less than 65 years old, meaning they're coming into Medicare because of disability. So federal law says they are not required to do that. So most states follow those kind of rules. They don't require carriers to make those policies available to you. Some State Commissioners say no, you have to make those available, but you can charge whatever rate you want to. Uh and so that's what is happening in Tennessee. Tennessee says uh that we want you to make those available, but but they don't put a restriction as to how high uh the premiums can be, which means the insurance companies don't want that kind of business, so they really priced it so high, so you won't take it. That's what is happening. So again, Federal law says don't have to do it. Some states say you can, but charge what you want. Now, uh there are some states, you're not in one of them, that actually will not allow the insurance companies to charge uh uh any more than what a normal 65-year-old person would be would be charged. Some allow it, but they limit it. So the point is there's, you know, we have 50 states, so every rule, every state is gonna be a little bit different. And so you live in Tennessee where they're they're available, but they're very high. And so the majority of people that would be in your position then would go ahead and do kind of what you're thinking, and that is go ahead and get an advantage plan. Because the time you pay five or six hundred dollars a month for a med-sup plan, now we're looking at six or seven thousand, you can get on an advantage plan that has a max out of pocket less than that. Um so that probably will make sense for you. So that's question number one. That's uh that's the why behind it. So then you ask about turning sixty-five. What will happen then in Tennessee and frankly every state, you get to totally reset the clock poll. Uh it's as though you weren't even on Medicare when you turned 65. Uh and so now you can get any Medicare supplemental plan, they cannot charge extra, you'll get the normal 65 rates, and you will not uh have to medically qualify. Uh because what happens around your birthday from your birthday, uh, whenever that is, give them what's what's your birth month? It looks like September?

unknown 31:32

Okay.

SPEAKER_02 31:32

September 19th. Okay, 1973. So you're gonna be 65 then. So we're talking um what uh sorry about that. Wow, you have a ways to go. You said 1973?

SPEAKER_01 31:45

Yes, I got 12 years.

SPEAKER_02 31:46

Okay. So exactly right. You have 12 years. So when that comes in 2038, um, what will happen? Uh you can submit a Medicare supplemental application three months before you turn 65. And that insurance company then has to approve the application, you'll get normal 65-year-old rates. Uh, they'll not rate that up. And then 9-1 of 2038, uh you'll be able to uh get uh your supplemental plan. Okay, that's why it works, just at normal rates. Okay. And so right now, if you did decide that you wanted a Medicare supplemental plan, uh Josh looked this up. You can get a supplemental plan in in your zip code for $363 a month. $363. Okay. So you can get it. And and again, there's no medical underwriting because what's gonna happen? I'm assuming that right now you have Medicare A only. Would that be correct?

SPEAKER_08 32:39

Yes.

SPEAKER_02 32:40

Okay, good. So when you set up your B, now you're gonna be able to um uh you know get one without underwriting because you have six months of your B date, but because of your age, you're gonna have to pay that basically the surcharge uh that the insurance company um is adding to that because of the risk that's involved.

SPEAKER_04 32:59

I wasn't paying attention to that. Did you walk through L564? No, we haven't talked about that. Okay.

SPEAKER_02 33:04

So uh anyways, let me ask you this, because I think it's important for you uh and and really everyone that would be listening today. So the the group plan that you're on right now, uh are there more you know, your your husband's employer, do they have more than a hundred employees?

SPEAKER_07 33:19

Yeah, they have thousands. Thousands. Okay, figure it out. So you're good.

SPEAKER_02 33:21

Yes, thousands. Here's why I'm mentioning it. Let's see if you said no, Marvin, uh there's only 50 uh employees. Well, that could be problematic. So uh when someone is on disability, what happens is there there's different rules. When when when when we when we're not on disability and we have an employer plan that is 19 or fewer, we got to go on Medicare. Um but we're on an employer plan with 20 or more, then we don't have to do anything at all with Medicare. But when we're on disability, the numbers are different. So if we're uh on a on a group plan where there's a hundred employees, excuse me, 99 employees or less, we have to go on Medicare. 100 or more, we don't have to. And I'm sharing that with you. It doesn't really necessarily apply to you, but we have people I know that are listening that are on disability, and so the rules are different. Now, for you, uh, you're gonna be able to come into Medicare, no problems, no penalties whatsoever. Has he set his retirement date yet?

SPEAKER_00 34:17

No.

SPEAKER_02 34:18

Okay. What do you think it would be approximately? Just so I'll give you a quick example. Just give me a date.

SPEAKER_07 34:24

Well, I I I actually think it's gonna be two years, two years from now.

SPEAKER_00 34:28

So it's a ways out. Okay.

SPEAKER_07 34:30

Yeah, but I've been looking into it because one of the other things I would like to share is that I had to get the form from the from his previous four employers from over the last because I've been qualified I've been qualified for over 20 years. I could have gotten it.

SPEAKER_02 34:49

Yes, ma'am.

SPEAKER_07 34:52

As a 30-year-old, I wasn't thinking about, oh, well, I need to get this documentation.

SPEAKER_08 34:57

Right.

SPEAKER_07 34:58

So that's kind of a scary thing. If you're young and disabled and in the same situation I am, make sure you're saving your taxes and maybe you can get that form filled out early.

SPEAKER_02 35:09

Right. And that's very, very smart. Yeah, good good for you.

SPEAKER_05 35:12

So uh so you're saying you did get them all feedback. She keeps getting the L564s. Yeah, you're very smart. You're the one percent.

SPEAKER_07 35:19

I've got three of the four done right now. And I had to actually talk to a supervisor about getting the forms done early. And so I'm gonna take them to social security office and get them in my file. But I'm only missing two months.

SPEAKER_02 35:36

Yeah. All right. Well, that sounds good. So uh let's just say it's gonna be June 1, 2028. Let's just go out. Uh a couple years. So what's going to happen is um uh you're going to 90 days prior to when he's gonna lose his plan, then you're gonna get that final L564 filled out by his pre, you know, his present employer, uh, and then you'll submit that along with that the form called the CMS 40B. And that 40B is a real simple form. You use it to tell Medicare when you want to start your benefits. So if I want to start July 1, I put on the my 40B, please begin my Medicare Part B, um, uh July 1st. So those are the two forms that are necessary for you to come in um uh and uh have your you know your um special uh enrollment. Now once you hit 65, you wouldn't have to do that, of course. Uh you know, you're you're you're you're gonna it sounds like you're gonna uh be on Medicare uh prior to that if he's gonna just uh work two more years. So you'll have your A and B, but then it will automatically reset so that when that application goes in to get that med SUP at 65, that that uh underwriter is going to know exactly what's going on. You're in your initial enrollment period two. We call it the IEP two. Um so that's the process. So you've you've you've made a real good decision, uh Paula, by getting those L564s. It's real smart. Good job.

unknown 36:53

Okay. Okay.

SPEAKER_02 36:54

What other questions do you have? Yeah. Yeah. Anything else at all? No. Have you?

SPEAKER_07 36:58

Yeah, nope, that's it. I'm just glad to hear that I can change at 65.

SPEAKER_05 37:02

Yeah, yep, absolutely. For sure. And if you need help, obviously comparing those advantages plan options. Uh we would love to help. We're uh able to uh do a lot of business with clients in uh Tennessee. So uh let us know if we can help you sort through all that. Oh, great. Yeah, love to help you. Okay. Okay, take care and appreciate the call.

SPEAKER_06 37:21

Bye.

SPEAKER_05 37:23

Bills that show up in the mail after you've been on Medicare can be confusing. You get explanation of benefits, you get, you know, it says this is not a bill, then you get other bills, and then maybe you have a deductible, maybe you're asked for money, a copay at a doctor's office, and you're not sure how all this fits together, what do you pay? Maybe it didn't even get to submit it into the right plan. There's a lot of confusion that surrounds bills that you receive, especially when you're first starting on Medicare. So tomorrow we're gonna walk through that. You're gonna learn what's important, what's not important, what you should set aside, what you should pay. We'll go through the most common scenarios of bills that uh show up in your mailbox uh and when you're asked for money. So join us tomorrow and we'll help clear up all that confusion.