Unexpected Medical Bills On Medicare - DO THIS FIRST

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Unexpected medical bills can be frustrating, especially when you thought Medicare was supposed to cover the service.

On today’s Medicare School Daily, we’re talking about what to do first when a bill doesn’t look right, common reasons Medicare bills happen, and how to better understand what you may actually owe.

We’ll also walk through situations involving claim denials, provider billing errors, coverage confusion, and where people often get stuck.

If you’ve received a medical bill that caught you off guard, this is a great conversation to join.

We look forward to taking your calls!

Transcript

SPEAKER_03 0:03

There's two types of bills you get when you are on Medicare. And today we're gonna go through those. We've got some actual bills uh ready to kind of walk through, and we're gonna show you uh what to pay, when to pay, and how to pay it. Welcome to Medicare School Daily. My name is Josh Music. I'm joined here in the studio by my dad, Marvin Music. And whether you're just starting Medicare or you've been on it for years, or maybe it's time to start Social Security and you're not sure exactly how to do it, welcome. You are in the right place. So in just a moment, you're gonna learn if an unexpected bill comes to you, how to handle it. So if at any point you have a question about your situation, maybe you have a question about Medicare or Social Security or retirement, or you have a story to share, something that went great on Medicare or Social Security, or something went really wrong. We would love to hear from you. Answer your questions, hear your stories, because we all get a little bit smarter when we talk to people who go through things. Um you can call into the show. The phone number is down there at the bottom of the screen. It's 833-824-2004, 833-824-2004. We'd love the chance to connect with you. Um, you can have all of your questions answered. We're here every day, Monday to Thursday, 11 a.m. Central Time to noon. And it's really an opportunity for you to get your question answered by the nation's leading expert and educator on Medicare, and that's my dad, Marvin Music. So don't make a mistake, don't make a wrong decision. Call in and get your questions answered. If you're turning 65 andor maybe you're over 65 and you're just now starting Medicare, you probably need someone to help you compare your plans and get enrolled in the right coverage. Because at the end of the day, like whenever you have been on employer coverage for the last 20, 30 years, you were probably given two or three options that you chose from and you made that choice. Well, now it's time to go on Medicare. Not only are there uh tricky government forms, deadlines, penalties, things you don't know that you don't know, there's also probably 30, 40, 50 options that are available to you. And there's also um plans that will serve you well for the long term and plans that are a little more short-term oriented. If you need immediate help, I want to invite you to call in to our office, Medicareschool.com. You're gonna be talking to somebody that's been trained by my dad. They are equipped and able to compare the options that are available to you. They're gonna put in your medications, you're gonna analyze uh your doctors, your health situation, your budget, your finances, all of these things um will be taken into consideration so that you can make sure that you're on the right coverage. Um, you don't have to mess up a government forum. You don't have to miss a deadline, you don't have to make a Medicare mistake. But if you do this process alone or you just call an 800 number off some screen, off some TV commercial, you risk making a mistake. That could end up being a lifetime uh penalty or stuck in coverage that you don't understand with no way out. So if you want help, um, our services are free. Love for you to call in the phone number to call into our office to schedule an appointment. Um you know, whatever state you live in, uh, we're able to serve all 50 states. Call our office, 800-782-6676. You're not gonna be shipped off to the other side of the world to some uh person who doesn't speak English natively. You're calling our office right here uh in the Midwest, where in Kansas City, Missouri, and we would love to help you. Uh the cool fit Okay. Is that good enough?

unknown 3:29

Yeah.

SPEAKER_00 3:30

I think you repeat the number.

SPEAKER_03 3:31

You just call in 800-782-6676-800-782-6676, and you will get five-star service and not only service for now, but service for life. Uh when you become a customer, you are assigned a dedicated client care manager. And this is someone that it doesn't matter what happens, you move across town or move across state lines, um, you have a billings issue, a claims issue, you lose your ID cards, your premium goes up. Whatever it is, we are here to help you. And you've got a relationship with someone that can hold your hand for life. So I encourage you to call in and get your Medicare situation sorted out in a way that makes sense for you. Uh, phone number is 800-782-6676.

SPEAKER_00 4:12

Now, as we look at the bills that you're going to encounter on Medicare, uh, there's two types. One, of course, would be uh paying for Medicare itself. The second type of bill you'll see will be for your healthcare services. So uh, in regards to uh paying for Medicare, the majority of people are gonna have Part A at zero premium because as long as we have 40 quarters paid in the tax system, we never pay a premium for part A for the rest of our life. But Part B is not going to be free unless you are on Medicaid. And so the majority of people are not, and so you're gonna have a premium for uh Medicare B. And so right now, uh the majority of people are paying $202.90 a month for their Part B. And so that is based upon income. And you've probably heard me talk about this before, but just real quickly, Medicare every year sets thresholds. And so if you stay below the thresholds, uh then you don't have an additional surcharge. If we're above the threshold, uh, as we had a caller earlier, that was um above it, uh, you don't have to pay the surcharge. So the thresholds this year for a single person uh would be um $109,000 modified adjusted gross income. For a married couple that file a joint return, uh that is $218,000. So again, below $109 or below $218, depending upon how you file your taxes, you're not going to have an erment. Now remember, when they establish part B's, they're always looking back two years prior. So are you on Medicare 2026 or looking at 2024? And so we're gonna have to pay for a Part B. And so the base is $202.90 a month. Now, if you're on Social Security, uh that $20290 is gonna come out of the check. There's no problem that you you have no issues there, there'll be no uh problems at all with that, because it has to come out of the Social Security check. But here's the issue when people are not on Social Security now, what you're gonna encounter is they're gonna bill you for your Part B premium. Uh and so the way it works is this uh you have some options for paying your Part B premium. Number one, you could be billed directly. Your very first bill, if you choose to be billed directly, is gonna be anywhere from two, three, four, or five months worth of Part B premium. It's very random. Uh when I got my my first bill, it was for five months of Part B. Uh, and so once we get that first bill, we're gonna pay that bill. And then after that, we're gonna be billed on a quarterly basis. So now, so if you don't want to be billed quarterly, what happens? You have two other ways that you can pay for your Part B. You can uh uh uh do it online uh through Medicare.gov, or you can set up what is called easy pay. Now that's what I chose to do. I wanted to do the easy pay. I gave uh Medicare uh a routing number, an account number, a name of my bank, and so every month they go in on the 20th of the month and uh uh take a withdrawal uh to cover my premiums. So again, uh we're on Social Security. B comes out of the check. If not, uh direct bill, uh pay it online through Medicare.gov, or uh you can set up an ACH uh called Medicare Easy Pay. And so that that's that's all about our part B. Now I want to clarify something for those of you that have ERMIS. Uh I have an IRMA, uh, I'm above the threshold. And so what happened, in fact, I brought the bills into the studio today uh when I uh uh first went on Medicare, which was in January. It took a couple months before um I actually started getting billed for my ERMIS. Uh and so I started Medicare in January, and I think by March I was actually getting bill for my ERMIS. But here's what's interesting. Uh I just got my very first bill for my D-ERMA. It just came in in the mail. In fact, I went online and paid it. And so it was five months uh because my drug plan, I went on Medicare in January, but my drug plan started in February, and so they sent me a bill for February, March, April, May, and June, five months of IRMA. Now, because um it's five months, they would not uh uh draft it under my checking account. Uh so I actually had to pay that direct. So when you're on the Medicare Easy Pay, everything is fine as long as it's just one month at a time. But because my my IRMA for the drug came in later, uh I had to actually pay that. And so all I'm trying to teach you is this uh when you have an IRMA, uh it can be very uh very random. Uh you you one month you uh may get a bill for two months of IRMA or none, or and like I had on D, it got five months, and just that just came in. And so you just simply pay the bills, and then eventually the dust will settle and everything will be accurate. I have followed through many of these bills in my career, and they're always right. They're a little hodgepodge when we have an IRMA, uh, but eventually it will be accurate. So that has to do with Part B. Now let's talk about other kinds of bills we're gonna get, and that's for our health care services. Now, uh the the bills for these are going to vary. And so what happens if you decide to be covered by Medicare A and B with a supplemental plan, uh then that billing process is gonna look differently than if you decide to be covered by an advantage plan. So let's talk about advantage plans first. They're a little bit easier, and then we'll talk about how supplemental plans work. So if you decide to be covered by an advantage plan, it is a pay-as-you-go system. So yes, we're enrolled in A and B and we're gonna pay our B premium, but now what's gonna happen is I'm responsible for copay. So if I go to the doctor, uh it may have I may have a $20 copay or a $50 copay, but I'm gonna pay that at the point of service. And those copays that I pay at point of service will actually be listed on my card. Now, sometimes the Medicare Advantage Plan for a primary care doctor is a zero copay, so you don't have to worry about it. But if it's a specialist, it's gonna be probably somewhere between $30 to $50. And again, you'll pay the copay. So let's say you go in for an MRI or a CAT scan or a PET scan, that copay could be $250. You'll write a check at the point of service for that particular service. If you go in for physical therapy, normally it's a $40 copay. So every time you go in, you're gonna pay for that. And so the issue is this on Medicare Advantage Plan, that pay as you go system, you're paying it at the point of service, and then the balance of that bill then is then sent to the advantage company, and then they're gonna pay that provider the rest of that. All right, so that's advantage. Now, when it comes to supplemental plan, totally different system. So when I go to the doctor and I've I've been uh to the doc, I had a detached retina before I went on Medicare, but I've had to have several follow-ups after um uh the surgery, and now that I'm on Medicare, uh what happens is I go to a provider, and so far I think I've uh uh been to the IDoc three or four times. Uh I uh see a dermatologist, I've been there to get you know some I'm fair complected, so I had some spots removed, and I also went to the chiropractor. So what happened is other than the chiropractor, uh all I did was I gave them my cards. I gave them my A and B card, and then I gave them my supplemental card. I did not give anybody any money whatsoever. Uh why? Because in that system, what happens is uh the provider will bill Medicare, Medicare pays its part, and then sends the balance over to the supplemental company. And so I did get billed uh from providers for up to my B deductible. I have a G plan. I have to pay the first $283. I've already done that. And so when I got my bills, Medicare showed me exactly uh what they would pay and what they wouldn't pay. And so they did not pay the first $283. I'm uh I'm responsible for that. So my checks for $283 will be written to uh those providers. Then after that, I'm done. I've already met my B deductible, so I am truly done uh for the rest of the year. All right, and so when you get statements, and I've got a couple of them here, it will say this is not a bill, and so don't pay it. Uh this is just simply Medicare saying, here's how we process the claim, and here's how much went to your deductible, and here's the uh provider that's actually going to bill you. And I went back through mine, it was exactly $283. It was a combination of bills uh to the doctors, but that's all they had to pay. Now, here's what's interesting. When I went to chiropractor, my chiropractor actually takes Medicare. But what he does is this uh he made me pay uh the full amount that that Medicare um actually would would would pay him. In fact, I'll just grab it for you right here. So I had an adjustment by my chiropractor, and uh the Medicare approved amount on that adjustment was $35.62. That's all Medicare would pay. And so what happens, it's $0.80.20. So the full bill was $40.95, $40.95. He made me write him a check uh for that full amount. Then when he processed the claim, he let Medicare know that I had already paid. So here's what they did. They took that $40.95 charge. It's on the B side, so it was $80.20. So Medicare covers 80%, and then um uh then I was responsible then for the 20%. And so what they did is um uh they actually then uh because I paid the full amount, uh they sent me a check uh for uh that 80 percent that they would pay for. And I actually got the check right here. If you uh uh can see us online, I've got it, I've got it right right from the government. And so that doesn't happen often though. But whenever you're required to pay for service uh at the time, which a chiropractor will often do, then uh the the the the the claim is filed with Medicare, they're gonna pay their part, and then again I got I got a check for the part that I went ahead and had to actually front uh to the chiropractor. So very interesting the way that happened. But normally, whenever you're seeing a doctor and you have original Medicare and a supplemental plan, just give them cards, they'll file the claim, and eventually you'll get a bill up to your B deductible if you have a G plan, and then you're done. I want to clarify one more thing, and that is some of you have an end plan. So the way that works, once you have met your B deductible, now you're responsible for a $20 co-pay, and then Medicare will pay the rest. And so we have that 20% coinsurance, and so your part of that will be a copay of $20, and then again, Medicare will pay the balance of that. So that's for those of you that have an in-plan, and if you ever excess charge on end plan, then of course that would come out of your pocket as well. So the whole billing system uh with Medicare is different than the advantage. Advantage, you pay at point of service, with normally on a uh a Medicare supplemental plan, you don't do that, except, of course, in the case of a chiropractor, uh, and then that that that uh claim is filed with the provider. I mean, the provider files a claim, Medicare pays first, sends a balance to your supplemental company, and again they'll pay everything except for, of course, that B deductible if you have the G plan. All right. So again, it can be complicated. I tell our clients all the time, please don't pay any bills until you actually get a statement saying this is a bill, because you're gonna get a lot of statements that are gonna say this is not a bill, as Medicare is processing that, making sure that you know exactly how that claim is going to be handled.

SPEAKER_03 14:25

Let's talk to Abraham in California. Abraham, welcome to Medicare School Daily. What questions do you have for us, sir?

SPEAKER_01 14:34

So I have the one of the questions I have is the the difference between Medicare Advantage and Medicare supplement as far as cost goes per year. What would the average cost difference be?

unknown 14:49

Okay.

SPEAKER_00 14:50

Sure. Okay. Well, when you have a supplemental plan, what you're doing is uh you're paying uh a monthly premium, whether you use your services or not. Uh so we can't really compare apples to apples by saying what's it gonna cost me because I don't know what kind of healthcare services you're going to need. So let's talk about how a supplemental plan will work for you. Uh Josh will look up some prices for you, but you could get either a G plan today or an N plan. That's the majority of plans that people are getting. And so you're gonna pay a monthly premium for those. Again, we'll we'll give that number to you. Um are you single or are you married?

SPEAKER_01 15:24

I am married.

SPEAKER_00 15:25

Married. Okay, very good. Uh so when you go on Medicare, let's say are you gonna go on Medicare in 27 or or or this year? 27. 27, okay. That's what I thought. So in 2027, uh the Medicare is gonna look at your 2025 modified adjusted gross income. So uh will you and your wife be below $218,000 a year in income?

SPEAKER_01 15:46

Or above and adjusted gross?

SPEAKER_00 15:48

Modified it, yeah, modified adjusted gross. So it would be adjusted gross plus uh your tax exempt interest if you have any of that. So $218,000 will you be above that?

SPEAKER_01 16:00

Yeah, I would say it's gonna be close, probably above that slightly.

SPEAKER_00 16:03

Okay, very good. And so we don't know for sure exactly what that number will be next year. It probably will be maybe $222,000 or whatever. But let's for now, just to keep it simple, uh let's just assume that well let's let's let's keep it below the number, and that'd be below $218,000. You would pay the base premium for your Medicare. Uh that's $202.90. So whether you have an advantage plan or a supplemental plan, we have to be enrolled in A and B. So that's the $202.90. Now, uh the very first level of IRMA for this year is between $218 and $274. And so if that's the case, then you'd pay an additional uh basically $95 extra. Uh that would be for your part B and D. So we'll take the $20290, we're gonna add $95 to it. So right out of the gate, uh we're gonna be right at $300. All right? And so that's whether we go uh SUP or an advantage plan. So if the on the supplemental plan, now you're gonna pay a monthly premium for that. And Josh just looked some rates up uh in your area. A G plan right now is $145 a month, uh, and an end plan is $115. So let's just use kind of the the the worst case scenario here. Let's say you decide uh to go with the G plan. By the way, that's what I did, but I mean worst case meaning you know the highest premium. So we're we're we're at $300 for A and B and our IRMA, and we have $145 for that G plan. Uh so you have paid on a monthly basis about $445 a month. But you only have beyond that out-of-pocket expenses of of meeting a B deductible, and that B deductible this year is $283. All right. So let's just say it's $450 a month, and so that would be uh basically $5,400 for the year that you would be paying in B and IRMAS and your premium. Uh then you have a small uh deductible of $283. All right. Now now you also have a drug plan. Josh, do we have uh any zero uh zero drug plans? You have to have a drug plan in with this particular situation, and there are some plans in California that Zero to ten. Zero to ten dollars a month. So if you don't take very many medications, you'll probably get by uh with that kind of a plan. Did all that make sense, what I just shared with you?

SPEAKER_01 18:14

Yeah, my my wife takes uh GLP3, so we need to do that.

SPEAKER_00 18:19

Okay, very good. Uh and so um uh we'll we'll look and we'll look to see what what that's looking at. But you asked me to compare MedSup to a Medicare Advantage plan. So with the MedSup, we're paying a premium, uh, we're paying our Part B, and of course we we have a drug plan, but after that we have very little out-of-pocket. Now, if you decide to get uh an advantage plan, uh you're still gonna pay that $300 a month for the A and B in your and your Irma, but instead of paying a premium now on the advantage, you're just gonna pay as you go. It's a pay as you go system until you reach the max out-of-pocket for that year. And so right now the average max out-of-pocket across the country is about $5,900. And so you're gonna pay as you go. So you go to the hospital, probably costs you $400 a day. Uh you have an MRI, probably costs you $250 uh for each scan. Um a specialist visit, maybe $50. Uh and so the point is you're gonna pay as you go. And so I don't know what healthcare services you're gonna need. So if you need very little, uh then you're gonna spend uh not much beyond just you know being enrolled in A and B. But if you have lots of services that you're gonna need, you get some kind of serious heart issue or cancer or something, then you could spend up to that max out of pocket, like I said, about $5,900. And all I'm trying to share with you, it is truly difficult to compare apples to apples because we don't know what you what you're gonna need.

SPEAKER_01 19:37

But I I you cleared it, you you you explained it very clearly. I understand the difference now. Okay, um one other question. Um my wife is is um uh she'll be like 63 and a half when I retire, and she'll no longer have health insurance. What can we do to recover for the year and a half that you won't have Medicare?

SPEAKER_00 19:58

Okay, all right. So uh well, number one, you possibly could, most people don't, but you could Cobra that. Uh, she'd be eligible for Cobra for uh at least 18 months. Uh and so if if Cobra uh you know was it was affordable for you, that would be an option. Another option would be to uh go through uh the exchange and get uh just an individual policy uh uh you know through, I think California has its own exchanges. Some some states use the Federal Exchange and some use the State, but again, you could get those, those we call the Affordable Care Act plans. That would be an option. Another option that she would have, now with her being a diabetic, I'm not sure she would qualify, but there are some plans today that are off-exchange that do make sense. Uh they're just they're they're more affordable, uh, and they're they're more like a catastrophic type of insurance. So uh you you'd you're gonna have to you know pay for regular doctor bills and small stuff, but if you she had something major happen, uh then catastrophically it definitely would be covered. So that's the way you do it. An individual plan through the ACA, you could possibly Cobra, or just get uh a short-term medical policy for her.

SPEAKER_01 21:07

Okay. Can you give me a rough idea of what that would be monthly?

SPEAKER_00 21:11

No, I can't. And the reason because I I uh if does California Josh have its own exchange?

unknown 21:17

Yeah.

SPEAKER_03 21:18

So it also it's gonna be dependent on income and subsidy levels.

SPEAKER_00 21:21

Yeah, and he and he says he's above you know a couple hundred thousand. So you have to do that. But I will say this to you. Uh you you you're are you gonna retire uh in and go on Medicare in February?

unknown 21:31

Yes.

SPEAKER_00 21:31

Is that what you said? Okay, sounds good. So uh what will happen is um uh around December, the the rates for 2027 should be out. Uh and so you'll be able to get those exact rates.

SPEAKER_03 21:43

And truly it just depends on uh can you get a subsidy or not if you end up going through the exchange uh so if you retire and your income goes way down, then there's a really good chance you can get a subsidy and get that massively subsidized. Yeah, because that's a how that is gonna be possible. At that time, I think we should be able to help your spouse. as well even kind of navigate through those situations. So yeah.

SPEAKER_01 22:04

Yeah, that would be great. Yeah I I it's uh it's uh foregone that I'm going to go with you guys. I've been listening to you m for a long time Marvin. Okay.

SPEAKER_00 22:13

Uh but uh so we've seen people pay we've seen people pay as you know little as $300 a month and and sometimes $1200 a month for those individual plans. Uh but we're we will shop that for you make sure you have some good direction you know for the short term until she's ready for Medicare. And the the what is the income qualification for the uh the exchange is it it doesn't go back a couple of years it goes to the year you're in the exact right it'll it'll be the year of and you can even you can even project that you just want to be accurate of course and it is household income yes sir okay okay that makes sense all right sounds good thank you I appreciate your help all right well hey really good to talk to you we look forward to serving you in the future thanks Abe Yeah thank you Mark thank you guys you know one thing interesting about those quotes in California Josh is the difference between G and N was only thirty dollars a month you know so the majority of people in that scenario would probably go ahead and take the G. Uh that way they don't have copays along the way and don't have to worry about excess if indeed that were to occur. But not a big difference. And we know in some states we're seeing $100 a month. That's a little bit different but using when it's low like that and that's exactly why I went with the G because in Missouri it was only $35 difference. And I thought well for you know $400 a year it's worth it to me not to be concerned about any copays uh or excess charges.

SPEAKER_03 23:40

Yeah. Okay so just a little I I looked up kind of the the subsidies. I didn't have it ready for when he was on there but it you know it's it's based on the federal poverty level. So for a two-person household um a hundred percent of the federal poverty level is twenty one thousand one hundred and fifty dollars so if you are under a hundred and thirty eight percent of that so let's call it let's just let's call it what is it twenty one fifty times one point we'll just call it three seven so if you're under twenty nine thousand dollars worth of income you would generally be eligible for Medicaid right so from 138 to 150% so all the way up to about 32000 ish there's not really the you're they're not gonna have to pay anything for the plan it'll be fully subsidized. And then it kind of steps up all the way up to let's say you're at um let's say you're at 6300 you know ish um they're gonna pay about 10% right yeah and then above 400% of the federal federal poverty level um there's no federal premium tax revenue exactly right so yeah 400% yeah in fact right now 93% of all people are getting some form of subsidy you know premium tax credit you know reduced cost sharing those kinds of things so yeah the majority So if you make oh if you're a two person household making over basically 85000 there's no federal premium tax credit for 2026.

SPEAKER_00 25:02

Yeah I was thinking it was 400% of the poverty level was a cap. Hello Glenn from Kentucky welcome to the show can you hear me?

SPEAKER_02 25:12

Oh I can hear you can hear okay very good Glenn uh what questions can we answer for you today sir okay um I've gone through your your video on applying for Social Security that YouTube you have put out. Yes sir and um um I'm I'm here to make sure um because I I'm not sure if I need special documents uh that uh social security is going to get for uh marriage license uh that nature and also the one thing as I was going through your video um I've already got Medicare Medicaid or Medicare Medicare and and all the supplements for that um but how do I get uh through that area where it's asking me for that information or can I just skip it?

SPEAKER_00 25:58

Okay okay well uh let's go back. So what you're saying you're you you're uh online and you're applying for Social Security is that correct I will be yes okay very good not right now okay well first off um are you going to draw benefits off of your own work record or off of a spouse my work record my just your work okay very good now are are you married or single? I'm married okay very good they they will still ask questions about your spouse because that um application is is very generic it's it's it's kind of broad brushed so you'll still have to answer the questions about your spouse and the uh when you got married and um uh uh uh you know the um uh income uh in when it when it comes to uh her situation that they're gonna ask you those questions but it's not gonna have really any bearing at all on what your Social Security income is eventually going to be. I wish they wouldn't ask about the spouse uh whenever you know you're gonna take your own, but they will do that. Now you're not gonna have to um uh provide any information about um you know like a proof of marriage uh that would only be for those that are going to take a spousal benefit. So if you're drawing on your own work record just answer the questions but there will be no proof of anything. I promise you there will not be. The other thing that you want to be um uh sure to do is uh uh they're gonna ask you uh you know are in fact are you still working right now or you you totally done working? I'm done working I've been retired for almost a year now okay very good all right so uh they'll they'll ask you some information uh about income but it's not going to matter because if you're no longer working uh that there's there will be no earnings test that will apply for you. So my whole point is you just answer the questions there'll be no proof of anything and then once you have uh completed the application when you push submit uh then um it'll of course it's gonna go into uh the Social Security system and then I would say probably roughly within maybe three weeks, four weeks possibly then uh uh a caseworker will actually reach out to you to confirm everything is accurate that uh it really was you it wasn't a fraudulent application. So that will be the process. Nothing other than doing it all online. Now when when do you want to start your benefits?

SPEAKER_02 28:11

As soon as possible.

SPEAKER_00 28:12

ASAP okay very good so if you went on there today and made that application uh then they're gonna give the option they'll give you actually a range of dates where you would like to start so if you decide hey I want my first check to be um uh in j in June then you're gonna start your benefits this month. Okay now it's possible that you're not gonna get a check in June because it may take them uh uh longer than that to actually process it but you would then get two checks in July and my point is that when you uh start your Social Security benefits whatever month you select that means you your your uh check will come the next month because Social Security benefits are always one month in arrears. So again they'll give you the option Glenn let me tell you what's gonna happen. They'll actually will when they give you the range of dates uh they will allow you to actually start uh your Social Security benefits six months prior to now. So you'll see that on there. So and if you decide to go ahead and start it six months prior what that means is that uh you're gonna you're gonna uh take a reduction of three percent okay three percent because it's a half percent uh you know on a monthly basis so uh in if you don't want to take a reduction then you do you do not want to do you know let them backdate it six months. Now some people do that because then they get you know a lump sum check of that six month period of time. So you'll have to decide that but if you don't want to take a reduction then I would recommend uh going ahead and say I'm gonna start my benefits this month and then you'll get your first check of course then uh during the month of June. If they haven't processed it by then again you'll get your June uh with your July check. So that's the way it's going to work.

SPEAKER_02 29:44

Okay. Okay. First of all, what what what what would you recommend? Would you recommend me going back to that 3% thing? Or and how do taxes come out? Because I know Kentucky doesn't take but what about federal?

SPEAKER_00 29:56

Yes yeah well uh as a general rule Social Security is not going to withdraw any taxes unless you fill a form out uh and let them know that. And I think that form is a a I want to call it a Daniel can you look that up? I think it's called the WV he'll we'll look it up real quickly but there's a form you have to fill out and send it uh to your local Social Security office or upload it in the SSA system for them to take taxes out. So but so otherwise you your your check is going to be gross. Yeah you have to initiate uh them to withdraw. So back to your question what would I do? It really boils down to um uh you know longevity of life we know that as you delay and of course you know you're you're um uh uh you know well beyond your full retirement age now so uh uh the the the longer we delay then the longer we have to live. So if you think hey I'm probably gonna live to be you know 85 or maybe beyond that uh then it is fine to go ahead and and uh not take the lump sum because if you live long enough then then uh you'll you're gonna get your money back because there's gonna be an increased benefit. But if you say to me, you know, I wouldn't mind having that lump sum to pay off debt or do something else with it, then there's nothing wrong with you know with taking that reduction. It really boils down to your cash flow needs and then also uh longevity that you expect. None of us know when we're gonna pass away uh but if you feel hey I'm I'm healthy I feel like I could live a long time uh then it would be nice to have that increased Social Security check for the rest of your life I have a follow-up question go right ahead go right ahead I I I uh uh I have a pension from UPS that I've been getting um is it is that is that involved do they they want to know that information yeah well you they're gonna ask you about about wages and so because that's a pension income it's really not going to matter so if they do ask you about income and you feel like you need to include that it's no problem because remember uh you your income really has nothing at all to do with your situation because again you're you're beyond your full retirement age now okay and so the only people that that uh take social security benefits uh prior to full retirement age are the only ones where their income is going to have any bearing and the and the only income that really matters is wages and you're no longer working. So even if they ask the numbers just go ahead and give them to them it's a non-issue for you because again you're beyond full retirement age so so how will they will they ask me if I have other income and then that pension would be that okay yeah what I think they're gonna ask you is um uh your your your working wages uh they're gonna ask you you know are you still working and if you're not then I do not believe that question uh uh will be required of you I am just saying even if it is put it in there don't worry about it uh because listen you're born at you're born in 19 uh 58 so you had you have 66 and eight months right so let me just let me just write this out real quickly so uh last year uh excuse me 2024 um you had your 66th birthday and then we had eight eight months to that so three four uh five six seven eight nine ten eleven so November of twenty twenty four uh was your full retirement age so any time beyond that um uh it there is no earnings test at all so trust me there's there's no worry for you whatsoever and again I don't even think they're gonna ask you on that application they have updated a lot of their applications lately so um uh I'm just saying the wages would be the only thing they that would even affect you and it's not going to because again you're beyond full retirement age.

SPEAKER_02 33:31

Okay okay so I think the other question I had pretended is if if for some reason um I wanted to take a part-time job or something um there is it unlimited amount unlimited yeah yeah you can make as much money as you want to make as much as that's right yeah ever since uh ever since November of twenty twenty four uh you you you can have unlimited money once we've hit our full retirement age month and year yeah you can you can make a million dollars a year won't matter it will have no bearing on your social security check whatsoever man you guys are awesome okay okay I have another question though yes sir go ready um what about those those Medicare food cards or something that uh you keep see I keep seeing things about sure out there are are those legit do you do you recommend it is that something that you what that would help?

SPEAKER_00 34:24

Well I I I here here's here's the way it works. If you are uh eligible for Medicaid uh then that's when those food cards can be attractive but if you're not eligible for Medicaid what's what's happening is if they're going to offer you a food card on a just a traditional Medicare advantage plan it's probably gonna be minimal amounts of money and you also have to say if they're giving me a food card uh where where that money that is coming from them uh how is that how is that uh benefit affecting the other aspects of my plan? And here's why because when it when a company uh gives somebody a benefit like that they are not doing this to be benevolent. What they're doing is they're taking some of the money that Medicare gives them on a monthly basis and they're and they're just simply repositioning that. So when you see those kinds of things what's usually happening is you're gonna have a higher max out of pocket you're probably gonna have higher copays and those are always going to be advantage plans. Now let me make sure I'm clear on this do you do you qualify for Medicaid? I am I don't even know how do you qualify well it's but it's gonna be based upon income uh for sure and and you did tell me that you're married yes my wife's not working she hasn't worked for years over 15 years. Okay and what what st what state are you in again Kentucky? Yes Kentucky Okay so I I would just say this I'd say roughly probably in that $25 to $30,000 if you're above that in annual income you're probably not going to qualify for Medicaid. I can't tell you exactly what it is in Kentucky but that's kind of the norm. Single people are going to be around $18 to 20,000 married people around that you know $25,000. So if you're above that you're probably not going to qualify for Medicaid. But those who do qualify for Medicaid if that's you then some of those extra benefits that are offered by the Advantage plan can be attractive, including the food cards and they have uh over-the-counter cards and so they they they throw in some additional benefits because there's money coming from Medicare as well as Medicaid. But if you don't qualify for Medicaid, I'm just trying to say to you that what happens is those advantage plans that offer some of those extra benefits, normally you're gonna see uh uh those plans medically for you know hospital choices and doctor choices and your your uh prescription drug coverage, some of those may not be quite as attractive. So I would not be lured in with food cards if it were me. Number one, I I would not get an advanced plan anyways but if you decide that is in your best interest, then what I would look at before I before I would look at food cards, I'm gonna look to make sure that my doctors are in the plan. The hospitals that I want to go to are in the plan. My medications are covered very well. A lot of times the perks are advertised but again some of those plans you're you're giving up good medical benefits to be able to get you know free gym membership or a free this or a free that I would rather not do that. I'm more concerned about hey if I got cancer how's my plan going to work so that's what I'd be paying attention to if I were you.

SPEAKER_02 37:36

Okay I got that covered under flag and what I say that that's good. Okay so answer that question. The other question I had um I had referred a friend a year ago and well apparently you're having issues with uh giving the um card or whatever for for giving a reference book yes where are you guys at on that?

SPEAKER_00 38:00

Yeah well we number one we would love to be doing it uh but the insurance companies said no they felt like it was too close to uh a kickback and it wasn't a kickback because the people that uh we paid referrals uh to uh your your friend did not even have to buy so it had nothing to do with that but that's the way the insurance companies saw it as though it was a kickback and those are not legal uh even though it wasn't a kickback that's the way they viewed it and so they they made us shut that program down and I am really sorry for that. We loved it we loved it and it was legitimate I mean we had uh uh attorneys that are in the you know Medicare world that approved the whole program but the insurance company said nope so we had to stop that so we regret it we'd love to do it but we just can't do it anymore at all yeah last I heard that did you are still in litigation or something when I last spoke with somebody a few weeks ago yeah and okay yeah and our attorneys are still looking at it for sure but in the in the interim we we had to uh uh discontinue that program okay wow this has been really good well glenn hey it's been really really good to talk to you as well sir so uh as you you know approach uh you know whatever you whatever needs you have please let us know if we can be of help to you further okay oh man I can't thank you guys enough man I I just praise God that uh I I you were around to help me and my wife yeah uh get everything set up like like you did all right well hey it's it really is our call too yep yeah well called I was I was what yes go ahead yeah you go ahead sir oh um well uh yeah I I wasn't sure how this call was really gonna go and then you know 15 minutes isn't a real long time I wasn't sure I'd I'd get everything answered but yeah uh uh you answered everything 110.

SPEAKER_03 39:55

Well good it's uh been my privilege to talk to you today Glenn anytime sir appreciate the call have a have a good rest of your day you too for now bye if you are thinking about getting on a GLP1 maybe help lose some weight help curb some appetite to help some other things that are going in your health there is a new Medicare drug plan or Medicare drug program that is starting I believe July the 1st that you may be eligible for. And so we're kind of exploring all this right now and we're gonna be sharing with you on Monday what all it's about, how you can take advantage of it, what you have to do how you have to be enrolled so that you can take advantage of this new GLP1 program that is coming. So join us and learn everything you know about GLP1s and Medicare on Monday