Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Good morning and welcome to the show.
Speaker 2 (00:01):
This is Rob King, happy to be here with you today.
I want to do really give you a good update
on what's going on as we are now and to
the first stage of Medicare season as I call it.
Speaker 1 (00:14):
Now.
Speaker 2 (00:15):
We can't make changes until October fifteenth and through December seventh.
Speaker 1 (00:20):
But this year it's going to be an incredible year
of change.
Speaker 2 (00:23):
So if you work with an agent, or if you
haven't compared your stuff lately, you're really going to want
to do it this year because things are changing big time.
Speaker 1 (00:35):
Again.
Speaker 2 (00:35):
I highly recommend using an independent agent because they can
search and help you look at many different plans, whereas
if you call one of those eight hundred numbers are
just going to try to sell you on their plan.
Speaker 1 (00:47):
Again.
Speaker 2 (00:48):
You know, there's two different ways overall to put together
your Medicare package. You can have, you know, your Medicare
plus a Medicare supplement, you know, which was as a
plan letter.
Speaker 1 (00:57):
A lot of people have Plan after Plan G.
Speaker 2 (01:00):
There are some changes coming to those policies we'll touch
on here in a little bit. Big changes though this
year are because of the Inflation Reduction Act. They say
that seniors or Medicare people will pay no more than
two thousand dollars for their medications, which can and can't
(01:21):
be true depending on if you have the right plan
because of the formulas and so forth. I'll touch on
that later, but there's a lot of changes going on,
so let me just stay right off the bat again.
If you're on Medicare, you need to get with your
agent or you need to do your research and make
sure you have the proper plans for twenty twenty five,
(01:42):
because the Inflation Reduction Act has made big changes on
the drug programs and the Medicare dyanage program.
Speaker 1 (01:50):
So let's kind of go through that a little bit.
Speaker 2 (01:53):
So far, all I've heard about the Medicare supplements and
I've only seen one rate sheet come out.
Speaker 1 (02:00):
Company that's very popular. But I'm being told that.
Speaker 2 (02:05):
From what I've seen, is going forward, like twenty twenty
five and forward, they're no longer able to separate out
men and women. So again you might see that in
your rate adjustments or for new people coming in, it'll
just be one price for male or female. They can't
break it off. Traditionally, females were lower, males were a
(02:25):
little bit higher. Costs I'm told because the ladies take
better care themselves in general health wise, live longer, so
their premiums were a little bit lower. Again, depends on
if you're the Iowa Illinois side. I will remind you
that you can change supplements any time of year you want,
(02:46):
as long as you're healthy enough to answer the health
questions and gain accepted, you know, at their preferred rate
or standard rate, whatever's going to be best for you
or what you qualify. And then in Illinois there's a
company that's always guaranteed accept Again, as I go through
our discussions day, I'm not really going to put names
on different companies or whatever. Just give you some overall
(03:08):
big view examples of what I see in the marketplace.
Speaker 1 (03:12):
FYI, this year.
Speaker 2 (03:14):
Twenty twenty four was the first year that there were
more people nationwide on Medicare advantage plans, and they were
on supplements. So again, supplements had always been the leader
because they'd been around since the beginning of Medicare, and
Medicare advantage really just got popular ten twelve years ago
(03:35):
with their max out of pockets coming down and the
benefit packages being built up. So we'll go through and
kind of talk about again some of these other changes.
Speaker 1 (03:45):
So again medsups, if.
Speaker 2 (03:48):
You get into twenty twenty five and you're on one
and it's just got a huge increase and you want
to do some shopping again, as long as you can
qualify health wise, or if you live in Illinois, you
can make a switch any time of the year. However,
if you're on a Medicare supplement between October fifteen and
December seventh, and it's very important that you take your
drug list, either do it yourself or again go to
(04:11):
an agent that can help you run it through. I
use the medicare dot gov tool. You punch in your
zip code all your different medications, your pharmacies, because they
all might have their preferred, their standard, they're out of
network pharmacy, so it can make a big difference where
you're going and what you're paying for the different medication.
(04:34):
So make sure you put in all the choices that
you would use, not just the one that you currently use,
and then you can run your drug list. But the
standalone PDPs. Oh gosh, I guess about five years ago
there was a company that had the cheapest PDP program.
Drug program was twenty five dollars a month. Now over time,
(04:57):
those came down toward last year in there was a
zero premium plan for people that really didn't have you know,
maybe a couple of generics, no high cost medications, and
then also one in the Iowa side that was only
fifty cents a month, very similar plan there. Again not
for people with more expensive medications, because again they all
(05:19):
have all drug programs are put together with they may
or may not have a deductible to begin with.
Speaker 1 (05:26):
They will have their copay structures like this.
Speaker 2 (05:30):
Last year was real common Tier one, Tier two where
zero copay, Tier three might have been like forty seven dollars,
Tier four like one hundred dollars for a month, Tier
five like thirty three percent of the retail cost.
Speaker 1 (05:44):
Obviously, the higher the tier, the more expense of the medications.
Speaker 2 (05:47):
But again the Inflation Reduction Act has put been put
on all of these plans, Medicare Advantage and the PDPs
this year to where you will pay no more than
two thousand dollars, will pay no more than two thousand
dollars for their medications. Again, as long as all your
drugs are on the formulary. I've run some list where
(06:09):
a drug wasn't on the formulary and it was way
over two thousand dollars. So again, don't just assume your
plan is going to lock you in it under two thousand.
Make sure you check. You don't want to get stuck
in the wrong plan and then have to fight or
switch medications or whatever to get.
Speaker 1 (06:26):
That cost down.
Speaker 2 (06:27):
Anyway, so on both sides of the river this year,
there is a zero premium plan that's still available. Again,
it's not for people with more expensive medications, but if
you just have no drugs or maybe one or two
just generics, that would still be available to you, which
is awesome. However, I had a customer in the day
(06:49):
that we were just kind of playing around with stuff
and they want the female. The lady had a Eloquence,
which is a Tier three medication, and boy, what a
huge difference that it's just that one medicine took took
someone that just ted, you know, the zero premium and
(07:10):
had really no costs for their medications, that one medication
kicked them up between depending on which program that picked,
fifteen to seventeen hundred dollars for the year. So again
it's very very important and take a look at that
type of stuff and that we run those uh medications
and what pharmacy are going to pick them up and
make sure everything's on the proper formulary. When we talked
(07:34):
about Medicare advantage, like I said, this year was the
first year where people are on Medicare advantage and we're
on actual supplements with the drug program. So it really
makes a big difference there too, because when I compared
her stuff on a Medicare advantage basis, there was one
company where it was going to be about five hundred
(07:55):
dollars costs for the year, and all the others were
at seventeen one hundred were a little bit higher. So again,
she's probably going to make a switch for twenty twenty
five to that new program just because the you know,
prescription drug of twelve hundred dollars difference right there, that's
a huge benefit to switch that other company. And it's
(08:16):
a good company, well known company, and with Medicare advantage.
Over the last few years, what I had seen going
on was, you know, the max out of pockets were
coming down. The benefits, the goodie packages I call them,
you know, your dental vision over the counter, et cetera,
et cetera. All the goodies they put together to compete. Well,
(08:40):
all of the meetings that I went to this year,
all the different companies basically started off with the same thing.
Because of the implation reduction art seniors next year, we'll
pay no more than two thousand.
Speaker 1 (08:53):
Dollars for medications.
Speaker 2 (08:54):
This year because of the doughnut hole, the gap, and
so forth, a senior could have paid if they had
really expensive medications, up to eight.
Speaker 1 (09:01):
Thousand dollars out of their pocket.
Speaker 2 (09:05):
The way that they change that structure through Medicare is
that basically these insurance companies have to cover that difference
and cost. So every meeting that I went to what
they said is due to the Inflation Reduction Act, all
the Medicare advantage programs for the most part are going
back and focusing on the just the basics of your
(09:29):
Medicare insurance, your health care coverages. So they're trying to
keep you know, the max out of pockets as low
as they can, because when they have to put so
much money or effort into one area, they have to
take it away from others.
Speaker 1 (09:42):
So like you know, the medical, the dental division, all that.
Speaker 2 (09:45):
It has to be overall package that they submit to
Medicare and then Medicare will approve it. So over the
last few years we had really seen the goodie packages growing.
Speaker 1 (09:57):
We had, you know, three hundred and eighty.
Speaker 2 (09:59):
Five dollars for glasses, you know, two thousand of dental.
Speaker 1 (10:05):
Oh what else type of thing.
Speaker 2 (10:06):
There was last year they had a plan for people
didn't have any drugs, you could get twelve hundred dollars
back in like home exercise equipment, golf clubs, bulleyball, green fees,
all kinds of things that designed to keep you healthy.
And again, Medicare advantage programs are designed to keep you healthy.
That's how they are able to keep their costs lower.
(10:28):
But again a lot of that has been tailed back.
Of course, that twelve hundred dollars deal with that one
company's gone. They do still have one that has a
health benefit like that for stuff, but you're only going
to get ninety dollars per quarter. And again you really
only want to select that one if you didn't have
any drugs. Also, there was a plan this last year
(10:53):
twenty twenty four that was popular with my snowbirds if
you will, because it was a peep U which allows
you to use you know, any doctor that will accept
it and it had the same max in and out
of network max out of pocket, and the cops were
the same whether you were in or out. So it
(11:15):
was kind of like an HMOs, you just this copas
were the same no matter where you were at. But
it was when they expanded PPU version they were also
accepted at mail and really a lot of my snowbirds
liked that plan because, again, if you're considering using an
out of network facility, if I can lock in your
(11:36):
max out of pocket at four thousand instead of ten thousand, again,
we need to focus on the medical part of it,
not just the goodie package. Now again, for people that
are pretty healthy and whatnot, I had a ton of
them that were going with the goodie package, and that
one company that had the best kind of overall goodie package,
and a ton of my customers picked up over the
(11:58):
last few years. Part of the reason they were popular,
even though they weren't accepted at mail and it was
an HMO, was because they had the best overall goodie package.
You got one hundred and five over the counter, you know,
like sixteen hundred and eighty dental, But they're dental in
their vision and the.
Speaker 1 (12:15):
Vision I think it was like three eighty five.
Speaker 2 (12:18):
They got total reimbursements, so it didn't matter if they
went in or out of network, they could get totally reimbursed. Well,
that changed now that company is using a dental network
just like a lot of the other companies, and that means,
you know, you need to do a little more research
if you were on that plan, to make sure your
dentist is in network, otherwise you could have potential copase
(12:40):
as well. As you go for that, you're not going
to get fully reimbursed. You know, things like crowns and
implants may only be covered at a certain percentage. So
again it's important to take a look at that stuff
this year, especially so if you're on Medicare advantage. Wow,
what a change in the atmosphere there, because again they
had to pull back so much stuff for that. Again,
(13:07):
is Mayo a big deal because again some of the
HMOs are not accepted at Mayo. Some are, some aren't,
So again you got to know which company has what's available.
I've you know, only visited with one or two people.
We're kind of looking at stuff. And again the benefit packages,
(13:28):
the goodie packages are all down, so it's it's really.
Speaker 1 (13:31):
Kind of more wide open this year. But it's very
very important.
Speaker 2 (13:36):
That you get out there and you do do some
research and make sure that you've got the best plan
moving forward for twenty twenty five. Again, Medicare dot Gov's
a great tool. I recommend the independent independent agents because
again they can chop around more than just you know,
their one plan. But that's really the big, big extent
(14:00):
all the changes for this year. Again, Iowa and Illinois
do have different rules, they have different programs. Like myself,
I am licensed to do that for you. Already starting
to book up. I know my first week from October
fifteenth is already completely booked. That second week starting to
get booked out. So if you'd like to come in
(14:20):
visit with me, make sure you bring your medication less
make sure you know we'll talk about is Mayo important,
that kind of stuff. You know, we can take a
look at your supplements. When it comes to supplements, I
always license with what I call the big Boy, the
one everybody knows and loves. It's more standard on both
sides of the river. And then I also try to
(14:43):
have what I call the low price leader for each
state either. Now, the thing with Medicare supplements is typically
if you're going to do a supplement that's kind of
a long term, you're not really shopping.
Speaker 1 (14:55):
That every year. But basically the way that they work
is by law, they.
Speaker 2 (15:01):
Must pay eighty five cents of every dollar they taken
in premium back on expenses of the group the people
that are in their plan, you know in say like
Iowa or Illinois, at the same age or whatnot.
Speaker 1 (15:15):
And because of.
Speaker 2 (15:17):
That, you can see these low price leaders come into
the market, you know, saving you at thirty forty to
fifty bucks a month, and you get in with them
when you first get into Medicare, when you've got what
I call a free ticket. You can get into anybody's plan,
no health questions, ask no pre existing conditions. You got
a seven month window to make that choice. And the
(15:42):
anytime you're outside of that. In Iowa, if you want
to switch, you can, but you have to answer health questions.
Speaker 1 (15:47):
And you can be denied.
Speaker 2 (15:48):
Now in Illinois, there's one company that has one product
that has guaranteed acceptance all the time. Because of that,
it's not their lowest price plan available, but it is
available and people over there can start with the low
price leader and if their premiums get higher than that,
they can always drop back in no concerns about pre
(16:10):
existing conditions, whereas an Ioway you can't do that.
Speaker 1 (16:14):
Oh gosh, what fifteen.
Speaker 2 (16:15):
Years ago, when I started in the business, the low
price leader on the Iowa side again was forty fifty
dollars a month cheaper. But within two years they had
such big increases that they were more expensive, and I
had to go back out to all those customers ask
them the health questions. The majority were fine, they were
still healthy enough they could switch, but there were a
(16:38):
few that could not and they were just stuck with
the higher price supplements. There's also a lot of other
rules about if you're on a Medicare supplement and you
want to try Medicare advantage, you have twelve month trial
rights to where you can pick Medicare advantage. It would
start January first, run through that whole year. If for
any reason during the year wanted to disenroll and get
(17:01):
your supplement back, you're guaranteed to do that for the
following month. So again that first really eleven months because
you'd get it switched back, but you get it switched back,
you're guaranteed to get your supplement back, no health questions asked.
And I did have a couple of people that had,
you know, they had Medicare supplements. They started getting too
(17:21):
expensive for the folks you know, eating and they go
up every year, eating into their budget more and more,
and so they decided they wanted to try it. I
had I think two in my career that then you know,
developed cancer or a big issue problem that did. Then
they want to switch back to the supplement during that
(17:42):
middle year or during their trial rights period. Not the
only time you get special election period to do that.
But that's that's a main one. It's the first twelve months.
The other one is all Medicare advantage programs and drug
programs are approved by county, so if you ever move
outside of your county that you're currently in, you are
(18:04):
able to then look at where you're moving to see
what's available, and you either can pick someone else's Medicare
advantage or Medicare supplement again, no health questions, act Medicare
advantage on your basis, there's never any health questions for them.
They're always guaranteed acceptance, no pre existing so you can
change from one to another. Going to be a lot
(18:25):
of movement in the market this year, just because again
the Inflation Reduction Act has made some big changes. There's
still both great ways to provide your protection. But again
here Citi's Insurance, we're always focused on making sure that
you get the best overall value based on your needs.
So again, if that's important, you want to do a search,
(18:47):
you want me to help you just kind of review everything.
Speaker 1 (18:49):
Happy to do that, give us a call at five
six three three five nine eight five.
Speaker 2 (18:54):
Or it's going to be a busy medicare season, so
you don't get your opintments early. That gives you plenty
of time to think about if you're going to make
a change or not, and just make sure you get
it done by December seventh. I hope this information is helpful.
I hope it's a good warning to make sure that
you get out and do chop it around, make sure
(19:15):
you got the right product, and then we'll see all
the changes that'll come for the following year in twenty
twenty six. Again, this is Rob Kane, happy to be
here with you. Give us a call five six three
three five nine eight five four. Have a great weekend.
Good morning and welcome to the show.
Speaker 2 (00:01):
This is Rob King, happy to be here with you today.
I want to do really give you a good update
on what's going on as we are now and to
the first stage of Medicare season as I call it.
Speaker 1 (00:14):
Now.
Speaker 2 (00:15):
We can't make changes until October fifteenth and through December seventh.
Speaker 1 (00:20):
But this year it's going to be an incredible year
of change.
Speaker 2 (00:23):
So if you work with an agent, or if you
haven't compared your stuff lately, you're really going to want
to do it this year because things are changing big time.
Speaker 1 (00:35):
Again.
Speaker 2 (00:35):
I highly recommend using an independent agent because they can
search and help you look at many different plans, whereas
if you call one of those eight hundred numbers are
just going to try to sell you on their plan.
Speaker 1 (00:47):
Again.
Speaker 2 (00:48):
You know, there's two different ways overall to put together
your Medicare package. You can have, you know, your Medicare
plus a Medicare supplement, you know, which was as a
plan letter.
Speaker 1 (00:57):
A lot of people have Plan after Plan G.
Speaker 2 (01:00):
There are some changes coming to those policies we'll touch
on here in a little bit. Big changes though this
year are because of the Inflation Reduction Act. They say
that seniors or Medicare people will pay no more than
two thousand dollars for their medications, which can and can't
(01:21):
be true depending on if you have the right plan
because of the formulas and so forth. I'll touch on
that later, but there's a lot of changes going on,
so let me just stay right off the bat again.
If you're on Medicare, you need to get with your
agent or you need to do your research and make
sure you have the proper plans for twenty twenty five,
(01:42):
because the Inflation Reduction Act has made big changes on
the drug programs and the Medicare dyanage program.
Speaker 1 (01:50):
So let's kind of go through that a little bit.
Speaker 2 (01:53):
So far, all I've heard about the Medicare supplements and
I've only seen one rate sheet come out.
Speaker 1 (02:00):
Company that's very popular. But I'm being told that.
Speaker 2 (02:05):
From what I've seen, is going forward, like twenty twenty
five and forward, they're no longer able to separate out
men and women. So again you might see that in
your rate adjustments or for new people coming in, it'll
just be one price for male or female. They can't
break it off. Traditionally, females were lower, males were a
(02:25):
little bit higher. Costs I'm told because the ladies take
better care themselves in general health wise, live longer, so
their premiums were a little bit lower. Again, depends on
if you're the Iowa Illinois side. I will remind you
that you can change supplements any time of year you want,
(02:46):
as long as you're healthy enough to answer the health
questions and gain accepted, you know, at their preferred rate
or standard rate, whatever's going to be best for you
or what you qualify. And then in Illinois there's a
company that's always guaranteed accept Again, as I go through
our discussions day, I'm not really going to put names
on different companies or whatever. Just give you some overall
(03:08):
big view examples of what I see in the marketplace.
Speaker 1 (03:12):
FYI, this year.
Speaker 2 (03:14):
Twenty twenty four was the first year that there were
more people nationwide on Medicare advantage plans, and they were
on supplements. So again, supplements had always been the leader
because they'd been around since the beginning of Medicare, and
Medicare advantage really just got popular ten twelve years ago
(03:35):
with their max out of pockets coming down and the
benefit packages being built up. So we'll go through and
kind of talk about again some of these other changes.
Speaker 1 (03:45):
So again medsups, if.
Speaker 2 (03:48):
You get into twenty twenty five and you're on one
and it's just got a huge increase and you want
to do some shopping again, as long as you can
qualify health wise, or if you live in Illinois, you
can make a switch any time of the year. However,
if you're on a Medicare supplement between October fifteen and
December seventh, and it's very important that you take your
drug list, either do it yourself or again go to
(04:11):
an agent that can help you run it through. I
use the medicare dot gov tool. You punch in your
zip code all your different medications, your pharmacies, because they
all might have their preferred, their standard, they're out of
network pharmacy, so it can make a big difference where
you're going and what you're paying for the different medication.
(04:34):
So make sure you put in all the choices that
you would use, not just the one that you currently use,
and then you can run your drug list. But the
standalone PDPs. Oh gosh, I guess about five years ago
there was a company that had the cheapest PDP program.
Drug program was twenty five dollars a month. Now over time,
(04:57):
those came down toward last year in there was a
zero premium plan for people that really didn't have you know,
maybe a couple of generics, no high cost medications, and
then also one in the Iowa side that was only
fifty cents a month, very similar plan there. Again not
for people with more expensive medications, because again they all
(05:19):
have all drug programs are put together with they may
or may not have a deductible to begin with.
Speaker 1 (05:26):
They will have their copay structures like this.
Speaker 2 (05:30):
Last year was real common Tier one, Tier two where
zero copay, Tier three might have been like forty seven dollars,
Tier four like one hundred dollars for a month, Tier
five like thirty three percent of the retail cost.
Speaker 1 (05:44):
Obviously, the higher the tier, the more expense of the medications.
Speaker 2 (05:47):
But again the Inflation Reduction Act has put been put
on all of these plans, Medicare Advantage and the PDPs
this year to where you will pay no more than
two thousand dollars, will pay no more than two thousand
dollars for their medications. Again, as long as all your
drugs are on the formulary. I've run some list where
(06:09):
a drug wasn't on the formulary and it was way
over two thousand dollars. So again, don't just assume your
plan is going to lock you in it under two thousand.
Make sure you check. You don't want to get stuck
in the wrong plan and then have to fight or
switch medications or whatever to get.
Speaker 1 (06:26):
That cost down.
Speaker 2 (06:27):
Anyway, so on both sides of the river this year,
there is a zero premium plan that's still available. Again,
it's not for people with more expensive medications, but if
you just have no drugs or maybe one or two
just generics, that would still be available to you, which
is awesome. However, I had a customer in the day
(06:49):
that we were just kind of playing around with stuff
and they want the female. The lady had a Eloquence,
which is a Tier three medication, and boy, what a
huge difference that it's just that one medicine took took
someone that just ted, you know, the zero premium and
(07:10):
had really no costs for their medications, that one medication
kicked them up between depending on which program that picked,
fifteen to seventeen hundred dollars for the year. So again
it's very very important and take a look at that
type of stuff and that we run those uh medications
and what pharmacy are going to pick them up and
make sure everything's on the proper formulary. When we talked
(07:34):
about Medicare advantage, like I said, this year was the
first year where people are on Medicare advantage and we're
on actual supplements with the drug program. So it really
makes a big difference there too, because when I compared
her stuff on a Medicare advantage basis, there was one
company where it was going to be about five hundred
(07:55):
dollars costs for the year, and all the others were
at seventeen one hundred were a little bit higher. So again,
she's probably going to make a switch for twenty twenty
five to that new program just because the you know,
prescription drug of twelve hundred dollars difference right there, that's
a huge benefit to switch that other company. And it's
(08:16):
a good company, well known company, and with Medicare advantage.
Over the last few years, what I had seen going
on was, you know, the max out of pockets were
coming down. The benefits, the goodie packages I call them,
you know, your dental vision over the counter, et cetera,
et cetera. All the goodies they put together to compete. Well,
(08:40):
all of the meetings that I went to this year,
all the different companies basically started off with the same thing.
Because of the implation reduction art seniors next year, we'll
pay no more than two thousand.
Speaker 1 (08:53):
Dollars for medications.
Speaker 2 (08:54):
This year because of the doughnut hole, the gap, and
so forth, a senior could have paid if they had
really expensive medications, up to eight.
Speaker 1 (09:01):
Thousand dollars out of their pocket.
Speaker 2 (09:05):
The way that they change that structure through Medicare is
that basically these insurance companies have to cover that difference
and cost. So every meeting that I went to what
they said is due to the Inflation Reduction Act, all
the Medicare advantage programs for the most part are going
back and focusing on the just the basics of your
(09:29):
Medicare insurance, your health care coverages. So they're trying to
keep you know, the max out of pockets as low
as they can, because when they have to put so
much money or effort into one area, they have to
take it away from others.
Speaker 1 (09:42):
So like you know, the medical, the dental division, all that.
Speaker 2 (09:45):
It has to be overall package that they submit to
Medicare and then Medicare will approve it. So over the
last few years we had really seen the goodie packages growing.
Speaker 1 (09:57):
We had, you know, three hundred and eighty.
Speaker 2 (09:59):
Five dollars for glasses, you know, two thousand of dental.
Speaker 1 (10:05):
Oh what else type of thing.
Speaker 2 (10:06):
There was last year they had a plan for people
didn't have any drugs, you could get twelve hundred dollars
back in like home exercise equipment, golf clubs, bulleyball, green fees,
all kinds of things that designed to keep you healthy.
And again, Medicare advantage programs are designed to keep you healthy.
That's how they are able to keep their costs lower.
(10:28):
But again a lot of that has been tailed back.
Of course, that twelve hundred dollars deal with that one
company's gone. They do still have one that has a
health benefit like that for stuff, but you're only going
to get ninety dollars per quarter. And again you really
only want to select that one if you didn't have
any drugs. Also, there was a plan this last year
(10:53):
twenty twenty four that was popular with my snowbirds if
you will, because it was a peep U which allows
you to use you know, any doctor that will accept
it and it had the same max in and out
of network max out of pocket, and the cops were
the same whether you were in or out. So it
(11:15):
was kind of like an HMOs, you just this copas
were the same no matter where you were at. But
it was when they expanded PPU version they were also
accepted at mail and really a lot of my snowbirds
liked that plan because, again, if you're considering using an
out of network facility, if I can lock in your
(11:36):
max out of pocket at four thousand instead of ten thousand, again,
we need to focus on the medical part of it,
not just the goodie package. Now again, for people that
are pretty healthy and whatnot, I had a ton of
them that were going with the goodie package, and that
one company that had the best kind of overall goodie package,
and a ton of my customers picked up over the
(11:58):
last few years. Part of the reason they were popular,
even though they weren't accepted at mail and it was
an HMO, was because they had the best overall goodie package.
You got one hundred and five over the counter, you know,
like sixteen hundred and eighty dental, But they're dental in
their vision and the.
Speaker 1 (12:15):
Vision I think it was like three eighty five.
Speaker 2 (12:18):
They got total reimbursements, so it didn't matter if they
went in or out of network, they could get totally reimbursed. Well,
that changed now that company is using a dental network
just like a lot of the other companies, and that means,
you know, you need to do a little more research
if you were on that plan, to make sure your
dentist is in network, otherwise you could have potential copase
(12:40):
as well. As you go for that, you're not going
to get fully reimbursed. You know, things like crowns and
implants may only be covered at a certain percentage. So
again it's important to take a look at that stuff
this year, especially so if you're on Medicare advantage. Wow,
what a change in the atmosphere there, because again they
had to pull back so much stuff for that. Again,
(13:07):
is Mayo a big deal because again some of the
HMOs are not accepted at Mayo. Some are, some aren't,
So again you got to know which company has what's available.
I've you know, only visited with one or two people.
We're kind of looking at stuff. And again the benefit packages,
(13:28):
the goodie packages are all down, so it's it's really.
Speaker 1 (13:31):
Kind of more wide open this year. But it's very
very important.
Speaker 2 (13:36):
That you get out there and you do do some
research and make sure that you've got the best plan
moving forward for twenty twenty five. Again, Medicare dot Gov's
a great tool. I recommend the independent independent agents because
again they can chop around more than just you know,
their one plan. But that's really the big, big extent
(14:00):
all the changes for this year. Again, Iowa and Illinois
do have different rules, they have different programs. Like myself,
I am licensed to do that for you. Already starting
to book up. I know my first week from October
fifteenth is already completely booked. That second week starting to
get booked out. So if you'd like to come in
(14:20):
visit with me, make sure you bring your medication less
make sure you know we'll talk about is Mayo important,
that kind of stuff. You know, we can take a
look at your supplements. When it comes to supplements, I
always license with what I call the big Boy, the
one everybody knows and loves. It's more standard on both
sides of the river. And then I also try to
(14:43):
have what I call the low price leader for each
state either. Now, the thing with Medicare supplements is typically
if you're going to do a supplement that's kind of
a long term, you're not really shopping.
Speaker 1 (14:55):
That every year. But basically the way that they work
is by law, they.
Speaker 2 (15:01):
Must pay eighty five cents of every dollar they taken
in premium back on expenses of the group the people
that are in their plan, you know in say like
Iowa or Illinois, at the same age or whatnot.
Speaker 1 (15:15):
And because of.
Speaker 2 (15:17):
That, you can see these low price leaders come into
the market, you know, saving you at thirty forty to
fifty bucks a month, and you get in with them
when you first get into Medicare, when you've got what
I call a free ticket. You can get into anybody's plan,
no health questions, ask no pre existing conditions. You got
a seven month window to make that choice. And the
(15:42):
anytime you're outside of that. In Iowa, if you want
to switch, you can, but you have to answer health questions.
Speaker 1 (15:47):
And you can be denied.
Speaker 2 (15:48):
Now in Illinois, there's one company that has one product
that has guaranteed acceptance all the time. Because of that,
it's not their lowest price plan available, but it is
available and people over there can start with the low
price leader and if their premiums get higher than that,
they can always drop back in no concerns about pre
(16:10):
existing conditions, whereas an Ioway you can't do that.
Speaker 1 (16:14):
Oh gosh, what fifteen.
Speaker 2 (16:15):
Years ago, when I started in the business, the low
price leader on the Iowa side again was forty fifty
dollars a month cheaper. But within two years they had
such big increases that they were more expensive, and I
had to go back out to all those customers ask
them the health questions. The majority were fine, they were
still healthy enough they could switch, but there were a
(16:38):
few that could not and they were just stuck with
the higher price supplements. There's also a lot of other
rules about if you're on a Medicare supplement and you
want to try Medicare advantage, you have twelve month trial
rights to where you can pick Medicare advantage. It would
start January first, run through that whole year. If for
any reason during the year wanted to disenroll and get
(17:01):
your supplement back, you're guaranteed to do that for the
following month. So again that first really eleven months because
you'd get it switched back, but you get it switched back,
you're guaranteed to get your supplement back, no health questions asked.
And I did have a couple of people that had,
you know, they had Medicare supplements. They started getting too
(17:21):
expensive for the folks you know, eating and they go
up every year, eating into their budget more and more,
and so they decided they wanted to try it. I
had I think two in my career that then you know,
developed cancer or a big issue problem that did. Then
they want to switch back to the supplement during that
(17:42):
middle year or during their trial rights period. Not the
only time you get special election period to do that.
But that's that's a main one. It's the first twelve months.
The other one is all Medicare advantage programs and drug
programs are approved by county, so if you ever move
outside of your county that you're currently in, you are
(18:04):
able to then look at where you're moving to see
what's available, and you either can pick someone else's Medicare
advantage or Medicare supplement again, no health questions, act Medicare
advantage on your basis, there's never any health questions for them.
They're always guaranteed acceptance, no pre existing so you can
change from one to another. Going to be a lot
(18:25):
of movement in the market this year, just because again
the Inflation Reduction Act has made some big changes. There's
still both great ways to provide your protection. But again
here Citi's Insurance, we're always focused on making sure that
you get the best overall value based on your needs.
So again, if that's important, you want to do a search,
(18:47):
you want me to help you just kind of review everything.
Speaker 1 (18:49):
Happy to do that, give us a call at five
six three three five nine eight five.
Speaker 2 (18:54):
Or it's going to be a busy medicare season, so
you don't get your opintments early. That gives you plenty
of time to think about if you're going to make
a change or not, and just make sure you get
it done by December seventh. I hope this information is helpful.
I hope it's a good warning to make sure that
you get out and do chop it around, make sure
(19:15):
you got the right product, and then we'll see all
the changes that'll come for the following year in twenty
twenty six. Again, this is Rob Kane, happy to be
here with you. Give us a call five six three
three five nine eight five four. Have a great weekend.
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