Covering the Medicare Gap with Medicare Supplements

10/23/20 • 16 min

Some of the highlights of the show include:

A brief primer on the history of Medicare Supplements
Why Danny believes that Medicare Supplements are a great option for people
How Medicare Supplements plans can’t be canceled based on a year of high claims
The difference between when you can buy Medicare Advantage plans and when you can buy Medicare Supplements plans
What happens if your doctor drops out of the Medicare Advantage plan you’re enrolled in
The more popular Medicare Supplements plans that Zach and Nick see most commonly
Changes to the Medicare Supplements program that just went into effect on Jan. 1, 2020
How Nick was able to help a couple save upwards of $2,400 on Medicare Supplements plans
How Nick and Zach’s persistency can be a boon for clients
And more!

Quotes

“President Johnson is the one that signed Medicare into law, and that was done in 1965. And soon after that, a multitude of companies brought out Medicare type Supplement Plans. they were going to cover what Medicare didn’t, but they could add bells and whistles and different things that way.” — Danny

“That's what makes Medicare Supplements a great deal for people because it leaves them in control of what they want to do as far as their healthcare is concerned.” — Danny

“Medicare Supplemental policies are secondary to Medicare, meaning Medicare is still their primary, meaning it's a nationwide program, they can go anywhere that accepts Medicare. And they're also standardized. So, the coverage from one company to another is identical from plan to plan.” — Nick

“You can only buy Advantage plans at certain times of the year with the annual enrollment period, whereas you can buy a Supplement any time of the year.” — Zach

“If you're in a Medicare Advantage Plan and your doctor drops out of it, there's nothing you can do until the open enrollment period.” — Danny

“Medicare has evolved, coverages have been added, things have changed, and the same is true with the Part D. It's been evolving where it gets better and better as time goes on.” — Danny

“Since the plans are standardized, we had the capability to find the same benefit package, the same coverage with another provider saving them a ton of money.” — Nick

Links

Seniors Living Healthy: seniors-livinghealthy.com
Facebook: facebook.com/seniorbenefitinc
Contact Nick and Zach:
- [email protected]
- 1-844-437-4253

Transcript
Announcer: Welcome to our fireside chat with Seniors Living Healthy, the podcast that helps prepare and educate you as you enter and live out your golden years. With over 10 years of experience, Nick and Zach are experts in the senior market and are here to help you live a healthy, full life. And now fireside with your hosts, Nick Keene, and Zach Haire.

Zach: Welcome back to episode five of season one of Seniors Living Healthy. I'm your host, Zach, and with me as always, is Nick.

Nick: Hello, folks.

Zach: Also, we're pleased to be joined this week by Danny Haire, owner of Financial Services, Inc.

Danny: Hi. How are y'all today?

Nick: Doing well, sir. Thanks for joining.

Zach: Thanks for jumping on here with us, Danny. So, he has been in the business for over 40 years, and can even remember back when Medicare Supplement Plans first came out. Danny, real quick, do you kind of want to just give us a quick historical rundown of Medicare Supplements, where they came from, who brought them out, that type of thing.

Danny: Well, of course, President Johnson is the one that signed Medicare into law, and that was done in 1965. And soon after that, a multitude of companies brought out Medicare type Supplement Plans. The difference from those plans compared to today is there were no government standardized plans. Companies pretty much got to put together whatever they wanted to do. I mean, of course, they were going to cover what Medicare didn’t, but they could add bells and whistles and different things that way.

And then as time went on, of course, the government standardized these plans. So, that was pretty much, I think, in the ’80s, when that happened, that these plans become standardized and everybody was selling the same thing, and there could not be any deviation from those.

Zach: Gotcha. So, as we did discuss last episode, Medicare's got those gaps in it, and so there are plans out there to fill those gaps. As we talked about last episode, those Medicare Advantage Plans. So, this episode we're going to look at Medicare Supplements, and also, kind of similar to our last episode, instead of doing a product revie...

Some of the highlights of the show include:

A brief primer on the history of Medicare Supplements
Why Danny believes that Medicare Supplements are a great option for people
How Medicare Supplements plans can’t be canceled based on a year of high claims
The difference between when you can buy Medicare Advantage plans and when you can buy Medicare Supplements plans
What happens if your doctor drops out of the Medicare Advantage plan you’re enrolled in
The more popular Medicare Supplements plans that Zach and Nick see most commonly
Changes to the Medicare Supplements program that just went into effect on Jan. 1, 2020
How Nick was able to help a couple save upwards of $2,400 on Medicare Supplements plans
How Nick and Zach’s persistency can be a boon for clients
And more!

Quotes

“That's what makes Medicare Supplements a great deal for people because it leaves them in control of what they want to do as far as their healthcare is concerned.” — Danny

“You can only buy Advantage plans at certain times of the year with the annual enrollment period, whereas you can buy a Supplement any time of the year.” — Zach

“If you're in a Medicare Advantage Plan and your doctor drops out of it, there's nothing you can do until the open enrollment period.” — Danny

“Medicare has evolved, coverages have been added, things have changed, and the same is true with the Part D. It's been evolving where it gets better and better as time goes on.” — Danny

“Since the plans are standardized, we had the capability to find the same benefit package, the same coverage with another provider saving them a ton of money.” — Nick

Links

Seniors Living Healthy: seniors-livinghealthy.com
Facebook: facebook.com/seniorbenefitinc
Contact Nick and Zach:
- [email protected]
- 1-844-437-4253

Zach: Welcome back to episode five of season one of Seniors Living Healthy. I'm your host, Zach, and with me as always, is Nick.

Nick: Hello, folks.

Zach: Also, we're pleased to be joined this week by Danny Haire, owner of Financial Services, Inc.

Danny: Hi. How are y'all today?

Nick: Doing well, sir. Thanks for joining.

Previous Episode

Everything You Need to Know about Medicare Advantage Plans (Medicare Part C)

Some of the highlights of the show include:

A brief refresher on Medicare Part A and Medicare Part B and the associated gaps in coverage
The various types of Medicare Advantage plans, including HMOs, PPOs, and SNPs, and the differences between each of them
Why it’s important to consider in-network coverage when shopping for Medicare Advantage plans
The coverage benefits of Medicare Advantage Prescription Drug plans (MAPDs)
Three big things that Medicare doesn’t cover
What Medicare Advantage covers that Medicare plans do not
Why Medicare Advantage may be more convenient than other Medicare coverage options
When the Annual Enrollment Period is
Factors to consider when shopping for an MAPD
Why you should review your options every Annual Enrollment Period no matter what
And more!

Quotes

“There are two options, really, when it comes out there to filling in gaps in your Medicare: Medicare Supplements andMedicare Advantage Plans.” — Zach

“The HMO plans are primary care physician-based. Their networks are typically county-based or sometimes multi-county based, but they're for individuals that don't do a lot of traveling. They do have set copays on a lot of services, and they typically are relatively inexpensive.” — Nick

“And then the PPOs: there is no requirement for a referral on a PPO. They typically are going to have larger networks, regional, or in some cases, national networks.” — Nick

“The only thing that a Medicare Advantage Plan has to do is offer benefits equivalent to original Parts A and B of Medicare.” — Nick

“It's important to note that Medicare Advantage Plans wrap up and replace Part A and B, but also incorporate Part D of Medicare in the same type of plan. So, unlike Medicare, and a supplement and a stand-alone drug plan, it's all in one card.” — Nick

“Medicare Advantage Plans give you additional benefits that original Medicare does not cover. It basically Medicare Advantage Plan will pick up, like, deductibles, and coinsurance, things of that nature traditional Medicare does not cover.” — Tausha

“Medicare Advantage over traditional Medicare has a stopgap in place that caps the amount of spending that you would do each year, which is called a max out of pocket.” — Tausha

Links

Aetna: https://www.aetna.com/
Seniors Living Healthy: seniors-livinghealthy.com
Facebook: facebook.com/seniorbenefitinc
Contact Zach:
- [email protected]
- 1-844-437-4253

Transcript

Announcer: Welcome to our fireside chat with Seniors Living Healthy, the podcast that helps prepare and educate you as you enter and live out your golden years. With over 10 years of experience, Nick and Zach are experts in the senior market and are here to help you live a healthy, full life. And now fireside with your hosts, Nick Keene, and Zach Haire.

Zach: Hello, and welcome back to another episode of Seniors Living Healthy. As always, I'm your host, Zach, and beside me is Nick.

Nick: Hello, folks.

Zach: You guys, this episode we're going to look into the different options to fill in those gaps that Medicare covers where we've talked about in the previous episodes, with Part A being your hospitalization, and Part B being your outpatient. There are two different options out there. One of them is Medicare Supplements, which we're going to touch on next episode, where this episode we're going to focus on Medicare Advantage. You may see him also called MAPD or Part C of Medicare. Especially with Annual Enrollment Period coming up, you're going to see a lot of TV advertisements, radio advertisements, billboards, things in your mail, all of that stuff, in regards to that.

So, guys, as always, usually do a product review in our episodes, but since this whole episode is on a product, we're just going to jump right into it and just cover the whole product as a whole. And then, as always, we'll go into our interview, our confession section, and then wrap up the episode. So, now that we've talked about A and B has all these gaps, this episode—and we're going to spill over into next episode—we're going to talk about what covers those gaps that Medicare doesn’t. Some different options, everything out there for you. So, Nick, give me a quick rundown just to refresh everybody, what some of those gaps are?

Nick: Sure, absolutely, Zach. So, the main two parts of Medicare Part A and Part B. As you alluded to, Part A is the hospitalization, Part B is the outpatient. So, some of the major gaps under Part A of Medicare are, Medicare Part A has a $1408 deductible per 60-...

Next Episode

Season 1 Recap: Everything You Need to Know About Medicare

Some of the highlights of the show include:

A brief rundown of Medicare Part A, who is covered under the plan, and where their coverage might run out
The differences between Medicare Part A and Medicare Part B, and which one has a premium
IRMAA and how it can allow people to pay less or more for their premium depending on their income
How Medicare Part B costs break down
Which part of Medicare pays for the shingles shot
What Nick and Zach think listeners should know about the Medicare Part D’s “doughnut hole”
How Medicare Advantage plans can help fill Medicare gaps
Why you can’t really have a Medicare Advantage plan and a supplement plan
Why it’s never too early to start saving for retirement
And more!

Quotes

“Part A is paid in typically via payroll contributions, 10 years or 40 quarters, and there is no premium. With Part B there is a standard premium and in the year 2021, that premium is $148.50 per month.” — Nick

“Part B is elective. So, whereas Part A is automatic, there are plenty of individuals that are still working when they turn 65. They may have insurance through their retirement, through their union; that's considered credible coverage, so it's certainly elective.” — Nick

“The important thing to remember folks is prescription drug plans all have to meet a minimum benefit that Medicare determines, okay? And what that means is they have to cover at least two drugs in every therapeutic class. However, some drug plans may cover different drugs in those therapeutic classes. So it's important that you reach out to a professional.” — Nick

“A lot of times with an Advantage Plan, you're looking at paying less than the front end where you might possibly with copays and deductibles on the back end see a bill.” — Zach

“I recently turned 60. So, a lot of what I'll talk to you about is really based on my own experiences. I'm going through this in real-time.” — Ty Wooldridge

“My background was in actuarial science, and I can tell you that the time value of money is an important ally when you're retiring. If you just took $50 a week, and you invest in that, even at a really low rate, like 4% which, as an average rate for 40 years, which is fairly low, you have a quarter-million dollars by the time you're 40 years out.” — Ty Wooldridge

Transcript

Zach: Hello, and welcome back to episode six of season one of Seniors Living Healthy. I'm joined here as always with Nick.

Nick: Hello, folks.

Zach: So, this episode, we're going to wrap up what we've covered the first five episodes this season, touch base over what we have talked about, do a little refresher, review course. And then we're going to look into what next season is going to bring, and that's where our guest, Ty Wooldridge, President of Aetna Senior Supplements, will come in. We interview him, kind of looking forward to financial security once you do retire. So, as we just jump in here, we're going to talk about the parts of Medicare and the different things out there that can fill in those gaps in Medicare. Nick's going to run through those for us.

I'll ask him some questions, he'll just review them real quick to make sure everybody's up to speed if you're just now joining us, you’ll know we've touched on the last five episodes. So, Nick, as you know, we've been discussing the parts of Medicare this past season.

Nick: Sure.

Zach: So, real quick, let's start out with Part A of Medicare, give the listeners a run-through on that.

Nick: Yeah, so I want to start out real quick with the Part A and Part B, Zach, about who qualifies, when they qualify, and when they get it. So, individuals that have worked 40 quarters or 10 years and paid into Medicare, [unintelligible 00:01:45] payroll taxes mainly, qualify for Medicare, including any dependents and or spouses of those individuals. And other individuals, whether it be through disability, in limited circumstances regardless of age, or end-stage renal disease, or ALS can qualify as well, Zach. So, back to Part A, your question. Part A is hospitalization.

Anytime an individual is admitted to the hospital, they are covered under Part A and a couple things to remember under Part A is there is a period of care: that is 60 days, and that is covered with a $14058 deductible in the year 2021. So, beyond that, there are additional day costs, day 61 through 90 in the period of care $371, and then 91 through 150, they'...