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November 9, 2024 • 22 mins
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Episode Transcript

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Speaker 1 (00:00):
Good morning Dall. On the second Saturday of November. Thanksgivings
about three weeks away. Craig Schillig here, and this is
Safe Money. I'm here every Saturday to talk with our
listeners about financial strategies we use to manage and protect
the assets safely. I've been an insurance agent for over
twenty four years. During that time, I've learned a few

(00:22):
insurance strategies, like using annuities as safe money harbors, or
using cash value life insurance to supplement retirement income. Just
a reminder, you can call our office at five six
three three three two two two zero zero if you'd
like to enroll into one of my virtual Medicare community

(00:43):
meetings that I do via Zoom. I do those throughout.
I'll do them throughout this month and the month of December.
Or you can email me at craigat Craigshillig dot com
and I'd be happy to send you the Zoom codes.
I'd like to continue my discussion about Medicare Parts C,

(01:04):
known as Medicare Advantage plans. I'm going to pick up
where I left off last week. I was talking about
the AARP Medicare advantage from UHC that's the IOWA zero
zero four PPO. It's a Medicare Advantage PPO plan with
a Medicare contract. To join this plan, you must be

(01:29):
entitled to Medicare Part A, be enrolled in Medicare Part B,
live within the service area, and be a US citizen
or lawfully present in the US for at least five
consecutive years. And remember these are benefits and services that
go beyond original Medicare rules. So the CMS rule says

(01:54):
Medicare Advantage plans must offer equal to or greater CUTDGE
than what original Medicare offers. I mentioned the fitness gym
memberships in the past. It does have a built in
fitness program. There's no copey for that. That includes a
free gym membership, online fitness classes, on demand workout videos.

(02:21):
You can live stream some of the fitness classes, and
there's even some memory activities. You can go to Snap
Fitness Curves, Orange Theory YMCA in Bettendorf, the Life Fitness Center,
and there's many more. There's a nationwide network. If you're
traveling throughout the country, there's gyms you can visit while

(02:43):
you're traveling. The fitness program helps you stay active and
connected to the gym from home or in your local community.
There's an over the counter Essentials benefit. This is sometimes
called the ot SEE. United Healthcare will give you a
twenty five dollars credit every quarter to buy covered over

(03:07):
the counter products from thousands of participating stores, including Walgreens, Walmart, Dollar, General, Kroger,
and neighborhood stores near you, like Ivy. You can choose
from thousands of brands in generic over the counter products
like vitamins, pain relievers, first aid items, neil Sporren, bugspray, etc.

(03:35):
There's even an app called Healthy Benefits that you can
just click items and they'll be shipped to your mailbox.
Some of my clients use some of their quarterly credit
to buy items for local homeless shelters. I've had some clients.
I had one client who bought a box of one

(03:56):
hundred and fifty toothbrushes and took it to local women's shelter.
I've had people buy that it's called box and a
shower and it's a travel kit, and they've give that
to a men's shelter. Just a thought. United Healthcare will
give you certain rewards for performing certain tasks throughout the

(04:20):
calendar year. You can earn up to one hundred and
fifty five dollars in rewards when you become a member,
and that reward is via a gift card that you
can use on your U Card or to purchase over
the counter items on the OTC Benefit Platform. Some of

(04:40):
the other credits they'll give you. They'll give you a
five dollars reward to just watch a little video regarding
your U Card, fifteen dollars if you go get your
annual physical and wellness visit, ten dollars each month if
you just get up and movie. They want you to

(05:01):
track your steps and just stay active, ten dollars to
connect with others via a phone call or social media.
And they'll even give you five dollars if you just
go get your flu shot. There is a built in
meal benefit upon a hospitalization discharge. They'll give you up

(05:22):
to twenty eight home delivered meals immediately after an inpatient
hospital stay or a skilled nursing facilities stay. So some
good news for twenty twenty five, the coverage gap otherwise
known as the donut hole has been eliminated, and your
out of pocket maximum cost is lower than ever on

(05:44):
prescription drug costs. That means you're more protected from high
drug costs. In twenty twenty five, there is no monthly
drug plan premium. There's no deductible for generic medication. And
remember generic medication, that's going to be tiers one and
tier two. Your coverage for these drugs start at the

(06:06):
initial coverage stage. Now there is a four hundred and
ninety five dollars deductible. Remember the deductible next year cannot
be higher than five hundred and ninety but this plan
will have a four ninety five deductible for drugs on
brand name medication Tiers three, four, and five. You pay

(06:28):
the full cost for your drugs in these tiers until
you reach the deductible amount. Then you'll move to the
initial coverage stage, where you'll have a copey or co insurance.
Let me talk about prescription drug payment stages. The initial
coverage stage. In this stage, you'll pay your plan copes
or co insurance, and then the plan would pay the rest.

(06:51):
Once you or others on your behalf have paid a
combined total of two thousand dollars, which includes the amount
you paid towards your deductible, you move then to the
catastrophic coverage stage. In twenty twenty five. Let's go over
the preventative services that are included with this type of plan.

(07:11):
You get a routine physical and a Medicare covered physical.
There's an abdominal aortic aneurysm screening an there's alcohol misuse counseling.
There's an annual wellness visit. There's a bone mass measurement.
There's a breast cancer screening including mammograms. There's a cardiovascular

(07:34):
Disease Behavioral therapy class. There's cardiovascular screenings. There's cervical and
vaginal cancer screenings. There's a coal rectal cancer screening. There's
depression screenings and monitoring. There's a hepatitis C screening. There's

(07:55):
an HIV screening, lung cancer with low dose compute. You
did tomography screening. There's medical nutrition therapy services. There's Medicare
diabetes prevention programs OBCD screenings and counseling. There's also a

(08:15):
prostate cancer screening STD, infection screenings and counseling, tobacco use
cessation counseling, and there's vaccines including those for flu, hepatitis B, pneumonia,
and COVID nineteen. Now under emergency care, under this plan,

(08:37):
you would pay a one forty copey if you're admitted
to that if you're in the er. If you're admitted
to the hospital within twenty four hours, you would pay
the inpatient hospital copey instead of the emergency room care cope.
For skilled nursing facility care, you can choose to go

(08:58):
to a skilled nursing facility after just a one day
hospitalization on a partsy advantage plan. If you have original Medicare,
you'd need a three day hospital stay before you can
go to a skilled nursing facility under CMS rules. If
you're diabetic, there's diabetes management and diabetes monitoring supplies. With

(09:24):
a zero dollar cope, UHC will cover ac check and
one touch brands. They'll cover glucose monitors including one touch Veroflex,
one touch Ultra TiO, ACU check Guide ME, and ac
check Guide. Uh For test strips, they'll cover one touch Vario,

(09:45):
one touch Ultra ac check Guide, ac Check Aviva Plus,
and accheck Smartview. There are other brands are not covered
by this plan. As a UHC Medicare Advantage Plan member,
you have access to an exclusive collection of discounts on

(10:05):
hundreds of products and services. Once you're a member, you
can sign into your members site for a list of
discounts available to you. There's also an optional supplemental benefit
called the Platinum Dental Writer. As a UHC member, you
have the option to get dental coverage through the Platinum
Dental Writer for an additional monthly fee. This fees on

(10:28):
top of any monthly premium you pay for your Medicare
Advantage Plan and Medicare Part B coverage. For an extra
fifty four dollars a month, you'll get access to dental
coverage that includes fifteen hundred dollars per year for covered
dental services through the Platinum Dental Writer. There's a zero
dollar codepay for covered network preventative services such as oral exams,

(10:55):
routine cleanings, X rays, and fluoride. You do pay fee
fifty percent co insurance for bridges and dentures, but there'd
be a zero dollar copy for all other covered network
comprehensive services such as fillings, crowns, root canals, and extractions.

(11:15):
You'd have access to one of the largest national dental networks.
Out of network coverage is available if you choose to
see an out of network dentist. You might build more
even for services that are listed as a zero dollar cope.
You can enroll in the Dental Writer when you enroll
in your Medicare Advantage plan. If you don't enroll, then

(11:38):
you can call customer service or go to the coverage
and Benefits section of your member website to enroll in
the Dental Rider within three months after your plan coverage starts.
If you enroll in the Writer when you when you
enroll for your plan, your writer coverage will start when
your plan starts. Way to enroll within the three months

(12:02):
after your plan starts, your writer coverage will begin on
the first day of the month after the writer's purchased.
The easiest way to find a network dentist in your
area is to go to the UHC dot com slash
Medicare website and select shop Medicare Plans at the top
of the website. You can then choose to find a

(12:23):
dentist or scan the QR code inside one of your
member booklets. Some exclusions may apply, such as services performed
by an out of network dentist if your plan does
not have an out of dental network coverage area, dental
services that are not necessary, hospitalization or other facility charges,

(12:49):
dental procedures performed solely for cosmetic or esthetic reasons. Any
dental procedure not directly associated with a dental disease, Any
procedure not performed in a dental setting. Reconstructive surgery of
any type, including reconstructive surgery related to dental disease, injury,

(13:13):
or congenital anomaly. Procedures that are considered experimental, investigative, or unproven.
This includes pharmacological regimens not accepted by the American Dental
Association Council on Dental Therapeutics. The fact that an experimental, investigational,

(13:36):
or unproven service, treatment device, or pharmacological regiment is the
only available treatment for a particular condition will not result
in coverage if the procedure is experimental, investigational, or unproven
in the treatment of that particular condition. A few other

(14:01):
exclusions expenses for dental procedures begun prior to the covered
person's eligibility within that plan, service for injuries or conditions
covered by workmen's comp or employer liability laws, and services
that are provided without cost to the covered persons by

(14:24):
any municipality, county, or and or other political subdivision. This
exclusion does not apply to any service covered by Medicaid
or Medicare. Dental services rendered, including otherwise covered dental services

(14:46):
after the date on which individual coverage under the policy terminates,
including dental services for dental conditions arising prior to the
date on which individual coverage under the policy would be terminated.
Services rendered by a provider with the same legal residents

(15:09):
as a covered person or who is a member of
a covered person's family, including a spouse, sibling like a
brother or sister, parent, and or a child. Charges for
failure to keep a scheduled appointment without giving the dental
office twenty four hours notice, sales tax or duplicating or

(15:33):
copying patient records. Implants and implant related services are also excluded.
Tooth bleaching and or eniamal micro abrasion veneers orthodonics is
also included in that sustained release of therapeutic drug COVID nineteen,

(15:58):
screening testing and or vaccinations. Charges aligned to dental care management,
case presentation, consultation with other medical professionals, or translation sign
language services. Space maintenance is also excluded in any specified

(16:21):
procedure reported by dental codes next week. I'm going to
that kind of concludes my part C Medicare advantage. Remember,
I do a lot of companies besides United Healthcare. One
plan that's very hot this year is from well Mark

(16:44):
and they have a PPO program for twenty twenty five
that is very competitive against United Healthcare and EDNA for
the twenty twenty five plan year. If you've not seen that,
go look that up. I've had a lot of customer
inquiring about that plan. A couple of the benefits that

(17:05):
they are offering for next year is one no monthly
plan premium. The copays and max out of pockets are
very competitive, if not lower than United Healthcare, ID or ETNA.
They are offering a zero drug deductible for all tiers.

(17:29):
That's tiers Tier one, Tier one, and two generics Tier
three through five, which would be brand name or specialty drugs,
so there's no five to ninety deductible on that plan.
They're offering a fifty dollars quarterly credit on over the

(17:49):
counter essentials. The plan I talked about today is only
offering twenty five dollars a quarter, so that's another fringe
benefit for next year. This is the first year in
I would say four years that a well marked advantage
plan is banging heads or being very competitive with United

(18:10):
Healthcare and Edna in this area. That plans available in Muscatine,
Scott and Clinton County, most of the Eastern Iowa and
Central Iowa corridor. So that's something to check out. If
you'd like more information on that, please contact my office.

(18:30):
I'd be happy to help you with that. Remember, if
you are now on Medicare and you want to make
a change to your plan, you want to make a
change to your party plan, you want to make a
change to your Medicare advantage plan, or you have questions
about your supplement premium increase for next year, this is

(18:52):
the time to do that. The clock runs out on
December seventh, But please remember December seventh is a Saturday.
There's not a lot of agents to work on Saturday
these days, so I'll kind of tell you December fifth
because that's during the week. But again, this is that
time frame to make changes to that. Remember, also, I

(19:16):
give virtual I give virtual meetings. I do one every month.
I talk about Medicare Parts C. I do one from
United Healthcare. I also do one from well Mark, and
I talk more with that meeting about supplements and standalone
drug plans, where the Part C meeting, I focus solely

(19:39):
on a United Healthcare Medicare advantage plan. Some of my
meeting times coming up. My next couple dates i'll do
my meeting sponsored by Wellmark are going to be Tuesday,
November nineteenth, and my next one in December will be Tuesday,

(20:00):
December tenth. For United Healthcare Virtual Meetings coming up again,
I focus solely on Medicare advantage plans for that presentation,
and my next couple meeting dates for that are going
to be November twenty first, and that's a Thursday, and

(20:21):
then I'm also going to do one in December on Wednesday,
December eleventh. I don't get outside of most of my
meetings except for November and December are going to run
Tuesday Thursdays. But you guys don't call me or come
to my office usually after about December fifteenth or nineteenth,

(20:43):
so my December dates are kind of stacked that way.
And while we're on I'm going to give you my
January dates now because I already have those in the calendar,
and my dates for that are going to be I'll
do a well Marked meeting on Tuesday, January twenty first,

(21:05):
and I'm going to do a UHC meeting on Part C.
That date will be Thursday, January twenty third, so mark
those down on your calendar. If you don't want to
see me before the holidays, we can do that in January.
After the holidays blowover and you want to talk more

(21:26):
about medicare. You can call my office at five six
three three three two two two zero zero for my
zoom meeting codes on all those meetings or additional dates
and times. I usually pick my dates for the next
six months, so I'll have them probably out till June.

(21:48):
You're also welcome to email me at Craig at Craigshchillig
dot com and i'll spell that out for you. That's
c R a I G at c R a I
G S c h I L l I G dot com,

(22:15):
and I can send you the virtual zoom link meeting
codes for those meetings. This is Craig Shelligg with Safe Money.
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