Why So Many Medicare Agents LOVE To Switch Your Plan

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Ever wonder why some Medicare agents seem so eager to switch your plan?

Today on the Medicare Daily Show, we’re talking about what may be behind those recommendations, and more importantly, when switching your plan actually makes sense.

If you’ve been told to change plans, or you’re wondering whether your current coverage still fits, tune in today. We look forward to taking your calls live and helping bring clarity to your situation.

Transcript

SPEAKER_01 0:03

When you start Medicare, you may choose a plan that you think is going to last forever. And some of you have chosen plans like that. Particularly if you're on a Medicare supplement, you never have to change it. But there are some reasons that you may want to change it. If you're on an advantage plan, it's something that you may want to change as well. And that gets done on an annual basis. But you probably get calls. Whether it's happening now throughout the summer or maybe the beginning of the year during what's called the OEP or during the end of the year, which is called the AEP, or the annual election period, you're going to have people calling you. And they're going to be asking you questions about your plan and trying to position a new plan. So what we're going to do today is you're going to learn how to ask questions about whether or not this plan is in your best interest. How to know what they're asking, why they're asking, and how you can make sure that you don't get duped into a plan that may sound good, but actually isn't in your best interest. Welcome to Medicare School Daily. My name is Josh Music. I'm here with my dad, Marvin Music. And if you want to be a part of today's show, call in. Ask some questions about your specific situation. I want to invite you to do that. The phone number is 833-824-2004. 833-824-2004. This is your opportunity to talk to the nation's leading expert on Medicare, Social Security. Ask him your questions and you will get answers. He's not going to try to sell you anything. He's just going to give you answers from doing this for almost 20 years. We're here from 11 a.m. to noon Central Time, Monday to Thursday, 833-824-2004. So don't let your Medicare, Social Security, retirement question go unanswered. Uh get them answered truthfully from my dad. So, Dad, let's talk about this. Switching plans. Who can do it? Why should you do it? Why shouldn't you do it? Everything that's related to switching plans.

SPEAKER_00 1:49

There are some situations where switching uh is smart and is certainly going to be in your best interest for sure. We'll talk about those. But uh there's some times when switching is only in the best interest of the agent and not in yours. All right.

SPEAKER_01 2:03

And so And agents are trained. Uh not our agents aren't trained, but a lot of agents in call centers are trained to try to identify a tiny little sliver of something and drive a wedge so they can sell you into a new plan. Right.

SPEAKER_00 2:16

Yeah. You have to realize that uh all the activity you get uh is is really gonna be centered around you switching to an advantage plan or switching from one advantage to another. And the reason for that is because agents have one goal in mind and that is to make a commission. Inc and app that ink and app. So they're gonna try to convince you that that will be in your best interest. Uh my problem with the majority of agents, and and certainly not every agent out there is like this, but many are, is they will say whatever it takes to try to get that ink app, to try to get you to switch that plan. Even if it's untruthful, they will say it. Uh so their motive is for either you to get a new plan or change companies because now they just generated a new commission.

SPEAKER_01 3:00

And there are there are giant call centers all over the country that for the last two years have been losing contracts with in individual insurance carriers. So you're not making this up. It's literally Medicare and the insurance company saying, Why are you guys writing so much business that is canceling 30 or 60 days later? So then they go and they launch an investigation, they investigate all these calls and determine that people are enrolling people either fraudulently or without enough information, and so they cancel that call center's contract. So they're no longer able to be predators, which is good.

SPEAKER_00 3:29

Yeah. And and the way they lure you in is by highlighting maybe one or two aspects of a plan that looks real attractive that may not be quite as attractive in that area as the plan you're on. For instance, they may say, How much dental benefit are you getting? And you may say, uh I'm getting uh on preventive only, or I get a thousand a year, and they'll say, Oh, we have a plan that pays two thousand a year or four thousand a year. Uh so that's the tactic. The problem is that may be true in that that plan that they're offering you may have a stronger dental benefit, but there's more to a plan than just a dental benefit. You need to look at uh the holistically of that plan, because that plan could have a higher max out of pocket. It could cost you more to see a specialist, it could cost you more to go to the hospital. And so, but the but they don't talk about that. They they dangle the carrot a couple of benefits. Uh and so that's what you have to be aware of. You can't get lured into um, you know, this idea that uh just because that plant has a better dental benefit, it's gonna be uh better for you across the board. You have to ask more questions, and they're just simply not trained that way. Uh there they want you to switch. And if they don't see that you're willing to switch, I'm telling you, you're either they'll hang the phone up on you, is the way it works. Uh and so one of the other issues I think is important for you to note is that uh these agents today typically have very little accountability. They there's no accountability. Uh they're paid to switch plans, they're paid to do whatever it takes to get you to do that, and they know that they will never ever hear from you again. Okay? You may try to reach them, but they're not gonna talk to you for sure. And so there's really no uh commitment to uh to on their part to be able to really be truthful because they're not accountable to you. Uh now you have a problem that they just created, you're gonna have to fix it. And it's really sad that that happens. But again, it's all about commissions, all about generating uh new business. All right. So I do think it is important, though, to note that there are some times when people need to switch, when you may need to switch. Uh and the reason for that is because advantage plans are only written for one year at a time. Uh there were three million people that actually lost their advantage plan. That may have been you. You had to switch uh because your plan was terminated. So that is a legitimate reason to switch a plan.

SPEAKER_01 5:40

How would someone know if their plan has been terminated?

SPEAKER_00 5:42

Yeah, they'll be notified at least 30 to 60 days prior to termination. And normally advanced plans are not gonna terminate mid-year, though sometimes we see it. But it's usually a calendar of your plan.

SPEAKER_01 5:52

It did happen a little bit last year. Oh, yes. Very strange.

SPEAKER_00 5:55

Well, it's because they they the the network the networks were falling apart and and the companies were were not financially stable. And so CMS stepped in and said, Hey, we're done with you. Uh and those were canceled mid-year. But typically, uh they're gonna notify you uh 30 to 60 days before the open enrollment season, so you'll know the plan is being terminated, and so you are going to have to uh get a new plan. It's a great time to switch. Can a supplemental plan ever be canceled or terminated? Not by the insurance company other than for non-payment of premium. So anyone that's on a sub, if you're on a sub, you pay your premium, it's guaranteed renewable for life. Basically, it just renews and renews and renews and renews. That's a contract. Yeah, they they can't cancel it because of age, they can't cancel it because of claims, they can't cancel it because you moved away. Uh it truly is a lifetime. Exactly. Yeah. And also when it comes to So why would someone change a sub? Okay. Well, the reason sometimes people uh the their financial situation changes and they just can't can no longer afford the premium.

SPEAKER_02 6:51

Yeah.

SPEAKER_00 6:51

Uh it could be a divorce, could be a death, or whatever. Some same things happened tragically when you're talking about it.

SPEAKER_01 6:56

Maybe you took it wanting to be able to afford it, maybe knowing you couldn't, and you've used it.

SPEAKER_00 7:00

And eventually you kind of ended up there where you couldn't afford it. Now, uh I I to me I would do everything I could to keep affording it because you you need good health insurance at our age, but if you can't, uh then no harm done in moving to uh an advantage plan. Now, I want to make sure you understand when you can do that. If that's something you may uh have in your future, you can only do it once a year. If you're on a Medicare supplemental plan, you can move to a Medicare Advantage plan October 15th through December 7th. Uh no underwriting required. If it's in your zip code, you can take that advantage plan and it will go into effect January 1. And here's another issue. If that's you and you're going to do this, you have to be the one then to cancel your supplemental plan.

SPEAKER_01 7:38

It doesn't cancel automatically.

SPEAKER_00 7:39

It does not cancel automatically. So you be sure if that is in your future that you take care of it that way.

SPEAKER_01 7:44

Why would someone move from a supplemental plan to another supplement plan? Okay. And then when could they do that?

SPEAKER_00 7:49

Yeah. Uh normally you would be interested in that kind of a move, sub to sup, um, because you've been on the plan for two, three, four, five years, whatever period of time, and you've seen that premium inch up more than what you're really comfortable with, or at least you'd like to see if there may be something.

SPEAKER_01 8:03

Yeah, maybe there's a newer competitive plan that's in the marketplace.

SPEAKER_00 8:06

Exactly. Or someone could be on a G plan uh and they may decide, hey, an N will serve me well, it's gonna save me sixty, seventy dollars a month. That would be another good reason to do so. And now remember, when it comes to your supplemental plans, you are not bound to these open enrollment seasons. Medicare supplemental plans can truly be changed anytime. Now, you're gonna have to go through underwriting more than likely to make that switch, but as long as you're generally healthy, uh, we can find a carrier that will allow us to move. So again, you're not bound to the October 15th of December date if you want to move SUP to SUP. Anytime you want to do that, you can. Okay. I want to tell you one of the saddest things that I've experienced in my career is seeing people that were on submodal plans and and on them for a few years. And they they loved them, they realized the quality of the plan, but then some agent, smooth talking agent, comes along and convinces them how foolish they are for paying a premium when they could. I feel like some sometimes you get pressure for why are you paying this? I'm getting it for free. And I get to go to the gym and you don't. And so uh but people will get you to doubt that decision that you make, uh, which I think was a good one. I have a SUP and I'm glad I do. I'm not moving. Uh but if you did move from a SUP into an advantage plan, what happens is uh if you stay on that advantage plan for over a year and now uh in order to get off of it, you have to medically qualify. And so this is an interesting story, and Josh, uh the the the most elderly people that I I've put on Medicare to date uh was a lady who was 79 and her husband was 83. And the reason is because she was uh she was she called herself a comp troller. Today we say that the CFO. So this goes back just a few years. But the point is, I put them on Medicare, uh they had plenty of money, had supplemental plans, very happy. Um without me knowing this, this is into this five, six years they were my our clients, and uh someone approached them about an advantage plan and talked them into going on advantage plan. And again, these people could afford quality insurance with advantage. Anyway, so uh what happens? Uh the gentleman has a stroke and she calls me and says, Marvin, um we cannot find uh and again I didn't put them on the advantage. Some other agent did couldn't we can't find a skilled nursing facility to take the advantage plan. Uh can I get him switched back to original Medicare and get a supplemental plan now? And we could not do that. Anyways, he actually died. Um anyway, so he passed away and it was a couple weeks after he had passed away. She called me and said, Marvin, I want to go back on a supplemental plan. I should not have gone on the advantage. And so, of course, I started our normal spiel. Tell me about your health issues, and lo and behold, she had some heart issues. I could not get her through underwriting. Uh so now she's still on that advantage plan. She'll have to be for the rest of her life.

SPEAKER_01 10:42

I think there's a warning here as well. I mean, you have your mom still living, right? You you people who are 65, 70, oftentimes the parent is alive. And be you have to be really careful who now generally this happens during the annual enrollment period, like who is talking to your parents about their insurance. Because at that point it may be like, well, I don't know, it sounds good, but sure. We can we can each save, you know, we can save six hundred dollars a month or whatever. Right. Um but then that's just a terrible long-term decision. So I think there's a warning there for the other people in our life who may need some help.

SPEAKER_00 11:14

Right. So legitimate switching can occur if someone moves. Yeah, you have to switch switch a plan for sure. Uh there's some other special codes that Medicare allows that uh people may want to take advantage of. If someone moves into a nursing home or out of a nursing home, they have a they have a the right to switch plans. So the point is there are some times when switching is legitimate and it will be in your best interest, but sometimes not. So just again, don't be deceived by the agents that are just trying to get you to switch quickly, focus on a couple, you know, perks that uh may sound attractive, but really it's not a good plan.

SPEAKER_01 11:48

Okay, let's talk to Dave in Illinois. Dave, welcome to Medicare School Daily. Understand you got some questions, got signed up for an advantage plan, and want to make sure uh you made the right choice.

SPEAKER_03 12:00

Yes, that is correct. I signed up uh yesterday with Jaden Carlson, did a great job.

SPEAKER_01 12:05

Jaden's great.

SPEAKER_03 12:06

And I chose a human Humana USAA honor give back advantage plan. And I also got the uh co-pay protection and cancer plan as well. And listening to uh you know Marvin talk at the beginning of the show, you know, kind of got me thinking about you know losing that opportunity for a sub-plant. I do have some medical issues. I get 100% of my care through the VA and have been for years now.

SPEAKER_00 12:32

Yeah.

SPEAKER_03 12:33

And uh I was just kind of double thinking, you know, well, should maybe I go to an end.

SPEAKER_00 12:38

Yeah.

SPEAKER_03 12:39

Your thoughts?

SPEAKER_00 12:40

Well, my thoughts are, Dave, because you have VA as an option and you're happy with it, and most people are, uh, then I would have advised you just like Jaden did as well. Now, if someone doesn't have V as an option, or they hate VA, uh then that's a whole different situation. But it sounds like they've taken great care of you. Uh so in my opinion, honestly, it would be uh kind of a waste of money. Uh you'd be kind of over insurance. Yeah, overinsurance. Yeah, because you like VA, they they have taken great care of you. So uh I I like the fact that you the the those Humana Honor plans are nice. You got a uh you know a credit towards your Part B, which is very helpful.

SPEAKER_01 13:17

You'd be making a pretty substantial financial swing because you'd lose the give back, then you'd have a premium, and yeah, I mean it would be a big financial difference. Yeah.

SPEAKER_00 13:26

But it and the only reason we're saying this, Dave, is because you have the VA as a great option. Yeah. Okay. So again, it would be we have people that are on tri-care with the same advice. We you just don't need a med sub plan. Um yeah.

SPEAKER_01 13:38

I I feel like if we probably helped 10 people who have you know VA benefits, nine to nine and a half are doing exactly what you did.

SPEAKER_00 13:46

Yes. So I I don't think you you made a poor choice at all. And we'd we'd be gut level honest with you, I promise. Um we love seeing that.

SPEAKER_03 13:53

You know, I was just kind of running just kind of riding the fence a little bit. And you know, you know, I you know, I wanted to make sure, you know, I also had a civilian option available to me. Yeah, sure.

SPEAKER_01 14:02

And yeah, glad you did some parks, part B give back. There's probably gym membership included in that. You probably have some over-the-counter. There's a lot of extra things that get tossed into those plans, and they kind of beef them up because they don't have to cover drugs because you're gonna get your drug coverage through the VA, and there's just more benefit that's available. So take advantage of it.

SPEAKER_00 14:21

Yeah, I think it's a good, very good decision, sir. Okay, well, I appreciate your time very much, and I thank you all. Thank you, Dave. Appreciate the update to serve you as well. Take care. Have a good day, sir.

SPEAKER_01 14:32

Bye-bye. Okay, we're gonna talk to George. Yes. Hey, understand you have an advantage plan thinking about switching to a supplement plan when you turn 65. Is that right?

SPEAKER_00 14:43

Uh yes, sir. Good. Good. All right. So, George, uh uh in the state of Georgia, uh, I am assuming that uh because you came into Medicare uh uh through disability, that there were no uh supplemental plans available, or if they were, they may have been very expensive. And so that George, you're in a position that most people are around the country, and the reason for that is because federal law does not mandate that insurance companies offer supplemental plans to people that are under 65. Uh they do not make those insurance companies take on the risk. That's the federal law. Most states follow federal law. Now, there are some exceptions. Some states say no, uh insurance companies, you have to make them available, but you can price them where you want. And so what happens? They price them, you know, crazy high. Uh and so you're in Georgia. Uh what's going to happen for you, since you're not on a SUP yet, you are going to get an opportunity. Your initial enrollment period one was when you first went on Medicare through disability. Now you get to uh get a supplemental plan, there's no underwriting involved whatsoever. As soon as that application is submitted, uh the company knows that you're exercising your IEP two right. No health questions, they have to take you, they cannot charge you extra whatsoever. So it really is a blessing for you to be able to reset the clock May of next year. So this is about 10 months from now. That's right. Yeah. Not long.

SPEAKER_01 16:04

So you'll early how early can he do that?

SPEAKER_00 16:07

Well, he can he can apply uh three months or to uh up to six months in advance. So what I do is just right after the first of the year, uh I would I would apply. We'd love to help you, sir, if you're looking for a broker, uh, and we do it right at the end of the day.

SPEAKER_03 16:19

I am actually can you guys be my broker?

SPEAKER_00 16:23

You're at the right place, sir. We we can help you and we'll give you we'll give you the numbers. So just right after the first of the year, um what'll happen is uh we'll mm you know talk with you and we'll look and we'll look at uh the different options in Georgia um uh and see what's in your best interest. We're brokers who we write for lots of companies. And then at the same time, what we're gonna do is uh we're gonna help you select a drug plan. And that drug plan is what is gonna kick out your advantage plan automatically effective five, you know, May 1, uh, 2027. It'll happen uh internally. You don't even have to cancel your advantage plan. The drug plan will actually do that. So we'll help you get a SUP, help you get a drug plan uh that fits you, and then yeah, it's real simple. It really is your Medicare number's not gonna change, you just get this second opportunity uh to get a good quality plan. That's great. Yeah. Happy to do Joshua, you know, give him our Yeah, so phone number to call in.

SPEAKER_01 17:16

You can schedule an appointment. Um just jot this down for the future. It's a little too soon right now. Yeah. 800 800 782. 782 6676. 6676? Yep. And when you call in, you're gonna talk to someone who's been trained by my dad. Okay, they are everyone that worked here goes through extensive training with him. They're gonna shop all the different supplement plans that are available. You compare plan G versus plan N, try to figure out what the right option is there for you, what the lowest premium is, price stable, that sort of thing. We're gonna look at drug plans. So if you take some medications, make sure you come with those prepared. Um, we don't really care about your doctors or hospitals, none that we don't care about them, but you don't uh there's no networks on supplement plans. So as long as they take Medicare, you're good to go, right? So we don't have to, on an advantage plan right now, you have to be concerned about networks. On a Medicare supplement plan, you don't have to be concerned about networks. Medicare is your network. Yeah.

SPEAKER_00 18:15

And and George, one of the things you may want to you may want to consider, you are gonna have to be on a on an advantage plan uh uh the first four months of 2027. So if you want to review that, you can go ahead and call us early, and we'd be happy to make sure that whatever plan you're on uh uh right now would s take care of you for the next you know four months of 2027. Uh and so and if it is, we'd just leave it alone. But if it's not, you know, it's it's fine to go ahead and switch for those four months, and then we're going definitely on that submental plan 5.1. So you would just tell the agent that and our agents would know how to take good care. Are you happy with are you happy with your guards?

SPEAKER_03 18:49

What is the best time for me to call it to call?

SPEAKER_01 18:52

Yeah. Well it depends. If you want to do a review of your Medicare Advantage Plan, because you're gonna be on it for the first four months of the year, then you could you know get in touch with us sometime in September, schedule an appointment for October. Yeah.

SPEAKER_00 19:04

It has to be after October.

SPEAKER_01 19:05

It has to be after after the first.

SPEAKER_00 19:07

Yeah. Because we can't do any the plans aren't out until after October 1st. So really anytime mid-October uh is certainly fine, sir.

SPEAKER_01 19:15

And then you will you can tell them, hey, here's my plan. I want to get on an advantage plan, or make sure I'm on the right plan. And then if there's a plan that needs to be switched, they can switch you then and then tell them you want to switch to a supplemental plan uh in May. And so they'll just schedule a follow-up appointment um to get that switch done. Yep.

SPEAKER_00 19:34

Okay. And that appointment then would so call this call this mid-October.

SPEAKER_01 19:38

Oh, no, I call it late September. I call it in September. Schedule. Well, you can call now and schedule appointment for October, truly.

SPEAKER_00 19:44

Yeah. Yeah, give yeah, go ahead and get on the calendar. Uh so you can call now and then uh then you all will have a uh that that call and then you'll have a second call as we look at uh the the new plans to go in effect uh 5.1 uh 2027. Okay, yeah, we can help you all the way through the process, George. Happy to do it. No, and no cost for our services either. Uh you never pay an agent whether you use us or anybody. Uh agents are paid by the insurance company, not by you. Okay? We do accept cookies, all sorts of treat stuff. All right, hey, we appreciate your call. Good to good to talk to you, sir. Thank you.

SPEAKER_01 20:17

All right, thank you so much. Yep. Bye-bye. That was one part of switching that we didn't cover, which is if you're on disability, right? Because you're eligible for disability the first day of the 25th month that you're on disability. But in most states, you're on advantage plan, it's your only option. They may have a supplement plan, like a plan GN, but the premium is five, seven, eight, nine hundred. I mean, it's a lot of money for those plans. But then you have the opportunity to switch when you're turning 65, you know, for that that first time, and it's like you're basically treated as though you're turning 65. It's your first time on Medicare.

SPEAKER_00 20:49

Exactly.

SPEAKER_01 20:49

You've got an opportunity to switch, you get the same rate that everybody else does, no health underwriting.

SPEAKER_00 20:53

And there are a handful of states, only a handful, that the insurance commissioners will not let them charge exorbitant rates, but that's few and far between.

SPEAKER_01 21:04

Okay, let's talk to Jill. Jill, welcome to Medicare School. Welcome to Medicare School Daily. What questions do you have?

SPEAKER_05 21:14

Thank you. Um, I appreciate you taking my call. Just retired June 30th, signed up for Medicare A and B in a supplemental package and a dental and all that, but obviously I didn't wait until I was 67 to get the full, you know, a higher Social Security rate. And I recently read about a form SSA 521, where you can refile within 12 months. And basically it's called a premature filing type form, and it's to get a higher benefit. Right. And I wondered what what you what your understanding of that is. And how I should proceed if I'd like to get a higher benefit.

SPEAKER_01 22:04

Have you received your first check from Social Security yet?

SPEAKER_05 22:07

I have not. Nope.

SPEAKER_01 22:09

Do you know when? Do you know when you requested for it to start?

SPEAKER_00 22:16

July July 1. Okay. Yeah. Well, what that form does, it gives people the chance to be able to reverse their decision that they've made. And you have up to 12 months to be able to do that. So even if they do make that deposit, which they're going to this month, you can go ahead and file file that form, and then you'd have to, of course, return that Social Security amount to them. And then if you want to wait until you hit your full retirement age, then that'd be fine. So let's let me let me just review real quickly. So you're born in 1960. Is that correct? Correct. Okay. So you're born in December 1960. So your full retirement age is 67. So if you want to wait to full retirement age, then you would uh start your benefits December of 2027. Uh which is just you know just a year and a half from that. So the difference would be um uh think about this way, if you if you return the money, withdraw the filing, then what will happen is every month your account is gonna grow by a half a percent. Okay? So whatever your check could just call it, let's just call it nine nine to ten percent, because you already started you started social security in July. So uh you're gonna get another eighteen uh months uh of growth. So that's gonna be about nine percent. So that's what you have to decide. Is it worth it uh to go ahead and wait uh to earn that uh nine percent amount? Do you know what your full retirement age benefit uh would have been? Do you know that amount? They call it your primary insurance amount. Well, let me ask you this. Do you know what your gross check uh is going to be uh for July? They probably told you.

SPEAKER_05 23:48

Um yeah, I think they're taking a couple months of the B premium out, and I won't get it till August. I think it's even maybe around 18 or 1900, something like that. Okay, okay.

SPEAKER_01 24:03

So the the extra couple hundred bucks, maybe. Yeah, exactly right.

SPEAKER_00 24:07

So that's what you have to decide. There's always a break-even point. Do you do do you need the money? I mean, you need it just to make ends meet, uh cash flow, or are you fine without it?

SPEAKER_05 24:18

Well, uh you know, I planned it into my retirement. I just it when I learned about this, it made it sound like you could just change, you could refile but continue getting your check, and they would just up it at some point. But that's not the case. No, ma'am. No, that's okay.

SPEAKER_00 24:39

No, that's not no, it just means you're you're saying I don't want to take it. They give you up to 12 months to reverse it, send the money back, and they just you know let you file later. So, but yeah.

SPEAKER_05 24:49

Okay. Interesting. Okay. So I heard about that form. Yeah, well, thank you. I appreciate that. So that is an option if I decided I wanted to wait, but yeah, like you said, just weigh the difference.

SPEAKER_00 25:03

Yeah, yeah. And you would have you definitely are gonna have to live to be, oh, uh probably 82 range, 83 before you even even see the benefit of that waiting that extra eighty. Yeah, eight exactly right. That's called the break-even point. And so sometimes, you know, people live long enough, they uh may it have been in their best interest to delay, but again, it's that early 80 range, okay? So Okay.

SPEAKER_05 25:27

Well, that's perfect. I appreciate your input because that added a few insights to the situation that they didn't, you know, uh mention when I learned about that form. Yes, ma'am. So thank you. I appreciate it, and I always learn a lot from your show.

SPEAKER_00 25:43

All right, well, thanks for uh listening and uh good to talk to you today. Thanks for calling. Thank you.

SPEAKER_05 25:48

Bye-bye.

SPEAKER_00 25:49

Bye. And I think what happens, Josh, is many times uh people are planning on retiring and then they find out they're gonna get a job, so they've already applied for Social Security, and that's really the primary purpose of that. Say, oh I made a decision that I I now I'm I'm gonna I'm gonna switch it.

SPEAKER_01 26:05

Yeah, it almost sounded like she signed up for Medicare and then in the process also signed up for Social Security. Yeah, which is truly understand what she was signing up for. Right. I mean in a situation like that, I'd probably I'd probably take the money. Yeah. I mean like at the cost of inflation.

SPEAKER_00 26:19

Yeah, if I'm not working, I would because you you you she still has an earnings test to deal with. Exactly. But if you're not not working, I'd probably not not reverse it either.

SPEAKER_01 26:29

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

SPEAKER_04 26:35

Hey guys, greetings from Augusta, Georgia.

SPEAKER_01 26:37

Greetings.

SPEAKER_04 26:38

I am transitioned to part-time in the healthcare field uh at the end of this year, and will lose my healthcare benefit, a large company healthcare benefits. And my question is um, when's the best time for me to enroll in the specifically related to my you know my initial enrollment period? Because I feel like I need to be outside of that, um, or I'll be getting you know a month extra premium.

SPEAKER_00 27:08

And how how long will you be covered, Vince, by your group plan? Through what month?

SPEAKER_04 27:13

Until December 31st. Okay. Okay. Through December.

SPEAKER_01 27:17

All right, and so you've enrolled an A that will begin in August. You probably got a card already that says part A, perhaps?

SPEAKER_04 27:24

That's correct.

SPEAKER_00 27:25

Good. Yeah. All right, Vince, uh, what you're gonna do is you're gonna enroll into um Medicare B uh right after December 1. Um because if you were to enroll your last month of your initial enrollment period, they're gonna start you a month early. So you don't want to do that. That'd be a total waste of money, sir. So what I'd recommend doing is um all you have to do is you're gonna have the L564 completed by your employer. You initiate it. If you work with us, we are happy to initiate that for you. That's the L564, just approve credible coverage, because you can't come in uh anytime after December, of course, without an SCP. But that's the that's the right time to do it. And then uh on your 40B form, uh you're going to request an effective date of 1.1 of 2027. And so both of those forms, again, it has to be after 12.1 because you have to let the initial enrollment period expire. Once it's expired, then you can use the SCP. Okay? Uh so L564, CMS 40B form, uh, then it would be either uploaded uh th through your SSA.gov account or you can actually uh take those to a local Social Security office and then they can get uh that be started for 1-1. So that's the perfect timing in my opinion, sir.

SPEAKER_04 28:37

Marvin, is there any reason to do both of those things? I've heard you guys talk about sort of having a backup as far as the submission of forms.

SPEAKER_01 28:46

Like mail and fax or drop off or drop by and upload.

SPEAKER_04 28:53

Yeah. I don't know. That's why I'm asking.

SPEAKER_00 28:55

Yeah, that's it's good. Let me tell you how uh in the past has always been. We would say if you're going to fax, be sure to also mail a hard copy. Okay, so if you're gonna mail a hard copy, then fax one and two, it's just smart to do that and let them know that you've done that. Uh if you're going to use the new system of uploading that through SS uh the S SSA.gov system, I don't know that you have to do a backup in that regard. Um you know it's it's so new. It just started in March. Um is is there a low uh office, a local uh Social Security office close to you? Yes, sir, the gospel. Okay, good. Well then that's what I would do then. I would, you know, drop drop them off. If if a person is only going to do one, we love it when you drop it off. There's usually a a guard at the door. Uh you put the paperwork in an envelope saying SCP Medicare paperwork, and the guard will get it to the appropriate people. And if you just want to fax it in, that's fine also. It's hey, yeah, listen, okay, you know, it's a big system, things happen, and I'm you know, I I'm cautious. I like to, I'd rather do uh, you know, be safe than sorry. So that's the that's the reason for the backup.

SPEAKER_01 29:58

Vince, are you gonna pro are you I'm assuming you're gonna go with like a Medicare supplement plan and a drug plan as well?

SPEAKER_04 30:05

Yes, sir. And I'm I I wasn't gonna get into that necessarily, but I'm leaning towards in yeah um even though that we don't go, we're not on we're not in we're not on prescription meds right now, and sure we don't go to the doctor very often. I'm an I'm a doctor, so I don't I don't trust them.

SPEAKER_01 30:21

I understood. So I was just gonna say you you can actually do your Medicare supplement application before you enroll in Part B. You already have a Medicare number. So you don't have to wait until December to get that part. You certainly can. Um but you could actually you can actually do that um even before you enroll in part B. Um I mean I would just call you guys to Yeah, yeah, you can call us, we can rate shop it and see what the the right option is. Your drug plan, though, will need to be submitted probably when will that need to come in? Because he could use a UN SEP though.

SPEAKER_00 30:58

Well, well, I know, but he also could use uh uh AEP for that. He's in that yeah, you're kind of in a weird time time. All right, yeah. I know, that's why I'm calling. Yeah, well, we the the only issue, yeah. The only issue with the drug plan uh would be if you if you submit it um uh as a as an AEP, what's gonna happen? I'll start one one. You're saying either way, let me share it this way. Either way, here's what I think is gonna happen to you. It's not a big deal, but I still would would want you to know about it. Uh because you are uh going to come in with the drug plan effective one, uh you're actually gonna have one they're they're gonna have one month where you didn't have a drug plan, and and you don't have to. That's the month of December. Uh so you would submit a drug plan uh using the special enrollment period code as well. And here's what's odd, Vince. Uh you're you're literally going to get a letter saying that you're gonna get a drug plan penalty one month. 35 cents. Yeah, about 35 cents, but it's lifetime, so that's kind of a nuisance.

SPEAKER_01 31:56

But you can you can you'll get a form, you can fill out the form, mail it back in, and it'll get dropped. But that will probably come.

SPEAKER_00 32:02

Yeah, it will come. The other way around that, the other way around it is he actually could submit, he could submit a drug plan. Uh because he's gonna change look his zip code real quickly, son. And uh let's see, I bet there's some very low-cost drug plans in your area, anyways. But you could submit a drug plan um uh during the month of November and that would start in December. Uh and then you wouldn't have the hassle of that. Yeah, you could do it, but here's the issue.

SPEAKER_04 32:26

Okay, go ahead. Go ahead. No, no, no, and I would get a penalty even though I have uh the drug coverage through December as well. No, no.

SPEAKER_01 32:35

No, it they're going to if you yeah, if you come in using the special enrollment period, everybody gets this letter. Yeah. And so you just have to fill it out and say, hey, I had credible coverage.

SPEAKER_00 32:45

You had credible coverage, that's right. So the point is either way, you you're you're yeah. Anyway, so right now Wellcare has that zero premium drug plan. Now, I don't I do not know what it's going to be for uh 2027, but if you don't the hassle of having to respond to a letter, you can enroll into a drug plan that would be uh you'd you'd you'd actually uh enroll in November, they'd give you the drug plan in December, it'd be this well cared zero premium, and 90% chance that plan is probably in the bet your best interest for 2027, and then it just simply auto-renews. Um and so I'm But if you if I enroll in D. Yeah, go ahead. Go ahead. Yeah, go ahead, Vince. No, you please.

SPEAKER_04 33:25

So I I enroll in D in my initial period and B in the special period.

SPEAKER_00 33:30

Exactly right. Yeah, that that's that's that's what I would do. Now you're you're high income, so if you do that, you are gonna have an IRMA. Oh, he will uh for for uh yeah, for you for you know if you if you did it that way. I and by the way, I I forgot I just glanced at our screen here, and you're gonna have an IRMA, so you may not want to do that. I'd probably wait and enroll in December.

SPEAKER_01 33:49

Enroll in December, you're gonna get that letter, you're gonna fill that letter out, and then you're gonna send it back in, and that penalty will be dropped.

SPEAKER_00 33:54

Yeah, that's right.

SPEAKER_01 33:55

You that that don't don't do the November if you're gonna have an IRMA.

SPEAKER_00 33:58

Yeah, because yeah, once you enroll in a drug plan, now we got an or we got an IRMA problem. So I I I didn't notice that you had that. So change my mind. Let's submit it uh in in December for a January 1 start date. And when you get the letter, you can call in as well. You're just gonna call and say, hey, have hit a plan, you'll tell them whatever insurance company you had, and they will drop off that little penalty. Okay. Yeah, and just cleaner.

SPEAKER_04 34:20

I'm glad to know that the nation's the nation's leading experts still have to think about my situation.

SPEAKER_01 34:25

Yes. We're glad too. The uh the uh I was gonna say, if you want to work with us, uh call do it after October 1st, probably, because then we'll know what the new drug plans are for next year and all that.

unknown 34:39

Perfect.

SPEAKER_04 34:40

And the point was one of your ages in early October. That's perfect, perfect timing.

SPEAKER_00 34:44

Yeah, the plans would be out 2027 drug plans.

SPEAKER_04 34:49

Okay. Do you have time for one more brief question?

SPEAKER_00 34:52

Absolutely.

SPEAKER_04 34:54

My wife's gonna be eligible for Medicare in January of 2028. And so I am planning on letting her get coverage in Cobra. Because you know, we're both gonna get off of our plan.

SPEAKER_00 35:07

Right.

SPEAKER_04 35:08

Um, and is is you think that's the best it could be the best option, or should I explore others?

SPEAKER_00 35:16

Well, I think it could be. Have they told you or maybe already know what the premium is going to be on that plan? Yeah, okay. Is it is it reasonable?

SPEAKER_04 35:23

Eight or nine eight or nine hundred dollars. Yeah.

SPEAKER_00 35:25

Eight or nine hundred dollars. Yeah, that's not too bad because you're you're not gonna you know probably getting better through the uh, you know, through the exchange plans if you were to go through, you know, the um uh uh healthcare exchange system, you know, the ACA plans, you could look at it, I guess, before you make that final decision and make a comparison there. But really, there's there's nothing the only other thing that people are doing today is you would qualify if your wife is healthy, you can get a short-term medical plan. Uh and those those for a while were only going like three months at a time, but now they've extended those, so it's just called short-term medical. And the way I look at events, it's it's uh like an uh one of the old-fashioned um uh you know plans that are catastrophic, meaning they'll cover you. Uh she does have to medically qualify to get one of those plans. Pardon me.

SPEAKER_04 36:13

Right. There'll be some underwriting for that.

SPEAKER_00 36:15

Yeah, yeah, but it's it's just a couple uh a few health questions. Yeah, yeah. You don't there's no exams or anything, so that's another option. You can get a short-term plan if you're happy with it. Uh the premium will probably be better. Uh you can afford to you know pay Dr. Copays anyways, and whatever, you know, she's probably gonna need uh on the small stuff that would cover you in case something major were to happen. So again, that's an option you have.

SPEAKER_04 36:38

Um fortunately we have a fairly well-funded um you know health savings account as well.

SPEAKER_01 36:44

Good. Good. Uh the are you on the HSA plan this year? You just haven't contributed to it, or did you say you dropped that coverage at the end of last year?

SPEAKER_04 36:52

Well, I mean, I have an HSA through Fidelity through the account company, but I stopped contributing in December of 2025. I serendipitously did that. I didn't understand the Medicaid.

SPEAKER_00 37:02

Yeah, well, I'll tell you right now, what I would let me tell you what you can do, and it's not too late to do this. You can fund that thing all the way through July and you can max it out. And it's legal because your aid date is 8-1 of 2026. So you're fine.

SPEAKER_01 37:15

Yeah, the whole six-month rule only applies if you're over sixty-five. Right. Yeah. But you're not.

SPEAKER_00 37:20

Yeah. You can you can you can put money in there and it's not too late. Can you just put a property? Oh, you can put them on. No, no, no. No prorating. You can put basically $450 a month times seven. So you can basically put about you know $3,500 in there. So it's this year's uh are are you doing family contribution or individual, single?

SPEAKER_04 37:42

Well, I've been doing single through my employer.

SPEAKER_00 37:44

Okay, okay.

SPEAKER_04 37:45

So anyway, that that's this year's part of my understanding is the HSA will cover my spouse.

SPEAKER_00 37:49

Absolutely. Yep, you can use it for your spouse. So here's the bottom line. This year it's forty four hundred dollars plus a thousand catch up. So you take fifty four hundred, divide that by twelve, that's your monthly amount that you can put in with no penalty, times seven months. And you could write a check for that this month and put that in there, sir.

SPEAKER_04 38:07

Okay, gotcha.

SPEAKER_00 38:08

You can do it. Yeah, I promise. You're you're it's legal to do it. Okay.

SPEAKER_04 38:12

Hey, man, the the devil's in the details, isn't it?

SPEAKER_00 38:15

Yeah, you're right. So are the angels.

SPEAKER_04 38:18

All right, yeah.

SPEAKER_00 38:19

All right.

SPEAKER_04 38:22

All right, thanks, guys. You guys are all right.

SPEAKER_00 38:24

Hey, well, appreciate the encouragement. Our privilege to serve you, sir. Have a good day. See ya.

SPEAKER_01 38:27

He probably thought because you've heard, you know, many times you got to stop your HSA contribution six months before Medicare, but that only relates to if you're starting after 65. You can contribute all the way up until I guess the month before you turn 65.

SPEAKER_00 38:43

Yeah. When they backdate that A, they'll never go uh prior to 65. They're just going to backdate six months or to 65, whatever's first.

SPEAKER_01 38:50

Yeah. And it's six months when they do that backdating. So let's say you're 70 years old. Maybe you you had a HSA this whole time, so you didn't apply for A. From the moment you apply, they back it up six. So if you apply three months early, so let's say you're 69 in three months, or you're 69, you're 69 in nine months, they would uh actually go six months back from that date. So you need to stop contributing it in this example, 69 in three months.

SPEAKER_00 39:16

So the date you apply.

SPEAKER_01 39:19

Let's chat with Greg. Greg, welcome to Medicare School Daily. What do you have for us? Hello, hi. Hi. Thank you. Yes, sir.

SPEAKER_02 39:31

You got some questions or I well I was telling uh whoever I was talking to before, I I don't know if they have questions, is I just wanted to get on and talk about uh how helpful it has been to have Medicare school and uh the two of you help those of us searching for how to do this and navigate the minefield to me at times that is Medicare and uh supplemental plans, and it's been very helpful and has provided me with a great sense of I have the right coverage and the right plans to meet the healthcare needs I have.

SPEAKER_01 40:08

So our our goal is to me. Our goal is for people to have confidence in the choices they make uh in this process. Yeah, very glad to hear.

SPEAKER_02 40:18

Yeah, that's what you've given me. It's been very, very uh uh Marvin and all the uh help that I've gotten when I talk to you guys, it's been just extremely, extremely I think you guys are well uh on you understand the system very well. You're very knowledgeable and educated on what we're doing and help those of us who really don't know because I didn't really pay attention until I turned 65. What, oh, I should know something.

SPEAKER_00 40:43

You you don't have to, do you? It when necessary. Hey Greg, if you don't mind what what what part of the country do you live in, sir? Where are you from? I live in the capital of Iowa, Des Moines, Iowa. Des Moines, okay. Not far from us then. In our home offices in Kansas City, right outside.

SPEAKER_02 40:58

So Yep, that's a that's a three-hour trip south. I know that. Yeah. I have relatives. I had relatives in uh Kansas City. We went there. Yeah.

SPEAKER_00 41:10

What'd you do for a living?

SPEAKER_02 41:12

Um I have uh let's see, been a licensed massage therapist for 30 odd years. Wow. And uh I didn't necessarily retire, I just stopped doing as much work. I see. I still have clients of mine that have said, like, you can't quit on us yet that they're older than I am.

SPEAKER_01 41:33

So I'll keep working with them. That way they keep walking.

SPEAKER_00 41:36

Well, that's great. What what a what a wonderful occupation. My daughter, and one of my daughters actually is licensed in the in the very same thing. It's that's a great gift to have, man. I'm my hands would be worn out. I would yeah.

SPEAKER_02 41:48

As I as I've said, I was one of the very first in the state of Iowa to be licensed when we got went to school. I was uh before this, I was working with I was an addictions counselor working with chemically dependent adolescents, and I was in Sioux City, Iowa, and uh to get deal with my stress, I I said I dealt I had a massage from I think the woman that founded licensing in the state of Iowa, and she was one of the very, very first to do massage, and uh she encouraged my then wife and I to go to the massage school, and that's what we did. And so for many years we went and began to practice together and wow, that's a cool story.

SPEAKER_01 42:28

Yeah, it's cool.

SPEAKER_02 42:29

Yeah, watch the massage field explode because I said I have a job now with uh it's a place called Massage Heights that uh I I work as a therapist there you know a few hours a week. But I said those jobs didn't exist when we started.

SPEAKER_00 42:44

No, they just didn't have them. Well, you kind of pioneered that. That's that's pretty neat. So well, hey, thanks for the encouragement. It is uh nice talking to you. Yeah, and uh hope you have a great rest of your day.

SPEAKER_02 42:56

Thanks for uh putting me on. All right, our privilege there. Okay. All right, thanks.

SPEAKER_01 43:00

Uh-huh. Bye-bye. If you want to get help like Greg, you can call in. Our phone number is 800-782-6676. I think one thing that's different about working with us is Greg now or and you would have a number uh to call. One person, you're assigned a dedicated client care manager. This is somebody if you move across uh the country, if you have a claims issue, a billing issue, your premium goes up, your coverage terminates. Um, you have you just have something that goes up. You lose your ID cards, you can call in and have somebody who's on your side. They're ready and able to help you. So encourage you to call in. Our services are free. Does not cost you anything to work with us, and we'd love to uh love to help you. Join us tomorrow. You are going to learn why you need a drug plan even if you don't take any medications. You may be tempted to go without a drug plan, but you're gonna learn why you need to take one and how to get one, maybe even at no cost. We'll see you tomorrow.