What Happens To Your Medicare If You Move States

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Moving states? Your Medicare plan may not move the way you think it does.

In today’s episode, we’re talking about what can change when your ZIP code changes, why some Medicare coverage can follow you almost anywhere, and why other plans may need to be replaced when you relocate.

We’ll also get into the questions people should ask before moving, especially if they care about keeping certain doctors, hospitals, prescriptions, or plan benefits.

This is one of those Medicare details people usually figure out after the moving truck is already gone. Today, we’re getting ahead of it.

Transcript

SPEAKER_01 0:03

There are over 5,000 Medicare Advantage plan options in this country. There's probably 40 to 60 Medicare supplement insurance carriers offering probably eight to ten different Medicare supplemental plans. That is a lot of different options. When you start Medicare, you got to start one of these, right? You have to choose which direction you are going to go. Well, what happens if you move? Whether you move across the city, across the state line, across the country, uh, what's going to happen to your plan? Because some of these plans will move with you. Some of them force you to have to reshop and go back to the drawing board as though you were starting all over from the very beginning. So you're going to learn today what happens to your Medicare coverage when you move. Welcome to Medicare School Daily. My name is Josh Music. I'm here in the studio with Justin Cohen. Justin is filling in for my dad who is in India. He will be back uh, I think next week, and will be joining us back on the show. But in the meantime, you get the pleasure of listening to Justin. Justin has helped literally thousands of people, just like yourself, walk through their Medicare situation. So you can call in, you can ask for Justin, ask for anyone here at MedicareSchool.com, and we would love to help you. If it's not quite time for you to enroll, maybe you just have a question about your situation, whether that's Medicare or Social Security or just retirement in general, you can call in to this show. We're here from 11 a.m. to noon Central Time, Monday to Thursday, 11 a.m. to noon central time, Monday to Thursday. The phone number to call in, be a part of the show, get your questions answered from somebody who's not going to sell you anything. That phone number is 833-824-2004. 833-824-2004. Justin, let's talk about what happens when you move. Let's talk about advantage plans, supplemental plans, and everything somebody needs to know if they're planning to move once they're on Medicare.

SPEAKER_07 1:50

So, yeah, when you move, when you change addresses, uh depending on the kind of coverage you have, will affect if anything changes, right? For our clients who have original Medicare and a supplement plan and a prescription drug plan, largely their coverage just travels with them. Whether they move across the street or across the country, uh original Medicare is coverage in every state, so that doesn't get changed. And your supplement plan is also effective anywhere Medicare is, so that doesn't get changed. But your drug plan will not survive the move. You have to select a new one. Now you get a letter in the mail if you don't take any action. When they notice you've moved, they'll send you a letter telling you that they're canceling your drug plan and that you need to replace it with a new one. And we help people replace those all the time. It's done at Medicare.gov. You pick a new drug plan that's offered in your new county.

SPEAKER_01 2:39

Okay. Now drug plans are statewide, I think. I know they used to be like different, but I think they're largely statewide, right? So if you move within your state, you may not have to change drug plans. Would that be fair?

SPEAKER_07 2:50

Yeah, that's fair if the same drug plan code is offered in the new county.

SPEAKER_01 2:54

Okay.

SPEAKER_07 2:54

But the codes can vary from county to county. You can have the welfare value script in Jackson County, and it might be different in Cass County. If the code is different, then the plan will cancel.

SPEAKER_01 3:02

So what could someone do? They could probably go to Medicare.gov, look at the code on their card, type in their new zip code, and see if those codes match up. So when you're in Medicare.gov, it's always going to say the name of a plan. Like I'm looking at one right here, it says Humana Basic RX plan, and then it gives a plan ID. That code, which is going to appear on your ID card, is also the code that appears in your new county or your zip code on Medicare.gov, then you don't need to do anything, right?

SPEAKER_07 3:29

That's right. The same plan is available, so you don't need to change it.

SPEAKER_01 3:32

Okay, a couple of questions. So as it relates to the drug plan, and then I want to go back to supplement plans because I think there's a couple of questions there. You move. Do you call if you're with Humana, let's say do you just call Humana and say, hey, I need to know if I need to change plans, or do you just do an address change, or how is all that because they're not going to know you move necessarily. You've got to notify these carriers, right?

SPEAKER_07 3:54

Well, when you move, you need to notify Social Security. You call the national Social Security number or you visit the local Social Security office in your new area and you inform them of your move. They're sending you benefit notices in the mail periodically. You want to make sure those go to the right address. And so people do update Social Security by calling the main national number. Also, if you just uh file a change of address with the post office, that makes its way back to Social Security. And so they'll find out. Trevor Burrus, Jr.

SPEAKER_01 4:24

I wouldn't probably wait on that as it relates to your insurance coverage, though. No. You probably want to be proactive. Trevor Burrus, Jr.

SPEAKER_07 4:30

It's a good idea to go ahead and take care of it. Trevor Burrus, Jr.

SPEAKER_01 4:31

Call Social Security, then call your insurance carrier. And then the insurance carrier will tell you, oh, that plan doesn't probably exist.

SPEAKER_07 4:38

Well, we encourage our clients to call us and let us know as their agency of record so we can make sure they don't have to remember anything and we're going to handle the code. There you go.

SPEAKER_01 4:45

If you move, call us.

SPEAKER_07 4:46

Trevor Burrus, Jr. That's right. But for uh all of you out there listening who are not our clients yet, then yeah, you're going to go to Medicare.gov after reporting the move to Social Security, and you're going to find out if the Humana basic RX or whatever drug plan you're on has the same code in the new county. If it's a new code, then uh you want to enroll into that new drug plan. You get a certain amount amount of time to do this.

SPEAKER_01 5:08

Aaron Powell I think it's like 63 days or something. It's like yeah, 60 days maybe. Yeah.

SPEAKER_07 5:13

Well they give you the month prior to your move and then the month of and the month after. Okay. Or if you move and then notify Social Security, you get 63 days from the notice.

SPEAKER_01 5:23

Okay. So do it within 30 to 60 days, and then you're going to be safe. Okay. So uh back on the the uh Rx and the other thing I want to mention real quick on RX plans. So there are, let's say you stay on the same plan, right? So maybe it's the Humana Basic RX plan or the Wellcare value script or whatever it is, you move, there could be a price change on that. So the plan code that you could be on the same plan, but in a different state or a different plan code, it could come with a premium. So there could be some differences there.

SPEAKER_07 5:56

That's exactly right. And you're not necessarily looking for the same exact drug plan. You're looking for the best drug plan for your meds. Just like when you choose the original one, you tell the computer what medicines you take and what pharmacy you plan to use to fill. And Medicare's website will sort all of the drug plans so that the one that's most cost effective for you will be on top. That's the one you want.

SPEAKER_06 6:15

Okay.

SPEAKER_07 6:16

And it might end up being the same one. Last month I helped a gentleman move from Tennessee to Indiana. And uh in Indiana, the same plan was available, same name, different plan code. And in Tennessee it was $50 a month. In Indiana it was $71.

SPEAKER_01 6:30

Okay.

SPEAKER_07 6:31

But it was still the right plan. So we helped him enroll into that. And you know, he's doing great. But you have the opportunity to pick any drug plan that's offered in the new county, so you want to get the one that's best for those meds.

SPEAKER_01 6:44

Okay. Uh let's talk about Medicare supplement plans, because obviously, you know, the one of the great features of a Medicare supplement plan is it kind of supplements original Medicare. There's no networks, there's no location, right? It doesn't matter where you use it. There's not a region that this plan needs to work in. It's fully portable. So you can move with it. But they do have the right to change one thing. What is that?

SPEAKER_07 7:08

That is your monthly premium. That's right. Uh you have to buy a supplement plan that's offered for sale in the state in which you live. So those are by state. Yeah. Um but you can get it from any carrier. It works the same everywhere. Uh but when you move from an area where the rates are lower and you move to a state where the rates are higher, then you can expect to get a letter in the mail telling you that the r your rate is adjusting to match the community.

SPEAKER_06 7:33

Okay.

SPEAKER_07 7:33

In the new state. Now that doesn't obviously work in the reverse necessarily. If you live in an area where the rates are higher and you move to an area where the rates are lower, you don't get a letter.

SPEAKER_01 7:45

And they don't accept the higher premium.

SPEAKER_07 7:46

No, they keep it.

SPEAKER_01 7:47

But they have the right to adjust it to whatever would be normal and customary in that state. Because the states do vary in rate wildly. Uh yeah, not crazily, but you know, there are some states where a plan G is going to cost 140 and some states where it's going to cost 200. And so if you move. Generally those states are I would assume like Florida and probably California, like maybe not California.

SPEAKER_07 8:10

It depends on the area. The farther south you go in the Florida Peninsula, the more expensive supplements get. The farther north you go in the northeast, then the more expensive they get. That's where most of the OE, the open enrollment states are we were discussing the other day. Um New York, for example. Uh very expensive. Yeah. A supplement plan that's $150 in the Carolinas is $350 in New York. So if you move there, the rates are going up.

SPEAKER_06 8:35

Right.

SPEAKER_07 8:36

But if you move from New York to the Carolinas, no, you you you have to qualify medically if you want to lower your rates.

SPEAKER_01 8:41

Yeah. So i if you are moving, I think that's a that's an interesting point too. So if you move into a situation or to an area where you you let's say you move from the Carolinas to New York or just to a state that's more expensive. Uh you get hit with that notice, hey, your premium is going up a hundred bucks. At that point, if your health is good, it would be wise get in touch with us and let us shop and see if there's a better carrier uh or a better rate that's available. You're not going to change your coverage, you're just going to change the name on the insurance card, right? That's right. Medicare supplement plans are standardized by the government, their benefits are all the same. So it doesn't really matter uh necessarily from a benefits perspective what carrier is on there. If you can save a thousand bucks a year, you probably ought to make that switch. So when you do move, use that as an opportunity. If you get hit with a rate increase notice, reach out. Let us see if there is a better rate uh that is available. Uh okay. So subplans, Medicare supplement plans, uh drug plans, we talked about that. Let's talk about Medicare advantage plans.

SPEAKER_07 9:44

Yes. Uh these are also by county. And so if you move within the same county, then nothing needs to be done. If you move across county lines, then if the same plan with the same plan code is available in the new area, then you can just keep it. But you don't have to. You can use this opportunity to change your Medicare Advantage plan if you want to. Even if it's available? Even if the same one is available, because if there are new options available in the new county that were not available to you in the previous county, which is almost always the case, then you can use this opportunity to change your advantage plan if you want to.

SPEAKER_00 10:20

That's right.

SPEAKER_07 10:20

In fact, it's going to be necessary the farther away you move. Uh but just from county to county, you might not have to change, but you can if you want to.

SPEAKER_01 10:27

Even if that plan is available. Yes. I did not know that. Okay. So the the uh that's a that's a great little loophole. Now, I've heard it said, and I think it's true, that sometimes that can even trigger your right to get a Medicare supplement. You want to speak on that for a sec?

SPEAKER_07 10:43

Yes. Uh that's also a great opportunity. We're always looking for opportunities to help people change to original Medicare, mostly because that's what people are asking me to help them do. And when somebody cannot pass medical underwriting, um sometimes later we find out that they're gonna move to another state or another county. And um so that gives the opportunity to use what we call guaranteed issue for the involuntary loss of the Medicare Advantage plan coverage, so no fault of your own. You moved. It's not your fault.

SPEAKER_01 11:12

So it that plan would I the plan would have to truly not be available. Because we've gone through I've gone through this with some people, and um that there was somebody, this was probably two, three years ago, somebody moved. We tried to use this code to where they could get a Medicare supplement plan without any underwriting, saying, hey, they moved. And the person, I can't, I'm not gonna say the insurance carrier name, but they don't want that business. No, right? Because they know that person is doing this, and the reason they're trying to get in without medical underwriting is because there's something in their health. So they're gonna fight, just like the birthday rule that we talked about yesterday. They're gonna fight to keep you from doing this. And I remember going back and forth with like one of the people at this insurance carrier saying, uh, no, this is a different plan. And they said, Well, technically, we offer plans that are the same or better than the plan he was on, and so he needs to go on that plan. Or there are plans that are available. So they were like arguing back and forth, I don't think we won it. Like, I don't think we won that. I don't think the insurance carrier granted him to actually be able to get that or take advantage of that. But if you, let's say you were with a Medicare Advantage plan, you move across the country and there's nothing like it available, I think an insurance company would probably have to take you, but they're gonna make you fight.

SPEAKER_07 12:31

They don't make it easy for guaranteed issue. You're right. They don't want the business, they don't know the risk, and that makes them uncomfortable. And I've had clients that have super legitimate reasons to use guaranteed issue. There's no doubt about the situation. And sometimes they've called me back later crying, saying that the insurance carrier just strong-armed them, just just str stiff armed them, just said, no, what's what's a birthday rule? What are you talking about? Trevor Burrus, Jr.

SPEAKER_01 12:57

Other than in a handful of states, right, where it's year-round what we call OE or open enrollment, um the the the time to get a Medicare supplement, the only time that you can feel confident you are going to get that plan without any issues or headaches or hassles or health questions or anything is within the first six months of when you start your Medicare Part B.

SPEAKER_07 13:19

That's right. We generally always recommend that somebody understand the pros and cons of both coverage types before they make that initial decision. You have to get a supplement while the getting is good. Now we're here talking about it because the the loss of a Medicare Advantage plan due to a move to an area where that plan code is not available is a legitimate reason to use guaranteed issue to get a Medicare supplement plan. Not all letters. Some plans, some letters. Um but the law says the carriers have to do it. But getting them to comply and write your application is sometimes another story.

SPEAKER_01 13:51

Aaron Ross Powell, Jr. Are you going to go? I mean, how much leverage do you have over, you know, a $300 billion insurance carrier? Probably not much.

SPEAKER_07 13:58

I feel I have very little.

SPEAKER_01 13:59

Yeah, very little. I feel like I have very little and I probably have more than more than most. So yeah.

SPEAKER_07 14:04

Even with the law on our side, sometimes it's hard to get them to do the okay.

SPEAKER_01 14:10

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

SPEAKER_05 14:18

Hello, thank you. Thank you, thank you. Thank you. What's up?

SPEAKER_01 14:22

Tell us what's going on.

SPEAKER_05 14:26

Well, I want to know a little bit about what I'm getting into as far as trying to get Medicare for myself. Sounds good. And to know what is what do how do I know what is right for me?

SPEAKER_07 14:40

This is a very good question. Yes, one that I get all the time. It sounds like we need to help you understand Medicare a little bit, uh make decisions between supplement plans and advantage plans. Uh we recommend that you have a uh a meeting with one of us. Uh you're welcome to have that meeting with me or any of my colleagues. Uh we'll want to discuss your your current situation and learn quite a bit about it so that we can make a good recommendation. Um initial questions though, the that's right on the tip of your tongue that you really wanted to ask today.

SPEAKER_05 15:11

Yes, between the uh supplement and the uh what was the other one? Supplement and the advantage. Uh-huh. Um I was told, well, I've heard, I think I was told. I was hurt if I choose the supplement and no, the advantage, the advantage first, and then like I'm not very a sickly person, I'm very healthy person. I only take two medications right now. And if I wanted to switch up to a supplement, there is a penalty. Is that correct? Maybe I was told wrong. I don't know. I'm I'm learning.

SPEAKER_07 15:45

Yeah, you're you're starting to l the the the journey. Uh there's a lot to learn, but you're right. Uh there's only a certain period of time during which a person is guaranteed to be able to qualify for a Medicare supplement plan, and that's gonna be for the first six months while you're on Medicare. Okay. It's called your open enrollment for Medicare Supplement Plan. During that time, if you choose to get a Medicare supplement plan, you're gonna get it. Your application will be approved and you'll get the card in the mail and you'll enjoy what they call the Cadillac coverage. If you go the other way, though, and get a Medicare Advantage plan and then later decide that you want to switch to a supplement plan, it's not so much that there's a penalty on ADA. It's just that you're not guaranteed to actually get what you're looking for.

SPEAKER_05 16:30

Okay. Got it, got it.

SPEAKER_07 16:32

They'll ask you a series of health questions and you'll have to medically qualify for that coverage. And if you have pre-existing health conditions, the penalty is sorry, your application is denied. Please drive through. Okay.

SPEAKER_05 16:46

So when you So when you I'm sorry, I didn't mean to cut you off. So when you get Medicare, you get the A and B at the beginning. Is that correct?

SPEAKER_07 16:56

That's right. Part A is your inpatient coverage. Think of that as the inpatient half of your Medicare. Okay. Part B is the outpatient half, the medical insurance, the physician coverage. And that's the one that carries a monthly premium. It's a couple hundred dollars a month right now for most people. And then when you have both A and B, what you have is called original Medicare or traditional Medicare. And it's different from what you're used to, because it's from the federal government now instead of from a private health insurance carrier. You'll like it in three main ways. Uh just briefly, no networks, no referrals, and no pre-authorizations. That's the good stuff.

SPEAKER_05 17:33

Okay.

SPEAKER_07 17:34

But at the end of the day, they're only going to cover 80% of the medical bills. Okay. So while Medicare is a great start, it's not enough by itself. We have to get something to go with it to cover the leftover 20%. That's where your decision is going to come into play. Because there are two different ways to go. You mentioned them. One's a supplement, one's an advantage plan. And will again help you understand the pros and cons and decide which one you want to put your name on. But you want to pick this like you're going to be married to it. So very important, yes.

SPEAKER_06 18:11

Okay.

SPEAKER_05 18:12

That sounds, I mean, I understand that part. I got that real, I have that down real good right now.

SPEAKER_07 18:17

Oh good. Yeah. Well, what you're looking for is just someone to be honest and help you decide between these two things. Is that right? Exactly. Yes, sir. Okay. Well, you know, there's no right or wrong answer, given that there's no crystal ball that tells us if you're going to stay real healthy or get real sick. But you have to you have to decide early on which one you'll get. So just briefly, maybe we'll go through them just at a high level. Okay? Okay. Okay. Have you ever heard somebody say that they make Fords and Chevies because different strokes for different folks? Yeah. It's a matter of preference. Some people will sit on one, some people like the other. Well, in Medicare, it's really helpful to think of this as they actually make Cadillacs and Chevies. Option number one is called a Medicare supplement plan. A lot of people tell me that's the Cadillac. Not only because that's the one where are you supplementing your Medicare, all right? Medicare A and B covering 80% of the bills, you buying a Medicare supplement plan to cover the other 20% of the bills, leaving you with 100% coverage with no networks, no referrals, and no pre-authorizations. That's a Cadillac if I've ever heard of it. Plus, that supplement plan is going to cost you another $150 to $200 a month on top of the cost of original Medicare. So this could be $350 or $400 a month. So to a lot of people, that sounds like a Cadillac. Wow. Now the only thing anybody ever complains about after they decide to go this way is the monthly cost, right? They never complain about services being denied or providers being out of network, or there's really no problem that I need to typically help them solve. But it's just the monthly cost of it. It needs to be affordable. And you also, as a healthy person, need to decide that you're willing to pay to park that Cadillac in your driveway for I don't know how long before you might actually get some good use out of it, right? Right, right. You gotta get it while the getting is good in order to have it later on when you need it. So that's option one. And of course you'd have to get a drug plan to go with it. And if you wanted a dental plan to go with it, and so by the time we're done, sometimes it is $400 a month, maybe even more. Wow. So Cadillac. But not everybody's gonna go that way. Not everybody has that much money to spend on health insurance, no matter how good it is. So there's also an option number two, right? Uh that is called a Medicare Advantage Plan. Medicare Advantage Plan. And those are desirable because they don't cost an extra $180 a month. They actually cost nothing extra per month in most of Texas. Zero dollar a month premium. And you know what? Part D drug coverage is included as a part of it. Okay. And dental coverage typically included as a part of it. I mean, you don't have to buy these things separately. It's all included for $0 a month. So the price is right. Now remember that's zero on top of the cost of original Medicare Part B.

unknown 21:22

Why?

SPEAKER_07 21:22

But it's zero extra. So this isn't $400 a month, it's just $200. But Medicare Advantage plans are also known as Medicare Part C. And I think C stands for copays. Right. That's because when you're not paying a monthly premium to have the insurance, of course you're going to pull your wallet out when you go to use it in the form of copies. And the copay's really are not unreasonable. All right. If you look at the cost of the copay's, they are pretty reasonable.

SPEAKER_05 21:49

But if we get it depends on the specialists.

SPEAKER_07 21:52

It can depend on the specialist, the procedure, the the illness, the you know, if we're talking chemo, I mean that's 20%. So depending on how ill we are, those copayers can really start to add up. And they can eat a person's lunch. But only up to a certain point, right? Six, seven, eight thousand dollars a year is pretty normal for a max out-of-pocket where you live. So that would at least be uh the point at which when the bills stop adding up. Okay. Now you should also know that a Medicare Advantage plan is not supplementing your Medicare like that Medicare that option number one did. A Medicare Advantage plan, Medicare Part C actually replaces your Medicare A and B. And it becomes the primary insurance. And it's going to be an HMO or a PPO. It's a managed care program from a private health insurance company. So now we're back into the area where we do have networks. And we do have pre-authorizations. And if it's an HMO, you'll likely need referrals from the primary doctor. So these are not as flexible. They're more restrictive. They've got a couple of maybe a couple of bummers built in with pre-authorizations, but hey, at least it's less expensive on a monthly basis.

SPEAKER_05 23:12

Right.

SPEAKER_07 23:13

So most people then ask if they can start with the less expensive one and then change to the more expensive one if it's ever justified, right? Can I wait till I get really sick to switch over? And of course the answer to that question is no. Once a person has pre-existing conditions, they tend to get stuck in the Medicare Advantage category and cannot switch over. Not that it's terrible, it's just that's when the pre-authorizations start to become a headache, and that's when the copays start to add up, and that's when we want to see a particular doctor at a particular hospital, but we maybe find that they are outside of the network.

SPEAKER_05 23:49

Right, right.

SPEAKER_07 23:50

So pros and cons both ways, Juanita. And I uh we don't know which one you should get, but generally speaking, uh if it's affordable and it's a lifetime decision, we like to see people get better coverage.

SPEAKER_05 24:03

Right. So with the advantage, you were saying, so if I like the advantage and you're talking about referrals. So if for the instance, you know, um something happens, I get sick, and you if it's like my primary care doctor refers me to just say a knee doctor or something like that. And that doctor that she refers me has to be in network in order for me to see that doctor. Is that correct? Am I saying that right?

SPEAKER_07 24:32

Yes, if your plan is an HMO, the answer is yes. Uh you'll not be able to use any providers outside of an HMO network.

SPEAKER_01 24:39

Outside of an okay, what other questions do you have?

SPEAKER_05 24:43

Well I do have a million things going on in my head, but the main thing I wanted to know. Go ahead.

SPEAKER_01 24:52

What's the main thing you wanted to know?

SPEAKER_05 24:55

About the supplement and the advantage, you know, the the the pros and the cons about that.

SPEAKER_01 25:01

Um I think I think a really good next step. Um, so you can start, you can do this anytime after August 1st. So that's in what, 10 10 days, right? You're ready to go. Why don't you let you've been talking to Justin, he's just one of the one of the wonderful, amazing people here at our company. He would love to walk you through your situation. You've already started the conversation, you might as well finish with him. Right? So I can have him reach out to you. Uh he'd be happy to reach out to you today, get you something scheduled for next, uh I guess towards the end of next week, or maybe I can't remember. Yeah. Yeah. So here at a week or two from now, and then you guys can walk through. He can actually pull up because what you need to do next, I I feel like you have a pretty good understanding of these now. What you need to do next is you need to put some dollars and cents to it. What did the Medicare Advantage plan look like in the in that area? What does a Medicare supplement cost? That you said you're on two meds, I think. So how does all that play into it and get really specific? And then Justin can also help you sign up for original Medicare A and B. We're not paid for doing that, right? It's just something he knows how to do, and he can help you do it to make sure you don't hit any of the wrong buttons or you know, do something that's uh that's uh it's uh those government websites are really tricky sometimes. So we'll have Justin will reach out to you later today.

SPEAKER_07 26:19

Aaron Ross Powell I'll reach out to you a little bit later and most likely we'll schedule a time to get together. Um as Josh said, we have a process that we take everybody through, and just for everyone's benefit, I'll describe it briefly. We've sort of been talking about step number one, which is where we help somebody understand these two options well enough to be able to decide which one they want to commit to, which one feels like you want to put your name on it. That's step number one. Once a person's decided which category they want to pursue, step number two is where I'm gonna help you shop through the insurance companies that are offering this kind of coverage where you live to help you determine which carrier we would want to get this from, why should it be that carrier, and exactly how much it's going to cost. That part I don't want to do on the daily show. I want to do that with you personally, individually in a private setting. Now, then finally, once we know what you want and you tell me, yeah, we can afford that, let's do it. Step number three is where we'll get you signed up. I'll enroll you in Medicare A and B in your supplement or advantage plan. We'll make sure that it starts right on time with no penalties and no problems. We're very good at that. Okay. And then once you're done, and it feels good to be done, you're gonna keep our telephone number and you're gonna be able to call and talk to me anytime there's a question or a problem in the future. So we're looking forward to helping you, Juanita, and I thank you for calling in today. I'll be in touch later on.

SPEAKER_05 27:40

Uh I just want to let you know my brother recommended to you because he signed up with you guys. So I'm you know I'm trusting him.

SPEAKER_01 27:47

Well, I I don't think the trust is misplaced. We'll do our we'll do our very best for you.

SPEAKER_05 27:52

Well, I appreciate that. I appreciate your honesty and it and your help. So thank you, and I'll be looking forward to talking to you again.

SPEAKER_07 27:57

Good. See you later.

SPEAKER_01 27:58

Bye-bye.

SPEAKER_05 27:59

Bye-bye.

SPEAKER_01 28:00

Bye-bye. Okay, let's talk to D. Ryan in California. D. Ryan, welcome to Medicare School Daily. What are your questions for us?

SPEAKER_03 28:12

Yeah, so I am gonna be turning 65 in August.

SPEAKER_01 28:16

Coming right up.

SPEAKER_03 28:17

And uh I'm one of those people that the more I learn, the more confused I get.

SPEAKER_01 28:23

Well, you're in the right place, you're in the right place.

SPEAKER_03 28:26

Okay. So currently I have MediCal, which started in 2021.

unknown 28:32

Okay.

SPEAKER_03 28:32

And I've been on Medi-Cal. And I've been this year I got a questionnaire just maybe a week ago from Medi-Cal saying that since I'm turning 65, they have a very detailed questionnaire. And because of that, once I fill that out, most likely I'm gonna be borderline or I'm gonna be off of Medi-Cal. So then it puts me in the category where I'm confused about do I take the advantage plan or do I go supplement? I think all I understand right now is once I sign up for Medicare A and B, I have to pay $202 for B. But based on my income, I don't know. Um are you are they basing my income from 2024 or right now?

SPEAKER_07 29:19

So uh when determining whether you qualify for Medi-Cal, they're using your current income. When determining how much to charge you for Medicare Part B, they'd be looking at your taxes from two years ago. Of course, you were on Medi-Cal two years ago, so we're not concerned about them charging you an IRMA. Worst case scenario, your Medicare would be $202.90 right out of your Social Security check if you're drawing one. But that's only if you fail to qualify for the Medi-Cal, right? Um whenever somebody's on Medi-Cal and turning 65, much like Medicaid in other states, uh, the income threshold to qualify for the State Medicale and Medicaid program is lower. It's changed. It's it's harder to qualify for Medicare at Medi-Cal at 65 than it is at 64. So they need you to recertify and fill out that very detailed questionnaire answering questions about your income and assets. And they're going to determine whether you get to keep the Medi-Cal or whether you don't. Now, if you get to keep it, you likely will not pay the 203 for Medicare Part B.

SPEAKER_02 30:24

Uh, do you want to know anything about Medi-Cal, or do you just uh discuss Medicare?

SPEAKER_07 30:30

Well, we're more specialists in Medicare, but I deal with quite a lot of people who have Medi-Cal. Did you have a specific question about it?

SPEAKER_03 30:38

Okay, so um what happens? So they automatically approved me prior, and even as far so I had to go through approval in 21, and uh they automatically approved me, I guess they said based on the information that they have from all the government agencies. And even if as far as June, they sent me an approval letter, which supposedly was gonna cover me till next year. But end of June or early July, um, I think uh last week. Last week they sent me a questionnaire. This one said because you're gonna be turning 65, they need a details, and um they allow a house and a car. Other than that, I may disqualify. So that's why I need to find out about my confusion is I'm gonna assume I'm gonna disqualify. So I would need to be on supplement or advantage, and I'm really confused about that.

SPEAKER_07 31:44

Yes. Um there's a couple things going on. First of all, they didn't give you a lot of time, did they? They just sent you this recertification paperwork a couple of weeks before your Medicare eligibility. So first I would take care of those that questionnaire. I would fill that out fully and I would submit it immediately. And then we'll also want to have a conversation with you about if you do lose the Medi-Cal, uh, what are you going to put in place to go with the Medicare? It's either going to be a Medicare supplement plan or it's going to be a Medicare Advantage plan. Now, you're equally qualified for both of them. And we'll talk about the differences and the pros and cons of both, some of it now, some of it offline a little bit later. But uh generally speaking, just from experience, if somebody has Medi-Cal and loses it, they just barely lost it. And when you just barely lost it, your income and assets are not generally so robust that you feel all that confident paying the monthly premiums for the full coverage you get from a Medicare supplement plan. It's available to you, but it's going to look expensive when we talk about it. So just uh briefly, uh Medicare is health insurance from the government for $203 a month. It's uh really nice in that it covers you nationwide with no referrals or pre-authorizations. That's what you're gonna get from the Medicare A and B. But it's only gonna cover 80% of the medical bills. So we have to choose between a supplement plan and an advantage plan. The supplement plan is gonna cost extra every month, say another $150 to $180 a month, depending on where in California you are, and that would be on top of the $203. So if Medicare is $200, and then the supplement plan is another, say, $180, and then you need a drug plan, and that might be five, ten, twenty dollars a month, depending. This could be close to four hundred dollars a month for option number one, the Medicare supplement plan. And if that immediately seems out of reach, then you would be in the majority of people losing Medi-Cal who elect to get a Medicare Advantage plan. And there are some really good ones in California, depending on where you live. We'll help you find the right one. Uh but some of your situation is stuff that I don't want to talk about in front of our radio listeners and our daily show callers. So some of this I'm gonna save for a conversation that we'll have a little bit later, Dee. Um, but they did not give you a lot of time. I need you I would want you to get on that recertification paperwork very quickly. Uh also, are you drawn to any social security benefits at this time?

SPEAKER_03 34:17

Not yet, I was too dumb about that too. I I really didn't think about social security or medical benefits because all my life I had full coverage with employment until twenty-one.

SPEAKER_07 34:28

Until twenty-one. Don't be too hard on yourself, Dee. It's okay that you haven't done that.

SPEAKER_03 34:33

Well, I don't need I don't need Social Security. Okay. Um I have enough income.

SPEAKER_07 34:39

Okay.

SPEAKER_03 34:40

Uh in other words, I manage. Yeah.

SPEAKER_07 34:42

Okay. And the Medical is the only source of health insurance you have right now, correct? Well correct. Okay. We're also going to need to sign you up for Medicare. Uh if we can get to that by the end of the month, that would be great. Uh then again, nobody will penalize you if we get to it next month or the next month after that. I just don't want to see you potentially lose the Medi-Cal and have nothing in its place. Makes me a little bit nervous when don't people don't have coverage.

SPEAKER_03 35:06

So uh I kind of want to do it now. I don't want to wait because every day I wait, it's stressful for me.

SPEAKER_01 35:13

Yeah. Dee, would it be co would it be good if we followed up with you after, maybe later this afternoon, and you can get an appointment. That would be fine. An appointment scheduled. Go through, you know, kind of the the nuts and bolts, the details of your personal situation just in a private meeting. I think that may be helpful for you. That would be perfect. Justin can reach out and he'll walk you through this. Hold your hand through this entire process, okay?

SPEAKER_03 35:38

Thank you so much. Okay, take care. Great show, by the way. Great show.

SPEAKER_01 35:42

Awesome. Bye-bye. Okay, let's talk to Daphne in Texas. Daphne, uh, welcome to Medicare School Daily. What questions do you have for us?

SPEAKER_04 35:54

Um, everything.

SPEAKER_01 35:56

Okay. Well, we got we've got we've got five minutes before this ends, so let's go. Tell us what's up. Tell us your most important question.

SPEAKER_04 36:05

Okay. I have the simic lupus and I have to go to the ER a lot. Okay. I have to go to the ER to make sure I'm not dying. My kidneys are in stage two failure.

SPEAKER_00 36:16

Okay.

SPEAKER_04 36:16

And I have I have been in renal failure. I've had pneumonia. Um I've been sepsis about six times. But my thing is is I lost my husband two years ago, okay? Sorry. Which left me, yes, which left me without the husband and also without his income. And I don't want to just, you know, start off artificial relationship to have more money in my my my life. That's not what I'm doing. But well, you know what I'm saying.

SPEAKER_01 36:44

Yes.

SPEAKER_04 36:45

Um you lose your h you lose your spouse's income when you lose them. I mean, it's just a n it's a a part of life, unfortunately. But that's not what I was thinking about when I lost them. I thought, oh my god, I lost my husband, I can't live, right? But um now that I now that I'm here two years later, I need to make sure I'm on the right care. And I don't know the difference between supplemental and advantage. I'm 52, I've been in the hospital six times, I've been in IC six times. I I have systemic lupus. It does it has killed me. I've been in uh I've been um put in a coma so where I could they could breathe for me. But um that's all I know to tell you, and I'm on Healthspring. Well, I just signed up for Healthspring, what she told y'all I signed up for. Um Healthspring something, and I also got a letter from Texas saying that they give they're giving me 1.0 units of um medical um because I get SSDI, not SSI, so I don't know if there's a difference, and I'll get extra care. So I'm not so much worried about the medicines I get because I get extra care and they cover all the medicines.

SPEAKER_06 38:08

Sure.

SPEAKER_04 38:08

I'm I'm I'm mainly looking for um something like mainly for me right now a give back would be the best. You know, something that will cover my things and something for a give back. So I chose hosting because it gives back $185 in your check. That's what they told me. I don't I hope it's not a lie.

SPEAKER_01 38:29

No, yeah. No, that could be right. Yeah.

SPEAKER_04 38:32

Okay. And so um, is there anything y'all have to ask me? I mean, because I don't I just don't want to go rambling for y'all or something.

SPEAKER_01 38:39

When does your when does your Medicare start? I'm assuming it just started or No, no, no.

SPEAKER_04 38:44

I've been um I had to get on Social Security in 2011 because that's when I started having my episode.

SPEAKER_01 38:51

Okay, so you just switched to this Health Spring plan recently?

SPEAKER_04 38:55

Yes, and yes, and I started watching y'all's programs, and I started having all these questions about it because I don't know like supplemental advantage. I just only know advantage.

SPEAKER_01 39:05

Well, and there's so many of them. Because you are the the the really great thing for you, and it's it's it's a few years out, right? It's probably 12 years out or so. When you turn 65, you will have an opportunity, just like everybody else who starts Medicare for the first time at 65. You will have the right to get a Medicare supplement plan without any health underwriting issues at all. Right now, right now, it's really not an option for you. Right? So you you've chosen probably the best thing that that is for you at this time. Okay. Now, down the road, when you turn 65, you're gonna have that opportunity and you will probably want to go to a Medicare supplement plan if you can afford it, right? So that it's gonna be a little bit of a big swing though, because right now you're getting part B, which is $200 a month, but you have Health Springs giving you $185 of that back. So your out-of-pocket monthly premium is around $15. Right? When you turn $65, let's say you were $65 and went on a supplement right now, you would have $200, you wouldn't have that give back, and you'd have maybe $150 on top of that. So now you so that's a pretty big swing. So that health spring or a plan like it may be good even once you're 65. But right now, I wouldn't stress out too much about it. Right?

SPEAKER_04 40:26

No, okay. Well, that's good to know. I really I I really needed y'all's advice. I really wanted to talk to y'all because y'all know what y'all I mean, I watch y'all's show and I just know I just watch y'all and I listen to y'all and um I just like y'all's advice. And so I just wanted to see for myself if I'm doing the right thing for myself. Because I know everybody's different, I know everybody's story is different. So I do, you know, I do get a decent amount because I did make pretty good over the years. So I I'm I made very well actually. Um so I do get pretty good checks. So I and I'm I'm blessed that way, I know. Um, so you know. Um and that's it. I just mainly wanted y'all's opinion and I really appreciate that.

SPEAKER_07 41:13

Happy to help with that, Daphne. Yeah, you're sort of on the only viable option, which is Medicare Advantage. Now you get to change that Medicare Advantage periodically. When you have extra help, you can change it more often than than the average person can, not just once a year. But it's uh I believe quarterly. And when you're ever choosing a Medicare Advantage plan, you're choosing it based on your providers, your prescriptions, and your priorities. As long as the Medicare plan works with your important providers and it covers the medications are as long as they're on the formula that they're going to be inexpensive because of the extra help. So that's easy. And right now it seems to be that the priority is monthly cash flow. And so having that extra having that extra $185 a month back into your SSDI check every month is very helpful.

SPEAKER_04 42:00

Yes, it's grocery money.

SPEAKER_07 42:02

Yes. And again, those give back plans typically have higher hospitalization copays, higher uh max out of pocket. So we gotta do the pros with the cons. And when it's time to change your plan next, if you'd like some help, we'll be happy to look through the options with you and make sure that we're gonna be able to do that.

SPEAKER_04 42:21

Okay, I will.

SPEAKER_07 42:23

Yeah.

SPEAKER_04 42:23

I will. I would love to um keep y'all um on my radar, like you know, be able to get like would I just make another appointment with y'all?

SPEAKER_01 42:31

Yeah, you could just call in, call in, and we'll get you to somebody that can compare those options, okay? Yeah.

SPEAKER_04 42:37

Okay, awesome. Awesome. Um that's good. Sounds amazing. Do y'all have a straight number or is this the number I've got?

SPEAKER_01 42:44

The phone number, the phone number to get in touch with somebody at our office uh is 800-786-782-6676. 800-782-6676. And when you call in, you're gonna talk talk to somebody who's been trained by my dad, Marvin, and he'll they'll be able to sit down and go through all those options for you and help you do the do the red tape, all the paperwork associated with making a plan switch. Okay.

SPEAKER_04 43:11

Okay, and you said 1-800. I'm sorry, I just got a pin. It was eight. Give me that one more time. I'm so sorry.

SPEAKER_01 43:17

800 782 6676. 6676. Yeah.

SPEAKER_04 43:25

Sorry. That's my menopause calls. I made it forget. Everybody, everybody heard that on your show. Menopause is horrible.

SPEAKER_01 43:36

Thankfully, I have only to experience it. So the blessings to you.

SPEAKER_04 43:41

No, you won't. And blessings to you that you don't have to go through it. But I appreciate you guys talking to me. And I got the number and everything, and and y'all helped me see that I'm doing I'm doing okay right now. I just I saw y'all and y'all knew so much. I was like, I need to ask them. Yeah. So I encourage more people to call into the show because I love it. I feel like I feel more comfortable. And I thank y'all.

SPEAKER_01 44:04

I think you're in a good place. Let us know if we can help in the future. Thanks, Daphne. Bye-bye. Thanks, Daphne.

SPEAKER_04 44:09

All right, y'all have a blessed day. You too. Thank you. Bye-bye. All right, bye, guys.

SPEAKER_01 44:15

If you are married and your spouse passes away, there are some steps that you need to take as it relates to Medicare and Social Security. Obviously, this isn't a fun topic, but it's an important topic. Because if you don't know what these steps are, you can find yourself uh maybe shut out of benefits or not getting everything that you are able to collect. I talked to somebody um last week on the show. Their spouse had died 12 years before, and they had never um opted in to get their spouse's Social Security check, which was a higher amount. So they lost 12 years of extra money. Join us tomorrow. We're gonna be talking about this uh kind of uncomfortable topic, so you guys can be prepared for the future tomorrow.