Health and Wellness Show 01-11-25

Episode Transcript

Speaker 1 (00:19):
Hey, good morning, and welcome now to the Health and
Wellness Show here on one O three point five FM
and five sixty am WVOC, and of course anywhere you
head you can always catch us on the incredible Iheard
Radio app. You haven't done load of that yet. It's
absolutely free and it's a boy. It's updated now just
in the last couple of weeks, months or so, and
it's it's sweet. Check that out. Hey, it's good to

(00:42):
have you here. My name is Gary David, and we
got a very busy hour here. We're gonna be talking
again with Jeff Hollowood Health Markets. Jeff's been talking the
last number of weeks with us. Is this surprise announcement
after the Medicare enrollment period ended, which was back on
December seventh. After that period ended, the announcement that EDNA

(01:02):
had pulled out of being in network with election to
medical Center. Now, this affects folks on Medicare advantage plans
who chose that, and folks have been what do I
do now the opening rolling periods? So well, Luckily there
is a grace period here and there are things that
you still can do here, and Jeff will be by
to tell us all about that hand out some advice.

(01:23):
The guys from preservation specialists John Farley and Matthew Terrier
are going to join us as well. We're going to
run down a list of the things they offer, the
products they offer. This is these guys aren't stockbrokers, okay,
they're financial advisors. They're fiduciaries and they have a variety
of ways that they can help you get what we

(01:45):
all want when it comes to our retirement, whether you're
already there or getting ready to get there, and that
is peace of mind. Right, So we all want peace
of mind. So we will discuss that and all the
products they have to offer if we can get through them.
All coming up here in the next half hour the
Health and Wellness Show here on one of three point
five FM and five sixty AM wv C. But let's

(02:07):
get things started here this morning by having a discussion
with my friend and yours. He is the attorney over
to the Loss of James Now it's Jim Snow. A
couple of weeks ago we were talking about workmen's conversation
cases and we talked I think specific We spent most
of our time discussing how we as non lawyers think, well,
that's just a cut and dried thing. You know, I

(02:28):
get hurt on the job. My employer pays, you know,
for the insurance, and Bilm's going to be there automatically
and thing's gonna be good. But it's not always that way,
and things can go sideways.

Speaker 2 (02:40):
They can't.

Speaker 3 (02:40):
And I know we talked a little, you know, kind
of kind of spent probably a lot of time talking
about when things just seem to go kind of sideways
out the gate where maybe the the adjuster, you know,
the insurance office, you know, they tell you the contact
either it just ignores the claim or blows you off.

(03:00):
Sometimes you just get the red flags right away that hey,
this is not going to go the way I This
ain't going right, and and that's a signal when people
should get maybe talk to a lawyer and get some help.
But I will tell you, you know, that does happen,
all right. But I will tell you the the the

(03:21):
bigger risk, at least from from what I see from
from client perspectives, is when the the adjusters and the
insurance company seem like they are just so friendly and
so helpful. You know, the phrase is killing you with kindness?
You know, Oh, sure, we'll get you to you know,

(03:42):
go see uh this uh this medical clinic right away,
you know, and you know, we're trying our best to
help you. Oh, we're trying to do this and and
and they can kind of lull people sometimes into a
false sense of say security and any way, but even so,
in the world of workers comp specifically, all right, and

(04:04):
this that also applies to personal injury, just car wrecks
or other type of accidents, where just because the insurance
companies friendly are just seems friendly, doesn't mean they're necessarily
looking out for your interests. In workers' comp specifically, the
insurance companies get to pick the doctors they are. Why

(04:25):
is that, Well, that's okay. So the trade off is
you don't have to prove that the employer was at fault.
So it can be if you got hurt because of
your employment, you're covered just because you're on the clock. Yeah,
because you're on the clock, or otherwise because of your

(04:46):
employment and you're covered. It doesn't have to be your
employer's fault. It could be your own fault. I mean
you can literally it could be your fault. You fell
and night and broke your lef legg and you're still
covered the same and so we that's that's a trade off.

(05:06):
And then also the trade off is you shouldn't it's
not designed to have to wait a long time to
get the treatment. You're supposed to be entitled to treatment
up front or are as, you know, as as soon
as practical after an injury. And so because of it,
the employers get to to uh are the insurance companies

(05:28):
for them typically get to pick the providers. A couple
of other trade offs, like there are no punitive damages,
there's no pain and suffering, you know. But I just
would say this a lot of a lot of the
claims that we've gotten involved in that have been successful
from the standpoint of significantly increasing the client recovery. And

(05:54):
that's really the only measurement, you know, that's how these
things are compensated is just money. Our situation is not
necessarily where where insurance companies blew it off are are
denied it, but maybe stuff that was accepted or admitted
very quickly, and then just you know, we come to
realize that the doctors that are that are being provided

(06:18):
aren't diagnosing correctly or aren't making a comprehensive diagnosis, like
they're leaving stuff out or they're not charting everything. So
I don't say substandard, it's just maybe somebody, you know, somebody,
somebody gets hurt and they I'm just making up making
this up as an example, but maybe they they hurt

(06:38):
their arm, uh, maybe their their wrist and their shoulder,
and the insurance company will will authorize a doctor to
treats the risk, but they never get the shoulder looked at.
That happens sometimes, and it's not the doctor's fault. The
doctor just you know, they work off the either, yeah,
they just work off the authorisations. Or there's certainly examples

(07:03):
and lots of examples where the doctors may provide excellent
medical care, right, but they still, for whatever reason, will
chart the file or make the notes reflecting a better
recovery than there actually was or minimizing the symptoms. One

(07:24):
of the other things doctors and workers can't do is
is a science something called an impairment rating, where they
put down a numerical representation of how permanently affected a
body part is after the injury. And there's a book
called the Ame Guidelines to Permanent Impairment that lays out
charts on specific ways that happens. And I didn't go

(07:45):
to medical school, but I've you know, looked at the
book and done this work for a while. It's actually
not that unusual to get a doctor will do a
sign of rating, and it is no way possible that
rate could come from the book. It's just like it's
so low, it's it's it's impossible, right, And so that happens. Right,

(08:10):
But here here's yeah, here's the impression. I've got it
forming in my mind right now. Okay, you tell me
if I'm wrong.

Speaker 1 (08:17):
It almost sounds as though like there's this just this,
this this genre of medicine that's set up just to
do this. This is all they do. They get referrals
from insurance companies and workmen's comp claims, and it's almost
kind of like a like a doctor miller or something.
I mean, this is this is what they do. They
don't work for an insurance company, but they have this

(08:38):
symbodic relationship with them. Is am I crazy?

Speaker 2 (08:41):
Here? And I think I think that's I think that's right.

Speaker 3 (08:43):
And there there there are there are some medical practices
which do I think almost exclusively work place injuries. You know,
there's some these urgent care facilities that are designed to
you know that that primarily I think are maybe loosely
or are primarily take referrals. And then you also do

(09:04):
have like a lot of orthopedic practitioners I know that
do get a lot of their their business maybe all
of it, certainly, but they do get a lot of
their business from and that's fine at all.

Speaker 1 (09:15):
You know, but you wonder sometimes, okay, are you getting
the cream of the crop here, you know, for your
health care? When if that's the case, and again, and
I'll tell what the issue it. What I see at
least are people are situations where maybe maybe the medical
care could be exactly on point. It's just documented, you know,

(09:38):
where the symptoms are minimized, the effect is minimized, the
ratings are minimized, and what that has the effect of
is potentially lowering the amount of compensation.

Speaker 2 (09:50):
You know.

Speaker 3 (09:50):
So you have an injured person that feels like maybe
the insurance company was Johnny on the spot, get them
to their doctors. The doctors got all the medical care,
got them the surgery, did everything.

Speaker 2 (10:00):
And then at the end of the case.

Speaker 3 (10:03):
Or after they've recovered, now you know that they're offered
a lot less compensation maybe than they're legally entitled to
because of the way it was documented.

Speaker 1 (10:13):
Okay, I'm glad you brought that up, because I think
I was. I've been confused all these years. I always
thought when it came to workman's comp claim, it was
just about, you know, restoring you back to your state
before the accident. So it was it was just a
health recovery thing. But there there are dollar amounts attacked.
I guess that's for loss of future earnings.

Speaker 2 (10:33):
It's that lost future earnings. And it's a.

Speaker 3 (10:38):
Primarily is calculated based on the impairment ratings, where where again,
the physicians would assign a rating doc to demonstrate what
the differences between the before and after save for the
effective body part. And South Carolina law has basically a
whole chart with every part of the body kind of listed,

(11:02):
I mean toes and yeah, your tongue, and and how
many weeks of pay are you entitled to for a
total loss? Right, And that impairment rating is based on
a percent of total loss. So and it can be
you know, and that and and and sometimes in some situations,

(11:25):
you know, this can be significant amounts, right, I mean,
sometimes it's you know, the reality is I mean, it's
it's never worth the money. You know, people can have
finger imputations or something and you know, don't really the
money just doesn't seem like it's you know, it's definitely
not worth it, right, But but but still it can

(11:46):
be I spent all the.

Speaker 1 (11:47):
Money, but my finger is still gone.

Speaker 2 (11:49):
Yeah, and.

Speaker 3 (11:54):
I'm sorry, I just just away from No, that's fine,
it's but but that that's a that's a that's a
big part of it is that that impairment rating and
the born after you also have potential money for future medicals, right, yeah, Okay,
if it's possible somebody's gonna need a surgery in the future,

(12:15):
that can be dealt with.

Speaker 4 (12:17):
You.

Speaker 3 (12:17):
Also, there may be entitled to compensation for a scar
or any kind of permit disfigurement.

Speaker 1 (12:22):
Yeah.

Speaker 3 (12:23):
Right, so there are a few type of things, but
the impairments using the biggie.

Speaker 1 (12:26):
All right, But but typically would you say these these
cases go fairly smoothly typically, I mean we're talking about
the exceptions.

Speaker 3 (12:33):
Here or it's so so yeah, So I guess what
I'm getting at is this, there are there are certainly
a percent of cases where anybody can tell that it's
not going right, okay, and that's the red flag maybe
to get a lawyer right. And and I've said it before,
smaller cases, minor injuries frequently don't need a lawyer. There's

(12:55):
nothing a lawyer can do to be beneficial. Uh. My
office is hoped to tell people and that's a situation.
But I'll tell you that there are situations where people
can have significant injuries specifically like orthopedics, like things involving
orthopedic surgeries or you know, fractures, you know, different types

(13:21):
of of you know, shoulder injuries. I mean, things in
that world really cifically keep you from from earning a paycheck. Correct,
all right?

Speaker 1 (13:31):
The law officer James Snell, if you I think you
know of a good lawyer if somebody needs one, don't you?

Speaker 2 (13:36):
Uh? Maybe yes, maybe maybe?

Speaker 1 (13:40):
And how would they reached, said birk So.

Speaker 3 (13:42):
Uh, they give us a call at eight zero three
three five nine three three zero one. Our visitors online
at snow law dot com. That's three l's snow law
dot com.

Speaker 1 (13:52):
All right, but we're out of time. Enjoy your weekend, buddy.
We'll see you soon.

Speaker 2 (13:55):
Thank you.

Speaker 5 (13:56):
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(14:17):
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Speaker 6 (14:37):
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Speaker 5 (14:39):
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Speaker 7 (14:58):
Hi, this is John Farley. Now let me ask you
is your retirement inflation proofed? Here's what I mean in retirement.
Chances are you're on a fixed income with variable expenses.
So how do you not run out of money when
the cost of just about everything continues to go up?

Speaker 1 (15:15):
You inflation proof it.

Speaker 7 (15:16):
Our team at Preservation Specialists can show you strategies to
help combat inflation so it doesn't outpace your retirement income.
Call us today at ATO three nine retire to learn more.
Inflation could take a huge chunk out of your retirement savings,
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(15:37):
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Speaker 1 (16:00):
And staff at the Law Office of James Snell are
there to help those with injuries and workers' compensation claims,
car accidents on the job and other accidents resulting in injuries.
They want to help everyone resolve their claim as quickly
as possible, but they'll never recommend you accept a settlement
that's unfairly low the Law Office of James Snell, recognized
by AVA with a ten and an eight plus rating

(16:21):
with a Better Business Bureau. There's no cost to speak
to them. Insurance companies make their money by denying and
minimizing otherwise valid claims. The Law Office of James Snell
can help. They're not looking to try to take every
small mishap, but focus on real injuries that deserve to
be taken seriously. The Law Office of James Snell. I'm
Jim Snell. Contact me at Snell Law dot com. That's

(16:43):
three l's spell law dot com. The Law Office of
James Snell since two thousand and four, with offices in
Lexington and Columbia. Hey, we appreciate you joining us this

(17:18):
morning for the Health and Wellness Show on one of
three point five FM and five sixty AMWVOC. It's John
Farley and Matthew Terry from Preservation Specially. Let's get more
and to see you. Good to see both.

Speaker 2 (17:28):
Again, Garry, how are you?

Speaker 6 (17:30):
Good morning?

Speaker 1 (17:30):
I'm with good morning to you.

Speaker 8 (17:32):
So.

Speaker 1 (17:32):
Yeah, two weeks ago we talked about yeah, brand new
year resolutions, you know, get started a lot of people
and some have already fallen off. That bandwagon of course,
but we talked about the importance of that and planning
for your retirement, which is what you guys specialize in.
It's preservations specialists preservation you know. Go on, but we
haven't done this in a little while, and maybe we

(17:56):
can sit down and talk today about the white variety
of services that you offer. I mean, you know, we
talk about yeah, your default, well, talk about my money. Well, yeah,
but there's a there's a lot of different things to
be you know, to look at here, and a lot
of different ways that you help people plan for and

(18:17):
be successful in their retirement years. A lot of things
that you do. So let's then we can talk about
some of those this morning.

Speaker 7 (18:23):
Yeah, I mean, so, so we work in five areas
and the first. The first that we work in is income, right,
because if you don't have an income, you don't have
a retirement. So we want to make sure that that's covered, okay,
and so how do we you know, we have a
comprehensive income plan that says, okay, this is going to
carry you for the next thirty years. Because you know,
it turns out when you look at these these stats

(18:44):
on how long does the average man and woman live
in the United States. Right, they're factoring in all the
people who who who passed early. Right, So if you
make it the five they are, because you make it
to sixty five, you've got a long run for most people, right,
you got a long run. So we want to make
sure that we have a good income plan in place
that accounts for any contingencies in anything that can happen

(19:08):
in the future. So we make we make a nice
income plan, and in that income plan, it's going to
take into account things like inflation. Because you know, twenty
dollars today, twenty years from now, I was only going
to buy ten dollars worth of goods, right, it's about
half the amount.

Speaker 1 (19:25):
So the twenty dollars a day was forty dollars four
years ago.

Speaker 6 (19:28):
But yeah, yeah, yeah, you know yeah right, yeah that
it is.

Speaker 7 (19:30):
Yeah yeah, so yeah, that's how that goes, right, So
we got a factor in for the inflation, right, So
that's one of the things. So, but there are many
areas that we work in and so we we obviously
we talk about investments. We do that insurance if you
need it. So insurance is and probably the biggest thing
to discuss there. There there are different avenues. But people

(19:52):
who are looking to leave some assets to their errors,
there are different types of insurances we can use to
make that happen. Another one that we wanted to discussed
too is long term care because in this country, we
are responsible for our own long term care coverage. Yeah,
it's not cheap, and and you know you do the
math on that, and so so and there are and
you know, planning would be really easy if we knew

(20:14):
the outcomes, right, we don't, so we got to make
our best estimate. We got to do that sort of thing.
So those are the Those are a couple of the
areas that we work in. And then of course we
do estate and taxes, right. But but I think that
the biggest thing is, uh, if you come visit us,
first two meetings are no cost, no obligation. We're asking

(20:35):
you a bunch of questions in the first meeting, and
we are fiduciaries. That is, we're not recommending anything to
you that is not in your financial best interest. We
don't have any quotas, we don't have anything like that.
We are licensed in everything that's available. So what we
do is we sit down and we try to assemble
a put the puzzle together for your individual case and
for your family. So yeah, first meeting, a lot of questions.

(20:59):
Second me we have more questions, but also a kind
of a high level idea of where we think you
stand and where we we could help you or not.
I mean, there are sometimes people come in and and
they're completely buttoned up and we're like, listen, God bless you,
you're doing great, keep doing what you're doing. I would
say that's probably not most people, but that happens once

(21:20):
in a while.

Speaker 1 (21:21):
Yeah, and then what happens when somebody comes in and
he You're like, you know, this is going to be
difficult because you have those.

Speaker 6 (21:34):
Yeah, absolutely, you know.

Speaker 8 (21:35):
From time to time, we you know, we we we
come across those situations and obviously ask fiduciaries.

Speaker 6 (21:42):
Our job is to tell the truth right.

Speaker 8 (21:44):
Absolutely, and and and sometimes the truth hurts, but honestly,
it's better that they hear it now then just ignore
it and they kind of be in a in a
rough situation in the future. So yeah, it's our job
to to be that person to sometimes delivered the news
that we're not exactly looking for or that person may
be looking for as well.

Speaker 6 (22:05):
But yeah, we'll.

Speaker 8 (22:06):
Sit down We'll tell them what they need to do,
what changes they need to make, and we'll create a
plan and say, hey, you need to be very specific
and stick to this plan if you wish to have
some sort of enjoyable retirement in the future.

Speaker 1 (22:19):
So income, insurance, long term care, estate planning, taxes, yep.
So obviously you guys aren't just like stockbrokers.

Speaker 6 (22:31):
We are. We are absolutely not.

Speaker 8 (22:33):
No, yeah, yeah, So you come into our office, we
talk about our custom built retirement review, and the benefit
of working with the financial planner is we are exactly
not what you said.

Speaker 6 (22:47):
We are not a stockbroker.

Speaker 8 (22:49):
We are not someone who only cares about your investments.
And this says, hey, you know those other four areas
regarding your income, generation and your taxes, and you're in
state and you're in assurance. How you figure all those out?
We'll only focus on managing your investments. No, that's not
what we do here within our office. We understand that
everything fits together in one big plan, and we want

(23:11):
to make sure that you're buttoning up at all times
to feel good about where you stand now and where
you're projected to be in the future.

Speaker 1 (23:18):
I'm just curious because you mentioned insurance and as a
as a vehicle to leave you know, assets for your kids, grandkids,
et cetera. I think most people think that, well, this
is what my investments are for. What have you I
mean to leave it? Is there an advantage to doing
it another way?

Speaker 7 (23:37):
Depends on your circumstance. Sometimes there is, Sometimes there isn't.
We just have to look at the details, right. So
so sometimes people say, I mean, you know, a simple example,
Sometimes people say they want to leave that they want
to leave a certain amount to you know, to to
certain errors. And so you can get some forms of
life insurance that would that would take care of that.

(24:00):
And remember there's no tax consequence on like life insurance.
Everything that goes out is completely you know, you're you're
you're good to go. But sometimes that doesn't matter because
certain times, if you have holdings uh that are outside
of an IRA then uh, for example, you know, you
have maybe a lot of stocks and certain things, uh
if you at your passing, that goes to your heirs

(24:22):
at that at whatever the value was on the day
of your passing. So so there anyway, so you have
to look at the whole piece and say does this
make sense? Sometimes it makes a lot of sense. Sometimes
it makes no, it really doesn't. But but you have
to look at the at the details.

Speaker 2 (24:35):
Yeah.

Speaker 1 (24:36):
And at a time when you know, most American workers
they they they've they've got money saved up in iras.
There's that tax tax consequence.

Speaker 6 (24:43):
Yeah, it absolutely is.

Speaker 2 (24:44):
Yeah, yeah, yeah.

Speaker 1 (24:46):
So you're going to well you're still got to take
the hit now in your lifetime, right if you want
to move that money into say an insurance policy of
some sort. Yeah, they get it now. But yes, the
HiT's coming sooner or later. It's either for yours or
for your kids.

Speaker 2 (24:59):
Yeah.

Speaker 7 (25:00):
And and we've made the observation that that you know,
most economists believe that, and I you know, you could
make this observation that right now, income tax rates are
still the lowest they've been in and Gary, you're in
my lifetime. You know, they're low. They're very low, even
though people, you know, you ask people and they say,

(25:20):
what are the tax Oh, they're so high, they're so high.
And I'm like, look at this chart, I mean, look
at look at what happened. You know, even in that
you know, when Reagan came in in the eighties, he
lowered them from seventy to fifty you know what I mean.
I mean think about that, right, I mean those are
those are the income taxes. So you know we're nowhere
near that right now. So the idea is that that
they're probably at historically low times, low low values right now,

(25:45):
low rates, So we can take advantage of that and
and and do some planning with that.

Speaker 8 (25:50):
And John's you know, spot on for for people that
come into our office as part of that custom built
retirement birthew whenever it comes to tax planning, we want
you to understand your overall tax pitcher, meaning all the
moneies that you have saved for retirement. We want you
to understand that if you were to pass away, which
of those assets would actually pass tax free? Which of

(26:14):
those would actually just be a tax bill that you know,
the inheritor would be have to be on the hook
for paying. And that fits into your state plan.

Speaker 2 (26:23):
Right.

Speaker 8 (26:24):
So that's exactly the reason that we say all things
are connected, because it truly is. You know, if you
say that, no, I want to be the person. I
want to be the one that go ahead and pays
the tax, because whenever I pass away and my children
inherit these funds, I don't want them to be on
the hook for paying it, right, you know. And then secondly,

(26:45):
I also believe that now, just as John said, tax
rates are at historical lows, so why not let's go
ahead and pay taxes now. That way that if tax
rates do go up in the future, in essence, I'm
saving my future son or daughter money as they're not
having to pay taxes at the higher rate.

Speaker 6 (27:03):
So yeah, yeah, yeah.

Speaker 7 (27:04):
And the other thing is, I mean, it all depends
on what on what people's goals are in the circumstance.
I remember I was working with this one guy and
I and I showed him the tax advantage of this,
and he goes, so the kids are gonna have to
pay that.

Speaker 2 (27:15):
I don't care. So, you know, it just.

Speaker 7 (27:18):
Depends on who you are and what you are. So
we sit down and we say, okay, look at what
are your goals. We'll go through this. And really the
biggest thing in all of this is, no matter what,
we want you to have peace of mind to enjoy
your retirement. And we want you to have peace of
mind that at your passing, your wishes are preserved and
and things are done the way you want it to
be done. So this is, you know, the whole it's

(27:39):
all about. It's all about, look at you've worked your
butt off to get where you are. In most cases, well,
now we want to we want to make sure that
you're good and you can you can walk away calmly,
peacefully knowing that everything's buttoned up.

Speaker 1 (27:53):
There's no magic number. But I remember late last year
there was a survey and I think it was more
of gen z ers. Uh so we'll talk talk about
this with you, mister Terry, about how much money they
felt like they had to have in retirement in order
to be able to have an enjoyable retirement. And the
number was I think two and a half million dollars. Yeah,
something along those lines. You know, there was a time

(28:15):
when we thought, well, if we can, if we can
put aside a million dollars in assets, we're good to go.

Speaker 2 (28:18):
Yeah.

Speaker 1 (28:19):
I mean there's no magic number obviously, and no one
size fits all, but you probably get that question a lot.
How much do I really need?

Speaker 4 (28:31):
Yeah?

Speaker 8 (28:31):
And you know, as as we say all along, it's
truly not just getting to X amount of dollars because
that doesn't guarantee that you're going to be okay. Just
given the fact that you know each person's goals and
what they're looking to accomplish is just a little bit different.
You know, if someone says that I do want to
take those three to four you know, non domestic trip

(28:55):
per year, well, obviously that's going to be very costly.
And for someone as as that person, you know, they're
they're gonna need to have a little bit larger nest
egg if if they're going to be okay. But if
someone says, hey, you know what I've I've lived a
great life. I got to travel some while I was working,
love to play golf. I just want to play golf,
hang out on my back porch at home, and you know,
spend time with the family and grandchildren. Hey, you know

(29:18):
that's that's a that's a dream that they have, and
each person's dream is just a little bit different. And
we just want to talk you through that so you
feel confident. As John said, whenever you step away one.

Speaker 1 (29:27):
Of the again you mentioned long term care. Newsflash, if
you haven't been in a situation with a family member
who's had to be in long term care, it is
a lot of money, Yes, a lot of money. Are
there any any ways? I guess the only way to

(29:48):
save or you know, to to to get into long
term care that's not outrageously expensive is to actually take
pauses out earlier in life.

Speaker 7 (29:57):
Right, well, yes, yes, and so the traditional long term
care policy is something that most people know, which is
very much. It's just like your homeowners are auto insurance. Right,
you pay a certain amount on a monthly basis, you
hope you never need it, and then when you do,
you know, okay. Now, what has happened with those policies
over the years is that they've become really really expensive

(30:20):
that there's no virtually no limit to how much the
rate can go up on a yearly basis. So we
get people who come in and they're in their seventies
and you know, twenty percent increase this year, and then
next year it's a ten percent and then I mean
these are huge, huge numbers. There are ways to work
around that. Now, so there are different policies that you
can get that are different than these things that, yes,

(30:42):
that you can do either a lump sum or you
can do like a pay X over ten years and
that's it. There is no chance that that rate is
ever going up ever again. And you can have inflation riders,
meaning that these things so that you know, long term
care is going to cost so much this year, but
with inflation, it's going to cost more next year and
so on. So we can build those things in and
you can get some peace of mind. Like it's quite

(31:02):
common that what we'll do with folks to say, okay,
here's your whole situation. We're going to take this much
money and set of the side and we're going to
take care of a couple of policies, one for each
of you. If it's a couple, and say, okay, you
all are good to go. And there are certain other
things that you want in those policies that really give
you peace of mind. For example, if you're in your
eighties and your nineties or so, you know you're getting

(31:24):
up there and you now need long term care, you
do not want a policy that requires you to send
receipts in no, you got to track down receipts. You
gotta get it, you gotta no right.

Speaker 2 (31:36):
You want a.

Speaker 7 (31:36):
Policy that as soon as you need that, that that
money goes into your bank account and boom, you spend
it any way you want.

Speaker 2 (31:43):
Right.

Speaker 7 (31:43):
So, there are a lot of different ways to do
this It's kind of like as things have evolved over
the years, these sort of policies have evolved, and again
they can give you peace of mind, and that's really
what this is all about. That, Okay, you know that's
where it is.

Speaker 8 (31:57):
John, You're exactly right, and I'll also owned you know,
another one of the big benefits of the news style
of long term care policies that we have access to
is you know, we all hate wasting money, right, we
all hate paying for something and then you end up
just not using it. And the traditional form of long

(32:19):
term care policies, that's exactly what they are. It's a
benefit that you pay for. It's protection that you have.
But if you never use that, in essence, all that
premium that you paid for all those years, the insurance
company just keeps.

Speaker 2 (32:34):
You know.

Speaker 8 (32:34):
With the style of policies that John's referencing and the
style that we have access to, you know, sometimes you're
putting money in on a lump sum, or you're putting
money in over the course of a few years, but
if you never actually need those funds, you never actually
use you know, you never need need protection, which is
a blessing, right, we all hope and pray we don't
need long term care, but that then passes to your heirs.

(32:56):
So then you know, you feel like that you didn't
waste money for all those years, But what you did
was you bought peace of mind, right and upon your passing,
if you don't need it, it still goes to your
family members. So you're killing two birds with one stone,
and that's why and how we help our clients.

Speaker 1 (33:11):
That's great to know right there. Well, I hope you
got a sence over the last fifteen minutes. Again, these
these guys aren't stockbrokers. They are you know, financial planners,
and too many people don't understand the difference between the two.
But there's a huge difference. So there's a lot to
digest right there, whether it's you know, the income, the insurance,
the long term care, the estate planning, the taxes. You

(33:33):
want to sit down with these guys. How did they
get a hold of you and set up that appointment?

Speaker 7 (33:36):
John, Yeah, it's a aight oh three nine retired, eight
oh three nine retire. And our office is off of
Harveston and now the holidays are over, the traffic is
much less there. Set we're right near Harveston, we're between
Piney Grove and Harveston off at twenty six. You can
see our office on the on the side and the
blue letters that says custom Build Retirement.

Speaker 1 (33:53):
Yeah there you go, all right, John Matthew, good to
see you guys.

Speaker 6 (33:56):
Thanks Gary, thank you.

Speaker 5 (33:57):
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(34:18):
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Speaker 6 (34:38):
Covered literally from head to toe.

Speaker 5 (34:40):
Called Jeff Howell in Health Markets at eight O three
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one two one or Jeff Howle dot com and let
them find the right insurance for you.

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Speaker 1 (36:19):
We had a conversation a few weeks back with Jeff
Howell and still no resolution to all this. This was
the big falling out between that and Lection and Medical Center,
and again some folks who are on Medicare advantage plans
are having to make good changes here because of it,
and we wanted to replay this conversation this morning because
there's a very vital information here, some things you need
to know about that if you find yourself in this situation.

(36:41):
So let's do that now with that. Jeff Howe, our
friend from Health Markets, Jeff, good morning, Good morning Gary. So,
I guess recently we just found out that there's a
parting of the ways between ATNA and Lexin and Medical Center.

Speaker 2 (36:54):
Is that right?

Speaker 9 (36:56):
Unfortunately, that is correct. So this is really the first
time in a very long time as long as I
can remember, that insurance company and a hospital have part
of ways after the Medicare annuine roma ended. So essentially,
you know, October fifteenth December seventh is an annual enrollment

(37:16):
when people on Medicare can choose their Medicare advantage plan
for the next year. And during that time, of course,
we had we had assurances from ETNA and lex and
Medical Center frankly that at a Medicare advantage was not
part of the contract negotiations. We had heard rumblings that

(37:39):
the group side or the commercial side, if they were
that they were negotiating as the February first contract. They
didn't know if at the Group Health would still be
a network on February one, but they said no problem
with the Medicare advantage side, no worries on the Medicare
advantage side, and lo and behold. On December eleventh, that changed,

(38:02):
and letters went out and posts were made on people's
my chart account who have lex and Medical Center as
their doctors that at the Medicare advantage may not be
in network come February first, and so essentially it might
be time to start looking for other plan options. So,
which is a shot to all of us.

Speaker 1 (38:22):
Frankly, so you've got you've got customers and folks you know,
all across this area had had taken advantage of the
EDNA on the advantage plan, only to find out then
after the fact that yeah, no, hah.

Speaker 9 (38:35):
That's correct. And that was very disappointing, I must say,
because luckily we're not taping this on December eleventh. You
probably would not I would not have been a very
good mood since, but I certainly was.

Speaker 2 (38:48):
I was.

Speaker 9 (38:49):
I was not very happy with my representatives who had
assured me that Medicare was not not in play in
these contract negotiations because you know what I told them,
and the way I feel is that you know, senior
citizens and you know, of course, especially in our community
who we care about here in Lexing County, they should

(39:09):
not be used as palms and negotiations, right, And that's
exactly what's being and that's exactly how they're being used.

Speaker 2 (39:16):
You know.

Speaker 9 (39:17):
So from you know, taking Medical Center's word, what they're
what they told me and what was actually in writing
is that at the eleventh hour, you know, or essentially
you're right after open Roma ended around December.

Speaker 1 (39:30):
Tenth, past midnight in other kship.

Speaker 9 (39:33):
Right past midnight at a pulled pulled the Medicare advantage
from Lexington or they essentially reduced their fees so much
they included the Medicare advantage as part of the negotiations,
essentially saying, Okay, if you want to sign a if
you want to agree to our fees on the group
commercial side, then we're going to reduce our fees on

(39:54):
the Medicare advantage side so much that you're going to
lose the Medicare advantage.

Speaker 1 (39:57):
Okay, So this is a bargaining yeah, because that was
the original rub was the commercial.

Speaker 9 (40:02):
Side, right and correct. So that's very disappointing, very disappointing.
But luckily there is a law and that's called the
open Enrollment which lasts between January one to March thirty one,
which which actually, you know this, this situation was in
mind as other situations, so a person on a Medicare

(40:24):
advantage plan can make a one time change. So my
January is getting booked up with all my clients because
I've already told them, let's go ahead and get on
the calendar in January. And if this, if this contract
does not get resolved, then we're going to we're going
to make a change for February first. So luckily ATNA
is still in network with lex and Medical Centers until

(40:46):
February first, so everyone who has it at the Medicare
advantage plan, they're going to be in network in January.
But if we need to make a change to someone
that is in network, which is if Blue Cross Blue
Shields South Carolina, then we'll do so on February one,
and and that's then we'll pay that price for what's happened.

Speaker 1 (41:06):
So what is your what's your thought on this, Jeff, Now,
if if this were me, and you know I had
signed up for Medicare advantage with that NW and I
come to find out this news, and I come sit
down with you next month, and you say, well, okay,
now Edna's back in. You can still make the change.

Speaker 9 (41:23):
Or not, you can still make the change.

Speaker 1 (41:26):
Most people would, right, they're going to be ticked off
enough to say, well, the heck with you, ed Now,
I'm going somewhere else.

Speaker 9 (41:30):
That may just happen. Now if you can pick a day,
but before I meet with let's say that I'm meeting
with a client on January thirty first, right, and before
that day, at an elected medical center, made an agreement.
You know, what we do is what we always do
with our clients. We'll look at the doctors, we'll look
at the prescriptions, we'll look at the benefits, and we'll

(41:53):
put I'll put my client on the best plan for them.
But if if a client, if well, let's say two
companies are equals, let's say as equal to company Company
B in almost every way, then if a client says
I'm done with that, and I's done, well, I can't
hold them against them for making that decision. Frankly, right, No.

Speaker 1 (42:14):
Huh, huh, Well, there have been a rash of these recently.
It seems like this is like the third one in
the last maybe year or less.

Speaker 9 (42:21):
That's true. You know, we still have Humanita and MUSC
not a network, so that never got resolved, and then
last year it was prismon United Healthcare, which got resolved
on April one, twenty twenty four. But as we talked
about in the past, these are getting unfortunately more and
more common. As these national for profit insurance companies they're

(42:46):
beholden to their shareholders right to make as much profit
as possible so their stock goes up. They want to
pay these our hospitals, our local hospitals here in the
Midlands as little as possible, and these hospitals don't have
much leverage or much tools to fight back with other
than saying, well you just want to be in network

(43:07):
with our hospital.

Speaker 1 (43:09):
So how well, how popular is the plan here? I mean,
I would I'm just guessing here that maybe the Blue
Cross Blue Shield when it comes to the advantage plan
is maybe the most popular on this area.

Speaker 9 (43:22):
I would say there's I would say there's four in
this area that are very popular, and almost equally so
United Healthcare Humana at non blue Cross that and I
has a very large market share in Lexin County, very large,
and so there are many people I'm sure listening to
the show who have at the Medicare Advantage ID card

(43:43):
in their pocket. And so it's it's very disappointing that
this would happen after December seventh. I certainly didn't see
it coming, and you know, the rumbling on the commercial
side concerned me. But when I get assurances from all
part alreadies in writing that Medicare avange is not part
of the negotiation, you know, it really puts egg on

(44:08):
certainly a lot of people's faces, and it's very disappointing.

Speaker 1 (44:10):
Right, absolutely, Just curious now because you mentioned that. So,
but this does allow folks between January one and I
think you said March thirty one to make a one
time that's a one time change for this calendar year.

Speaker 9 (44:22):
Correct, not that's just twenty five okay, correct?

Speaker 1 (44:25):
If you blowed chest to make any more changes, Okay,
just listen, what would have happened or could this have happened?
Would have had to come down April one and said
we're pulling out, what would happen? Then?

Speaker 9 (44:38):
Yes, that would have been. That would have probably been
That's probably the worst case scenario because at that point
in time, a person has no really I guess way
to make a change from one carrier to another carrier.
We would have to maybe, you know, talk to Medicare

(44:58):
and see if any special exception would be allowed under
that circumstance. I've never seen that happen. However, I've never
seen that happen on December eleventh. Yeah, so I can.

Speaker 2 (45:12):
I would.

Speaker 9 (45:12):
I would say in the past, oh, that's not possible,
but now I can't say that because now it seems
like anything is possible.

Speaker 2 (45:18):
You know.

Speaker 1 (45:18):
I'm never one to uh to ask for you know,
government intervention and much of anything, but it would seem
like there ought to be some kind of a law
that would approved that would prohibit an insurance company from
pulling the stunt like that. After that, you know, grace
period is over all, right.

Speaker 9 (45:33):
And that's something you know. I work with a group
of insurance professionals. We go to Washington every every February,
and this is definitely gonna be a top of the list,
these these contract negotiations and these changes and how how
our clients are being used as pollings and these negotiations
and how something definitely needs to be done.

Speaker 1 (45:53):
Absolutely okay, So again to recap, if you're holding a
that in a card and you're you're in that work
at election to the Medical Center, you won't be after
what in the january correct February one, as of February one,
And again, what you hope is that somebody's not sitting
out there and not aware of this. Do they get

(46:14):
notification from ETNA or election to Medical.

Speaker 9 (46:16):
Center legs and Medical Center has been very good about
notifying its clients. They posted it on their my chart
in the morning of December eleventh, and then letters went
out right after that. So patients should have either one
or two way. You either read it on their my
chart computer or their app on their phone, or received
a letter in the mail.

Speaker 1 (46:37):
Well, you know, there's gonna be somebody out there who
just totally misses all that, right, and they're going to
get a rude awakening.

Speaker 9 (46:43):
That's true. That's true, but it's well, we try to
get the word out as much as we can, certainly
and talk to our clients and you know it and
it may get resolved, it may not, but either way
we want to we want our clients to be prepared,
and certainly we welcome people who are not our clients.
We'd be happy to meet with you in January and

(47:04):
look at all the options. You know. It's it's disappointing
that is happening, but we'll do the best we can
to help and help as many people as we can.

Speaker 1 (47:12):
Certainly, and of course that's always free, right.

Speaker 9 (47:15):
Yes, my services are free, so do not cost anything,
and I'm glad to help.

Speaker 1 (47:21):
Do you recall another time in the span of less
of a year that we've had not one or two,
but three different situations like this?

Speaker 9 (47:28):
No, No, this is very unusual, for sure, and I
hope it's not a trend for the future.

Speaker 1 (47:33):
Yeah right, okay, Well, something else going on, and although
help me understand this. So the open marketplace enrollment period
endo December fifteenth, but not really.

Speaker 9 (47:45):
Or that's a good point. So it's interesting how they
do the commercials with Healthcare dot Go. They push everyone.
They extended it actually just to December eighteenth, but essentually
the commercial were pushing people to December fifteenth, which is
a Sunday, and then because it fell on a Sunday,
they extended the open Aroma for January first coverage to

(48:09):
December eighteenth, and of course now we're talking about people
under sixty five, people who are on the individual marketplace
for individual health insurance. However, that is not the deadline.
So the true deadline is January fifteenth, fifteenth, Okay, So
anyone who would gets the policy between December nineteenth and

(48:29):
January fifteenth will have a February first effective date. So,
like anything in life health care, I go knows that action.
You know, deadlines breed action, right, So they're pushing every
one to the first deadline, then the second deadline December eighteenth,
and now you'll see commercials and radio ads pushing everyone

(48:50):
to get enrolled by January fifteenth, which is the true
drop dead deadline.

Speaker 1 (48:56):
Okay. Yeah, Now, of course you have options here. I mean,
you can go on the government website. But again keep
in mind it's a government website. They're not always the
easiest to navigate.

Speaker 9 (49:11):
It is probably the trickiest website I've ever been on them.

Speaker 4 (49:15):
I like that.

Speaker 9 (49:16):
It is very tricky, and I have many clients that
have come to me and they have been on there,
and they've tried and tried, and they put all their
information in time and time again, and can keep getting
one thousand dollars a month premiums. And they come to
me and I show them a premium of one hundred
and fifty dollars. You know, it's just because it's tricky

(49:37):
how how the subsidies are applied and how what questions
you have to answer exactly the right way to get
the subsidies at a person with their family. Absolutely so.

Speaker 1 (49:47):
In other words, even if you were to charge somebody
in this instance, you know, eight hundred and fifty dollars
for your expert advice, they'd pay that off in a month.

Speaker 9 (49:58):
I wouldn't do that.

Speaker 1 (50:00):
You know, you don't charge then you don't trarge folks anything.
It's absolutely free.

Speaker 9 (50:03):
But yeah, yeah, I appreciate the analogy, but yeah, my
services are free. But yeah, I think it's just it's
the way the website's written and the questions they ask
are not defined well. And so you know, if someone's asked,
for example, you know, are you offered an HR? Well,
you know these acronyms. People people don't know what.

Speaker 1 (50:24):
They mean to ask you what that meant? I have
no idea, right and.

Speaker 9 (50:28):
So exactly, so you answer yes to the wrong question.
And your subsidies knocked out, and then you know you've
got you've got this gigantic price staring you in the face,
and you have no idea what to do. So I'm
always glad to help them people with with healthcare dot
go and get them individual health insurance. Absolutely.

Speaker 1 (50:46):
Now, just a quick question here before we wrap things up.
Let's say we're in a situation someone has maybe a
spouse who is working and has coverage to their employer,
but you know, you start adding on, you know, family
members and stuff, it gets all outrageous. Can that Can
that spouse who's not employed go on the open marketplace?

(51:09):
Or are they or is that going to be so? No, No,
I'm sorry, your spouse has coverage their employe got to
go with that.

Speaker 9 (51:15):
Luckily, that law changes in twenty twenty three. So used
to be the old way that if one person was
offered group health insurance, that essentially knocked the whole family
out of subsidies, which makes the health insurance affordable in
the individual marketplace. But starting January one to twenty three,
now only employees Essentially, now only the employee has to

(51:38):
stay with their group health plan and spouse independents can
now shop the open marketplace and get subsidies and get
affordable health insurance.

Speaker 1 (51:46):
Okay, okay, and what I mean, what's the average? And
I always hate asking this question because it's so many
variables involved, I know, but I mean, the average subsidy
for the average person, you know, gets this this coverage
down to about what range any given month.

Speaker 9 (52:01):
I mean, yeah, yeah, you're right. There are so many variables,
but essentially, i'd say the average customer pays around two
hundred dollars a month for their health insurance if I
had to put an average on it.

Speaker 1 (52:14):
And we certainly know that if you ever covered a
spouse on your employee health plan is going to be
probably a lot more than that.

Speaker 9 (52:21):
Yes, usually it is absolutely.

Speaker 1 (52:23):
Okay, so does January fifteenth deadline for that, So keep
that in mind. And again, as we started talking about originally,
if you're on Medicare advantage in ATNA, then they call
this guy right here and go over and sit down
and talk to him by the end of January, certainly
before then, to see what your options are.

Speaker 9 (52:43):
That's right, We'll be here. Our office is right beside
the flight deck restaurant Health markets and glad to take
walk ins and glad to set appointments and help people
and make sure they're not left out in the cold
after February first.

Speaker 1 (52:58):
All right, so eight three six seven eight eight one
two one right six seven eight eighty one twenty one
and your website is your name?

Speaker 2 (53:06):
Right?

Speaker 9 (53:06):
Yes? Www dot J E. F. F. Howle dot com.

Speaker 1 (53:10):
The lawyers in staff the Law Office of James Snell
are there to help those with injuries and workers' compensation claims,
car accidents on the job and other accidents resulting in injuries.
They want to help everyone resolve their claim as quickly
as possible, but they'll never recommend you accept a settlement
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(53:54):
three l's spell law dot com. The Law Office of
James Snell since two thousand and four, with the office
is in Lexington and Columbia,