Oh. Welcome to Finishing Well, brought to you by CardinalGuide.com, with certified financial planner Hans Shile, best-selling author and financial planner, helping families finish well for over forty years. On Finishing Well, we'll examine both biblical and practical knowledge to assist families in finishing well, including discussions on managing Social Security, Medicare, IRAs, long-term care, life insurance, investments, and taxes.
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Well, welcome to Finishing Well with Certified Financial Planner Hans Shile, and today's show, Medicare planning. What are seven items to know? I love that. And so I was thinking about this from a biblical standpoint. Is in Proverbs six six, you know, it says, "Go to the ant, thou sluggard; consider her ways and be wise." You know, it made me think of.
I had an old boss by the name of Royce Reynolds once told me. He said, "Robbie, if you think education's expensive, try ignorance." And when it comes to Medicare, oh my goodness! If you think education is expensive, and the nice thing is the education you could get from this video on these seven items, oh boy, would could they save you a ton of money? But more than that, a lot of people I think think of it as a necessary evil or something. And and the and the aunt would tell you that insurance is about what if you get bad sick.
You know how are you going to be taken care of when you really, really, really need insurance? And and this is the point from my standpoint where if you think education is expensive. Like this, education is so valuable to my heart to know. Wow! If things really go go badly, that I've got the got the insurance I need, and and for that reason, you know, I I think it's well worth investing the time to listen to what we have to share with you today, because you know.
When you find yourself, you know, running in the hospital on on an ambulance, it's no time to be trying to figure out what was the best way to go. Right?
Well, that that is exactly right. And I, I thought maybe I'll just state the seven items to know about Medicare, and kind of go over everything we're going to go over because the order of this is important. The very first one, you need to stay stuck on that until you get it. And there's no point in going on to two through seven if you don't get number one. But the first one is the knowing the difference between original Medicare and a supplement, and then Medicare Advantage is that there's two distinct paths that you can go down, and knowing the difference between the two and the differences is extremely important.
And there's a lot of people. That don't even know which path they're on.
So that that's the first one, and then the second thing is we're going to talk about Medicare supplement insurance, and discuss that. That's the second item. The third, we're going to talk about under Medicare Advantage. We're going to talk about networks and preauthorization, and all the rules you got to follow if you go down the Medicare Advantage route. Fourth, we're going to talk about seasons, and the seasons.
Like one of them is upon us now, where it's the annual enrollment period, abbreviated AEP by people in the industry. It's October fifteenth to December seventh, and that's the period of time when you can make your elections. You can come in and go out of plans. The fifth one is penalties, and the penalties you get for late sign up. For doing improper sign up or for getting signed out and signed back in, you're going to have to pay penalties.
The sixth one is Irma, which we've talked about on several shows. It's the extra Medicare premiums or it's the Medicare tax on the high income people, and there's ways you can plan for that. There's ways you can manipulate it. We'll talk about that a little bit today. And then the seventh one is the Part D standalone.
That you need to buy is a little piece of Medicare Advantage that you need to have if you're over on the other side of the board with Original Medicare and something.
Okay, is that clear, Robert? Yeah, absolutely, and I'm glad that you guys have number seven in there because that that that's really changed a lot in recent. Years, and it's it's becoming more and more expensive. Drugs are, and so it's a big part of understanding the overall package of them. Again, I I love these seven items.
I love the way you idolat you know itemized them so that we could you know hone in on these these things that are so important with that. First one being extremely important because I like what you said that before we got on the air, that you know you don't know much about Medicare. All of a sudden you turn sixty five and some guy standing there at the door at the Medicare door going, "Follow me, I got this all for you," and and you never hear about anything else other than what they're trying to sell you. That happens to a lot of people. Yeah, I mean we run into them sixty eight, sixty nine, seventy, and Somehow or another, they pick up on one of our shows.
They're coming into us, and then we're asking them the question: Are you on Medicare Advantage, or are you on Original Medicare? I don't know. And then they start guessing, and then we start asking them questions about their last time they got sick. And then pretty soon, do you have your wallet on you? Do you have your card on you?
Just get it out, and I can look at it. We literally have to do that with some people that have been on Medicare. For three or four years, and we have to back it all the way back and say when Medicare started. For you at sixty-five, you had a choice, and it's a it's a binary choice. I mean, you can go one way or you can go the other.
You can't go down both roads, and that's where people get mixed up as they start attributing things of original Medicare onto their Medicare Advantage plan, or vice versa.
So let's talk about the difference. His original Medicare is just like it sounds. It's Medicare Part A and Part B, and it's started in 1965, and it's pretty much the same as it was in 1965. Part A and Part B. I'm talking.
Is that Part A is your hospital, Part B is your doctor and outpatient, and it has. Really, kind of big deductibles and copayments.
So, in other words, Medicare, Original Medicare by itself, back in 1965, it was they were big deductibles. They look small now, but you're going to have a lot of out-of-pocket if you just go with Medicare only and you don't have a supplement.
Okay, and so that's Original Medicare, and Original Medicare was pretty much all there was to have with Medicare. Until along about two thousand and five, two thousand and six, so that for the first forty years of Medicare, there was no need to define original Medicare. It was just called Medicare Part A, Part B, and it's when they invented Part D, like drugs, in two thousand and five, that they came out with Medicare didn't pay for drugs until. 2005, and that's when Part D was invented, and that's the last thing we're going to talk about today. But they also invented Part C, Medicare Advantage, and that was a way that because of those big deductibles and copayments, that you could leave original Medicare, leave the government plan, and elect to go with a private insurance company that was your substitute.
For original Medicare, and then the government would send that Medicare Advantage plan a check every month on your behalf. You know, in other words, they were you were outsourcing your Medicare, or the government was outsourcing you. They'd rather just send the money to an insurance company, and then the insurance company provides the benefits and services.
Okay, it sounds wonderful, and it can be because a lot of them, they'll do this at zero premium.
So they're not going to charge you the cost of a supplement, and you got much lower deductibles and copays. And like I said to you in the beginning of the show, and you mentioned it, is the problem comes in is when there's these people out here selling Medicare Advantage to people turning sixty-five. They don't even tell them about well, you don't have to do this. You could, you could stay on original Medicare, and then you could buy a supplement policy. And there's some reasons to do that.
Okay, and we're going to get into those, but I'm just in point number one here. I want to get clear. It's one way or the other. You can't be a little bit of both.
So, I mean, it's just and and so and we're going to get into like why you'd want one and why you want. I just fundamentally, I want you to identify which one you're on, and then I want you to get clear like why am I on this? Why did I choose this? And I want you to understand a little bit today about the one you're not on, because you may want to consider getting on that, either side.
So that's point number one: is are you on Original Medicare, the red, white, and blue card, Part A and Part B, and then plus a supplemental plan like a Plan G, or a Plan N, or a Plan F. That kind of thing is it? Are you there, or did you leave all that and get on a Medicare Advantage plan like United Healthcare, like Humana, like Blue Cross, where you're, you know, you're actually getting your Medicare directly from an insurance company? Makes sense. Yeah, absolutely.
The two things is. You know, again, and I've been on both. It's just simply, am I on original Medicare with a supplement, like I was, or am I on Medicare Advantage? I've been on Medicare Advantage. The big question is, do you know why you're on the one you're on?
Right?
Yeah. And so, a, do you know what you're on, and b, do you know why you're on it? You know, and if you have those two answers, and that's a big, that's a big plus.
So, which one are you on, Robbie? Right now, I'm on Medicare, original Medicare plus a supplement. I have Plan G, and I know exactly why I'm on that one.
Okay, and I can tell you if you want me to. Are we? Yeah, I do.
Okay, I'm on I'm on Medicare Plan G because I realize that if I get bad sick, I don't. I want to be able to go to the doctor. I want to go to get the test that I need to get. I don't need an out-of-pocket that it becomes totally out unaffordable to me, as I saw happen with people that were on Medicare Advantage that got bad sick. But the biggest issue is obviously I have health insurance to make sure that I'm taken care of in the best possible way.
And in my mind, the reason I'm on Medicare Original Medicare and a supplement, even though it costs me more, there's no doubt it does. But I feel like I have better insurance. In that situation, where I know that I'm going to get the best possible coverage, yeah, I mean, you know, in the second part of the show, we're going to go over those reasons from the textbook, from the board on the video.
Okay, really, that's not going to say it as well as you said it. And then, in the second part of the show, number three, we're going to go over the you know the pluses of Medicare Advantage, the reasons.
So if we had somebody on the show today that's on Medicare, being understand what they have, they like it, understand the reasons, I'm gonna kind of stand in for them, and I'm gonna give you all that information. We're gonna keep keep right on rolling for that. Yeah, I've been there too.
So this would be a good time to remind you that this show is brought to you by Cardinal Guide, CardinalGuide.com. If you go to CardinalGuide.com, you're going to see seven worries tabs right there, and Medicare is one of the first ones. I think it may be the second one, as a matter of fact. And so, if you go click on Medicare, you're going to see a wonderful video on the same subject. Got a board, show notes, all sorts of detailed information on what we're going to talk about today, and.
It's all there at cardinalguide. dot com on the worried tab. That it would be Medicare, but also really, really helpful is Hans's book, The Complete Cardinal Guide to Planning for and Living in Retirement. And there's a workbook that goes with that, and that's one of the great places to me to really sit down and figure this one out because it really is helpful to know what you're on and why you're on it. And then, of course, there's to contact Hans and Tom Page or Andrew.
Now, it's all At CardinalGuide.com, we'll be right back with a whole lot more of Medicare planning. Seven things to know. Investment advisory services offered through Brookstone Capital Management LLC, abbreviated BCM, a registered investment advisor. BCM and Cardinal Advisors are independent of each other. Insurance products and services are not offered through BCM, but are offered and sold through individually licensed and appointed agents.
Cardinal Advisors is not affiliated with or endorsed by the Social Security Administration or any other government agency. Welcome back to Finishing Well with Certified Financial Planner Han Shile, and today's show is Medicare planning: Seven Things to Know.
So, Robbie, in the end of the last segment, went through that he's on Original Medicare plus a supplement, and why. And you did a great job. And so now I'm going to go over item number two. Is what are the pluses about you know having original Medicare and a supplement? And where I'm just you can go to any doctor that you choose as long as they take Medicare anywhere in the country.
So my wife was sick and still has some issues with it, but we're fighting a cancer diagnosis and you know and working through all of that. And we were considering MD Anderson. We were considering the Mayo Clinic. She even got part of a study at the, you know, MD Anderson. And you don't want to be dealing with networks when you're.
We were already at Duke, where you don't want to have to have make sure the Duke people are a network, or you can't go to them if you want to go to them for your cancer. But anyhow, God helped us greatly with her, and we just had a miraculous recovery. But having a Medicare supplement plan G was just priceless, and just knowing that we didn't have to worry about money, we didn't have to worry about networks, we didn't have to worry about prior authorization. When you get into cancer, you know, going to all these expensive tests is to really find out what they're dealing with. You don't want to stick the insurance company in the middle of that to get approved on.
With original Medicare, you don't. I mean, there's some guidelines running the doctor. They just can't willy-nilly send you any test they want. But you don't. The doctor doesn't actually have to call Medicare or contact them and get approval for Hans's wife to go get this test tomorrow.
I mean, it's just it's all it's all in the system. And we'll talk about Medicare Advantage in a minute, but the Medicare supplement plans. They're available. They're standardized, so the gov. This is thirty-five years ago.
The government said, "All right, enough from you insurance companies. We're going to come out with ten policies that are going to be exactly the same from company to company." So if you're an insurance company in the Medicare supplement business, these are the ten policies you can offer. You can price them as you choose, but so that it made it very easy. For you to pick a particular lettered plan that you like, like a Plan G, Robbie referred that he's on a Plan G. I sold it to him, and the Plan G has the highest benefits.
So that's why most people pick a Plan G is because it covers more than the other ones. And the important thing to know is you don't really have to compare. You know, Mutual of Omaha's Plan G. To Medico's Plan G, to Etna's Plan G, because they're all exactly the same. To the pen, to the word, they're exactly the same.
The price is different, and we could talk about that on some other shows. The monthly premiums from company to company vary greatly. Medicare supplement insurance has underwriting, so if you're on a Medicare Advantage plan now, and you are bad sick, as Robbie was saying. And you've got a bunch of health conditions, and that's why you want to get off this Medicare Advantage. You may have difficulty going back to Original Medicare.
It'll be easy to get on Original Medicare, but you may have difficulty purchasing the supplemental coverage you want because they're going to ask you health questions.
So, just a word to the wise that when you're turning 65 or you're approaching that, just you need to learn these two options. And you need to learn the pluses and the minuses of the two options. And let's just move. We don't have much time. Let's move on to Medicare Advantage, and really talking about networks and pre-authorization because that's the disadvantage of Medicare Advantage is that you you pretty much have to go to doctors within the network of the plan you've chosen.
So, when we sell these to people. We pre-evaluate that their doctor is accepted in the network of the plan they're buying from us.
Okay, but that isn't has no guarantees. That doctor could leave that network, and you're stuck there for all the next year. I mean, it's just so you have to go to a different doctor when you want to go see a specialist. You're going to have to choose from what's in the network, and.
Some people say no problem, and I don't want to make that sound like it's the end of the world, but it is a factor. I know when we were dealing with my wife's illness, that that's just one hassle that I didn't want. Because a lot of the best doctors, they might not be in the network if you want to, and certainly not in Houston, MD Anderson or the Mayo Clinic. We just don't have to mess with that. You need referrals on a Medicare Advantage typically to see a specialist.
So you can't just decide I'm going to go to a cancer doctor. You have to go to your primary doctor. He has the cancer diagnosis or she does, and then they refer you to the specialist. You go to the oncologist. Same thing with orthopedic.
Just about anything. When you go see a specialist, you have to do a referral. If you're on Original Medicare, you can just make an appointment with the specialist of your choice, go in and see them, and your Original Medicare and your supplement are going to take care of. And then the pre-authorization from a third party, that's just pre-authorization for tests, pre-authorization for surgery. I mean, it's just one more step that you don't want if you can afford to not have it.
You know, it's just pre-authorization. I mean, you read horror stories about this stuff in the press of people that need, you know, life-saving surgery or they need something to go on with their life, and the the plan is just turning them down.
So, I'm not saying you couldn't run into that with Medicare too, but it's much less common.
Okay. Fourth one is of items to know is talking about seasons.
So we're in the annual enrollment period now for Medicare Advantage.
So the people get mixed up. October fifteenth to December seventh, you can come in and out of Medicare Advantage plans. I mean, if you're on one and you want to switch to another, this is the time to do it. If you're on one and you want to leave Medicare Advantage, go back to original Medicare and buy a supplement.
Now's the time to do it. And if you if you get past December seventh, then you're going to be more limited during the next year in what you can do. I don't want to get into the details of that, but that's the that's the season. Another season is when you're turning 65 and going on Medicare. Or retirement, if it's later than sixty-five, it just duplicates that season around your retirement.
Now you've got a season where you can enroll in a Medicare supplement or a Medicare Advantage, or you can do anything without answering any questions. I mean, as long as you get on Medicare, yeah, do that first. Then you've got a six-month time frame that you can make all your decisions.
So I just wanted to mention seasons. We have other videos. The other thing you might want to say about seasons is that. You need to pay close attention to certain ones. If you're turning sixty-five, you you've got to get on one, or you could face lifetime penalties.
Same thing with a drug plan. And so those seasons are really important. If you're if you're fixing to be sixty-five, to make sure you're aware of that, you need to either sign up or have some other insurance plan where they you know you.
Well, you can explain it better than me, Hansford.
Well, yeah, we make our living offering consulting. I mean, people do the whole do-it-yourself stuff. That's where they get in trouble.
So they listen to their nephew or their uncle or their somebody that's out there that's been through it before, and he's kind of biased to whatever his situation was, or maybe he hasn't even done it yet, but he knows people that have, and people are just working through it. You're going to mess some of the stuff up. We're in the business of offering Medicare consulting, so just give us a call. We're in fifty states and the District of Columbia. We're licensed just about everywhere in the U.S.
So we talked about penalties, and you know the key thing with penalties is they're for your lifetime. Once you get assessed a penalty, it never goes away, and that's just frightening to some people. I mean, just in a lot of people. Even though the penalties a lot of times aren't even that big, it's just maybe frightening or annoying, and so they can be prevented. And again, it's from not being educated properly and not really knowing the do's and don'ts.
Medicare, doing it by yourself. The sixth item is Irma. You know, old good old Aunt Irma, and it's income related. Monthly adjustment amount. Medicare comes up with these really nice terms of five words to describe.
I'm going to say it easier. We charge you extra if you're well-to-do for Medicare, okay? And then we have this complicated formula to get you based because we use your income from two years ago, okay? And This really angers people. I'm just telling you because it comes as a surprise.
I've got lots of videos out there on Irma. I'll be glad to explain it to you if you think it affects you. It's already affected you, and it's really handled best one-on-one. Just give me a call, email in, and we'll look at your situation. It also can be appealed.
So if you have a certain life events like you retire. Then we can appeal it, and we can show them what your income is going to be after retirement. And I can help you with that as a financial planner, as well. Just planning out so we can specifically target what your income is going to be next year and the year after. We put that in the appeal form, and we make Irma go away.
So that's just one of the things we can do. But I just you need to be educated on Irma. If you, if you've had a high income in the past, or you're going to continue to have one in retirement, and the last section is what we talked about in the beginning, the Part D standalone, and we're just getting ready to shoot a video this Thursday, on October first, we're going to actually bring up my Medicare.gov, and we're going to go into my account. And all the new prices and the new Part D plans are going to be up there.
So, and my Medicare.gov already knows all the drugs I'm on, and it knows that I'm on one of the plans. And so, I mean, we're going to teach everybody. This is one area you can do yourself. I mean, if you can navigate through that, and you really need to start there before you call us. Right, good time to tell you because we're about out of time, I'm afraid.
But by all means, the show's brought to you by Cardinal Guide, and if you go to cardinalguide.com, you're going to see a link to Medicare, wonderful video with all this information and ways to get to the very places we're talking about. Again, Hans's book, "The Complete Cardinal Guide to Planning for and Living a Retirement," the workbook that goes along with that. But again, the most important thing is cardinalguide.com, to my point of view. Is the contact Hans or Tom Page? Again, they would love to do a Zoom call with you, whatever, to really get at the heart of your situation.
Because this Medicare stuff—it's so easy when you understand it, but when you don't, it could be—it could be costly. Great show, Hans. Yeah, thank you, and God bless you. The opinions expressed by Hans Shile and guests on this show are their own and do not reflect the opinions of this radio station. All statements and opinions.
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