Why You Need A Drug Plan Even if You Take ZERO Medications

No prescriptions? You might think you can skip Medicare Part D — but that decision could cost you permanently.

This video explains why enrolling in a drug plan matters even if you take zero medications right now, and what happens if you wait until you actually need one.

Understanding this rule could save you from a penalty that follows you for life.

Catch us live Mon–Thu, 11am–12pm CT at medicareschooldaily.com

Transcript

SPEAKER_02 0:03

You may be tempted to go without a drug plan when you start Medicare if you don't take any medications. After all, you don't take any? Why are you gonna have an additional expense? That is a line of reasoning we hear from a lot of people, and today you're going to learn why that is a bad idea and why you should consider getting a drug plan even if you don't take any medications, along with your options for what to do if you do make that choice to not get a drug plan. Welcome to Medicare School Daily. My name is Josh Music. I'm here in the studio with my dad, Marvin Music. So excited to be here. You are gonna learn all about drug plans today. But if you have a question, a concern, if you have a situation in your personal life as it relates to Medicare, Social Security, or retirement, you can call in 833-824-2004, 833-824-2004, and you can talk to us live and get your questions answered. You're not gonna be sold anything, you're not gonna be pushed into anything. It's truly an opportunity for you to get your questions answered from somebody who is an expert in this field that isn't gonna sell you anything. That opportunity is rare because most people that you're gonna talk to, they're trying to sell you a plan. So give us a call, 833-824-2004, 11 a.m. to noon Central Time, Monday to Thursday. Don't let your questions go unanswered. Dad, let's talk about drug plans. Why do people need to get them even if they don't take medications? And who doesn't need to get them? Because there are some that don't.

SPEAKER_00 1:31

All right, let's uh talk about those of you who don't need to have a drug plan. By the way, that's far and few between, but it does happen. Uh so you're no longer working and you're on Medicare, uh, it is not necessary for you to have a drug plan if you can get your medications through the VA, which means you served our country and you're eligible for VA. Uh VA uh drug coverage is credible, so you don't have to have a drug plan if indeed you can get all those meds to the VA. Also, if you served our country and retired from the military, you have what's called TRICARE insurance. It's excellent insurance, by the way, which also includes TRICARE uh pharmaceutical benefit. Uh and so if you have that as an option, you do not have to have a Part D plan. If you uh served in the uh federal government, civil service, and retired, you have what is called FVHB, Federal Employee Health Benefits. And again, it's an included drug plan as part of that package. So those are the three groups that do not have a VA, VA, FECA, TRICARE and FEHB. Exactly right. Now, there could be one other, and that would be, of course, anyone that's still working. Uh uh, you know, they're on a group plan, employer plan, union plan, then certainly they don't have to have one either. But the main three would be VA, TRICARE, and FEHB. But beyond that, uh, you need a drug plan. Now, some people say, well, I don't need a drug plan because I don't take any medications, or I just take generics and I can get them for two-dollar copay or four-dollar copay. And that is probably very true. Uh I don't take any medications at all, and I'm glad I hope I never do. However, I know that things can change for you, could change for me, which means what happens if we were diagnosed with cancer, and there happened to be a medication that was an oral cancer med, and there are plenty of those today. Uh, instead of uh traditional uh chemotherapy, a lot of people they are taking oral medications uh that are covered by uh Part D plans, and those are very expensive. So, Josh, I I brought these in the studio today because I thought they were very interesting. Yes, very interesting. Listen to this. Uh there is a medication uh that is um uh called POMList. Uh it is for those who have advanced uh multiple myeloma, um, uh, you know, fairly common disease. And that medication uh retails anywhere from $200,000 to $250,000 a year. So we're talking $20,000 a month. Uh if someone has leukemia or lymphoma, they could be on a medication called calquins. It's an oral med, again, about $200,000 a year. Uh those who have uh non-small cell lung cancer, uh, there's a med called Tregiso, $260,000 a year. And so on and on it goes. So these cancer meds are very expensive. And again, they're not covered by Part B, they're covered by drug plans. Uh, there's a medication that is taken for uh leukemia and lymphoma called uh Imbruvica, very uh popular today, $240,000 a year. Uh one for uh multiple myeloma again, $300,000 a year. So you see the point. We're talking $20,000 to $25,000 every single month for these medications. So if you have a drug plan, which you should have, all of these would be covered. Uh they're they're in the formulary, they have to be covered, uh, and the most you would spend on these meds that are $20,000 to $25,000 a month would be $2,100 for the whole year. Every single drug plan has a cap, uh out-of-pocket spending cap uh that you're responsible for. Medicare establishes that number. Uh last year it was $2,000, this year it's $2,100. So a med cost $240,000 for the whole year, what will you spend? Because you have a Part D plan, $2,100. I am on a Part D plan that costs $9.60 a month. Uh I take no meds. And so my advice to you is do the same thing if you take no meds, still get a drug plan, just get one that's inexpensive. That same drug plan that I'm on uh cost $960 a month in Missouri, it is zero in many states. And we had a uh yesterday we looked at, I think it was like $3.40 in states as well. So the point is you need a drug plan because you have no idea what the future could hold. And you cannot add a drug plan uh just because you get cancer and now you need medications. You can only add drug plans once a year, and that is October 15th through December the seventh. So if you found yourself diagnosed with cancer, needing an oral medication for cancer, and uh you're in April, well, you are out of luck until October 15th to December 7th. You can enroll into a plan that will not begin until January 1st. Okay. That's the issue.

SPEAKER_02 5:53

While you were talking about these cancer meds, because I feel like growing up, whatever, it was always like you didn't have oral cancer meds. So I went back like 15 years, like less than 10 percent of people ever was prescribed some sort of an oral cancer med.

SPEAKER_03 6:07

Right.

SPEAKER_02 6:07

Now, um, and I just look this is on pubmedcentral.gov. Um, they look at the cost split between part B and Part D. Part B covers it's 49 49.1%, and part D is 50.9%. So it's basically a 50-50 split whether or not you're gonna be put on one of these really expensive oral meds that you take at home versus, you know, in in facility treatments, which would be covered under part B. Yeah. I don't know it was that high.

SPEAKER_00 6:36

Yeah, pharmaceutical companies, Josh, they're chasing the money. Uh number one, uh people like the convenience, not having to go to an outpatient clinic. 85 percent of patients preferred. That's exactly or do. Uh and since they don't have to pay uh that full amount, their insurance is or Medicare is, they're happy to do that. Yeah. Uh so that's uh why you know I'm encouraging you to make sure you get a drug plan. And and just so you know, too, 90 percent of all medications that are prescribed are generics. 90 percent. And those are all very low-cost medications. Even oral cancer meds? No, no. Beyond that, I'm not saying I'm saying that as we think about the meds that that our clients take and you're taking right now, it's probably a generic medication. Again, 90 percent or more, and they are very, very low cost. So we don't get, you know, uh you don't get a drug plan to just to cover the meds you're taking now. You get a drug plan in case something were to happen and you needed that expensive med and you want to take advantage of that Medicare cap of $2,100.

SPEAKER_02 7:31

So if half of cancer meds are done orally, covered under Part D, as in drug, you have a $2,000 cap as long as you have a drug plan. If you don't have a drug plan, you could be out of the pocket hundreds of thousands of dollars, right? Because you couldn't sign up until the following year. If it's covered under part B, as in boy, how does the billing on that work? Trevor Burrus, Jr. Right.

SPEAKER_00 7:52

Well, if uh covered by B, everything on the B side is eighty twenty. Everything. Once we've met a small deductible this year, $283, everything on B, including uh uh outpatient meds, uh, will be 80-20. So uh Medicare pays 80 percent, uh, you are going to be responsible for 20 percent, but most uh people have a supplemental plan, and so uh they wouldn't have to pay anything if they had a G plan or an N plan. Uh once that deductible is met, that 20 percent coinsurance uh will be covered for you by your supplemental plan. That's the way it works.

SPEAKER_02 8:22

Okay. Okay. So that's the same.

SPEAKER_00 8:23

And someone who just had A and B only, then they would be out of pocket on that 20 percent on the B medications. Right. All right. And so I I do want to talk uh with you a little bit about uh some of the options out there to save some money on generics. Uh we know that Good RX uh has uh attractive pricing through coupons. Uh another one very similar to that is called single care. Uh we like that. Uh the Mark Kubin started a company a few years ago called um Cost Plus Drug Company. Uh so all those platforms really are excellent to get medications, but again, typically generics. You're not going to see some huge coupons on brand name medications for sure. Uh great for generics, but not so for your brand. So get uh a drug plan. And so if you are on a generic, you don't have to use your drug plan. If you can get a cheaper cash, go cash. Uh but I can assure you uh if you had an expensive medication, uh you'll be grateful that you had a drug plan. Let me just mention a couple others. Those are really high ones. And Josh, right now I have clients that are on uh Stellara. Stellara is a medication that is for Crohn's disease, uh ulcerated colitis, uh plaxorasis. But point is it's an autoimmune uh drug. And right now, uh I have clients that are uh their dosage is 18,000. I had one the other day that was $33,000. And I think it's taken it like every eight weeks. So very expensive medication. Uh and all drug plants cover it. They have to. Um so the point is that's um uh what you're faced with. And and and you know, uh now that Medicare is beginning to negotiate some of these Part D uh uh prices, we have seen some of the even the brand name men's like Eloquis, Jardian, Sarelto, all those, they are still coming down. But uh uh even though they've come down, the drug plan still helps uh substantially because of the $2,100 cap.

SPEAKER_02 10:10

So let's say I have a couple things. First off, I want to talk about um there was a hundred and I think a hundred thousand people that got their drug plan canceled in the last 30, 60 days. I don't know if you've heard about that. So we're gonna talk about that. Um also let's say you didn't go with the drug plan. I know there's a penalty. Let's talk about that, and then when can they enroll?

SPEAKER_00 10:29

Okay. That that's great. First off, let's let's discuss this issue of the hundred thousand. I was not aware of that. What happened?

SPEAKER_02 10:35

Yeah, so uh it basically so welfare is the largest prescription drug. I think you're on a welfare plan.

SPEAKER_00 10:42

I am.

SPEAKER_02 10:42

Right. So they did they they kind of came into the market, said here's a bunch of these zero dollar drug plans, so you don't have to pay anything for it. And then they've started to go up. So there are still some. Everything used to be zero with them. Now they're starting to go up in premium. And so people were essentially not aware of that, or they weren't paying their bills. Okay.

SPEAKER_00 11:03

And so it went from zero premium to nine dollars.

SPEAKER_02 11:06

Eight dollars, nine dollars, twenty-eight dollars, whatever it was. Um and then it went beyond the grace period. Yeah. And then they got canceled. So there's 140,000 members who got terminated for nonpayment and are locked out of drug coverage now until January 2027. Wow. And I I don't think that makes like welfare a bad company as it relates to what they did here. I mean, they they did give people, I think, three months.

SPEAKER_00 11:30

Oh, I I guarantee you those people got notice. Yeah.

SPEAKER_02 11:32

But they I mean there's so much Medicare junk mail, though, you don't even know what's real or what's not.

SPEAKER_00 11:37

Right. Well, the problem really there was, Josh, uh those people were not informed well you know by their broker or they were doing it themselves. They didn't realize the importance of reviewing uh your drug plan every single year. Uh so many people will assume because I like my drug plan this year, I'll like it next year. Well, maybe, but maybe not. That drug plan could be dropped, as in this instance here, could uh uh premium, even though it went up by a few dollars. It wasn't because people couldn't afford the premium, they were just not paying attention to the fact that that went. But that they had a premium now.

SPEAKER_02 12:05

Yeah. And this is I think this underlines when it comes to drug plans, you know, you're probably not gonna switch every year. My guess is you're gonna be on that same drug plan for the next few years unless something drastically changes.

SPEAKER_00 12:16

If they if they drop it terminated.

SPEAKER_02 12:17

But in September, you you know, you if you're on Medicare, you have a drug plan, you're gonna get this thing called an annual notice of change. We call it an ANOC, ANOC annual notice of change. And it's gonna tell you these things. And so if you're going from a $0 drug plan to an $8 drug plan or a $12 or a $25 drug plan, you need to like ask the question, well, how is this gonna get paid for? If not, you're gonna find yourself in the same situation. Yeah.

SPEAKER_00 12:40

Yeah. Let me add to that, Josh. It's true. You have to decide how you want to pay that. If it's zero, it's a non-issue. But if there's a premium, you can do a direct bill, you can have it come out of your Social Security check, you can do an ACH, but you do have to elect how you're gonna pay that. And that's really what happened. Um so that's really unfortunate. I was not aware of that.

SPEAKER_02 12:59

There's a story in here, uh, a guy named uh a lady named Judy Pear and uh or Jude Pear and his partner die in Texas. Uh live in Minnesota until temperatures dip below freezing when they take refuge in Arizona. So he's 77 years old. He said he didn't receive any warning that his drug plan went from zero dollars to now having a premium of I think eight or nine dollars. So his plan got canceled. Now uh he can't get a drug plan until July or until January of 2027, and he's going to have, you know, it's not gonna be a big penalty, you know, two, three bucks um probably, but he'll have to pay that every uh month for the rest of his life. Pear takes the Rall to a blood thinner that reduces his risk of stroke, so he could bleed to death without it. A 90-day supply of the drug cost about $1,800 using a coupon from Good RX. So he's amongst tens of thousands, actually a hundred thousand of people who are on that plan, didn't upgrade, didn't figure out how to pay their premium, and now they're they can't do anything. There's no enrollment.

SPEAKER_00 14:01

Yeah, they won't be reinstated.

SPEAKER_02 14:02

Yeah.

unknown 14:04

Yeah.

SPEAKER_00 14:05

Um that's unfortunate.

SPEAKER_02 14:07

Okay, so that kind of leads us into the next thing. So let's say you don't have a drug plan or your drug plan got canceled, uh like in this situation. When can you enroll and the penalty?

SPEAKER_00 14:16

Yeah. Uh later this year you you will have the opportunity to take a plan uh during uh October 15th through December 7th. Uh we call that the AEP annual enrollment period. Uh, this is a time when if you're on an annual plan, whether that's advantage plan or prescription drug plan, you can switch those plans. Uh so you'll be able to s uh find that plan October 15th, December 7th, but it won't start until January 1. Uh so these people that got uh canceled effective July 1, they are now without uh drug coverage for six months. Yeah. Yeah, and you think about that that that eloquent for him or zero, whatever it was, uh he could he'd probably he'd probably have a deductible, uh small deductible, 615 after that a very reasonable copay. So he's paying about three times the amount for that medication now because he didn't have a drug plan. Yeah. Yeah, yeah. It's crazy. Yeah. Unfortunate.

SPEAKER_02 15:06

Okay, let's talk to Mary Ann in Maryland. Mary Ann?

SPEAKER_01 15:10

Hello, this is Mary Ann.

SPEAKER_02 15:12

Hi, what questions do you have for us?

SPEAKER_01 15:15

Actually, it was more a statement of two experiences I've had with switching plans for my family member. Let's hear it. Um, my family member um Medicare, Medicaid, whatever. Um but I wasn't able to convince you. Unfortunately, because she moved, he could switch without having to put any handwriting. And so sometimes people, I was hoping that and um I have my broker and her so I have a fantastic broker. So I would encourage anybody to get a broker. Um because the education piece, right, in and of itself is great.

SPEAKER_02 16:44

Yes. Um yeah, better than trying to figure it all out alone and then calling a bunch of insurance companies, then there's a lot of rules, a lot of a lot of ways you can make mistakes and things easily.

SPEAKER_01 16:56

And I was very lucky because they had a retirement class at work, and they one of the things was they gave us access to a broker, not thinking how to do that, but it was great.

SPEAKER_02 17:07

That's awesome.

SPEAKER_01 17:10

Now, the second part you were talking about, and I had put this in the chat already. Um I picked a supplement because I had um underwriting pre existing conditions and I knew that I didn't I wanted to do that, and um I got the key because I had enough doctor's appointments that it helped with the end. Um I picked the lowest price and when I first went um Medicare or Medicare part being a supplement. Because why not because the quality of service you get from a company could be important and um initially purchased a page and it was not well known. I thought we'd fine. Um I found they didn't have a website that was interactive. Um and you only got statements once a quarter, maybe. Who was this hard?

SPEAKER_00 18:23

Who was the carrier?

SPEAKER_01 18:24

Yeah, the carrier um light shield.

SPEAKER_00 18:28

Yeah, never heard of them. Yeah, I've never heard of them either. You're probably dealing with a company that was more regional. Yeah.

SPEAKER_01 18:34

Well no, it definitely is. And they wouldn't even be, even though on our Medicare book it was listed there in the you know, Medicare menu you know, 2004, 2000, whatever it is. But um anytime you went to the doctors, they never heard of it, it wasn't in the drop-down menu of company. And then my other family, my family member, um they couldn't find it and they charge her money for it, and then she had to get reimbursed later on. And it it just was a big deal. Um but fortunately, Maryland has so we could switch plans on our birthday without underwriting. And I know not every state does that, but that was something that was fortunate for us that we could then switch it. So that was wonderful.

SPEAKER_02 19:36

And um and that was one of my broker would be like, what did you get switched to?

SPEAKER_01 19:42

Humana.

SPEAKER_02 19:43

Humana. Okay, there you go. Nice, that's a good plan. Oh, we have heard of Humana. Definitely, definitely wouldn't recommend. There, there are some fly by night insurance carriers out here offering these Medicare supplement plans. And you know, the service is, I guess, one thing. Generally, there's not a whole lot of service, I guess, that happens on a Medicare supplement because they pay the bill after Medicare pays. But, you know, I think your point about having a website to go to lock in login, like that's that's all very um standard now in in insurance and what our expectations are. So that's a great point.

SPEAKER_01 20:18

Well, they didn't have that, and then so um my family member they had her pay up front because they didn't know how to process the claim. Eventually it got worked out, but it but she had to pay up some of it, and it was that was not something that she wanted to do, but um, and I just like the convenience of having um a website um so I could find the status of my bills, especially when you're doing the deductible. When is when is my deductible hitting so that I have to pay and and so forth.

SPEAKER_02 20:54

Um okay, Marianne, thank you for sharing your experience. We're gonna hop to our next call. It's wonderful talking with you. Thanks for sharing because I do think it's helpful for folks. Yeah. Thank you. Take care. Bye bye. See ya. I think that underscores like not only is like logistically being able to have a website, all those sorts of things, the bigger thing is a company like Life Shield, never heard of them. I tried to look at their website. Um, there's probably like a few thousand people in that plan. Compare that to Humana, who has hundreds of thousands or maybe millions of people in their book of business. And so from a long-term price stability, but uh it's probably some insurance broker working out of the back of his car, recently got a contract with Life Shield or whatever it is. And I'm not trying to knock them. We started out the back of our car too, 15, 20 years ago. But they get contracted with one insurance carrier, that's all they know, like some Life Shield.

SPEAKER_00 21:46

Well, they're also selling price, Josh. Yeah, yeah, yeah. That's all they're doing is uh they're saying all the the coverage is the same, so why worry about just take the cheapest? But obviously, as that lady testified, there can be more to it than just that. Plus, I I can assure you There's no way that company is going to stay long-term stable. They just don't have enough uh people in the book in the book. It's just not going to happen. So that's how they attracted it. No one's going to buy it unless it's a low price. And so that's that's what the agent really capitalizes on.

SPEAKER_02 22:16

Okay, we've got uh Bill in North Carolina. Bill, welcome to Medicare School Daily. What questions do you have, sir?

SPEAKER_04 22:23

Hey, good afternoon. Thank you for taking my call. Yes, sir. Um, I have signed up for A and B, which will start on the first. I am currently on a Cobra plan for just dental and vision from a previous employer. And I'm wondering, since I'm leaning towards an end plan, which does not include vision or dental, can I stay on the COBRA plan for vision dental once Medicare starts?

SPEAKER_00 22:47

You sure can. No problem at all. So uh is that going to what last 18 months uh or longer? Correct. Okay, good. Correct. Yeah, it's no problem. You can you can Cobra that as long as they allow you to Cobra it. Yeah. Uh so it won't won't interfere uh with that. And then what will happen that once that Cobra is expired for the dental vision, then you can buy a standalone dental vision plan if you decide that's uh what you want to do.

SPEAKER_02 23:09

Yeah, so there's something that is kind of that is important. Um there's this concept called uh CPC, uh credit for prior coverage. And so it it's not available everywhere, it's not offered by most insurance carriers, it's not offered in every state. But hopefully um you can work with maybe a broker that can help you when you do make that transition, find a policy that gets you credit for prior coverage, meaning there's not going to be a year or more waiting periods before the plan really does much. Right? So generally, when you purchase a dental plan on the individual market, there's it's set up as a waiting period. And if you think about it, it makes sense, right? There they they can't say, hey, here's a $35 a month premium or whatever it is, and the very next month you go and have $2,000 worth of dental work done that they have to pay for. And then you cancel the plan in month three, right? So what they do is they say, Hey, get the plan. We'll cover a little bit, we'll cover your cleanings, we're not gonna cover too much more. And then after you've been on the plan for a year, then we will go ahead and we'll kick in and um basically have have have real insurance at that point. But there are some plans that have this credit for prior coverage, and as long as you're coming off something, they will say, Well, you know, there's probably not gonna be a bunch of bills right away because they already would have got it done because they already had a dental plan. Make sense, right?

SPEAKER_04 24:28

Correct. Um, but let me let me just clarify when you say let the Cobra run for its whatever however many months, then get a dental plan. When you say get a dental plan, this will not be part of Medicare. This would just be some standalone piece of insurance that I buy from a broker. Generally, yes. Yeah.

SPEAKER_02 24:45

Yeah, there's that dental Medicare doesn't offer dental coverage. Some Medicare advantage plans will have some small benefit included, um, but generally it's an independent, you know, it's it's a piece of insurance like you described it. All right.

SPEAKER_04 25:00

Well, since you bring up an advantage plan, let me ask you if you know about this one. You guys seem to be very knowledgeable. In the state of North Carolina, I'm a retired school teacher. So um they have a plan which basically is just it's it's Humana Advantage, but it's basically a continuation of the coverage we're on before we turn 65. Do you guys have a I mean, I know you can't prop particular companies, but anything bad to say about that or good to say about that?

SPEAKER_00 25:26

Yeah. Well, I have a couple things I'd be concerned about if I were you. Uh so the employer plan uh once you retire becomes a Medicare Advantage plan. So it's not going to be the same for sure, same name, but advantage plans are still going to have uh their network issues. They're still gonna have pre-authorization that uh they can impose upon you. If you need uh anything that's expensive, an MRI, a CAT scan, uh if you need a skilled nursing stay, if you need an outpatient surgery, inpatient surgery, because of an advantage plan, they have the right to say uh we have to approve that first. And if they don't agree with the doctor's recommendation, they're not going to approve it. Uh so now of a sudden you're um either gonna have to pay for it out of pocket or or just not get that service. So that's the issue with advantage plans, whether it's a uh just a normal market advantage plan or it's one that's become uh uh you know an employer extension plan. Those are called waiver plans.

SPEAKER_02 26:20

Uh is that plan does it have a premium? Like do you have to pay a cost for that?

SPEAKER_04 26:26

Well, there's three different versions of the plan you can choose from. Two of them have no premium, and the enhanced plan does have a premium. Okay. Um but um uh I mean my my the reason I kind of am leaning looking at that is because you guys have mentioned that a lot of advantage plans disappeared, and one of the reasons is enrollment, which I don't think would be a concern in this one, uh considering it's you know retired state employees. But um I don't know, just just wondering what y'all might think about it.

SPEAKER_00 26:58

Well, Bill, even though it may not disappear, they still have the right to change whatever they want. Yeah, I just give you annual contract. Yeah, a personal story. Uh my mother uh retired from ATT and had great insurance from ATT. They had what they call an indemnity plan, which paid second to Medicare, and then they took all their ATT retirees and put them on advantage plans. Um and and honestly, she's had nothing but but but problems on that. Uh unfortunately, I can't get her off of it because she can't medically qualify to do that. So the plan's still there. Uh but um it's it's truly not a very good plan uh compared to you know as far as an end plan goes. Bill, my view is this, sir. You have to decide what's important to you. But I would want uh at our age, and I'm just a little bit older than you are, but at our age, uh I think we do not need to be cutting corners on the quality of our health insurance. And when you get an advantage plan, you're you are cutting the corners somewhat. Not totally. Uh they're still they'll still cover things, but you have to decide what what's important to you. How how do you want your insurance to work? Do you want to be in a network plan? I don't want to be. I want to be able to go to any doctor I want to. What happens if you want to go to certain oncologists with your cancer and you can't uh go to that one because they're not in the network? Those are the kind of issues that people face on advantage plans.

SPEAKER_02 28:13

Uh it is not all access to specialty clinics, mayo clinic, M.D.

SPEAKER_00 28:17

Anderson, all of those are you can't go to those places. And I'll tell you else what's going to happen. Humana is going to decide when you get discharged from a skilled nursing facility. And this happens all the time. There are premature discharges because an insurance company says uh we're we're not going to pay after 14 days, we're not going to pay after 22 days, and they set that limit, uh, not not based upon uh what the doctor is saying or the clinical evidence. They're just saying we're done paying. And I mean, story after story I can tell you about people being discharged from skilled nursing facilities on advantage plans, or even can't even find someone to take it. Uh and then that happens regularly as well, because the reimbursement rate is so low from advantage plans on skilled nursing um facilities, uh they they just won't take them. So I'm saying you you're gonna have some limitations. Uh so my view is if you can't afford a little extra, get an end plan. What's it gonna cost you? $100 a month, $110 a month, and now you can go to any doctor that takes Medicare, you don't have to fight the insurance company on pre-authorizations. To me, it's worth it.

SPEAKER_02 29:18

No, not works. It's your plan for as long as you want it. The one thing you can be guaranteed of on this North Carolina State Health Plan, Humana Medicare Advantage Plan, is it's gonna change every year, and you don't have a control over that. Right?

SPEAKER_04 29:29

And so if you ever one office, the current plan Yeah, the current plan is Aetna, and then they switch it to Humana, and it's only been Aetna for two years before it's Blue Cross refuge.

SPEAKER_02 29:38

Yeah, so yeah, it changed. It's always gonna change. And the here's like I I guess the difference in and how I would I would view some of this as it relates to like when you're on employer coverage, you're given a couple, two, three options, right? Of a plan, you know, you want the high deductible this year because you're feeling healthy, something comes up in your health, next year you switch to, you know, the enhanced plan. You know, you can move around. When it comes to once you're retired, you're on Medicare, you're making a decision, perhaps right now, that this is your plan, right? And you are you're saying, hey, if something comes up in my health that I am not able to medically qualify to get on an in plan or to get on a G plan down the road, like that's that's a risk you're taking, right? Just like my dad's mom. That's the same thing. Plan changed, she'd love to get off, can't. So it it it all it not to say this plan is bad. It's just to say you have to understand like the pros and the cons, the risks, the trade-offs, and all of it. Trevor Burrus, Jr.

SPEAKER_00 30:32

And you just can't look you just can't look at the the dollars in in monthly premium. That's yeah, I I wouldn't. I would look at the quality of what you're gonna be dealing with if you had a cancer or you uh uh you know have some kind of a you know serious heart issue. You've got to look at at the ramifications of that decision to take a Medicare Advantage plan. Bill, no one complains about being on a supplemental plan ever, ever, ever. Now, the premium may go up and they may dis be disappointed in that, but when they look at what they're really getting for uh their premium dollars, they're really quite satisfied with that. Yeah. Yeah, because you don't have to go ahead, I'm sorry.

SPEAKER_04 31:10

No, I I was uh Josh kind of got me yesterday uh listening to the program because I was thinking, you know, do the base plan for a year and then kind of evaluate and switch. And he kind of dorped that yesterday. So you guys are on top of it.

SPEAKER_02 31:24

Yeah, okay. All right, thanks. Thanks, Bill. If we can help you, let us know. Um we know it's not easy to switch yet.

SPEAKER_04 31:30

Go ahead. Go ahead. Yeah, what one other quick thing I'll take off the air. Uh when I went on the website, I was trying to follow you guys' instructions as far as signing up for A and B, and it's not quite as easy as y'all make it sound. So maybe I want to go through that again for us.

SPEAKER_02 31:43

Okay, well, we are getting ready to roll out a new instruction because there have been a few pieces that have changed. Um it got very circular.

SPEAKER_00 31:52

It's taking you back to the same string. Okay, now I just did one, Josh.

SPEAKER_02 31:56

It's a login.gov, all of that. Yeah, I just go through it.

SPEAKER_00 31:59

Okay, let me ask you this. So, do you do you have an SSA.gov account? I do. I do. Okay, very good. I I promise you, I just did one. Okay, it took five minutes. Okay. So once you're logged in.

SPEAKER_04 32:09

No, I I I I've signed up. I've been calling them and signing up. Okay. Yeah. I just I tried to go through the website and it just was not working for me.

SPEAKER_00 32:17

Okay. Wow, that's a bummer. But I will say say this, just so you know, anyone uh you know listening today, if you if you look you get logged in there, uh it it takes you to basically the Social Security site. Yeah. And you almost feel like you're applying for Social Security, but but you're not. You just you just push there's one, I'm gonna uh you know, do the application, and then it's gonna come and within about two or three minutes, it's gonna ask you uh are you applying for Medicare only or for uh retirement benefits? And you're gonna say Medicare only. And then they will not ask you any any more financial questions, any more Social Security questions. So that's I think one of the confusing aspects about that. In the old days, we could initially say I only want Medicare, and now you've got to get in the application a little bit before they do it.

SPEAKER_02 32:59

What was your particular problem?

SPEAKER_04 33:01

Well what what happen what happen what happened with me, and I don't know if other people are running into this, but you got to the tab that said sign up for Medicare. And you would click on that and it would take you back to sign in that you had already just done to get in SSA, sign in, you'd get back to the same screen, say sign up for Medicare, it'd take you back to sign in. I mean, I could never get past that. So it was just kind of dissolved. So how did you end up signing up? You said you called? I I I called the Social Security office, they uh signed me up over the phone, and I have received my cards.

SPEAKER_02 33:32

Could they just handle it recently?

SPEAKER_04 33:34

They did they did everything they did it over the phone? Yeah, there you go. That's great. That's great. I'm saying that's interesting. No, I mean that's fine. I mean, there's other ways of getting it done, but it's just it was uh I kept looking for that tab at the top you were talking about, like apply for Medicare, and it I didn't see it. They moved it. Maybe it's user user error.

SPEAKER_02 33:53

Good trick, quite possibly user error. Well, they probably have changed the system, so we are working on updating all of our instructions as far as that relates. So makes sense. I appreciate that. Well, thank you guys.

SPEAKER_03 34:03

You guys are very good. Thank you.

SPEAKER_02 34:07

Appreciate it. Take care, see you. On our YouTube channel, you can leave questions, and we have somebody, uh, his name is Chad, that actually goes through and answers all of your questions on YouTube. Sometimes we answer them live on the air. William ask a question: Do you also sell advantage plans? That's uh a funny question because we say all the time that we do. Um, but we also talk about Medicare supplements a lot. So I think people associate Medicare school with, oh, that's who I'd call to get my Medicare supplement. The truth is, if you call us, there's a hundred people that call us, 75 of you will probably end up choosing a Medicare supplement, like a plan G or a Plan N. The other 25 will choose a Medicare Advantage plan. We are not anti-advantage plans at all. We just believe that everyone should know the truth about them, the pros and the cons, and make an educated choice. And we've we talk about, you know, the good and the bad all the time. So, yes, if you want to go with an advantage plan, or maybe you're on a Medicare supplement plan, premium's gotten too high. Or maybe you're on a Medicare Advantage plan and you want to switch to a new another Medicare Advantage plan. We uh are able to help you. You can call in. Our phone number is 800-782-6676. When you call in, you're not calling the other side of the world, that somebody you can't understand. You're gonna call into somebody who's right here in Kansas City. They've all been trained by my dad, Marvin, and you're gonna get a great, great experience. You're gonna be able to compare all the advantage plans, the supplement plans, drug plans, dental plans, whatever it is. Hold your hand through that whole process so you don't make any mistakes, and you can literally kick back and it's gonna be done. There's no cost for our services. So I encourage you to call in if you need assistance, 800-782-6676. There are two ways that you can guarantee yourself that you are going to pay a Medicare penalty. Tomorrow we're gonna talk about those and how you can make sure you don't make that mistake. Unless you like making a penalty, paying a penalty, of course, which nobody does. So join us tomorrow. You will learn how to guarantee you're gonna have a lifetime penalty and of course how to avoid it. See you then.