Navigating The ONSLAUGHT Of Medicare Information At 65

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Turning 65 comes with an onslaught of Medicare information: mailers, commercials, phone calls, advice from friends, and opinions from every direction.

In this episode, we talk about how to sort through the noise, understand what actually matters, and avoid feeling pressured into a Medicare decision before you’re ready.

This will help you cut through the noise so you can approach Medicare at 65 with more clarity and confidence.

We look forward to taking your calls! 

Transcript

SPEAKER_00 0:03

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. Did 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 did you ever work with a guy named Lucas at our company? No, he came because he harassed my dad.

SPEAKER_01 3:12

Exactly right. He caught 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 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. 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. So the assets are gonna be typically no more than $2,000. Uh so it's very limited.

SPEAKER_00 5:16

Is your house excluded from that? Uh sometimes, sometimes not. Couldn't tell you. I think it's gonna be a good thing. Exactly right. So basically what you're saying is like a lot of these things that are kind of advertised 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 gonna find out. Are you on Medicaid? When they find out not, they're gonna 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 uh 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 6:51

My 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 advantaged 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 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 a 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 two 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 um 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 11:40

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 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 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 14:10

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 submental plan, hey, that is totally your decision, but you 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. Okay, Dad, there is a uh medication that's really popular that I think it's been having some recalls or something. Can you tell us about this?

SPEAKER_01 17:19

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

SPEAKER_00 17:27

That's super popular.

SPEAKER_01 17:29

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 17:37

Oh, okay. I didn't know the difference of that. I always knew when you go type it in.

SPEAKER_01 17:41

I was like, you have take it twice, and this this is extended release, so you don't have to. But uh for those people that may not may not be familiar with it, is it's basically it's a beta blocker, and it's used to treat high blood pressure, angina, and heart failure.

SPEAKER_00 17:55

Okay.

SPEAKER_01 17:56

Uh what's also neuristic about this medication is it improves the survival rate uh for those that have already heart 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.

SPEAKER_00 18:09

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

SPEAKER_01 18:12

No, no, 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 it is. How do you find a lot number?

SPEAKER_00 18:27

Uh well is it on a pill bottle?

SPEAKER_01 18:29

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 week we're seeing some type of uh 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 a dissolution failure. And what that means is uh the FDA did a laboratory uh kind of a quality uh control test, and the active ingredient was not absorbed properly into the body. Uh and so this thing is not going to work.

SPEAKER_00 19:22

There's 14.8 million people that take metoprol.

SPEAKER_01 19:25

Yes, yeah.

SPEAKER_00 19:26

How do you say it? Motoparol.

SPEAKER_01 19:27

You're saying it right. Yeah. Metoprolot. 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 19:39

Okay, let's talk to Sandra in New York. Sandra, welcome to Medicare School Daily. What questions do you have, folks? Hi. Hi.

SPEAKER_03 19:48

Um what my question is, is I wondered if you have any insight. Um, I'm in United Healthcare, and they changed their policy this year to where all your doctors need referrals from your primary. And we're having nothing but issues with the insurance company, and all of our doctors, they're all fed up with the insurance company with all the extra work it's causing, and they don't want to hire extra people to take care of all these referrals. Um, our doctors are saying they're not going to carry this insurance anymore, and they're not taking new patients because of it. Um, so there's a lot of anxiety on our part of what we're supposed to do. Um every time we need a referral, um that's piling in my primary doctor, and it takes time to get the referral, and we don't get it in time. And uh the doctors are threatening that if they don't get these referrals, they're gonna cancel our appointments on us. So there's a whole lot going on.

SPEAKER_00 20:58

And are you in Buffalo area? Or where are you? Yeah, okay.

SPEAKER_01 21:02

Okay.

SPEAKER_00 21:02

And you're on United Healthcare, is that what you said?

SPEAKER_01 21:05

Yes. Okay. And we are we're assuming that you're on an advantage plan. Is that correct, Sandra? Yes. Okay.

SPEAKER_00 21:14

Okay. And this is a new thing you're experiencing, correct? So sorry for the 20 questions. We just want to make sure you have the context.

SPEAKER_03 21:19

Yeah, no, no. It it it it last, uh I just retired a year ago, and we got on this insurance last year, and there was no referrals needed.

SPEAKER_04 21:28

Yes.

SPEAKER_03 21:29

And then January came around and they changed it to where you need a referral for any doctor that you go to except for your primary. And um, the doctors are all getting set up and they don't have the the people to handle all this extra work, and uh they're just saying they're not going to carry us anymore.

SPEAKER_01 21:47

Sandra, let me ask you this is there any way possible that well well, first off, how how long have you have you been on this advantage plan? How long? Uh since May of last year. So May of twenty twenty.

SPEAKER_00 22:04

I'm assuming it's like an HMO plan, correct?

SPEAKER_03 22:07

Yeah, yeah.

SPEAKER_00 22:08

I just pay my monthly and that's a HMO Medicare Advantage plan. Yeah.

SPEAKER_01 22:13

HMOs require uh that uh you have to have a referral uh in order to see a specialist. And basically what's happening is your primary care doctor is is forced to become the gatekeeper to make sure that you really do need to see a specialist, number one. Number two, that you're seeing somebody that is within the network so that it'll be covered. That's the purpose of that. So, Sandra, my question is is there any way at all that you could afford to go on a supplemental plan? Uh have you looked at some of the plans? I don't know.

SPEAKER_03 22:41

I'm no, I'm I'm totally lost. When we called last year and I got set up, um they said that this was the best plan for us for our area. Yeah, and again, we took it.

SPEAKER_01 22:53

Yeah, and again, it really could be. It could be for sure. Uh I'm not saying it's not. I'm just saying too, I was just curious if maybe you could uh go on one. If this is the primary issue, the only way you're gonna get away from having to get referrals is to go on a supplemental plan, because original Medicare and supplemental plans do not require referrals at all. The problem in New York is the prices. Uh, they're very expensive. So that's why I can see exactly why someone or even it was us would have recommended an advantage plan. They just simply make sense for you know uh uh up there. Another way that you could avoid this, and by the way, Sander, I I'm just sharing thoughts with you. I'm not telling you what to do because you're you're really you know you're in a difficult situation. Another thing, if I were you, uh I would probably look at what is called a high deductible G plan. Uh I'm and and just so you know, as a general rule, I'm not a huge fan of high deductible G plans, but the reason I'm saying that is because at least then you would um you wouldn't have to deal with referrals. Now you would be responsible to pay for the first $2,950 out of your pocket. Uh Medicare pays first, and then your your your plan is not gonna pay anything until you've you've paid the $29.50. But that's $250 a month. You take that $3,000, you divide it by $12. So it's basically about $250 a month on average. Your G plan is gonna be, you know, fairly um reasonably priced.

SPEAKER_00 24:16

High deductible one, yeah.

SPEAKER_01 24:17

Yeah, the high deductible one, yeah. The the the regular G plan uh is is very pricey in New York. And again, uh across the country, I would I would not even give this advice, but where you are, uh you're just in a very difficult situation. So what I hear you saying is, hey, do you guys have any ideas to get me some relief from this uh requirement to get referrals? And frankly, this is the only way to do it.

SPEAKER_00 24:39

Well, I mean, PPOs, right, could be an option. Trevor Burrus, Jr. Yeah, are there PPOs in her? Yeah, there's there's there's some PPOs that are available. You'd have to here's the thing. So in the Medicare Advantage Plan world for a long time, I would say the last five years, there has been a really big push and trend towards getting people on PPO plans, because PPO plans are a bigger group of doctors, you don't need a referral, if you go out of network, you have some coverage. The problem is it's put a lot of strain on these Medicare Advantage plan carriers. And so now they are all trying to get everybody pushed back into an HMO plan, which it sounds like is what happened to you. So this isn't just happening to you, it's happening to a lot of people because they can't make the economics of the PPO plans work. So we are expecting to see over the next uh probably five years a big push from people going from PPOs to an HMO. Um plans are literally starting to go away. Um and when they and if they're not going away, then they're making the benefits so bad, like the max out of pocket is you know $14,000 or something. It's just it's a lot of people.

SPEAKER_01 25:48

They don't make them attractive enough where anyone wants them.

SPEAKER_00 25:50

Yeah. So you're kind of in this very interesting position. There are some PPO plans that are still available. Um, they've got pretty high max out of pockets. Um, and you know what I my suggestion would be let's talk, maybe call into our company when it cut gets rolled around to annual enrollment period, which would be October, and let's see if we can see what PPOs are available for the 2027 for 2027. That being said, we expect for there to be fewer than 2026, just like there were fewer in 2026 than in 2025 and and so forth.

SPEAKER_01 26:27

Yeah. And then the I'm I don't like Josh's idea. I think I think it makes sense. Uh the what are the premiums, are there premiums?

SPEAKER_00 26:33

Yeah, there are $0.03 premium ones. So those in-network max out of pockets are almost all $10,000.

SPEAKER_01 26:39

Right, right. So I like his idea. The other thing that you may want to look at is what I had suggested would be the high deductible G. That's that's that that is definitely a possibility.

SPEAKER_00 26:49

And then you eliminate it for she can't do that until this annual enrollment period.

SPEAKER_01 26:52

No. No. So you're kind of she is in New York, and so I think that's something I don't think she can, but that could be an exception. Yeah.

SPEAKER_03 27:00

Yeah. The the um I was wondering how that's gonna how how does that affect like the insurance companies? All these doctors are jumping ship and don't wanna do that.

SPEAKER_00 27:10

Well, but they the the it's kind of working out according to plan for the insurance carriers because they don't want that busy care. Yeah, it's kind of right, right. Yeah.

SPEAKER_03 27:21

The doctors are all telling us that this is their way to get you know, get out of having to pay for anything for the people.

SPEAKER_00 27:27

And that's probably true. Yes.

SPEAKER_03 27:30

They're trying to slow down the whole process so everybody gets aggravated.

SPEAKER_01 27:34

This is the way they control cost. It's true. It's it's yeah, because they bring friction to the doctors for uh friction to you as the uh uh the patient, and they succeed at it. Insurance companies today have way, way too much power in this whole uh this whole uh you know scheme of health insurance. It's ridiculous. So we we feel your pain, but right now, um and of course, you know, I know that uh New York is an open enrollment state, so I'm not sure that you would have an opportunity to go to a submodal plan right now. Josh is saying no. So you're gonna have to stay where you are, jump through the hoops, but hopefully be able to improve your position. So meaning going stay on advantage, go to a PPO plan, Sandra, or uh look at the possibility of going to a high deductible G plan in New York. And again, those rates, I'm not even sure what they are, but we've looked at them before, and I think they're they're halfway decent. You just have to have that $3,000 set aside in case you know something were to happen. Now, that that doesn't mean you're gonna meet the the that high deductible, but it does give us a way to to get away from this whole network issue that you're dealing with right now and referrals. Okay. Okay. Okay. So give us a call uh as we approach the open enrollment season October 15th, December 7th, and we'd be delighted to help you and hopefully we can get you in a better position.

SPEAKER_03 28:49

Okay, great. Yeah, you guys helped me a lot last year. Yeah.

SPEAKER_00 28:52

Okay, well let's talk. Let's talk in October and we'll look at see what PPOs are available for next year, and then look at high deductible G's as well. All right. Okay. Thanks for the call, Sandra. Nice to talk to you. Take care. Thank you. 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_02 29:24

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 great. Sorry about that. Yeah, just goodness. 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. Everyone's a doorship.

SPEAKER_01 29:59

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

SPEAKER_02 30:02

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 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. So I'm gonna have to do that. Yeah, right? It's only 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 twenty-five tax return numbers, and in step three I put what I think they are for twenty-six with my reduced income?

SPEAKER_01 30:56

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 twenty twenty-six, and they will look at that because that was your life ch 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 well, 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 by 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 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 in February 2026. Uh, you know, however you file your, you know, as 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. Thank you, sir.

SPEAKER_00 32:13

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 32:30

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 a line.

SPEAKER_02 32:46

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

SPEAKER_01 32:55

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

SPEAKER_02 33:02

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 go into 202, so it's worth doing this for the yeah.

SPEAKER_01 33:10

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?

SPEAKER_02 33:22

But I again I've I've called thousands of call you from my re I'm gonna call you during open open enrollment because you guys deserve my business. You you do great things.

SPEAKER_00 33:31

All right. Thanks. Now did uh did you get set up on a supplement or what'd you do in Connecticut? You're you're not he's not quite 65.

SPEAKER_02 33:42

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

SPEAKER_00 34:00

There you go. Okay. Well, we'll be happy to serve you come October.

SPEAKER_02 34:03

Yeah.

SPEAKER_00 34:03

Let us know, Keith. I appreciate the questions. Both of you. Bye-bye. All right, bye-bye. Let's talk to uh Ernest in Pennsylvania. Ernest, uh, welcome to Medicare School Daily. What questions do you have for us?

SPEAKER_05 34:18

Hi. Hi. So uh very briefly, a little bit about my history. I joined up for Medicare uh for December 1st of uh 2025. I joined my supplement V plan uh on uh January 1st of 2026. And the uh gentlemen that I signed on with, I'm not gonna say any name. I had asked him a few questions, not a dozen questions, and he could only answer about maybe nine of these or about three of the twelve questions. Like I decided to sign on with him, and he had told me that one of the things that he could not answer was the uh the policy that I signed up with, what there was through his previous experience telling you policy of the U plan, of course. How uh how how much was the premium increase on a year-to-year base?

SPEAKER_04 35:19

Okay.

SPEAKER_05 35:20

And he said that he couldn't answer that question, I would have to call it. And uh so I try to do some research and basically don't advertise what your premium is basically increases year-to-year-linking. Well, after signing a contract, my broker then told me that through his cash experience that the premium increases between seven and ten percent annuals. And I thought that was uh a big increase. And I was surprised if I I was actually a little bit upset because I had asked that question before I chose the policy that I you know, this the plan that I take, and I signed with him, and after I signed with him, he then indulged his information. So I just didn't feel like he was a problem to me. This has been bothering. Sure. And I'm wondering within six months, from what I understand, I can switch my my coverage, or can I also switch my broker?

SPEAKER_01 36:28

Yeah, you you can. Let me ask you this, Ernest. Is that your uh last question? So I can because I don't want to. Okay, very good. But yeah, let's let's go back. So I just want to be clear. So what you're telling me is that your A and B date is uh 12.1 of 2025. Is that correct? A and B. Yes. Okay, very good. All right. Uh so first off, when it comes to um uh stability of rates, uh in in the past, uh Josh and I have been doing this 15 years now, uh, we have been able to, with confidence, tell people that we're normally going to see anywhere from about a three to seven percent uh price increase. But but but uh uh from COVID years on, everything changed. And so it's not like that any longer. So uh it is it is i I think it's uh difficult for us to give numbers to people because companies have been going up ten and twenty percent. So it's you know very disheartening that that that's kind of where the market is. Now in regards to we we don't expect that to last forever. Right, but yeah, we we do think that there's gonna be now that that correction has occurred. We're certainly hopeful that we'll we know we'll see uh a return to stable rates. But what happens is this not all carriers do report uh their their previous price increases. Many do, and we actually have access to the information, uh, but not all do. And so sometimes you know people even will ask us, hey, can you tell us? And we'll tell you what what's available publicly. But again, not all report that. So uh once you know about that. I do think rates will become more stable, uh, but no agent can predict how stable a company is going to be because we don't know how many claims are gonna be within that that group. We have no idea uh how large the group is going to be. So there's a lot of factors that actually come into play when it comes to uh predicting what the stability of the rates will be. In fact, uh Josh and I were in a meeting yesterday with uh a bunch of our agents, and you made the comment uh you know, don't overpromise, don't tell people we know this is gonna be uh uh you know a real stable company. And the ha in the past they have been. That does not mean that we need to be making that promise moving forward.

SPEAKER_00 38:26

Let me give you an example. So our number one carrier for probably a decade, uh for always in and they had a they had a I think it was like a 21-year track history of this, uh, said, hey, we have an average of a 2.9% rate increase, so 3%, right? Um and that was like a big selling point, and that lasted for 21 years. The last two years, that carrier has taken back to back between 15 and 20 percent rate increases. And that's not the insurance company's fault. Right now, there's been a ton of fraud that's happened within Medicare ever since kind of the COVID thing, um, you know, ever since COVID happened. There's been an increase in the individual market and in the group plan market that has pushed deductibles up. And so people are waiting, and they're waiting for things like knee replacements and shoulder replacements and gym, you know, all these things to do it once they get on Medicare. And they do that the first month they get on Medicare. And so now these the utilization of these plans have gone up, and it's been doing that for the last three years. Now, there are a lot of initiatives underway to put a stop to that, to to kind of measure and blend that out. And so we do expect that to even out. Um, hopefully, uh, you know, this is the last year. Maybe there's one more year of these larger than normal rate increases. Um, but I don't want, I don't I don't want you to get kind of like, oh, my broker should have a crystal ball into the future. No one knew COVID was gonna happen. No one could predict all this fraud that was gonna take place. No one could predict that the individual market and the group plan market was gonna raise their deductibles and max out of pockets so much that people were gonna wait till they went on Medicare. Right. Like these are things that your broker isn't gonna be able to predict. It's things that happen and then the market shifts so that insurance companies can stay in in business. All right. So that that was kind of a long tirade. Let me can I ask you what what carrier, if you can say, what carrier is the one that that you went with?

SPEAKER_05 40:21

So I did get the G plan and I went with uh um Wellaby.

SPEAKER_00 40:27

Well, okay, yeah. So so Medico Wellaby. Yeah, we've we've helped a lot of people get on Wellaby. They're kind of known for, especially for people who are um who were able to get quite a few things through underwriting with them. They've been lenient, they've been pretty lenient with letting people who are outside of their open enrollment period. You're you know, you're in a time period right now and that it ends at the end of the month, um, that you can get any plan you want. It doesn't matter what health qualification or health issues you have, but beyond the end of this month, you're gonna have to medically qualify to switch plans. And medico has kind of been known the last 12, 18 months of like, hey, we'll we'll accept people that are maybe a little higher risk profile.

SPEAKER_01 41:07

So you can change, Ernest. Yeah, you can change. If you want to do that, if you want to get off Medico Wellaby, uh I I would tell you this, I don't think they're a bad carrier by any of the things.

SPEAKER_00 41:15

We've we've been medico or wellby brokers uh for a decade. Many years. But they only became really price competitive the last 18 months.

SPEAKER_01 41:24

Yeah. So I if you want to if you want to move, you can. Uh and we'd be happy to help with that. Just you know, call in and uh uh you don't have to medically qualify, you just simply switch. And the way we would do that is we'd submit the application, it'll automatically go through, and then you would have to call Medico and cancel that effective uh 531 or June 1st, and then your new one would go into effect.

SPEAKER_00 41:44

Yeah, June. Yeah, June 1st.

SPEAKER_01 41:46

June 1.

SPEAKER_00 41:46

So you still have time to do that. So it's easy to do if you need help. Do you have our office phone number?

SPEAKER_05 41:51

I do. Okay. What about my broker? If I were to drop the brokerage I have now and go with uh the Medicare school, uh you guys. Would you still be compensated like she would be? Oh, sure.

SPEAKER_00 42:06

Yeah, so when you switch your plan, we would become the new, we would become the broker for policy agent of record for that policy.

SPEAKER_01 42:14

Um and then the good thing about us is you you have, you know, we have we have a you know fairly large company, so you have uh a dedicated uh um client care manager.

SPEAKER_00 42:24

So you'll be you'll have a person, you know, if you lose your ID cards, if your premium goes up, if you move across you know the state line and need to change your plan or you have a billings issue, whatever it is, you're assigned a person. It's not an 800 number. You know, a lot of these call centers use outsourced, you know, across the across the country, you know, across the world. That's never gonna happen with us.

SPEAKER_01 42:45

Yeah, we do it within in-house, so we'd be delighted to serve that way. So if you want to call us, um we'd be happy to make that switch for you.

SPEAKER_05 42:53

That sounds great. Now, can I keep the Wallaby uh plan that I have and just change my broker?

SPEAKER_01 43:00

No, sir. No. No. No, the the original broker that set that plan up will will still continue to be agent of record. Um has to be that way. Yeah, unfortunately, but that's that's the system. But if we can help you, you uh let us know. Ernest, any other questions you have for us before we let you go?

SPEAKER_05 43:18

That's that's it. Thank you so much for the uh insight and your appreciation.

SPEAKER_01 43:21

We appreciate your call. Take care.

SPEAKER_00 43:23

Take care. For the last 15 years, over 75,000 people have called in to our office, and we want you to be the next one. This is your opportunity to get uh your questions answered from truly the nation's leading expert, my dad, Marvin Music. So take advantage of that opportunity. Don't let that uh burning Medicare question go unanswered. Don't make a Medicare, don't make a Social Security mistake. Uh just make the call, 833 824 2004, and get your question answered.

unknown 44:02

Mm-hmm.