DON’T Take The Bait When You Turn 65

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Turning 65 suddenly comes with a flood of Medicare ads, mailers, phone calls, and promises that can make it hard to know what’s actually important and what’s just marketing.

On today’s Medicare School Daily, we’re talking about the pressure and confusion many people face when they first become eligible for Medicare, how to avoid getting pulled into misleading messaging, and what you should focus on instead when making decisions about your coverage.

If you’re approaching 65 or helping someone who is, this is a conversation worth hearing.

We look forward to taking  your calls!

Transcript

SPEAKER_00 0:03

It seems like everyone knows when you turn 65, and they start to fill up your mailbox with all sorts of mail. Or maybe you start to see a lot of TV commercials now that you're approaching Medicare. They also can target you on Facebook or Instagram or just about any place, letting you know, hey, you're 65. It's time to make some decisions. The problem is most of those advertisements and commercials are not designed to educate you. They're designed to get you stirred up. They're designed to get you scared, fearful you're going to miss something and make a mistake. And they're designed to get you to call an 800 number almost every single time. And we've all heard of the term bait and switch, and that's exactly what happens a lot. I can't tell you how many times there are commercials run for a plan that seems like, wow, that's gotta be the best thing ever. You call in and they say, ah, that's actually not available in your area. Let's get you to someone who can share with you what is available. Bait and switch happens all the time in advertising, especially in Medicare. Today, everything's gonna be slowed down. We're gonna talk about these most common bait and switch, and you're gonna learn how to protect yourself. Medicare is too important for you to make a decision off of a 30-second TV commercial. So stick with us here. You're gonna learn everything you need to know about how to see what is true and what is not true whenever you're first starting Medicare. I'm joined here in the studio by my dad, Marvin Music. If you guys have a question about your situation, welcome to Medicare School Daily. My name is Josh Music. This is my dad, Marvin Music. You have an opportunity to call in and talk to the nation's leading expert on Medicare education. And he's not gonna try to sell you anything on this call. So if you have a question, if you have a concern, a story you want to share, please call in and get your questions answered. No one deserves to be in the dark about something that is going to last for a long time. Like you're gonna be on Medicare probably 20, 30 years, and you deserve to have your questions answered, and you deserve to know what's going on. So if you're just starting Medicare, uh maybe you're just starting Social Security, you have a Social Security question, I encourage you to call in and uh do Medicare the right way the first time. You'll have all your questions answered from Monday to Thursday, 11 a.m. to noon Central Time, Monday to Thursday. So don't let that Medicare question go unanswered. Call in 833-824-2004.

SPEAKER_01 2:32

Well, Josh, as you know, I started Medicare uh just a few months ago, turned 65 in January. And what was interesting is uh I started getting bombarded with mail uh about six to nine months prior to turning 65. I actually had someone knock on my door uh a couple times, left a sticky note telling me to call them. So uh the Medicare market is certainly very, very aggressive. Wait, wait, d didn't that guy that knocked on your door, didn't we end up hiring him? Well, that was someone who called me. Oh, somebody who called me. Yeah, exactly right. But he did a great job in um presenting himself, and I said, hey, if you're ever looking for a a better career path, uh give us a call.

unknown 3:06

Yeah.

SPEAKER_00 3:06

So have you ever worked with a guy named Lucas at our company? No, he came because he harassed my dad.

SPEAKER_01 3:12

Exactly right. He called he called me and uh we recruited him. He now works for us and really, really a very good agent. So uh so everyone that's turning 65 is gonna get bombarded. You know, the list have been uh being compiled for years and years and years, and there's no way you can escape that. Uh they know about you, they know you're turning 65. And so you will be bombarded. Now, what's interesting, you're gonna notice that you're not gonna be bombarded about Medicare supplemental plans ever. Of course not. In fact, occasionally you may see a med-sub ad, but not generally. Uh so all the millions and millions of dollars it's spent on advertising for Medicare. Oh, yeah, for sure. Is directed uh towards uh uh you getting a Medicare Advantage plan. Why is that? Well, because insurance companies make uh billions of dollars of profit, so that's what they want you to buy. And so there's basically two different uh uh tactics that are used. The first one that you're gonna recognize is uh they're gonna talk about uh perks such as uh food card, transportation benefits, um, uh dental, vision, hearing, uh, over-the-counter cards. And and all those uh really are legitimate, but the problem is the ones that are advertised are normally uh for people that qualify for Medicare and Medicaid. In our business, we call that a dual eligible person. It just simply means not only do they have Medicare at 65, but they're also on Medicaid, and that means there's more money that's available for the insurance company to spend on you. Well, the truth is most people are not on. What happens is most people are not gonna be on Medicaid. They don't qualify. Uh they make too much money, they have too many assets, and so the truth is uh you're probably not gonna qualify for Medicaid. Trevor Burrus, Jr.

SPEAKER_00 4:50

Generally speaking, uh what are the levels of assets and income? And I know it's very state to state, but I mean it's pretty low.

SPEAKER_01 4:58

Aaron Powell Right. Yeah. Yeah. It's definitely uh for a single person uh you would have to make uh eighteen thousand dollars or less in income. In annual income, exactly, right? And the majority of people, they make you know that much in Social Security alone. Right, right. Uh so the assets are going to be typically no more than $2,000. Uh so it's very limited. Trevor Burrus, Jr.

SPEAKER_00 5:16

Is your house excluded from that? Uh sometimes, sometimes not. Couldn't tell you. I think it's going to be a good thing. So if you're married or not. Exactly right. So basically what you're saying is like a lot of these things that are kind of advertised, you know, are bait and switch because it's, hey, you're not even eligible because you're not on Medicaid.

SPEAKER_01 5:35

So that's the first thing they're going to find out. Are you on Medicaid? When they find out not, they're going to switch you then to, you know, some other kind of a Medicare Advantage plan. But what what's their goal? Their goal really is not to make sure you get all those benefits. The goal is to make sure you pick up the phone and call them and give them the opportunity to be able to tell you some other plan that you would qualify for.

SPEAKER_00 5:53

Okay, so as a company, we obviously run advertisement. People maybe have found us through ads as well. Um so I mean, I I feel like somebody's going to end up helping you. Right. So how do how do they determine whether this is a bait and switch or not? And I'm not trying to derail your, so maybe we'll save that question for a minute. But I was just thinking, like, we have I've called into these numbers off these advertisements just to see what the experience is like. And you'll call in and they I've literally had it. I still remember I was on an entrance ramp because I was doing it in the car. On an entrance ramp uh about five miles away from the office, I called, um, or they call maybe they called me and they asked, um, hi, are you know you eligible for Medicare? And I was like, Yeah, probably soon. And they said, Do you have part B yet? And I said, Oh, no, not yet. I'm gonna need some help with that. And the person just hung up straight up. So it's like it's not necessarily bad to call the, but like a lot of the people that you're going to be calling, they may say, number one, the plant's bad, but they may also be not able to help. Yeah.

SPEAKER_01 6:52

My view is this they're looking for low-hanging fruit. They're looking for immediate sales because that's the goal. Um, and so now if you're already on Medicare A and B, that you know, then you're happy you're probably on A and B because you're on Social Security. But the truth is the majority of people are not yet on A and B because they're not taking Social Security yet. They haven't reached their full retirement age. Uh but uh I think what happens is you have to be aware of this is this is primarily uh ads and agents are all about Medicare uh advantage plans. Now you may want one, and that may be a wonderful fit for you, but it may not be. But the rarely will an agent today educate you about all your options. They're gonna educate you about the option that makes them the most money. And that's just the way the business works. And so these ads are designed to get people to call, and and and uh rarely uh are people going to take advantage of all those uh uh added perks. They just can't because there's not enough money available. That we need the Medicaid money in there as well, right? And so uh what you have to be aware of is that uh there's another uh and another thing you'd be aware of is that not all ads are about Medicare, Medicaid, but what they are almost always about would be HMO plans. And so uh you probably are not going to want to be on an HMO plan, maybe, but but but maybe not. And the reason they do this is because when you think about HMO plans, uh this is a very restrictive uh type of the network. And the reason insurance companies like HMOs is because they are able to control those costs more. They pay the hospitals less, they pay the doctors less. In fact, we will see, and you will see people that will, doctors that will take maybe a PPO plan, but not an HMO, because that reimbursement rate is so low. But again, what are the advertisers doing? They're advertising uh those plans where uh their HMO plans, and so uh when when the agent talks to you, uh they're gonna ask you about your doctor, hospital choices, and then what happens? Uh oh, they're not in network. So again, there's the switch. Now we're gonna move you then to a PPO plan. Doesn't mean that's bad, but again, you called in because you saw the benefits offered by an HMO plan uh and probably not gonna be able to um uh you know be able to be uh you know really taken care of well uh by that particular plan.

SPEAKER_00 9:02

I feel like another like bait and switch that would be pretty common is you uh super common. You go somewhere, some website somewhere, and you type in uh you know, it says get a quote. Maybe this could be for a Medicare supplement plan, it could be for whatever type of plan. Type in get a quote or see what plan is best for me, fill in your information thinking you're going to see a quote for a plan. And what do you see instead? It says, Oh, hi, a licensed agent will be in touch with you shortly. And then what happens? Then your phone starts blowing up because they took that lead and they sold it to 12, 15, 18 different people, probably at $50 a pop. Right? Maybe maybe that's a little aggressive, maybe it's 25, but they sold your name and information and really intent that this person's in market, like they're shopping for a plan right now, and you thought you were gonna get a quote, but instead you got you're gonna be harassed by phone calls or text messages or all these different things. Be very careful whenever you're on the internet searching around for information that it doesn't say in that fine print, hey, you know, we're gonna sell your information, that sort of stuff. It's very common. Now, there's a lot of good companies like ours, MedicareSchool.com, there's other um people in our business like ourselves that we don't share information. We don't sell information or anything. Anytime you sign up and say, hey, I want information on a plan or whatever it is, you're going to get it, and it's not gonna be shipped off to 50 different people that are gonna start harassing you. Right. Okay. Uh I want to I want to go back for a second if we can. Uh you talked about, you know, this this thing, and I don't know that people fully appreciate it. So you might see uh an advertisement for a plan um that's got all of these great things, right? You call in and you use the term HMO, right? And HMO is generally like a smaller group of doctors that you're able to see. And the other thing to know on an HMO advantage plan is if you ever were to go out of network, a hundred percent of those bills are in you. That's right. Right? You do not get any help from the insurance company. Yeah, you can, you're just gonna pay for everything, cash out of your pocket. So nobody does that.

SPEAKER_01 11:09

Let's share the exception. That would be unless you're in an emergency situation. Exactly right. Then you you're you're covered uh anywhere uh that takes Medicare. But if it's not emergency, not urgent care, then you have to stay in your network. Trevor Burrus, Jr.

SPEAKER_00 11:22

So you might see the b you might see these plans advertised, you know, thinking it's not so restrictive. You call in, find out it's restrictive, and you say, hey, I want a PPO plan. And maybe they have one, maybe they don't, but those benefits are probably not going to be as good as what was advertised.

SPEAKER_01 11:37

Plus, and also you're gonna have a much higher max out-of-pocket.

SPEAKER_00 11:41

Yeah, on a PPO. Well, and PPOs largely uh like they're they're really getting, I would say, even decimated financially in the Medicare Advantage Plan market and have been for the last couple of years. We're seeing a big shift, a very big shift for all insurance carriers who are offering Medicare Advantage plans to start to shut down their PPO plans. So if you want to be able to go out of network, um it I it seems like the trend is really the the PPOs may not be around for a whole lot much longer, and maybe there'll be a rebirth five years from now. But these insurance carriers can't figure out how to make the financials work on a PPO plan, so they're cutting them way back and only pushing people into their HMO. So if you want to be out of network, the the the if you want to have the ability to go wherever you want, supplement plans are maybe your only option. The couple million people last year got booted out of PPO plans. They didn't they couldn't do anything about it.

SPEAKER_01 12:36

Yeah, yeah. The advantage company's goal is to make their 15 percent margin. And it's too difficult for them to do that on with um uh the ability for people to go out of the network on a PPO plants. Yeah, so they're just shutting them down. So you may see an ad that looks very attractive, and I understand that. And then another issue that we see is when they'll advertise, they'll say we offer dental benefits. Well, the truth is uh the majority of plans today only offer um uh preventive benefits. Now, if you're on Medicaid, uh they'll throw in, you know, for $3,000 worth of additional uh comprehensive benefits. But on the average uh advantage plan today that would be a PPO plan, you're gonna have uh uh uh preventive services only. Yeah. So you're not covered for extractions or fillings or root canals and crowns and those types of things. But you see them advertising, oh, we'll we'll give you dental, and that's that's what your mind goes to. It goes to, oh, they're gonna give me a dental plan. Probably not. Probably not. And they'll uh oftentimes talk about hearing aids. And the hearing aids, I'm not saying it's not legitimate, but it's definitely gonna be network hearing aids. So it doesn't mean just because there's a hearing aid you want it's gonna be covered, probably not. Uh so you just have to be aware of it. Again, they're trying to get you to get an advantage plan and do so uh in a very uh you know quick call. Uh in fact, we have people who work for us that uh have worked in call centers that push advantage plans, and they they told us they get bonused if a call was completed within 30 minutes or less. You know, who cares uh uh if you really got all the information you needed, but uh that agent was able to successfully write a plan um and uh got a bonus on that. That's really a shame.

SPEAKER_00 14:09

Trevor Burrus, Jr. If you've had an experience like this, maybe you called in, got hung up on, called in, got bait and switched, called in, got wrong information, or experienced some sort of a high pressure sales environment, uh please call in. Let us know. We'd love to hear about that experience so we all can learn. If you want to work with a company that's not going to do it, in fact, I sit in uh leadership meetings every week, and I I one of my main things I tell people is, hey, we've got to figure out how to make sure that we talk to people long enough. I hate it when people will rush through phone calls. I want you to, when you call in, for you to be on the phone for an hour. Why? Because it means you understand what you're getting. It means you've had time to sit and think about okay, what is it, what does this option look like? What does this option look like? You don't need to spend, you know, 50 hours figuring out Medicare, but you don't need to spend five minutes either. And a lot of these call centers that you call into are pushing you to go quicker and quicker and quicker. If you want help comparing a Medicare Advantage plan versus a Medicare supplement, if you want help, um the other thing uh as a company, when you call in, you're not going to get pushed just to a Medicare supplement. We're going to show you both of those options because a Medicare Advantage plan is right for some people. It is. Uh about one out of every four people that we help end up with an advantage plan because it makes sense budget-wise. It makes sense for maybe where they are or what state or whatever their health situation is, it can make sense. Uh but you deserve to be able to call in and talk to someone who isn't just going to push you one advantage plan option or two advantage plan options. You need to look at the whole gambit and compare supplements versus advantage. So if that's something you would like to take advantage of, you can call in to our office. It's 800-782-6676, 800-782-6676. Uh, when you call in, you're gonna be talking to somebody right here in our office in Kansas City. Uh, you're not gonna be shipped off to somebody on the other side of the world where you can't understand their language. You're gonna call in, get somebody that's been trained by my dad, and you're gonna have confidence that you've gone through your options and you understand. And so whether it's enrolling in Medicare A and B, all the way down to filling out late enrollment penalty paperwork or filling out Irma appeal paperwork, uh, you're gonna have somebody by your side to help you uh walk through that entire situation.

SPEAKER_01 16:27

Yeah, we think you deserve uh a thorough experience. Yeah. Not some hurried rush-through, uh write a quick plan and then have doubts about it. We want you to have confidence in the plan that you select. We're we're just simply here to educate you, show you your options and the consequences uh that you'll have to face with those options, and then you you choose the plan. And we're gonna service you regardless. Yeah. Whether you take an advantage plan or a supplemental plan, hey, that is totally your decision, but you are gonna need someone to help you down the road. Plans change, things happen. Uh there's just issues that occur. Insurance is not perfect. Uh it's not. But we are here to help make sure that this journey of yours is um enjoyable, not terrible.

SPEAKER_00 17:07

800-782-6676. If you need help uh talking with one of our people one-on-one. If you want to uh call in, get your question answered by Marvin. Uh phone number for that is 833-824-2004. We're gonna get to Keith. Uh talk to Keith in Connecticut. Keith, welcome to Medicare School Daily. Hi. How are you? Good. What's your question, sir?

SPEAKER_03 17:34

Well, first let me say thank you to both you guys, but especially to your dad. Uh I've learned so much about Medicare. I've sent all my friends and neighbors and colleagues to watch your videos. And I wake up in the middle of the night, you're on my Facebook. So God bless you. You guys are going to be able to do that. Sorry about that. Yeah, just click the feet, you know. No, no. I learned so much from you. I just God bless both of you for the great work you're doing, and and I really cannot under understate how much you're you're valued out in the street.

SPEAKER_01 18:08

That's kind of you. We appreciate the encouragement, Keith.

SPEAKER_03 18:12

So here's why I'm calling. Um last year, I I went on Medicare last year, so I I had my income from you know two years ago. I'm paying uh an IRMA. I got my welcome letter and I got an IRMA. But I stopped working in February of this year. I retired. So when I do this Irma form. Thank you, thank you. Now I'm I don't know what I'm bored. Yeah, right. It's something to keep me busy. Um what I'm confused with on this IRMA form is in my life-changing event happened in February of 26. And it was a work stoppage, obviously. But on the form, do I in in step two or step three? Do I put my in step two, do I put my 25 tax return numbers, and in step three I put what I think they are for 26 with my reduced income?

SPEAKER_01 19:05

Well, you can do that, but you don't have to. What you can do is just in in step two, go ahead and give them uh your 2026 numbers. You do not even have to complete step three. Um fact I encourage people, don't even worry about it. So the the point is So he put in twenty-six? Oh yeah. He can he can project he can tell them exactly what you're gonna make, or at least close to what you're gonna make in 2026, and they will look at that. Because that was your life changed that was your life-changing event. It happened this year. So don't worry about step three. Uh it really will not matter. Because what's gonna happen, and we as we roll into 2027, Keith, they're gonna look back at 2025 anyway, and they're gonna send you uh another IRMA letter because you're gonna come apply in 2025. So it's not gonna carry over. I wish the system worked that way. And by looking at the forum, you're you're thinking, oh, I'm I'm I'm appealing to this IRMA for two years. That is not reality. So just put in the 2026 and step two, leave blank uh step three blank, uh, and you should have no issues whatsoever. Okay, put down your life-changing event, February 2026. Uh, you know, however you file your, you know, was head of household, I mean, or uh, you know, married filing joint return or single, however you do that, uh, give them the new numbers and they will not hold your 2024 income against you. They will use 2026. And you'll win that.

SPEAKER_00 20:21

Um, yeah, and you also don't have to, some people kind of you know, do I have to submit pay stubs? Because on page eight it says an original signed statement from your employer, copies of pay stubs, blah, blah, blah. You don't have to do that, right? It says in the absence of such proof, we'll accept your signed statement under penalty of perjury, right?

SPEAKER_01 20:39

You're basically signing an affidavit when you signed the form. If you had proof, submit it. It's fine. Most people don't. But if you don't, don't worry about it. Uh you don't have to have any proof. You're your basically your signature is your proof that you're telling the truth, subject to you know, penalty if you're relying.

SPEAKER_03 20:55

And then what happens is when I file my 26 tax return and and and they call back in 28, they'll kind of check this to make sure I'm clearly accurate correctly.

SPEAKER_01 21:04

They will out. And you don't have to be to the penny at all, it's estimated. Just yeah. Are you single or married?

SPEAKER_03 21:11

I I'm widowed, so I'm single. But the thing is I'm gonna I'm gonna drop from paying almost $300 a month to going to $202, so it's worth even this.

SPEAKER_01 21:19

Oh, absolutely, sir. Absolutely. So you you have to fall below the $109, $109,000. I am. Okay, good. Yeah. And you'll you'll win it. They won't fight you. And if and if it doesn't go as I said, you call us back, okay? But I look again, I've I've got thousands of questions.

SPEAKER_03 21:35

I'm gonna call you during open open enrollment because you guys deserve my business. You you do great things.

SPEAKER_00 21:40

All right. Thanks. Now, did uh did you get set up on a supplement or what would you do in Connecticut? You're you're not gonna flight 65.

SPEAKER_03 21:51

We're blessed in Connecticut. We don't need a we don't need a physical to get on a supplement. Okay. And we don't need a physical to switch. Yeah, you're okay. So I went advanced. Okay. Knowing that I could move anytime regardless of my health conditions. It's so far in Connecticut, you don't need a physical to get onto a supplement. So I get advantage.

SPEAKER_00 22:10

There you go. Okay. Well, we'll be happy to serve you come October. Yeah. Let us know Keys.

SPEAKER_01 22:15

I appreciate the question.

SPEAKER_00 22:16

Bye-bye. All right. Bye-bye. Okay, let's talk to Mark in Georgia. Mark, welcome to Medicare School Daily. What Medicare questions do you have?

SPEAKER_02 22:28

Uh how do you determine what plan is best for somebody? Sure.

SPEAKER_00 22:35

Retire next year. You're retiring next year? Okay, congratulations. Yeah.

SPEAKER_01 22:39

That's great. Well, Mark, uh what I would 12 months, yes. Okay, very good. What what I would do is uh decide uh what I'd encourage you to decide w what what matters most to you. The some people uh what matters most to them is how much will it cost them on a monthly basis uh for their their premium, you know, their insurance uh plan. Others premium's not everything to them. It matters, it matters to all of us, and so it probably matters to you.

SPEAKER_02 23:08

But I think is a little bit of a concern, but not not a whole bunch. Not everything. Okay. Yeah.

SPEAKER_01 23:15

And and the reason for that, because once once you've decided that, it really, in my opinion, is very simple because there is no doubt in my mind that you will have better quality coverage if you have a Medicare supplemental plan, no doubt. And the reason for that is because you are not going to have to deal with any type of an insurance company interference. If you decide, hey, I can't afford a supplemental plan. And by the way, rates in Georgia are very attractive. Uh, but if you decide that you can't afford one, uh, do we have his zip code Josh can run one for you just real quickly? Now, when you're you uh it looks like you're born 1959, so you're retired next year, so you'll be 68 or 67 when you retire. You there? Yep, Mark, will you be 67 or 68 when you retire?

SPEAKER_02 24:03

Uh 67, almost 68, yeah.

SPEAKER_01 24:06

Okay, very good. Okay. Well, Josh, you can run you the one, but he's gonna run it for you. Uh so uh when it comes to people that decide that they they do not want to spend any money uh on an insurance premium, then they're gonna go with an advantage plan. Those who decide, yes, I'd like to have the quality insurance uh that comes with a MedSup plan, you're gonna have to pay for that. That's what I decided to do. I could afford the premium, but but I'm I'm getting a lot for the premium. So if you decide that uh you're willing to pay a little bit, then here's what you're going to get. Exactly. You're gonna go to any doctor as long as they take Medicare, which is 99% of all docs. You'll go to any hospital that takes Medicare, uh, and 100% of them do. Uh, you'll have a permanent plan, meaning it can never be canceled by the insurance company unless you don't pay your premium. Uh, and then you also have national coverage. So whether you're in Georgia or you're in uh you know Seattle, Washington, or you're in New York City, wherever, and something happens to you, everyone is going to take your uh uh uh A and B and your supplemental plan. So my point to you is that you have this awesome uh coverage, uh you know, a nationwide plan that can never be canceled. If you move, you take it with you. And so, yes, you have to pay a premium for that, but I think you get honestly a lot of bang for your buck. I think it's a great value. Uh if you say, nope, I don't want to pay a premium, then you're gonna have an advantage plan. Now you still have fine insurance, but it's not a permanent plan. Medicare advantage plans are are are only annual plans. They're always network plans. You're either gonna be an HMO or a PPO, and most of the industry now is trending to HMOs, which means what? You can't go outside of your network. If you do, you've got to pay for it. Uh and so uh what you're gonna see is that you have to say, what matters? Are you willing to pay a little extra to have quality insurance? All right. Let me let me just give you some prices real quickly. Right now, and I know you're not going on until next year, so uh these will probably be a little bit different next year, but right now the G plans in Georgia are for for is this a 67 or 68-year-old? Do you know?

SPEAKER_00 26:10

Uh just with his database.

SPEAKER_01 26:12

Okay, very good. Okay, so 67 right now. Uh the G's are right now a range between about $190 to $220 a month. That's the plan G. Your in plans are in the range of about $125 to $150 a month. So as you can see, they're about, you know, $60 to $70 less expensive on the N plan. And honestly, I think they're both very good. And with these kind of a price points, uh, if that $60 to $70 a month is going to be helpful in your budget, I would not uh discourage you for a second to take an end plan. Uh it's it's very close to G, just not quite. Uh so let's let's let's review real quickly. So, Mark, here's what happens. Uh Are you single or married? Uh single. Single, okay. So if you go on Medicare in 2027, they're gonna look back at your 2025 return. Now, we don't know what the 2025 numbers are yet, but but we can we'll go based upon what the numbers are today. Do you make uh $109,000 or less a year? Your income? Less. Less. Okay. So if you were going on Medicare, if you're going on Medicare right now, uh that part B premium would be $202.90. Let's call it $203. Okay? So you take your B premium, you take your supplemental plan, which again, G was in $190 to $220,000 you're in $125 to $150, and then you add a drug plan to that. Uh the drug plans, as a general rule, are very low cost. I'm on one that's less than $10 a month. That same plan uh throughout the country in some places is zero premium. So I I just want you to see you're looking here at about, if we go in an in-plan, you're looking at around that $400 a month range. If you do an in-plan, uh, you know, about uh $325 a month. Okay? And so if you said that's too much for my budget, then I would encourage you to do an advantage plan. You still have to pay that $202.90, but instead of paying a premium, you're just gonna pay as you go. Um go to the hospital, you know, you pay a daily copay. You see abesticist, you pay a copay. So those are copay plans. But here's what we know to be true. Uh if you had a serious illness, cancer, some kind of heart issue, uh, you will spend less money on your premiums for your supplemental plan than you will out of pocket uh on your advantage plan. That's a that's a stat that's been out for years. So if you can afford that money we just talked about, that's what I would encourage you to do. A lot of flexibility, in my opinion, much better coverage as well. Okay? Any anything else while we maybe on the phone?

SPEAKER_02 28:44

I have been getting treated for cancer. Do you look at that negatively?

SPEAKER_00 28:48

Okay. I it just it would just really solidify that decision to go with a Medicare supplement. Because the other thing that happens Yeah, you go with the Medicare advantage, you get stuck on it because of the cancer history for forever.

SPEAKER_01 29:00

Yeah. You can start your supplemental plan when you retire in a year uh with no health questions asked whatsoever, because you I'm assuming right now, do you just have A only? Medicare A only?

SPEAKER_02 29:13

I have just A.

SPEAKER_01 29:14

Good, good. So when you add B, what happens once you've set that date? Let's say you do it next year at this time, and we set a date of June 1 of 2027 for your Medicare B. During that window of time, uh six months before your B date and six months after, there's no underwriting uh requ allowed. The insurance company will approve your policy, even if you've had cancer in the past. Now, after six months of that B date, you would be in a mess because you would have to be cancer free and and uh cancer cancer free treatment free for it uh around three years typically. So I would encourage you if you can afford it, get that supplemental plan. You will you will not regret that.

SPEAKER_02 29:51

I think they're only gonna check me out like twice a year now.

SPEAKER_01 29:56

Okay, well, good, good. I'm I'm I'm glad you're so it's in remission right now. Is that correct?

SPEAKER_02 30:02

Uh from what the doctor told me it's completely they can't find any sign of it at all.

SPEAKER_01 30:08

Oh wow, I'm glad to hear that. Good for you. All right. Uh Mark, any other questions that you have for us?

SPEAKER_02 30:16

Uh no, I think I think I got a guy calling me from your school because uh Cohen?

SPEAKER_01 30:21

Jacob Justin Justin Cohen. Yeah, Justin is a great guy. Justin Cohen. Yeah, yeah, he's just one of our I mean, I I love all of our agents, but he is just uh been with us a long time. Actually, his wife works for us as well. Uh just just a great guy. Uh he'll he'll care about you, he'll be thorough. Uh you'll you'll see with m you know, all of our agents, we encourage him. There's no pressure here. Yeah, we're not gonna pressure anyone into anything. We're here to serve you.

SPEAKER_02 30:48

The one the one last question I got. Yes, sir. Should I decide to move to another state and I'd buy this supplement, does it just transfer with me?

SPEAKER_01 30:56

Yes, it does. Yeah. It's we call that portability. It just simply means you can take the policy with you. And uh and also the the premium could even if sometimes when people move away, their premium goes down, sometimes up a little bit. But you actually are in a state that's very unique. Uh you're in a state that's called issue H. By the way, I live in Missouri, same same way. And so rates are a little bit higher because of issue H. So what's gonna happen with you, uh Mark, is that uh your policy initially, when it's written, it's gonna be based upon your age. But in the future, it's never gonna go up because of age. Now, it's gonna go up because everything goes up, but the only way you'll see an increase um is when they take a group increase. And I'm uh I'm on the same type of policy as that as well. It's issue age in Georgia, uh, Florida, uh, Arkansas, and the state of Missouri. Those are the four states where issue age uh policy. So that's what you're gonna get. So you can take it with you, sir. That's the beauty. So if you decide to retire and move somewhere else, that submental plan is always yours for for life as long as you pay the premium.

SPEAKER_02 31:57

Oh, that's that's not a problem, I don't think. Good. I think you got me. Just been going, that's who it is. He I think he's gonna call me back. Yeah, he will. I think he's gonna call me back. Okay. Okay.

SPEAKER_01 32:10

All right. That sounds great.

SPEAKER_02 32:11

Hey, hey, Marvin. I appreciate you.

SPEAKER_01 32:15

Yeah, well, you're very welcome. Um our privilege to serve you as well, sir. We appreciate the call today.

SPEAKER_02 32:21

All right, thank you.

SPEAKER_00 32:24

Okay, now there is a uh medication that's really popular that I think has been having some recalls or something. Can you tell us about this?

SPEAKER_01 32:30

Yes. Uh it is um uh just recently uh there was an Indian manufacturer of a medication called mitoprolol susinate.

SPEAKER_00 32:39

That's super popular.

SPEAKER_01 32:40

Yeah, exactly. There's there's two types of metoprolol. There's metoprolol tartrate. People have to take uh those uh twice a day, but susinate is an extended release.

SPEAKER_00 32:48

Oh, okay. I didn't know the difference of that. I always knew we go type it in, I was like, okay. Okay.

SPEAKER_01 33:07

Uh what's also in risk about this medication is it improves the survival rate uh for those that have already had a heart attack. So very common medication. Uh and so what it does is it slows down the heart rate and um um yeah, very much.

SPEAKER_00 33:20

So if you're on metoprolol, do you need to throw it away? What's the like?

SPEAKER_01 33:23

No, no, let's talk about that. Well, it is this uh no, not at all. Okay, not necessarily. So the one that we call were uh um uh 25 milligram strengths. Uh and I'm gonna go ahead and say the lot number just so you know no one panics here. I want you to know exactly which lot of the. How do you find a lot number?

SPEAKER_00 33:39

Uh well is it on a pill bottle?

SPEAKER_01 33:40

It is yeah, it should be. It is two five one four zero eight five nine. Let me say it one more time. Uh two five one four zero eight five nine, twenty-five milligram strength um of um, of course, generic uh metroper law. And there was an expiration date on that lot of January of 2027. Okay. And what's interesting, I of course I read this stuff all the time, I would say um this is not uncommon. I probably at least once every other week we're seeing some type of a uh of a manufacture problem. So what they do, Josh, is they actually will uh randomly uh you know do tests on these meds, and this is the most common reason they recall them. It's called the dissolution failure. And what that means is uh the FDA did a laboratory uh kind of a quality uh con control test, and the active ingredient was not absorbed properly into the body. Uh-huh.

SPEAKER_00 34:32

And so this thing's not going to work. There's 14.8 million people that take metoprool.

SPEAKER_01 34:36

Yes, yeah.

SPEAKER_00 34:37

How do you say it? Metoprolol. You're saying it right. Yeah.

SPEAKER_01 34:39

Metoprola. And remember, this is sustainate, not tartrate. Okay. Uh, in that particular lot number. So if you were on that, um hopefully you know by now, but go to the pharmacy, take it back. Exactly right. They'll they'll make that right.

SPEAKER_00 34:52

It can be difficult to know what's true out there. Most people seem to have an angle and they're trying to sell you a plan. I want to invite you to join the Medicare School uh community Facebook group. There's about 50,000, 60,000 people in there. And you can log in every single day, ask a Medicare question, and you're gonna get an answer from real people who are on Medicare, probably in your state, maybe in your city, and maybe somebody who's on the same plane as you. There's a lot of people in there. So uh I want to answer a couple of questions from within that uh Facebook group live here today. Let's talk. Sherry Barefoot Simonson uh said, My husband is almost 66 and still working. He signed up for part A at the appropriate time last year. He has insurance through his employer, over 20 employees, but has an outrageous deductible. Can he withdraw from an employee group plan and sign up for part B and a supplement plan while still working? If so, will his part B premium be based on his wages? So let's talk about this. So has an outrageous deductible. We are seeing that more and more deductibles going up. And so people, uh obviously she's in this situation, is trying to decide. Like, how do I decide between employer coverage versus uh, you know, with a high deductible versus Medicare. So let's walk through that first and then we'll do the rest of her.

SPEAKER_01 36:04

Okay, sure. Well, if you're on a deductible that would be, in my opinion, uh $2,500 or up, then I think at times uh Medicare may make sense for you. Uh $5,000 up, definitely is going to make sense, especially if you're having some type of health problem. So uh that's I just want to address the whole idea of an outrageous deductible. We are seeing it more and more uh frequently. Now here's what yeah, Sherry, you have to do. Uh it is fine to be able to keep working and come off Medicare, but there are some companies, and I would say uh maybe 10 or 10 to 20 percent of them will only allow you to get off of your employer-provided plan uh during the company's open enrollment season. Now, they can't uh hold to that rule when you first go on Medicare. They have to let you go on Medicare. It's a life-changing event at 65. But some companies will say, yes, you can go on Medicare while you're still working, but again, it has to be during the company's open enrollment season. Is that most companies after if you miss that 65, it will be very few. The majority of companies are are are happy to see you go on Medicare at any time, but they can still enforce that rule. Okay. All right, so that that's that deal.

SPEAKER_00 37:11

So for sure at 65. They have to. When you turn 65 for salvage, they have to. They will let you. Beyond that, probably.

SPEAKER_01 37:17

Probably. But you want to double check before you make that decision, because I've seen it happen, uh. Especially with some larger players.

SPEAKER_00 37:25

You don't want to do that.

SPEAKER_01 37:26

Just call the HR department and they'll let you know whether you can go on Medicare at any time. Uh and now remember, if you decide to do this, now you're gonna come into Medicare using what's called the special enrollment period. Special enrollment period is a little bit different. And that just simply means that you're gonna have to prove that uh your husband had credible coverage back to 65, just means that he was working yet, he had a plan. So that form that we use, and we're happy to help you with this, is called an L564. And the L564 verifies credible coverage, and then we fill out one more form called the CMS 40B, and that is uh you selecting the date that you want to start your Medicare coverage. That's the difference between starting your Medicare at 65 versus starting it after 65 and four months. All right, so that's that process. And then you said uh ask about his Part B premium based on his wages. That is in part true, but it's not just his wages because Part B premium is based upon if you and your husband file a joint return, it's based upon your whole income. That's called the modified adjusted gross income. So not just his wages. And so for a married couple right now, uh, as long as you're below $218,000 in modified adjusted gross income, uh, you'll just pay the base premium for Medicare, Part B, which is $202.90 a month. But if you're above that, it's still no big deal. Uh I I'm I'm above that. I have an IRMA. Uh and but still, Medicare is a great value, uh whether you have an IRMA or not. That's the way it works.

SPEAKER_00 38:51

So uh if you want help uh kind of working through the cost, comparing the the employer plan to what's available on Medicare, and then also questions about you know just how to pay for it and how to enroll, uh call in to our office uh 800-782-6676. We'll hold your hand through that entire process. You are going to be on Medicare a long time, and you deserve to have uh somebody who can be honest and share with you um exactly how it all works and help you make that.

SPEAKER_01 39:17

Yeah, we'll do the paperwork for you and uh email it to you, make sure you get it all completed properly and then also on time.

SPEAKER_00 39:25

Okay, Mary Kay. Uh I've moved to a new city and will be looking for a new primary care uh physician. When I when I have the need to go to a new primary care, more than likely I will be charged for a new patient visit. Will Medicare pay for this?

SPEAKER_01 39:40

Okay. Okay. So you will not um uh have to personally pay for a new new uh patient visit. If the doctor codes it that way, uh then Medicare is going to cover it that way.

SPEAKER_00 39:51

Okay, but I will tell you this it's not always I mean it kind of depends on what plan she's on, too, is it or is it just always free? Yeah.

SPEAKER_01 39:58

Well, here's what she chooses an advantage plan, it's not possible. The advantage plan, whether it's a new visit or not, you're just you're gonna pay your copay, whatever that would be. Ten bucks, twenty bucks, whatever the year. Or zero. Exactly right. And so when it comes to the submodal plan, um then the Medicare is going to cover that as well. Okay. But again, I do not think that when it comes to Medicare coverage, there is a new patient visit. It's just you're going in for the very first time. It's gonna be coded as a normal office visit. Trevor Burrus, Jr.

SPEAKER_00 40:24

Right. Which if you're on a Medicare supplement like a plan G, if you've met your deductible, you won't pay anything for it. Exactly right. If you haven't met your deductible, which this year is $283, you'll have to pay a little bit for it. But once you pay that deductible, on a plan G, it's 100% coverage after that. If you are on a plan F, or pardon me, if you're on a plan N, rather, uh, you're probably gonna have a $20 copay. Yeah, right. After you met your deductible.

SPEAKER_01 40:48

Exactly right.

SPEAKER_00 40:50

Medicare Advantage plans come with some restrictions, and one of those restrictions are the insurance company on a lot of services has the final say so on whether or not you are going to be able to get uh that service that your doctor may have ordered. Um I remember a while back I was talking to a guy and he got on a Medicare Advantage plan and his doctor said, Hey, you uh you need to get a hip replacement. And uh the Advantage Plan company pushed back and said, No, you need to do nine months of rehab first. Let's see if we can fix it that way. Uh and so he had to go through nine months and then he got his hip replacement. If you were on a Medicare supplement plan, there you know, doctor says it, Medicare approves it. The supplement plan, the insurance carrier is not gonna have any say so in that claim.

SPEAKER_01 41:34

Yeah, Josh, I've had a few occasions where people uh were recommended to have a full hip replacement and they only got a rod. The advanced company would not pay for that full hip replacement. Never had that happen.

SPEAKER_00 41:45

So tomorrow we're gonna be talking about the top five most denied services by Medicare Advantage Plants, because you deserve to know that. All of those commercials, filling up your mailbox, filling up the TV airwaves, filling up everything, they're not talking about this part of it. They're talking about, hey, you're gonna get a dental clean or whatever. Yeah, you're gonna go to the gym for free. So we're gonna talk tomorrow top five most denied services by Medicare Advantage Plants.