October 20, 2023 • 27 mins
Ready to unravel the complexities of Medicare? I'm Danielle Tantone, and in this episode, I'll be your trusty guide through the labyrinth of insurance options available to you as you approach and surpass the age of 65. A seasoned independent agent, I've cultivated an abundance of knowledge about how the whole thing works. Together, we'll fend off the overwhelming influx of information, sidestep deceptive tactics and dodge fraudulent calls.
I like to say that Medicare is the silver lining, the hidden gem of getting older. And my goal is to unpack it in a way that is simple, understandable, peaceful, and even fun.
Beyond original Medicare which only covers you 80% and leaves you with unlimited financial risk, the two principal options are Medicare Advantage and Medicare Supplement Plans. Both have their pluses and minuses, and I'll lay them out for you in an unbiased manner. There's no one-size-fits-all right choice.
Whether you're researching Medicare options for yourself or someone you care about, this episode could be your first step to help you make the most informed decisions about healthcare coverage. So, buckle up and let's get started!
Schedule a free 30-minute consultation with me here:
https://calendly.com/danielle-tantone/30min
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:07):
Hi there, welcome to Peace of Work the podcast.
I'm Danielle Tanton.
I'm a nurse, author, coach andsurvivor.
I love inspiring people to livetheir best life, reach for
those big dreams and find joyeven in the pain.
As I wrote my memoir over somany years, trying to make sense
of a story where I was way toooften the bad guy instead of the
(00:28):
hero, I came to understand thatwe are all a piece of work, but
we're also a work in progressand even in our messiness we are
a work of art too.
All at the very same time, infact, we are all beautifully
unique pieces of one masterpieceWaves in the same ocean.
This podcast will explore thestories and struggles that make
(00:50):
us human, the miracles thatsurround us and all the ways we
work to make sense of it all.
Welcome to Peace of Work thepodcast.
Hello, it's Danielle Tanton,and today it's just me.
I wanted to chat with you todayabout Medicare.
(01:11):
I know so exciting and sexyMedicare, but we are right now
in the first week of AEP, whichis the annual enrollment period
for Medicare, and it's kind of abig deal in the Medicare world.
So I thought I'd just give alittle brief overview of what
(01:32):
Medicare is all about and how itworks and how I can help you or
your mom or your dad or someoneelse that you might know who
needs help with Medicare.
So what Medicare is?
It's for seniors, 65 and over,and it's actually the silver
lining of getting older as faras I'm concerned.
They are able to access suchamazing coverage and such
(01:57):
amazing options, but it is superoverwhelming.
So I mostly work with seniorswho are just turning 65.
And I help them just understandtheir options and pick the plan
that's going to work best forthem.
So this time of year, anybodysorry when you turn 65, you can
(02:18):
sign up for Medicare, and youcan sign up within a six to
seven month period around your65th birthday.
So when people are about 64,they're getting bombarded by
information about it.
But this time of year, anybodywho's already on Medicare can
make a change to their plan.
So they're also gettingbombarded by ads and phone calls
(02:42):
.
I, incidentally, somehowsomeway have.
My phone number is associatedwith my late uncle who died a
couple of years ago, and so Iget these calls myself and I
can't get myself off these listsbecause I don't know.
(03:03):
Who knows they were sold amillion times or whatever.
So I have an idea, an inkling,of just how many sales calls
that they get from all differentcompanies, and it's crazy.
So what I do?
I'm an independent agent and Iwork with many of the insurance
carriers that have Medicareplans and I represent my clients
(03:26):
.
I don't represent a specificinsurance carrier, I represent
my clients and I basically justhelp them figure out what's best
for them, because there'sreally not any right plan.
There's a couple of differentways to go and, frankly, a lot
of them are really similar.
So a lot of times what willhappen is if they see an ad and
(03:48):
they call in the 800 number, orif they get one of these cold
calls they're sort of like abait and switch thing.
A lot of them they have thesegreat ads that sound so amazing
You're going to get all thismoney back and you're not going
to have to pay anything and youcall in and they're like, oh
well, you can't really qualifyfor that plan, but we have this
other one, and this other onemight be super similar to what
(04:08):
they already have, but theydon't really know and they don't
really even realize thatthey're changing plans and they
don't even realize that they'reno longer have an agent that's
representing them.
They're just– they have some800 number person who they could
never get a hold of again.
I actually had one of my goodfriends, who's also a Medicare
(04:29):
client, last year, right at theend of the enrollment period,
got one of these calls and hethought it was actually a
representative from hisinsurance company, from the
insurance carrier.
They made it sound like thatthe way they worded it.
So he recommended I think youmight want to switch to this
(04:50):
plan.
He went ahead and switched.
Then he just called me just tolet me know that.
Hey, I just want to let youknow that blah blah blah
healthcare called and justthought this plan would be
better.
I just want to let you know.
He called me after theenrollment period was over and I
was like no, that was not true.
So it was a big headache to tryto get that reversed because it
(05:15):
was actually pretty fraudulentand pretty manipulative.
So, anyway, just wanted to letyou know.
That's out there.
So this is the AP.
I don't even have regular TVanymore.
I don't know about you, but Ionly have streaming services.
So I don't really see the ads,but once in a while I'm a nurse
(05:39):
as well.
So once in a while I'll be in apatient room and they're
watching regular TV and I'm like, wow, there are still so many
commercials that I just don'tsee anymore.
So, yes, they are beingbombarded.
So if you have a friend, familymember, relative or yourself
who is being bombarded and hassome questions about any plan
(06:01):
that you see or anything aboutyour plan, please feel free to
give me a call.
You can always call me480-236-1861, or email me,
danielle, at DanielleTanTonecom,or those are probably the best
ways.
On my website,danielletantonecom, there is a
(06:22):
calendar app that I try to haveupdated, where you can set up a
30-minute consultation.
But other than that, just callor email me and we'll set up a
time to talk, and this can benationwide.
So I'm mostly I am in Arizonaand so I'm licensed in Arizona,
but I have the ability to eitherrefer to somebody else or to
(06:44):
get licensed in other states.
So most of my business rightnow is still in Arizona.
So anyway, just to give a quickoverview of how it works and
what the options are, the firststep when you're signing up for
Medicare is to sign up fororiginal Medicare.
So that's that red, white andblue card that you might have
(07:06):
seen a picture of, and itincludes Part A and Part B.
So Part A is the hospital andinpatient coverage and that is
generally $0 a month for mostpeople as long as you've been
working in this country for morethan 10 years, which most
people have by the time they're65, then Part A is free.
(07:27):
Part B is covers the doctorvisits and outpatient care and
that one has a monthly premium.
It goes.
It changes roughly, you knowchanges every year usually goes
up, although this year it wentdown from last year but and then
(07:49):
it also has almost like tiers,almost like your tax brackets.
So if you make more money, youwill pay a little bit more.
But just to give you an idea ofthe pricing in 2023, it was
like $165, roughly $165 a month.
So that would be for originalMedicare.
(08:09):
You'd pay roughly $165 andyou'd pay it to Social Security
and you'd get that card.
Now, if you only had originalMedicare, that would be 80%
coverage.
So if you went to the doctorand I'm giving you very general
explanation there's a littlemore to it than that and that we
(08:29):
could always get into the nittygritty if we sit down, but
typically I don't, because mostpeople don't care about the
nitty gritty, so I'm just tryingto give you an overview of how
it works.
So if you only had originalMedicare which no one should
ever only have original Medicare, because that would leave you
with unlimited financial risk,basically but if you did, you
(08:50):
would have 80% coverage.
So if you went to the doctorand it was $100, they would pay
80 and you would pay 20, whichwould be fine if all our medical
bills were $100, but, as youmay know, they could be $1,000,
$100,000, a million dollars.
So where I come in is figuringout how to protect you against
(09:13):
that risk.
So there's two different pathsthat people can go.
One is the Medicare supplement,and I actually spent some time
I spoke with a colleague of mine, brian, on a previous episode a
lot about the supplements.
So the way the supplement worksand another name.
(09:33):
You might hear them calledMedigap plans, you might hear
them called MedSupp plans, butit's all the same thing.
It's a supplement.
It basically piggybacks on yourMedicare plan.
So if you go to the doctor,you'd give them your Medicare
card for that 80% and then thesupplement for the additional
20% and together you'd have fullcoverage.
(09:56):
What's nice about this is thatyou'd pay a monthly fee to have
that supplement, but for themost part you really have
nothing out of pocket, dependingon the plan.
But again, keeping it simple,you'd pay your monthly premium,
which is pretty reasonablecompared to what we pay when
we're not 65 yet for insuranceand you have basically full
(10:19):
coverage.
So a lot of people like thatoption and what's nice is that
you can go to any doctoranywhere in the country that
takes Medicare and everydifferent insurance company
offers Medicare supplements Well, maybe not every company, but
many of them.
So these plans are named byletters generally.
(10:40):
So the one that's most common,most popular with my clients who
are on a supplement, would bePlan G, and you can get Plan G
through United Health Care orthrough a number of other
carriers.
I mentioned United Health Carebecause that's the one I
probably work with the most, butI'm independently licensed and
(11:04):
I'm having trouble talking.
Anyway, I am contracted withseveral different carriers.
I don't really do a lot ofsupplement business and I'm
going to tell you why.
Not that I'm opposed to it, butfor where I live, in Maricopa
County, arizona, we have anamazing assortment of advantage
(11:25):
plans.
The advantage plans is almostlike a whole separate thing.
Like I said, there's twooptions for your coverage when
you go on Medicare.
Option one is the Medicaresupplement, like I just
mentioned.
Option two is the Advantageplan.
The Advantage plan workstotally differently.
With this route, you're stillgoing to pay your premium to
(11:48):
Social Security and that's goingto get you your original
Medicare, but you're no longerreally on original Medicare for
your insurance.
You're going to get a planthrough various carriers and
there's probably 50 or 60different options in Maricopa
County.
So it's not one plan per se.
(12:09):
We a lot of times say theAdvantage plan but there's many
different plans.
But with this route you'regoing to have an insurance plan
that's much more like theinsurance plan that you would
have had before you turned 65.
So it's more of a traditionalplan and it's going to cover you
from start to finish.
So you're no longer going tohave that 80 percent on Medicare
(12:30):
and then 20 percent on thesupplement.
It's just going to go right tothe Advantage plan.
So it's one card.
It also includes drug coverage,prescription drug coverage,
which is an add-on if you gowith a supplement route.
It also includes a lot ofancillary benefits, such as
dental, vision, hearing, gymmembership, and those are really
(12:52):
popular, especially with peoplewho are just turning 65, who
are still pretty healthy, activeand really enjoy those perks
and they don't necessarily go tothe doctor all that much.
So what my clients really loveabout these Advantage plans is
many of them are $0 a month, sothey have zero monthly premium.
(13:12):
It doesn't mean they're free,and that's the next question is
how can they be free?
And we'll go into that a littlebit.
So they're not free, but theydon't cost anything on a monthly
basis.
So you're still going to payyour Part B premium to Social
Security that $165 a month butyou're not paying any additional
monthly fee to have yourAdvantage plan.
What you will pay instead isjust small co-pays as you get
(13:37):
medical services, and theyreally are small.
There's no deductible.
So most of us who are under 65have huge deductibles sometimes,
or even if they're smalldeductibles, they're still
hundreds of dollars, usuallythousands of dollars.
So these plans many of themmost of them that I work with
have zero deductible, so theystart paying right away and the
(13:58):
co-pays are like $30, $40, $100,very reasonable.
And you have a maximumout-of-pocket that's like a cap,
so you can't go over thisamount.
So what I have found doing thisfor the past several years is
that for most people it wouldtake a lot to even reach your
maximum out-of-pocket and itwould take a lot of things going
(14:19):
wrong to come anywhere nearspending a couple hundred
dollars a month, which is whatyou will spend if you go on the
supplement.
So from a cash flow perspectiveit makes sense, and then from a
more bang for your buckperspective it makes sense, and
so most of my clients here inMaricopa County really like the
(14:41):
Advantage plans.
Just to play devil's advocate,though, there are reasons to
choose a supplement.
There are some you know like.
First of all, so with theAdvantage plans you have to be
aware of the network.
There are different types ofplans.
There's HMO and PPO, and wedon't need to get into the weeds
on that.
(15:01):
But HMOs are generally a morerestricted, smaller network,
tighter network, and then youdon't really have out-of-network
coverage at all.
And then you also need to go toyour primary care provider for
any referrals.
Anytime you want to go to anyother specialist.
And a PPO is generally abroader network, many of them.
(15:24):
You're part of a nationwidenetwork and you can go out of
network as well.
You'll pay more for services.
So you generally want to stayin network but you don't have to
.
So PPO offers a lot morefreedom and flexibility and some
of the plans here where I liveare just really great.
I mean they have nice bignetworks and it's going to feel
(15:46):
like the best insurance planyou've ever been on for the
cheapest amount of money you'veever paid.
So that's kind of the generalthing.
Oh, I started to say I'm goingto play devil's advocate Like,
okay, what's the catch first ofall?
So those are questions I getasked why is it free?
(16:06):
How is it free and why wouldanyone choose a supplement?
So I'll start with that lastquestion first.
Why would anyone choose asupplement?
The first thing is it dependswhere you live.
So I have done some business inCalifornia in the past and in
California the networks and thehealthcare system is really
(16:26):
different than it is here.
So over there you might haveone doctor and one network and
one doctor and another networkand they don't really like
crossover.
So here in Maricopa in Arizona,like our networks, like there's
, most doctors will do businessat Banner and also at Honor
Health and also at Dignity.
There's not really as muchsegmentation as there is in
(16:50):
California, so it's not really aproblem.
Plus, we have many, many PPOoptions, which again is that
broader network that willinclude multiple healthcare
systems, whereas in Californiamost of their Advantage plans
are HMO.
It used to be all I think nowthey're starting to get some PPO
options.
So that's one big reason why youmight not want an Advantage
(17:14):
plan, because you might feellike too restricted by it.
So a lot of times you knowanybody who can afford it would
rather have a supplement.
And historically you know theAdvantage plans are relatively
new.
So historically you'd ratherlike the supplement was kind of
known as like the gold standard,like the better option, and I
(17:37):
think a lot of people, evenMedicare advisors and financial
advisors, still think of it thatway, like that it's better and
if you can afford it you'll getthat, but if you can't, there's
some good Advantage plans.
That's kind of like the mindsetthat I've heard out there.
But I kind of have a differentmindset, like to me.
I just don't see how that'snecessarily better.
I mean it's it really dependson your personal situation.
(18:01):
It might be better for somebody.
You know they may not just wantto, not want to think about
networks, they might want to get, you know, go to a different
state to get a second opinion,be able to travel and go to the
Mayo Clinic or whatever it isthat they want to do, and they
just don't want to have to dealwith network and making sure
it's covered and all that.
They want to go to any doctoranywhere in the country that
takes Medicare and in that casethe supplement is better.
(18:23):
There are some, some medicalsystems that do not really take
the Advantage plans.
I mentioned, mayo Clinic andthat that, if you, that's one of
them.
So that would be the mainreason for the supplement.
The other one would be, you know, if you are in a, you know
(18:45):
managing multiple diseases oryou just have a high medical
acuity, I guess there it mightsometimes it's easier.
You know you paying a monthlyfee and then you don't have to
worry about any out of pocketcosts, so you're not like kind
of feeling like you're nickeland dime.
So some people just like thatand they just like to not have
(19:06):
to worry about it.
Some people might be thinkingof moving, or they might move
around a lot and not be in oneplace and it's just easier, and
then a lot of times when you'refirst turning 65, it just makes
sense to start that way becauseyou, you're, you're allowed,
you're in a guaranteed issueperiod when you first go on
(19:29):
Medicare.
So what that means is there'sno medical underwriting and
anybody can get.
They can't deny you access tothe supplement.
The advantage plans don'treally have any medical
underwriting so you can join anadvantage plan anytime, at least
at this point.
That may change, but at thispoint there there's no medical
underwriting involved so anyonecan can join in your approved,
no matter what your healthstatus.
(19:51):
But the supplements are not likethat.
You, if you join at any timeother than when you first going
on Medicare, you would need toqualify and you would, you would
pay more.
Potentially, if you have somehealth issues, you might not
even be approved at all.
So that's another reason whysome people are like kind of
almost there's a lot of fear inMedicare marketing.
(20:12):
I think so, like they're almostscared into going that route.
So I just when I sit down witha client, I really just try to
take away all the fear and justtell them like it is and show
them the options, and I tryreally hard not to push them in
one way or another and to justjust tell them the facts and
(20:33):
there's not.
The great thing is that, despiteyou know the fear marketing
that I've talked about, youreally as long as you choose a
plan and you have someprescription drug coverage,
because you're not gonna getpenalized if you, as long as you
, you know, are somewhateducated and do things right.
(20:54):
And I think there's a lot offear of that of getting
penalized for life.
And I have seen it wheresomeone is penalized for life
because they didn't sign up forMedicare at the time and they
didn't have a creditablecoverage other than Medicare.
So I like to just really helprelease some of that fear, set
(21:14):
people at ease and even make theprocess a little bit fun.
I know that sounds crazy, butit's actually is really amazing
coverage and there's lots ofoptions and to me that is kind
of fun.
So that is the basics ofMedicare and I think in the
future I'm gonna work on somedifferent things.
(21:38):
I have been playing around witha brand called Medicare Moxie
and I love the word Moxiebecause it kind of sounds fun to
me and it means, you know, kindof like gumption sass, like
knowledge, someone giving youthe power.
So I wanted empower people toreally understand how it all
(22:00):
works and be able to make theirown choices.
And so I started to say you canchange every year.
So right now, aap, anyone canmake a change to their plan.
So you could be on a supplementand you could go to an
Advantage plan.
You could be on one Advantageplan and go to a different one.
That doesn't mean that youshould change your plan, because
I think another thing is it'syou know there's no reason to
(22:22):
change your plan every yearunless there's something about
it that you don't like.
But I'm happy to sit down withanybody and chat with them and
figure out what option might bebest.
So that's kind of my spiel.
On Medicare, I would like totake just a few minutes to talk
(22:43):
about how I even got into thisand why I keep doing it, because
it's if you know me at all, youknow that I do multiple things.
I'm a labor and delivery nurse.
I used to be a realtor I'mstill licensed, but not doing
that actively.
I wrote a book called Piece ofWork, a memoir, and I have a
(23:06):
podcast, obviously, and I havethree kids and I probably am
forgetting like five things thatI do.
So why Medicare?
Well, here's the thing.
So a few years ago it was duringCOVID I was just recovering
from breast cancer surgery and Ihad sent out an email to my
(23:27):
sphere of influence, just kindof updating them, telling them I
was writing this book and justkind of keeping in touch.
I've always been in sales andmarketing and I knew that down
the road I'd be having a bookthat I'd wanna sell and I wanted
to kind of build my email list,and so I was just sending out
an email to basically everyone Iknew, everyone I'd ever worked
with, and one of the people thatI used to work with in real
(23:48):
estate responded and said hey,my wife and I have recently
gotten into Medicare and I thinkyou'd be really good at it.
You like to help people andblah, blah, blah, blah.
And I'm like are you kidding me?
I just sent you this emailtelling you all these crazy
things I'm doing and you think Ishould add one more business.
Well, I was in nursing school,by the way, and he said, yeah, I
(24:09):
think you should.
So I said, okay, maybe I will.
It was right in the middle ofCOVID and I was on a little
break from school and from workas well, so I started taking the
classes and getting certified.
I already had my insurancelicense because I had done
employee benefits for a coupleof years and I found that, you
(24:29):
know, while it was certainly dryand boring and bureaucratic and
overwhelming, if I could makesense of this and actually help
people, this is something thateverybody who turns 65 needs to
do and it's overwhelming andit's scary and, if I can make it
(24:52):
easier for somebody, this isalmost like the easiest sales
job ever, because I'm notselling anything, actually Like
I'm representing these insuranceplans and I get paid by the
carrier, but it doesn't cost, Idon't know.
Money is exchanged Like unlikereal estate, there's not 40
(25:13):
other realtors fighting fortheir business, there's hardly
any of us and I actually canreally help people.
So and they don't, you know,they don't have to give me any
money, they don't pay me acommission, they don't.
The plan doesn't even cost thatmoney in most cases.
So it's like just really awin-win.
(25:33):
I really do like helping peopleand I really do like educating
people.
It's really gratifying.
So it's kind of neat.
I deliver babies and watch themtake their first breaths.
I help people in the lateryears of their life as well.
That's a really cool thing tome.
(25:54):
So a lot of people have asked ifI would stop doing Medicare
once I became a nurse and I waslike, no, why would I do that?
I mean, with nursing I have toshow up and I get paid when I
show up, but with Medicare Ibuild a book of business and I
take care of my clients and itkeeps paying me year after year.
So that's another thing.
(26:16):
If you have any interest ingrowing your own Medicare
business, let me know, becauseit's a really cool business and
it's a really cool thing to do.
It does take a little while tobuild it up.
It's not a huge commission foreach client, but when you build
it up you really can help a lotof people and you get paid
(26:38):
pretty nicely for doing it.
So that is my spiel aboutMedicare.
If you have any questions,reach out to me and I'd love to
help.
If you'd have enjoyed thispodcast, listen back through to
some of my other episodes.
We'll see a lot of them aboutseveral about breast cancer.
Lots of them about a coupleabout addiction, a couple just
(27:00):
about, you know, living yourbest life and dealing with all
the stuff that comes our way.
So thank you for listening toPiece of Work and please like
follow.
Share this episode if you thinksomeone might be interested.
Hi there, welcome to Peace of Work the podcast.
I'm Danielle Tanton.
I'm a nurse, author, coach andsurvivor.
I love inspiring people to livetheir best life, reach for
those big dreams and find joyeven in the pain.
As I wrote my memoir over somany years, trying to make sense
of a story where I was way toooften the bad guy instead of the
(00:28):
hero, I came to understand thatwe are all a piece of work, but
we're also a work in progressand even in our messiness we are
a work of art too.
All at the very same time, infact, we are all beautifully
unique pieces of one masterpieceWaves in the same ocean.
This podcast will explore thestories and struggles that make
(00:50):
us human, the miracles thatsurround us and all the ways we
work to make sense of it all.
Welcome to Peace of Work thepodcast.
Hello, it's Danielle Tanton,and today it's just me.
I wanted to chat with you todayabout Medicare.
(01:11):
I know so exciting and sexyMedicare, but we are right now
in the first week of AEP, whichis the annual enrollment period
for Medicare, and it's kind of abig deal in the Medicare world.
So I thought I'd just give alittle brief overview of what
(01:32):
Medicare is all about and how itworks and how I can help you or
your mom or your dad or someoneelse that you might know who
needs help with Medicare.
So what Medicare is?
It's for seniors, 65 and over,and it's actually the silver
lining of getting older as faras I'm concerned.
They are able to access suchamazing coverage and such
(01:57):
amazing options, but it is superoverwhelming.
So I mostly work with seniorswho are just turning 65.
And I help them just understandtheir options and pick the plan
that's going to work best forthem.
So this time of year, anybodysorry when you turn 65, you can
(02:18):
sign up for Medicare, and youcan sign up within a six to
seven month period around your65th birthday.
So when people are about 64,they're getting bombarded by
information about it.
But this time of year, anybodywho's already on Medicare can
make a change to their plan.
So they're also gettingbombarded by ads and phone calls
(02:42):
.
I, incidentally, somehowsomeway have.
My phone number is associatedwith my late uncle who died a
couple of years ago, and so Iget these calls myself and I
can't get myself off these listsbecause I don't know.
(03:03):
Who knows they were sold amillion times or whatever.
So I have an idea, an inkling,of just how many sales calls
that they get from all differentcompanies, and it's crazy.
So what I do?
I'm an independent agent and Iwork with many of the insurance
carriers that have Medicareplans and I represent my clients
(03:26):
.
I don't represent a specificinsurance carrier, I represent
my clients and I basically justhelp them figure out what's best
for them, because there'sreally not any right plan.
There's a couple of differentways to go and, frankly, a lot
of them are really similar.
So a lot of times what willhappen is if they see an ad and
(03:48):
they call in the 800 number, orif they get one of these cold
calls they're sort of like abait and switch thing.
A lot of them they have thesegreat ads that sound so amazing
You're going to get all thismoney back and you're not going
to have to pay anything and youcall in and they're like, oh
well, you can't really qualifyfor that plan, but we have this
other one, and this other onemight be super similar to what
(04:08):
they already have, but theydon't really know and they don't
really even realize thatthey're changing plans and they
don't even realize that they'reno longer have an agent that's
representing them.
They're just– they have some800 number person who they could
never get a hold of again.
I actually had one of my goodfriends, who's also a Medicare
(04:29):
client, last year, right at theend of the enrollment period,
got one of these calls and hethought it was actually a
representative from hisinsurance company, from the
insurance carrier.
They made it sound like thatthe way they worded it.
So he recommended I think youmight want to switch to this
(04:50):
plan.
He went ahead and switched.
Then he just called me just tolet me know that.
Hey, I just want to let youknow that blah blah blah
healthcare called and justthought this plan would be
better.
I just want to let you know.
He called me after theenrollment period was over and I
was like no, that was not true.
So it was a big headache to tryto get that reversed because it
(05:15):
was actually pretty fraudulentand pretty manipulative.
So, anyway, just wanted to letyou know.
That's out there.
So this is the AP.
I don't even have regular TVanymore.
I don't know about you, but Ionly have streaming services.
So I don't really see the ads,but once in a while I'm a nurse
(05:39):
as well.
So once in a while I'll be in apatient room and they're
watching regular TV and I'm like, wow, there are still so many
commercials that I just don'tsee anymore.
So, yes, they are beingbombarded.
So if you have a friend, familymember, relative or yourself
who is being bombarded and hassome questions about any plan
(06:01):
that you see or anything aboutyour plan, please feel free to
give me a call.
You can always call me480-236-1861, or email me,
danielle, at DanielleTanTonecom,or those are probably the best
ways.
On my website,danielletantonecom, there is a
(06:22):
calendar app that I try to haveupdated, where you can set up a
30-minute consultation.
But other than that, just callor email me and we'll set up a
time to talk, and this can benationwide.
So I'm mostly I am in Arizonaand so I'm licensed in Arizona,
but I have the ability to eitherrefer to somebody else or to
(06:44):
get licensed in other states.
So most of my business rightnow is still in Arizona.
So anyway, just to give a quickoverview of how it works and
what the options are, the firststep when you're signing up for
Medicare is to sign up fororiginal Medicare.
So that's that red, white andblue card that you might have
(07:06):
seen a picture of, and itincludes Part A and Part B.
So Part A is the hospital andinpatient coverage and that is
generally $0 a month for mostpeople as long as you've been
working in this country for morethan 10 years, which most
people have by the time they're65, then Part A is free.
(07:27):
Part B is covers the doctorvisits and outpatient care and
that one has a monthly premium.
It goes.
It changes roughly, you knowchanges every year usually goes
up, although this year it wentdown from last year but and then
(07:49):
it also has almost like tiers,almost like your tax brackets.
So if you make more money, youwill pay a little bit more.
But just to give you an idea ofthe pricing in 2023, it was
like $165, roughly $165 a month.
So that would be for originalMedicare.
(08:09):
You'd pay roughly $165 andyou'd pay it to Social Security
and you'd get that card.
Now, if you only had originalMedicare, that would be 80%
coverage.
So if you went to the doctorand I'm giving you very general
explanation there's a littlemore to it than that and that we
(08:29):
could always get into the nittygritty if we sit down, but
typically I don't, because mostpeople don't care about the
nitty gritty, so I'm just tryingto give you an overview of how
it works.
So if you only had originalMedicare which no one should
ever only have original Medicare, because that would leave you
with unlimited financial risk,basically but if you did, you
(08:50):
would have 80% coverage.
So if you went to the doctorand it was $100, they would pay
80 and you would pay 20, whichwould be fine if all our medical
bills were $100, but, as youmay know, they could be $1,000,
$100,000, a million dollars.
So where I come in is figuringout how to protect you against
(09:13):
that risk.
So there's two different pathsthat people can go.
One is the Medicare supplement,and I actually spent some time
I spoke with a colleague of mine, brian, on a previous episode a
lot about the supplements.
So the way the supplement worksand another name.
(09:33):
You might hear them calledMedigap plans, you might hear
them called MedSupp plans, butit's all the same thing.
It's a supplement.
It basically piggybacks on yourMedicare plan.
So if you go to the doctor,you'd give them your Medicare
card for that 80% and then thesupplement for the additional
20% and together you'd have fullcoverage.
(09:56):
What's nice about this is thatyou'd pay a monthly fee to have
that supplement, but for themost part you really have
nothing out of pocket, dependingon the plan.
But again, keeping it simple,you'd pay your monthly premium,
which is pretty reasonablecompared to what we pay when
we're not 65 yet for insuranceand you have basically full
(10:19):
coverage.
So a lot of people like thatoption and what's nice is that
you can go to any doctoranywhere in the country that
takes Medicare and everydifferent insurance company
offers Medicare supplements Well, maybe not every company, but
many of them.
So these plans are named byletters generally.
(10:40):
So the one that's most common,most popular with my clients who
are on a supplement, would bePlan G, and you can get Plan G
through United Health Care orthrough a number of other
carriers.
I mentioned United Health Carebecause that's the one I
probably work with the most, butI'm independently licensed and
(11:04):
I'm having trouble talking.
Anyway, I am contracted withseveral different carriers.
I don't really do a lot ofsupplement business and I'm
going to tell you why.
Not that I'm opposed to it, butfor where I live, in Maricopa
County, arizona, we have anamazing assortment of advantage
(11:25):
plans.
The advantage plans is almostlike a whole separate thing.
Like I said, there's twooptions for your coverage when
you go on Medicare.
Option one is the Medicaresupplement, like I just
mentioned.
Option two is the Advantageplan.
The Advantage plan workstotally differently.
With this route, you're stillgoing to pay your premium to
(11:48):
Social Security and that's goingto get you your original
Medicare, but you're no longerreally on original Medicare for
your insurance.
You're going to get a planthrough various carriers and
there's probably 50 or 60different options in Maricopa
County.
So it's not one plan per se.
(12:09):
We a lot of times say theAdvantage plan but there's many
different plans.
But with this route you'regoing to have an insurance plan
that's much more like theinsurance plan that you would
have had before you turned 65.
So it's more of a traditionalplan and it's going to cover you
from start to finish.
So you're no longer going tohave that 80 percent on Medicare
(12:30):
and then 20 percent on thesupplement.
It's just going to go right tothe Advantage plan.
So it's one card.
It also includes drug coverage,prescription drug coverage,
which is an add-on if you gowith a supplement route.
It also includes a lot ofancillary benefits, such as
dental, vision, hearing, gymmembership, and those are really
(12:52):
popular, especially with peoplewho are just turning 65, who
are still pretty healthy, activeand really enjoy those perks
and they don't necessarily go tothe doctor all that much.
So what my clients really loveabout these Advantage plans is
many of them are $0 a month, sothey have zero monthly premium.
(13:12):
It doesn't mean they're free,and that's the next question is
how can they be free?
And we'll go into that a littlebit.
So they're not free, but theydon't cost anything on a monthly
basis.
So you're still going to payyour Part B premium to Social
Security that $165 a month butyou're not paying any additional
monthly fee to have yourAdvantage plan.
What you will pay instead isjust small co-pays as you get
(13:37):
medical services, and theyreally are small.
There's no deductible.
So most of us who are under 65have huge deductibles sometimes,
or even if they're smalldeductibles, they're still
hundreds of dollars, usuallythousands of dollars.
So these plans many of themmost of them that I work with
have zero deductible, so theystart paying right away and the
(13:58):
co-pays are like $30, $40, $100,very reasonable.
And you have a maximumout-of-pocket that's like a cap,
so you can't go over thisamount.
So what I have found doing thisfor the past several years is
that for most people it wouldtake a lot to even reach your
maximum out-of-pocket and itwould take a lot of things going
(14:19):
wrong to come anywhere nearspending a couple hundred
dollars a month, which is whatyou will spend if you go on the
supplement.
So from a cash flow perspectiveit makes sense, and then from a
more bang for your buckperspective it makes sense, and
so most of my clients here inMaricopa County really like the
(14:41):
Advantage plans.
Just to play devil's advocate,though, there are reasons to
choose a supplement.
There are some you know like.
First of all, so with theAdvantage plans you have to be
aware of the network.
There are different types ofplans.
There's HMO and PPO, and wedon't need to get into the weeds
on that.
(15:01):
But HMOs are generally a morerestricted, smaller network,
tighter network, and then youdon't really have out-of-network
coverage at all.
And then you also need to go toyour primary care provider for
any referrals.
Anytime you want to go to anyother specialist.
And a PPO is generally abroader network, many of them.
(15:24):
You're part of a nationwidenetwork and you can go out of
network as well.
You'll pay more for services.
So you generally want to stayin network but you don't have to
.
So PPO offers a lot morefreedom and flexibility and some
of the plans here where I liveare just really great.
I mean they have nice bignetworks and it's going to feel
(15:46):
like the best insurance planyou've ever been on for the
cheapest amount of money you'veever paid.
So that's kind of the generalthing.
Oh, I started to say I'm goingto play devil's advocate Like,
okay, what's the catch first ofall?
So those are questions I getasked why is it free?
(16:06):
How is it free and why wouldanyone choose a supplement?
So I'll start with that lastquestion first.
Why would anyone choose asupplement?
The first thing is it dependswhere you live.
So I have done some business inCalifornia in the past and in
California the networks and thehealthcare system is really
(16:26):
different than it is here.
So over there you might haveone doctor and one network and
one doctor and another networkand they don't really like
crossover.
So here in Maricopa in Arizona,like our networks, like there's
, most doctors will do businessat Banner and also at Honor
Health and also at Dignity.
There's not really as muchsegmentation as there is in
(16:50):
California, so it's not really aproblem.
Plus, we have many, many PPOoptions, which again is that
broader network that willinclude multiple healthcare
systems, whereas in Californiamost of their Advantage plans
are HMO.
It used to be all I think nowthey're starting to get some PPO
options.
So that's one big reason why youmight not want an Advantage
(17:14):
plan, because you might feellike too restricted by it.
So a lot of times you knowanybody who can afford it would
rather have a supplement.
And historically you know theAdvantage plans are relatively
new.
So historically you'd ratherlike the supplement was kind of
known as like the gold standard,like the better option, and I
(17:37):
think a lot of people, evenMedicare advisors and financial
advisors, still think of it thatway, like that it's better and
if you can afford it you'll getthat, but if you can't, there's
some good Advantage plans.
That's kind of like the mindsetthat I've heard out there.
But I kind of have a differentmindset, like to me.
I just don't see how that'snecessarily better.
I mean it's it really dependson your personal situation.
(18:01):
It might be better for somebody.
You know they may not just wantto, not want to think about
networks, they might want to get, you know, go to a different
state to get a second opinion,be able to travel and go to the
Mayo Clinic or whatever it isthat they want to do, and they
just don't want to have to dealwith network and making sure
it's covered and all that.
They want to go to any doctoranywhere in the country that
takes Medicare and in that casethe supplement is better.
(18:23):
There are some, some medicalsystems that do not really take
the Advantage plans.
I mentioned, mayo Clinic andthat that, if you, that's one of
them.
So that would be the mainreason for the supplement.
The other one would be, you know, if you are in a, you know
(18:45):
managing multiple diseases oryou just have a high medical
acuity, I guess there it mightsometimes it's easier.
You know you paying a monthlyfee and then you don't have to
worry about any out of pocketcosts, so you're not like kind
of feeling like you're nickeland dime.
So some people just like thatand they just like to not have
(19:06):
to worry about it.
Some people might be thinkingof moving, or they might move
around a lot and not be in oneplace and it's just easier, and
then a lot of times when you'refirst turning 65, it just makes
sense to start that way becauseyou, you're, you're allowed,
you're in a guaranteed issueperiod when you first go on
(19:29):
Medicare.
So what that means is there'sno medical underwriting and
anybody can get.
They can't deny you access tothe supplement.
The advantage plans don'treally have any medical
underwriting so you can join anadvantage plan anytime, at least
at this point.
That may change, but at thispoint there there's no medical
underwriting involved so anyonecan can join in your approved,
no matter what your healthstatus.
(19:51):
But the supplements are not likethat.
You, if you join at any timeother than when you first going
on Medicare, you would need toqualify and you would, you would
pay more.
Potentially, if you have somehealth issues, you might not
even be approved at all.
So that's another reason whysome people are like kind of
almost there's a lot of fear inMedicare marketing.
(20:12):
I think so, like they're almostscared into going that route.
So I just when I sit down witha client, I really just try to
take away all the fear and justtell them like it is and show
them the options, and I tryreally hard not to push them in
one way or another and to justjust tell them the facts and
(20:33):
there's not.
The great thing is that, despiteyou know the fear marketing
that I've talked about, youreally as long as you choose a
plan and you have someprescription drug coverage,
because you're not gonna getpenalized if you, as long as you
, you know, are somewhateducated and do things right.
(20:54):
And I think there's a lot offear of that of getting
penalized for life.
And I have seen it wheresomeone is penalized for life
because they didn't sign up forMedicare at the time and they
didn't have a creditablecoverage other than Medicare.
So I like to just really helprelease some of that fear, set
(21:14):
people at ease and even make theprocess a little bit fun.
I know that sounds crazy, butit's actually is really amazing
coverage and there's lots ofoptions and to me that is kind
of fun.
So that is the basics ofMedicare and I think in the
future I'm gonna work on somedifferent things.
(21:38):
I have been playing around witha brand called Medicare Moxie
and I love the word Moxiebecause it kind of sounds fun to
me and it means, you know, kindof like gumption sass, like
knowledge, someone giving youthe power.
So I wanted empower people toreally understand how it all
(22:00):
works and be able to make theirown choices.
And so I started to say you canchange every year.
So right now, aap, anyone canmake a change to their plan.
So you could be on a supplementand you could go to an
Advantage plan.
You could be on one Advantageplan and go to a different one.
That doesn't mean that youshould change your plan, because
I think another thing is it'syou know there's no reason to
(22:22):
change your plan every yearunless there's something about
it that you don't like.
But I'm happy to sit down withanybody and chat with them and
figure out what option might bebest.
So that's kind of my spiel.
On Medicare, I would like totake just a few minutes to talk
(22:43):
about how I even got into thisand why I keep doing it, because
it's if you know me at all, youknow that I do multiple things.
I'm a labor and delivery nurse.
I used to be a realtor I'mstill licensed, but not doing
that actively.
I wrote a book called Piece ofWork, a memoir, and I have a
(23:06):
podcast, obviously, and I havethree kids and I probably am
forgetting like five things thatI do.
So why Medicare?
Well, here's the thing.
So a few years ago it was duringCOVID I was just recovering
from breast cancer surgery and Ihad sent out an email to my
(23:27):
sphere of influence, just kindof updating them, telling them I
was writing this book and justkind of keeping in touch.
I've always been in sales andmarketing and I knew that down
the road I'd be having a bookthat I'd wanna sell and I wanted
to kind of build my email list,and so I was just sending out
an email to basically everyone Iknew, everyone I'd ever worked
with, and one of the people thatI used to work with in real
(23:48):
estate responded and said hey,my wife and I have recently
gotten into Medicare and I thinkyou'd be really good at it.
You like to help people andblah, blah, blah, blah.
And I'm like are you kidding me?
I just sent you this emailtelling you all these crazy
things I'm doing and you think Ishould add one more business.
Well, I was in nursing school,by the way, and he said, yeah, I
(24:09):
think you should.
So I said, okay, maybe I will.
It was right in the middle ofCOVID and I was on a little
break from school and from workas well, so I started taking the
classes and getting certified.
I already had my insurancelicense because I had done
employee benefits for a coupleof years and I found that, you
(24:29):
know, while it was certainly dryand boring and bureaucratic and
overwhelming, if I could makesense of this and actually help
people, this is something thateverybody who turns 65 needs to
do and it's overwhelming andit's scary and, if I can make it
(24:52):
easier for somebody, this isalmost like the easiest sales
job ever, because I'm notselling anything, actually Like
I'm representing these insuranceplans and I get paid by the
carrier, but it doesn't cost, Idon't know.
Money is exchanged Like unlikereal estate, there's not 40
(25:13):
other realtors fighting fortheir business, there's hardly
any of us and I actually canreally help people.
So and they don't, you know,they don't have to give me any
money, they don't pay me acommission, they don't.
The plan doesn't even cost thatmoney in most cases.
So it's like just really awin-win.
(25:33):
I really do like helping peopleand I really do like educating
people.
It's really gratifying.
So it's kind of neat.
I deliver babies and watch themtake their first breaths.
I help people in the lateryears of their life as well.
That's a really cool thing tome.
(25:54):
So a lot of people have asked ifI would stop doing Medicare
once I became a nurse and I waslike, no, why would I do that?
I mean, with nursing I have toshow up and I get paid when I
show up, but with Medicare Ibuild a book of business and I
take care of my clients and itkeeps paying me year after year.
So that's another thing.
(26:16):
If you have any interest ingrowing your own Medicare
business, let me know, becauseit's a really cool business and
it's a really cool thing to do.
It does take a little while tobuild it up.
It's not a huge commission foreach client, but when you build
it up you really can help a lotof people and you get paid
(26:38):
pretty nicely for doing it.
So that is my spiel aboutMedicare.
If you have any questions,reach out to me and I'd love to
help.
If you'd have enjoyed thispodcast, listen back through to
some of my other episodes.
We'll see a lot of them aboutseveral about breast cancer.
Lots of them about a coupleabout addiction, a couple just
(27:00):
about, you know, living yourbest life and dealing with all
the stuff that comes our way.
So thank you for listening toPiece of Work and please like
follow.
Share this episode if you thinksomeone might be interested.
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