Episode Transcript
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Speaker 1 (00:02):
Nice find time us with John Roman. This segment is
called Rethink Healthcare Together. John Roman is with Cover Sensing
and Heena's team can to help you get a better
medical insurance package. In medical insurance, we're talking about you know,
you got your group plan through your employer, which sucks
because you have tons of out of pocket liability. You
gotta pay heatload of money before the insurance even kicks in.
Very limited, as John has talked about many times, poles
(00:23):
in the bucket as he calls it, some things are
covered and some things are not. John and his team
work with hundreds of medical insurance companies, have access to
thousands of policies. Because they're working for you, they do
the best to sort through all those and find a
better way. Dollar one coverage, catastrophic coverage, hospital coverage, all
that for less money. And I can emphasize less money
(00:46):
and sometimes it is a lot less money for better coverage.
And I know the situation seems impossibility, which is why
I always say just call them. You don't have any
obligation to work with them past the initial discussion. They'll
provide you with accurate information, they'll find a better path
for you, or at minimum confirm that you have the
best possible package of insurance out there, which I tend
to doubt. So talk to John on the team. It's
(01:07):
five one three eight hundred call five one three eight
hundred two two five five, or head on over to
the website. Get the process started by filling a format.
It's cover sincey dot com. John, It's always good see you,
welcome or good to have you back on the show,
and of course it is your segment. I merely facilitated.
Speaker 2 (01:23):
Well, we do this together, Brian, and I feel like
so blessed that we've been able to do this for
such a long time now, and I feel like you've
almost become an expert. When it comes out, I'm gonna quit.
Speaker 1 (01:33):
I'm gonna quit my day job and come work for
Cover since he and I have learned a lot, and
you've really opened my eyes up to this, the how
you do business and how much better it is for
people because you are working for them. I regularly drawn
a parallel to a financial planner with a fiduciary obligation.
They have to work for you. Their effort and their
(01:55):
goal is to maximize your return on investment, and your
goal is of course to do the best you possible
we can to find better medical coverage for less money.
Absolutely wildly successful. Yeah, I mean it's we take such
great pride into Brian. I mean it's you know, we
we base our entire company on educating our clients, right,
I feel like just just the education part, you know,
(02:16):
by you know, calling in and sitting down with us,
regardless if you end up taking a plan that we do.
I mean it's you know, one of the biggest things
that we do on every meeting that we have with
any of your listeners, any of our prospects or clients,
is you know, we sit down and educate them on
the plan that they have, show them where some of
the holes are.
Speaker 2 (02:33):
We educate them on healthcare, you know, how to maximize
their dollar, you know, to minimize their expense. And that
could be you know, shopping healthcare look yeah, affordable imaging places,
or getting better lab opportunities, or just knowing that God
you can negotiate, you know, and and a lot and
so many people don't. And you know, with rising out
(02:53):
of pockets, you know, on every health plan you know
that's out there, group health plans, you know, your look
looking at the marketplace, the ACA stuff or Obamacare wherever
you want to call it. For twenty twenty six, I mean,
you got a pockets are increasing there, you know, and
the premium is going up to and the premium is
going up yeah, and then and the tax credits are
going away, I.
Speaker 1 (03:13):
Mean talked about that's really alarming. Man. They took the
tax credit away. So if you make more than sixty
four thousand dollars.
Speaker 2 (03:19):
It's a little bit more this year. I we weren't
really sure the number is yet, but I mean yeah,
I mean it's it's close to like seventy thousand, but
it's like the money goes away, like.
Speaker 1 (03:27):
There's no tax credit after the extra dollar beyond the cap. Yeah,
it's gonna cause a lot of people to just dump
the plan, which leaves Obamacare as the insurer of last
resort for the most unhealthy segment of the entire population.
Speaker 2 (03:40):
Which, as we know with high risk pools, it's gonna
go up. It's gonna it's gonna continue to go up, right,
I mean, you can't. You can't have a plan based
upon just a bunch of unhealthy people. It doesn't work.
It's not Economy's a scale when it comes to ensuring
and you know, you know, this segment's gonna be a
little bit more geared toward Medicare, right you're over sixty
five or getting close to that, or you know already
(04:03):
on Medicare, or maybe a Medicare advantage plan, or maybe
you're just listening to this like that doesn't really apply
to me, but I'm sure to apply to your parents,
your grandparents. Right. You know, there's big changes coming up
just for the twenty twenty six plans on the Medicare side.
You know, you're gonna see so many companies right now
start looking at raising out of pocket expenses on these plans,
(04:23):
and we're already starting to see some of those coming around.
You know, the maxim out of pockets on some of
these plans can be over eight grand for a senior
you know, on a fixed income, and that's that can
be a lot. It can be daunting, you know, and
most of these people aren't going to be aware of that.
You know, you're gonna start seeing things like reduced networks.
So it's so important right now if you're listening to
(04:43):
the show, you're gonna start getting your annual notice of
change here within the next few weeks. This is what's
gonna tell you. If you're on a Medicare advantage plan,
you're gonna get a letter basically says, hey, these are
the changes of your plan. And so many people, Brian,
don't even look at that, and they don't know. And
then and then they're in a situation come next year
(05:04):
where they lose a doctor because an insurance company dropped
their network of a hospital group, or now they're out
of pocket expenses or increasing or maybe they were accounting
on that dental or vision plan helping them for the
next year, and they just reduce the benefits. I mean,
we're going to see I think a massive reduction in
this realm, because I'm already hearing insurance companies pulling products
(05:26):
completely out of the market, reducing options on PPO plans
that give them the big broad access that a lot
of people rely on. So it's it's just so important
to really look at your coverage, especially that letter. And
then you know, right now we're taking calls and scheduling
all of our clients. So, Brian, I mean, we did
so well last year with Medicare Advantage, helping so many
(05:48):
of your listeners. I literally train my entire office to
do Medicare this year for AEP so your phone it
was off the hook. I mean I was doing most
of the appointment myself. I didn't have enough time and
so I had to literally train my entire staff. We
just we've been working on it every single week. My
guys are going to be experts in this field, I feel,
and you, so we can help anyone that's on a
(06:12):
Medicare advantage plan just look at other options and just see, hey,
should I stay on the plan that I'm at or
should I look at maybe a different plan. But really,
at the end of the day, Brian and a lot
of what we're going to talk about today on the
show is covering those out of pocket expenses, right because
a lot of people go, hey, I'm great, i have
a Medicare advantage plan. Maybe I'm not really paying anything
(06:33):
for it because a lot of them could be zero premium.
So it helps a lot of people in that realm.
But I always tell my clients, like, listen, there's no
free lunch. When you have a zero premium there's something
that you're giving up, and a lot of cases that's
huge potential out of pocket expenses. And if you're someone
that's like, well, I want to go to a couple
of doctor visits a year. It's not a question of
if it's when you are going to go into the hospital,
(06:55):
when you are going to have a surgery, or god forbid,
develop something that's going to be you know, more long
term illness that you're going to be treated for. You know,
how many people can really afford eight thousand, nine thousand
dollars a year and medical expenses, and god forbid, you're
married and you and your spouse are going through that
same type of situation in the same year. You know,
(07:17):
especially if you're just counting on maybe a small pension
so secure, that's going to wreck you financially well.
Speaker 1 (07:22):
And that's why getting ahead of this early is important,
so you have you have an awareness of your options
and how to reduce these potential expenditures. So now is
the time you call Covers Since he at five point
three eight in a call and scheduled appointment and you know,
John and the team aren't going to charge you to
go through this analysis. I got to emphasize that this
is not a service that you pay for. This is
(07:42):
something they hope they can get you in a product
that you'll be happy with and save your money. You
put a smile on your face. So you've talked before
about a lot of the pitfalls that are involved in
going onto Medicare and you different options in terms of supplements,
and again, this is a good time to be thinking
about that. So what are the key Medicare advantage changes
(08:03):
that we're looking at right now? And then how might
that be impacted or how could you lessen the blow
with some other add ons or other things to think about.
Speaker 2 (08:12):
Yeah, so basically, you know, we're approaching like the Medicare
advantage plans, just like we do for everyone that we
help that's under sixty five, right, group plans or individual plans,
you know, where we look at layering coverages. Right, So
many of you are probably like, well, you know, I'm
not really paying much for this plan, how do I
(08:32):
cover these high out of pocket expenses? Or maybe you're
looking at a meta gap plan right, and here's a
big downfall in the meta gap plans. So you know,
right now I'm seeing the ones that we call them
the T sixty fives, the ones that are turning sixty
five and going on Medicare, and for a very long
time here in our area, we've had very affordable rates.
(08:53):
They've been very like you're talking less than you know,
around one hundred bucks a month. They can get a
really good plan on at a gap plank, which a
lot of people were gravitating towards. Well, we see a
lot of insurance companies right now that have legitimately raised
their rate fifty percent. Oh wow. Yeah, and they're telling
us it's because of the file releasing of the COVID numbers.
I'm literally hearing insurance companies that are I know two
(09:16):
insurance companies that literally stop selling meta gap plans completely
their AVD market. I heard another company that's literally postponing
sales of meta gap plans till next year. So they
just shut down. They said, we are no longer taking
any more meta gap plans.
Speaker 1 (09:31):
Sort of to test the water to see what happens. Yeah,
because I guess they have.
Speaker 2 (09:35):
What we're hearing is they have a very hot block
of business where it's very costly for them. So they're like, hey,
we got to like slow this down. We can't take
a lot more risk on because we've got to be
able to pay the claims of the people that are
on there. Right So you're starting to see this big
trend where you know, the meta gap plans, which is
really the better coverage, getting more and more astronomical on
(09:56):
pricing right and higher increases. I can't tell you how
many people are calling and going, John, I'm paying three,
four or five I had in Pennsylvania paying six hundred
bucks a month on a meta gap plan for him
and his wife. So they're paying twelve hundred dollars a month,
you know, and they just don't make sense at that point.
You're paying way too much for actually even the great
(10:16):
coverage that you're getting, but it just it's way too much.
So you know, a lot of these people are starting
to look at the alternatives, like, well, hey, what if
I moved to a Medicare advantage plan, Well, yeah, I
can save you six hundred bucks a month, and that's
a lot of money. So people are gonna start looking
at alternatives. And when you look at the Medicare advantage plans,
they're looking at saying, hey, I like this option. It
(10:36):
saves me six hundred bucks a month, But do I
really want to potentially come out eight thousand dollars out
of pocket each year? So we're taking the same approach
we did with the under sixty five market, where you
have your catastrophic coverage and then you add on indemnity
insurance to help cover those out of pocket expenses. So
you know, most people go always like, well, where's my
biggest holes in Medicare advantage? Welt your hospitalization? It's typically
(10:58):
your surgeries, your er and like your ambulance rides, and
these can be pretty significant copays. So a lot of
times you look at Medicare advantage plans, you're gonna have
somewhere between a three to five hundred dollars per day
cope every day that you're in the hospital, and it's
usually for like the first one through six days, right,
so maybe twenty five hundred and three grand. If you're
in the hospital for a week. Well what happens if
(11:20):
you go out of the hospital and then a couple
months later you're back in again, there's maybe another two
or three grand out of pocket, right. So you know
what we're helping people do right now is add on
a supplemental plan. And I'm talking about Brian. These plans
are like maybe a little over a dollar a day,
and they literally cover that entire hospital stay. They literally
(11:42):
will pay your entire co pay. If you have a surgery,
they can cover the copey for your two to three
hundred dollars ambulance ride. They can help you with your
emergency room cope. So literally the biggest out of pocket
expenses that you can ever have a Medicare advantage. You
can pick up a small little plan for maybe thirty
to fifty bucks and it will completely cover all those expenses.
(12:04):
So now we've literally shored up a majority of your
potential out of pocket expenses. And a lot of insurance
companies are putting these products out right now. You know,
as a broker that writes for one hundred companies, I
have many plans that do these. And the best part,
Brian is you know now they're getting a really good
healthcare package for like forty or fifty bucks a month,
(12:24):
and the math doesn't seem to work out.
Speaker 1 (12:26):
I mean, pivoting back to your prior example about this
other policies doubling, Yeah, maybe more in price that you
can get that level of upfront coverage for maybe what
four hundred dollars a year?
Speaker 2 (12:37):
Yeah, yeah, I mean fourner bucks a year. I mean
think about the break even on that, right, I mean
it's gonna take you eight to ten years of never
going into the hospital to justify not buying it.
Speaker 1 (12:47):
Yeah, it doesn't make any sense.
Speaker 2 (12:48):
That doesn't make any sense at all. So it's a goodbye.
And some of these insurance companies Brian, right now, especially
if you're turning sixty five, you know they'll do it
guaranteed issue. Some of them are doing up to seventy
four years, so the first nine years. If you get
on a Medicare advantage plan, you want to get take
one of these secondary policies out. They're guaranteed issue regardless
of your current pre existing conditions. So anyone can qualify
(13:11):
for these plans. It makes so much financial sense to
pick one of these plans up. And here's the funny
thing about it, Brian, I talk to people all the time,
and a lot of the listeners came to me because
they bought insurance from somebody else. They called some one
eight hundred number that they saw at two o'clock in
the afternoon on their soap opera show or whatever they
(13:32):
were listening to, and they went through one of these
you know, we call these phone rooms, these huge conglomerate
phone rooms, and they just they're just finding a plan,
slapping them to a plan and goodbye. And you know,
you don't even have a broker anybody you're gonna be
able to call to deal with later, and they're not
advising the clients properly because they go, hey, I can
go sell a zero dollar premium plan. That's easy to
sell a plan like that, Brian, but it's a little
(13:53):
bit harder to sit down to the client and really
do them as service, to show them where those pitfalls
are and making sure they're set up properly. So I'm
helping those people as well. So one of the biggest
things I can tell you is, like, listen, you're started
seeing some one one hundred number on us on a
screen on your TV, or you know these huge marketing
ads that are going to be going running here in
the next month or two. Don't reach out to a
(14:14):
local broker. Reach out to someone that can actually sit
down with you and explain the plan properly, and someone
that's going to be there two months later if you
have a question.
Speaker 1 (14:22):
Yeah, and again I can't let that comment go without
chiming in and reminding folks, if you're working with John
on the team that covers since you got claims issues
and disputes. You get an explanation of benefits claim has
been denied for some reason. You're puzzled scratching your head.
You don't have to spend time on the phone with
the insurance company, regardless of which insurance company it is.
John and the team will iron up the problem for you.
(14:43):
They've got folks there that are willing to get on
the horn and they know these shortcuts to reach them
and they'll iron out and he claims dispute for you.
That's it. No charge. Again. This goes along with working
with this team that covers sensing so valuable important service
you provide there.
Speaker 2 (14:56):
John, Oh, we appreciate. I think we know the value
of keeping our clients at be in the value of
keeping client you know, I did a huge training. I
trained hundreds of agents all throughout the country that work
under me. And you know, one of the biggest pieces
that I always tells me, listen, it is actually cheaper
to maintain a client than go market to find a
(15:16):
new one. I say, so, do the customer service, making
sure that you're actually sitting down with your clients once
a year and doing a review, answer a phone when
they call you. You know, these are just so important. But again,
something that I have found working in this industry for
over twenty years is that a lot of agents don't
even do that.
Speaker 1 (15:33):
No, they don't, No, clearly. That's why I always take
the chance to emphasize it. Yeah, I mean, this is
a real benefit anybody who spent time with two hours
on damn phone with the insurance company out a whole
waiting for us to reach somebody, and then not really
being in an informed position to have a conversation about
it because of all the codes and everything else that's involved.
It's like, wash your hands and let John on the
team take care of it. So I'll give you a
(15:54):
little pointer right now. If you are currently on Medicare,
if you've ever called your insurance company and you can't
understand the person on the other end of the line,
how frustrating is that? Very you know, it's like, you know,
I have to train my team that goes if you
can't understand them, hang up and call back, you know,
because we're dealing with those same insurance companies too, and
(16:16):
it's it's a tough because you mean, I can tell
you how many times we've spent an hour trying to
get through to an insurance company to help a client,
and I can't imagine what they go through. But one
of the key points that I'm going to tell you
right now, especially in our area, we have a you know.
Speaker 2 (16:31):
I can specifically say the insurance company on the live air,
but we have an insurance company's making a huge stride
here in Ohio, a very good company. They're a US
based company and they do not use call centers outside
the United States for customer service. We're very happy with them.
I actually, i'd probably say they're the most highly rated
you know company as far as customer service that we've
dealt with. And I'm very excited that they're going to
(16:54):
be very strong and it's gonna be covering a lot
of the hospitals here in our area. But what's nice
sits a newer company to our location, and a lot
of people aren't on it. So it's a great opportunity
for your listeners to say, hey, you know what, I've
had some issues in the past with the carrier that
I have, maybe I should look at this other option.
I feel like they're going to make a huge play
(17:16):
here in this Greater Cincinnati area and probably be the
better player here for the next few years.
Speaker 1 (17:22):
All right, Well, since we're talking about Medicare and the
and what my folks moving in that direction need to
deal with, which is get in touch with John early
so they can walk through all your options. Something we
all need to consider that we have talked about before
home health care. This this policy and you submit. You
gave me an option, and I need to follow through
with you on that. My personal experience, I'm considering home
(17:43):
healthcare policy from John to the team that covers sincey
because well, having lived through the experience with my father
and seeing my mother struggle with you know, trying to
take care of him when he was dealing with his Alzheimer's,
I mean, just rapid deterioration. Boy, if she had some
folks that were able to come into the house that
period of time, it would have things out a lot.
Speaker 2 (18:01):
Yeah, It's it's daunting just the stories that I get
from clients that they tell me, like personal experience of
their parents going through those situations. And you know, until
I really started pushing myself and my team to really
highlight this to our clients, you know, it was kind
of one of those things or anything in sales, right,
(18:22):
and unless the client's really asking us about we weren't
talking about it. And you know, I've realized it's such
a prevalent situation right now, just in our in America.
There's even states right now in the United States that
are starting to require people to purchase it. Like you.
It's like like like with like car insurance. They are
not requiring you, like in certain states that you have
to have long term care. Wow, because it's such a
(18:44):
draining financial pitfall for states that have to put through
Because the number one payer for home health care and
facility coverages is Medicaid. You know, I can imagine working
your entire life and then something happens to you and
you have to liquidate your assets to Medicaid to you know,
pay for your assisted living facility or whatever you're you're
in and or you know, requiring your kids or family
(19:07):
members to potentially take care of you. Right. It's not
something I would ever want to put my kids through.
I know my parents are exactly the same wa when
they knew I was selling, they were like the first
people to buy from. Well, we're not doing that to
you because we because we dealt with that with my grandmother,
and you know, it's just it's it's just it makes
so much sense, and especially in today's market. Right. So
(19:28):
one of the things that you know, I'm kind of
bringing back, and I want to come full circle here,
is when I when I'm dealing with these clients and
they're they're a little bit older, maybe mid seventies, early eighties,
and they're all on these supplement plans, right, and they're
paying three hundred, four hundred, five hundred bucks a month.
One of the things we really started looking at is going, hey,
if I can save you three four five hundred bucks
(19:49):
a month and move you to a Medicare advantage plan.
And at this stage it probably makes sense just financially
because really the money you're paying in premium is close
to like half of the out of pocket a year
on the Medicare advantagelan, so you're better off just saving
that money. But if I can move you from that
high dollar Medicare supplement gets you into one of these
hospitals and these indemnity plans that helped cover those out
of pock expenses for a little over a dollar a day, right,
(20:13):
that's a huge savings for you. Well, that's some of
that savings, you can put towards things like home healthcare.
You can put towards things like facility coverage. Right, you
might be able to take a small little life insurance policy. Yeah,
if you don't have any life insurance or funeral plans anymore.
We just had a client here recently. They were paying
almost five hundred bucks a month on the Medicare supplement.
We were able to move them at eighty two to
(20:35):
a Medicare advantage plan last year. Not only was I
were able to save her all that money, but we
add on all those other products to her and she
was still saving like one hundred and fifty bucks a
month once she was paying on the Medicare supplement. It
is a lot more coverage and a lot more coverage,
so much more coverage because you got a member too.
Even with those Medicare supplements, you still got to pay
for your prescription drug plan. She was paying another one
(20:56):
hundred dollars for a prescription drug plan. She was you know,
didn't have dental insurance, she didn't have vision insurance, she
didn't have hearing She did hearing coverage, and all that
stuff is actually covered under the Medicare advantage plan, so's
it's even more valuabfore, because she picked up a lot
more coverage just with the Medicare advantage plan that she
didn't even have offered before. So it was a lot
(21:17):
more coverage for her. And you know, of course, it
is so important to make sure you picked the right
Medicare advantage plan because you know, there's HMOs, there's PPOs.
I'm not a firm believer in HMOs. I always, I
always always poked this out. I got into this business
twenty one years ago. And then then the guy that
trained me goes, John, you won't put your worst enemy
in an HMO. And I've stuck to that. And oh
(21:40):
my gosh, oh my god, especially what we just had
last year where we were losing hospitals. You know, one
of our biggest insurance companies, they were kicked out of
certain hospitals here in our area, like consistently throughout the year.
So if I had somebody on an HMO, they basically
would have turned around. Oh I just lost my doctor
for three months, right, you know, I can't go anywhere else.
I gotta go find a new doctor. Hopelly, the hospital
(22:02):
and the insurance company work it out, so I can
go back to my doctor. I can't imagine if they
had gone through a situation where they actually needed weekly
or monthly treatment. You know, what does that look like
when you can't see your primary care or god forbid
your specialist, right, you know, And you know that's why
we always set them up on PPO plans. But you know,
just kind of getting back to that home health care
situation and long term care, I mean, I mean, like
(22:24):
I've showed you, Brian, these plans aren't that expensive, you know,
if you're doing the right type of plan. And what
most people don't realize. And I ran to a guy
not too long ago on a very very very good
long term care policy, but I mean he was literally
paying like five six hundred bucks a month for it,
and I was like, that's a lot. That's a lot
to pay for that plan. He goes, well, I've had
(22:44):
it for a very long time. It's got a lot
of covers. Is that it really does. And I advise
you to stay there if it's not financially a hardship
for you. But I'm like, you do realize that there
are a lot of facilities, Like when we put my
mother in law, my wife's grandmother. She ended up getting
into a very good facility, but eventually the money ran
(23:06):
out right, right, and a lot of these facilities they
don't kick you out when the money runs out. So
she had enough money to get her into the facility
for a couple of years. But then once some money
ran out, Medicaid kicked in right, so Medicaid started paying
for it. But she never lost her room. She never
lost the nice private room that she had this very
nice facility. They didn't turn around and go, sorry, man,
(23:26):
because Medicaid's not paying for it, because you ran out
of money, we're going to remove you from this facility.
So the nice thing is if you had a plan
that can least get you into that facility for the
first year or two, which a lot of these cheaper
plans can and I'm talking about Brian. This plan that
I'm talking about is like one hundred bucks a month
compared to the one that was six hundred. That's six
thousand dollars a year savings right at that point where
(23:49):
we can get them into that facility. And as long
as you're not one of those facilities that will kick
you out, they'll keep you there, you know. And so
we can start really looking at that as a better
financial decision. So many people Brian when they call in,
they don't think about this in their forties or fifties.
They start thinking about this when they're they're in their seventies,
when these things get more and more expensive, and you know,
(24:11):
they can't do a traditional long term care policy because
it's so expensive, and I'll be honest with you, most
people can't qualify at that point in their life. So
then they're like, well, I can't do anything. We have
those options, and there are a fraction of the price
of those really expensive long term care policies, and for
the most part, they offer the same type of coverage
for those first few years that those big companies that
(24:32):
are charging you five times more, you know, have And
like I said, we're our goal here is not to
get you kicked out once you get you into that
good facility, because they're getting expensive and most people don't
even know what it costs. But it's over ten grand
a month, I mean, and a good one is gonna
be twelve to fifteen thousand dollars a month. A month, yeah,
a month. So unless you have a bunch of money
(24:53):
saved up, got to plan on selling your house or
hopefully you got a great pension, sell security incomement.
Speaker 1 (25:00):
I want to hear that figure. I just just it's
just hard for me to believe.
Speaker 2 (25:04):
Mm hmm.
Speaker 1 (25:06):
We complained about rents being high, but this is I mean,
it's assisted living facilities, but fifteen thousand dollars every single oh.
Speaker 2 (25:13):
I know, but again I remember it's round o'clock service.
Speaker 1 (25:15):
There.
Speaker 2 (25:16):
They have transfer that takes shoots in one of your doctors.
You know some of these great facilities. I mean I've
been in them. They're like they're like spas, you know
what I mean. I'm much to be honest at the
end of the day, Like where I want to put
my mom right, you know what I mean? Thanks Mom,
You took care of me my entire life. You know,
every time I got into a situation, it bailed me out. Well,
you know what, I'm putting you in this place and
somebody might check on you once every week.
Speaker 1 (25:38):
The cut great place.
Speaker 2 (25:39):
Yeah, I'm putting you in the budget motel. I mean,
and you know, and then even more so, you know,
we see a lot of you know, people that are married,
their spouses. You know, they want you to be able
to stay at home, right, And I think that's a
huge thing. Right now. We see so many people when
they have, god for a bit of stroke, or they're
(26:00):
going through something that requires them to become some sort
of this disabled, right, they want to stay at home.
And you know, I look at my wife like I'd
want her to be able to stay at home. I
don't want to put her into a facility and you know,
go see her once in a while. I want her
to be able to be where she feels comfortable. But
the burden of me, like, oh, I couldn't even imagine
having to take care of that, I know.
Speaker 1 (26:21):
I mean that's why I mean you really need to
be forward thinking on.
Speaker 2 (26:23):
That befoward thinking, right. And so even home health care
bringing and aid in or the people that have to
come in and help out. Right, guess who doesn't pay
for that Medicare. Medicare isn't turn around and paying for
all those extra people that have they come to your home. No,
it's you, right. So you know when I kind of
talk about that like dollar a day, that's literally I
can get you a home health care plan even in
(26:45):
your sixties. It's like a dollar a day that you
can have someone come into your house and take care
of your spouse. And you might not need them there
every day, right, but hey, what about well, I'm going
to come in once a week and give you eight
hours off. Hopefully you will.
Speaker 1 (27:00):
Need to access the benefits offered under the plan. I
don't want to ever have to have something coming to
my home to take care of me. But for four
hundred bucks a year, that's a worthy investment. That's why
you have insurance. Nobody wants to use their auto insurance
policy because they got in a wreck, because you got
into a wreck, but there it is just in case.
Speaker 2 (27:18):
No, so yeah, and it's and you're you hit the
nail on the head. I mean, the business that I'm in, Brian,
is I'm selling something to my clients. I hope we
never used right every single day, you know, I hope
in every use health insurance. I hope you never have
to go into the hospital and have a surgery. I
hope you never have to. But it's not really a
question of if, it's when. Eventuality, you know you will
(27:39):
be in this situation, and then numbers don't lie. You know.
Medicine is fantastic nowadays, right, I mean I was reading
reports that you know, life spans have what doubled in
the last like eighty years from where we were, you know,
And it's medicine. It's keeping you alive. The stroke or
the heart disorder that can so you go through doesn't
(27:59):
kill you usually anymore. It's it's gonna be a longer
drawn out process. And a lot of people now are
more and more ending up in some sort of assisted
situation or a facility or living longer. I mean you
see all these people that in their nineties. I mean
eventually you might be in that situation. You want to
make sure that you have that coverage there to protect
(28:19):
you well.
Speaker 1 (28:20):
And that's why you don't wait until October to find
out if you're overpaying or undercovered. Call John Roman and
the team today. Schedule the free Medicare Medicare review and
appointment for this year. Get ahead of the game, learn
about your options, protect yourself from what seems to be
the inevitable. It's five one three eight hundred two two
five five. That's five O one three eight hundred call
(28:42):
or fill the format online at cover since you with
Y or I cover Sincy dot com. I don't care
what state you're in. John and the team can help
you out. It's not just a local, try state thing
for hearing the Spreater Cincinnati area. This has been another
edition of Rethink Healthcare together with John Roman from Cover
since he coversincey dot com
Nice find time us with John Roman. This segment is
called Rethink Healthcare Together. John Roman is with Cover Sensing
and Heena's team can to help you get a better
medical insurance package. In medical insurance, we're talking about you know,
you got your group plan through your employer, which sucks
because you have tons of out of pocket liability. You
gotta pay heatload of money before the insurance even kicks in.
Very limited, as John has talked about many times, poles
(00:23):
in the bucket as he calls it, some things are
covered and some things are not. John and his team
work with hundreds of medical insurance companies, have access to
thousands of policies. Because they're working for you, they do
the best to sort through all those and find a
better way. Dollar one coverage, catastrophic coverage, hospital coverage, all
that for less money. And I can emphasize less money
(00:46):
and sometimes it is a lot less money for better coverage.
And I know the situation seems impossibility, which is why
I always say just call them. You don't have any
obligation to work with them past the initial discussion. They'll
provide you with accurate information, they'll find a better path
for you, or at minimum confirm that you have the
best possible package of insurance out there, which I tend
to doubt. So talk to John on the team. It's
(01:07):
five one three eight hundred call five one three eight
hundred two two five five, or head on over to
the website. Get the process started by filling a format.
It's cover sincey dot com. John, It's always good see you,
welcome or good to have you back on the show,
and of course it is your segment. I merely facilitated.
Speaker 2 (01:23):
Well, we do this together, Brian, and I feel like
so blessed that we've been able to do this for
such a long time now, and I feel like you've
almost become an expert. When it comes out, I'm gonna quit.
Speaker 1 (01:33):
I'm gonna quit my day job and come work for
Cover since he and I have learned a lot, and
you've really opened my eyes up to this, the how
you do business and how much better it is for
people because you are working for them. I regularly drawn
a parallel to a financial planner with a fiduciary obligation.
They have to work for you. Their effort and their
(01:55):
goal is to maximize your return on investment, and your
goal is of course to do the best you possible
we can to find better medical coverage for less money.
Absolutely wildly successful. Yeah, I mean it's we take such
great pride into Brian. I mean it's you know, we
we base our entire company on educating our clients, right,
I feel like just just the education part, you know,
(02:16):
by you know, calling in and sitting down with us,
regardless if you end up taking a plan that we do.
I mean it's you know, one of the biggest things
that we do on every meeting that we have with
any of your listeners, any of our prospects or clients,
is you know, we sit down and educate them on
the plan that they have, show them where some of
the holes are.
Speaker 2 (02:33):
We educate them on healthcare, you know, how to maximize
their dollar, you know, to minimize their expense. And that
could be you know, shopping healthcare look yeah, affordable imaging places,
or getting better lab opportunities, or just knowing that God
you can negotiate, you know, and and a lot and
so many people don't. And you know, with rising out
(02:53):
of pockets, you know, on every health plan you know
that's out there, group health plans, you know, your look
looking at the marketplace, the ACA stuff or Obamacare wherever
you want to call it. For twenty twenty six, I mean,
you got a pockets are increasing there, you know, and
the premium is going up to and the premium is
going up yeah, and then and the tax credits are
going away, I.
Speaker 1 (03:13):
Mean talked about that's really alarming. Man. They took the
tax credit away. So if you make more than sixty
four thousand dollars.
Speaker 2 (03:19):
It's a little bit more this year. I we weren't
really sure the number is yet, but I mean yeah,
I mean it's it's close to like seventy thousand, but
it's like the money goes away, like.
Speaker 1 (03:27):
There's no tax credit after the extra dollar beyond the cap. Yeah,
it's gonna cause a lot of people to just dump
the plan, which leaves Obamacare as the insurer of last
resort for the most unhealthy segment of the entire population.
Speaker 2 (03:40):
Which, as we know with high risk pools, it's gonna
go up. It's gonna it's gonna continue to go up, right,
I mean, you can't. You can't have a plan based
upon just a bunch of unhealthy people. It doesn't work.
It's not Economy's a scale when it comes to ensuring
and you know, you know, this segment's gonna be a
little bit more geared toward Medicare, right you're over sixty
five or getting close to that, or you know already
(04:03):
on Medicare, or maybe a Medicare advantage plan, or maybe
you're just listening to this like that doesn't really apply
to me, but I'm sure to apply to your parents,
your grandparents. Right. You know, there's big changes coming up
just for the twenty twenty six plans on the Medicare side.
You know, you're gonna see so many companies right now
start looking at raising out of pocket expenses on these plans,
(04:23):
and we're already starting to see some of those coming around.
You know, the maxim out of pockets on some of
these plans can be over eight grand for a senior
you know, on a fixed income, and that's that can
be a lot. It can be daunting, you know, and
most of these people aren't going to be aware of that.
You know, you're gonna start seeing things like reduced networks.
So it's so important right now if you're listening to
(04:43):
the show, you're gonna start getting your annual notice of
change here within the next few weeks. This is what's
gonna tell you. If you're on a Medicare advantage plan,
you're gonna get a letter basically says, hey, these are
the changes of your plan. And so many people, Brian,
don't even look at that, and they don't know. And
then and then they're in a situation come next year
(05:04):
where they lose a doctor because an insurance company dropped
their network of a hospital group, or now they're out
of pocket expenses or increasing or maybe they were accounting
on that dental or vision plan helping them for the
next year, and they just reduce the benefits. I mean,
we're going to see I think a massive reduction in
this realm, because I'm already hearing insurance companies pulling products
(05:26):
completely out of the market, reducing options on PPO plans
that give them the big broad access that a lot
of people rely on. So it's it's just so important
to really look at your coverage, especially that letter. And
then you know, right now we're taking calls and scheduling
all of our clients. So, Brian, I mean, we did
so well last year with Medicare Advantage, helping so many
(05:48):
of your listeners. I literally train my entire office to
do Medicare this year for AEP so your phone it
was off the hook. I mean I was doing most
of the appointment myself. I didn't have enough time and
so I had to literally train my entire staff. We
just we've been working on it every single week. My
guys are going to be experts in this field, I feel,
and you, so we can help anyone that's on a
(06:12):
Medicare advantage plan just look at other options and just see, hey,
should I stay on the plan that I'm at or
should I look at maybe a different plan. But really,
at the end of the day, Brian and a lot
of what we're going to talk about today on the
show is covering those out of pocket expenses, right because
a lot of people go, hey, I'm great, i have
a Medicare advantage plan. Maybe I'm not really paying anything
(06:33):
for it because a lot of them could be zero premium.
So it helps a lot of people in that realm.
But I always tell my clients, like, listen, there's no
free lunch. When you have a zero premium there's something
that you're giving up, and a lot of cases that's
huge potential out of pocket expenses. And if you're someone
that's like, well, I want to go to a couple
of doctor visits a year. It's not a question of
if it's when you are going to go into the hospital,
(06:55):
when you are going to have a surgery, or god forbid,
develop something that's going to be you know, more long
term illness that you're going to be treated for. You know,
how many people can really afford eight thousand, nine thousand
dollars a year and medical expenses, and god forbid, you're
married and you and your spouse are going through that
same type of situation in the same year. You know,
(07:17):
especially if you're just counting on maybe a small pension
so secure, that's going to wreck you financially well.
Speaker 1 (07:22):
And that's why getting ahead of this early is important,
so you have you have an awareness of your options
and how to reduce these potential expenditures. So now is
the time you call Covers Since he at five point
three eight in a call and scheduled appointment and you know,
John and the team aren't going to charge you to
go through this analysis. I got to emphasize that this
is not a service that you pay for. This is
(07:42):
something they hope they can get you in a product
that you'll be happy with and save your money. You
put a smile on your face. So you've talked before
about a lot of the pitfalls that are involved in
going onto Medicare and you different options in terms of supplements,
and again, this is a good time to be thinking
about that. So what are the key Medicare advantage changes
(08:03):
that we're looking at right now? And then how might
that be impacted or how could you lessen the blow
with some other add ons or other things to think about.
Speaker 2 (08:12):
Yeah, so basically, you know, we're approaching like the Medicare
advantage plans, just like we do for everyone that we
help that's under sixty five, right, group plans or individual plans,
you know, where we look at layering coverages. Right, So
many of you are probably like, well, you know, I'm
not really paying much for this plan, how do I
(08:32):
cover these high out of pocket expenses? Or maybe you're
looking at a meta gap plan right, and here's a
big downfall in the meta gap plans. So you know,
right now I'm seeing the ones that we call them
the T sixty fives, the ones that are turning sixty
five and going on Medicare, and for a very long
time here in our area, we've had very affordable rates.
(08:53):
They've been very like you're talking less than you know,
around one hundred bucks a month. They can get a
really good plan on at a gap plank, which a
lot of people were gravitating towards. Well, we see a
lot of insurance companies right now that have legitimately raised
their rate fifty percent. Oh wow. Yeah, and they're telling
us it's because of the file releasing of the COVID numbers.
I'm literally hearing insurance companies that are I know two
(09:16):
insurance companies that literally stop selling meta gap plans completely
their AVD market. I heard another company that's literally postponing
sales of meta gap plans till next year. So they
just shut down. They said, we are no longer taking
any more meta gap plans.
Speaker 1 (09:31):
Sort of to test the water to see what happens. Yeah,
because I guess they have.
Speaker 2 (09:35):
What we're hearing is they have a very hot block
of business where it's very costly for them. So they're like, hey,
we got to like slow this down. We can't take
a lot more risk on because we've got to be
able to pay the claims of the people that are
on there. Right So you're starting to see this big
trend where you know, the meta gap plans, which is
really the better coverage, getting more and more astronomical on
(09:56):
pricing right and higher increases. I can't tell you how
many people are calling and going, John, I'm paying three,
four or five I had in Pennsylvania paying six hundred
bucks a month on a meta gap plan for him
and his wife. So they're paying twelve hundred dollars a month,
you know, and they just don't make sense at that point.
You're paying way too much for actually even the great
(10:16):
coverage that you're getting, but it just it's way too much.
So you know, a lot of these people are starting
to look at the alternatives, like, well, hey, what if
I moved to a Medicare advantage plan, Well, yeah, I
can save you six hundred bucks a month, and that's
a lot of money. So people are gonna start looking
at alternatives. And when you look at the Medicare advantage plans,
they're looking at saying, hey, I like this option. It
(10:36):
saves me six hundred bucks a month, But do I
really want to potentially come out eight thousand dollars out
of pocket each year? So we're taking the same approach
we did with the under sixty five market, where you
have your catastrophic coverage and then you add on indemnity
insurance to help cover those out of pocket expenses. So
you know, most people go always like, well, where's my
biggest holes in Medicare advantage? Welt your hospitalization? It's typically
(10:58):
your surgeries, your er and like your ambulance rides, and
these can be pretty significant copays. So a lot of
times you look at Medicare advantage plans, you're gonna have
somewhere between a three to five hundred dollars per day
cope every day that you're in the hospital, and it's
usually for like the first one through six days, right,
so maybe twenty five hundred and three grand. If you're
in the hospital for a week. Well what happens if
(11:20):
you go out of the hospital and then a couple
months later you're back in again, there's maybe another two
or three grand out of pocket, right. So you know
what we're helping people do right now is add on
a supplemental plan. And I'm talking about Brian. These plans
are like maybe a little over a dollar a day,
and they literally cover that entire hospital stay. They literally
(11:42):
will pay your entire co pay. If you have a surgery,
they can cover the copey for your two to three
hundred dollars ambulance ride. They can help you with your
emergency room cope. So literally the biggest out of pocket
expenses that you can ever have a Medicare advantage. You
can pick up a small little plan for maybe thirty
to fifty bucks and it will completely cover all those expenses.
(12:04):
So now we've literally shored up a majority of your
potential out of pocket expenses. And a lot of insurance
companies are putting these products out right now. You know,
as a broker that writes for one hundred companies, I
have many plans that do these. And the best part,
Brian is you know now they're getting a really good
healthcare package for like forty or fifty bucks a month,
(12:24):
and the math doesn't seem to work out.
Speaker 1 (12:26):
I mean, pivoting back to your prior example about this
other policies doubling, Yeah, maybe more in price that you
can get that level of upfront coverage for maybe what
four hundred dollars a year?
Speaker 2 (12:37):
Yeah, yeah, I mean fourner bucks a year. I mean
think about the break even on that, right, I mean
it's gonna take you eight to ten years of never
going into the hospital to justify not buying it.
Speaker 1 (12:47):
Yeah, it doesn't make any sense.
Speaker 2 (12:48):
That doesn't make any sense at all. So it's a goodbye.
And some of these insurance companies Brian, right now, especially
if you're turning sixty five, you know they'll do it
guaranteed issue. Some of them are doing up to seventy
four years, so the first nine years. If you get
on a Medicare advantage plan, you want to get take
one of these secondary policies out. They're guaranteed issue regardless
of your current pre existing conditions. So anyone can qualify
(13:11):
for these plans. It makes so much financial sense to
pick one of these plans up. And here's the funny
thing about it, Brian, I talk to people all the time,
and a lot of the listeners came to me because
they bought insurance from somebody else. They called some one
eight hundred number that they saw at two o'clock in
the afternoon on their soap opera show or whatever they
(13:32):
were listening to, and they went through one of these
you know, we call these phone rooms, these huge conglomerate
phone rooms, and they just they're just finding a plan,
slapping them to a plan and goodbye. And you know,
you don't even have a broker anybody you're gonna be
able to call to deal with later, and they're not
advising the clients properly because they go, hey, I can
go sell a zero dollar premium plan. That's easy to
sell a plan like that, Brian, but it's a little
(13:53):
bit harder to sit down to the client and really
do them as service, to show them where those pitfalls
are and making sure they're set up properly. So I'm
helping those people as well. So one of the biggest
things I can tell you is, like, listen, you're started
seeing some one one hundred number on us on a
screen on your TV, or you know these huge marketing
ads that are going to be going running here in
the next month or two. Don't reach out to a
(14:14):
local broker. Reach out to someone that can actually sit
down with you and explain the plan properly, and someone
that's going to be there two months later if you
have a question.
Speaker 1 (14:22):
Yeah, and again I can't let that comment go without
chiming in and reminding folks, if you're working with John
on the team that covers since you got claims issues
and disputes. You get an explanation of benefits claim has
been denied for some reason. You're puzzled scratching your head.
You don't have to spend time on the phone with
the insurance company, regardless of which insurance company it is.
John and the team will iron up the problem for you.
(14:43):
They've got folks there that are willing to get on
the horn and they know these shortcuts to reach them
and they'll iron out and he claims dispute for you.
That's it. No charge. Again. This goes along with working
with this team that covers sensing so valuable important service
you provide there.
Speaker 2 (14:56):
John, Oh, we appreciate. I think we know the value
of keeping our clients at be in the value of
keeping client you know, I did a huge training. I
trained hundreds of agents all throughout the country that work
under me. And you know, one of the biggest pieces
that I always tells me, listen, it is actually cheaper
to maintain a client than go market to find a
(15:16):
new one. I say, so, do the customer service, making
sure that you're actually sitting down with your clients once
a year and doing a review, answer a phone when
they call you. You know, these are just so important. But again,
something that I have found working in this industry for
over twenty years is that a lot of agents don't
even do that.
Speaker 1 (15:33):
No, they don't, No, clearly. That's why I always take
the chance to emphasize it. Yeah, I mean, this is
a real benefit anybody who spent time with two hours
on damn phone with the insurance company out a whole
waiting for us to reach somebody, and then not really
being in an informed position to have a conversation about
it because of all the codes and everything else that's involved.
It's like, wash your hands and let John on the
team take care of it. So I'll give you a
(15:54):
little pointer right now. If you are currently on Medicare,
if you've ever called your insurance company and you can't
understand the person on the other end of the line,
how frustrating is that? Very you know, it's like, you know,
I have to train my team that goes if you
can't understand them, hang up and call back, you know,
because we're dealing with those same insurance companies too, and
(16:16):
it's it's a tough because you mean, I can tell
you how many times we've spent an hour trying to
get through to an insurance company to help a client,
and I can't imagine what they go through. But one
of the key points that I'm going to tell you
right now, especially in our area, we have a you know.
Speaker 2 (16:31):
I can specifically say the insurance company on the live air,
but we have an insurance company's making a huge stride
here in Ohio, a very good company. They're a US
based company and they do not use call centers outside
the United States for customer service. We're very happy with them.
I actually, i'd probably say they're the most highly rated
you know company as far as customer service that we've
dealt with. And I'm very excited that they're going to
(16:54):
be very strong and it's gonna be covering a lot
of the hospitals here in our area. But what's nice
sits a newer company to our location, and a lot
of people aren't on it. So it's a great opportunity
for your listeners to say, hey, you know what, I've
had some issues in the past with the carrier that
I have, maybe I should look at this other option.
I feel like they're going to make a huge play
(17:16):
here in this Greater Cincinnati area and probably be the
better player here for the next few years.
Speaker 1 (17:22):
All right, Well, since we're talking about Medicare and the
and what my folks moving in that direction need to
deal with, which is get in touch with John early
so they can walk through all your options. Something we
all need to consider that we have talked about before
home health care. This this policy and you submit. You
gave me an option, and I need to follow through
with you on that. My personal experience, I'm considering home
(17:43):
healthcare policy from John to the team that covers sincey
because well, having lived through the experience with my father
and seeing my mother struggle with you know, trying to
take care of him when he was dealing with his Alzheimer's,
I mean, just rapid deterioration. Boy, if she had some
folks that were able to come into the house that
period of time, it would have things out a lot.
Speaker 2 (18:01):
Yeah, It's it's daunting just the stories that I get
from clients that they tell me, like personal experience of
their parents going through those situations. And you know, until
I really started pushing myself and my team to really
highlight this to our clients, you know, it was kind
of one of those things or anything in sales, right,
(18:22):
and unless the client's really asking us about we weren't
talking about it. And you know, I've realized it's such
a prevalent situation right now, just in our in America.
There's even states right now in the United States that
are starting to require people to purchase it. Like you.
It's like like like with like car insurance. They are
not requiring you, like in certain states that you have
to have long term care. Wow, because it's such a
(18:44):
draining financial pitfall for states that have to put through
Because the number one payer for home health care and
facility coverages is Medicaid. You know, I can imagine working
your entire life and then something happens to you and
you have to liquidate your assets to Medicaid to you know,
pay for your assisted living facility or whatever you're you're
in and or you know, requiring your kids or family
(19:07):
members to potentially take care of you. Right. It's not
something I would ever want to put my kids through.
I know my parents are exactly the same wa when
they knew I was selling, they were like the first
people to buy from. Well, we're not doing that to
you because we because we dealt with that with my grandmother,
and you know, it's just it's it's just it makes
so much sense, and especially in today's market. Right. So
(19:28):
one of the things that you know, I'm kind of
bringing back, and I want to come full circle here,
is when I when I'm dealing with these clients and
they're they're a little bit older, maybe mid seventies, early eighties,
and they're all on these supplement plans, right, and they're
paying three hundred, four hundred, five hundred bucks a month.
One of the things we really started looking at is going, hey,
if I can save you three four five hundred bucks
(19:49):
a month and move you to a Medicare advantage plan.
And at this stage it probably makes sense just financially
because really the money you're paying in premium is close
to like half of the out of pocket a year
on the Medicare advantagelan, so you're better off just saving
that money. But if I can move you from that
high dollar Medicare supplement gets you into one of these
hospitals and these indemnity plans that helped cover those out
of pock expenses for a little over a dollar a day, right,
(20:13):
that's a huge savings for you. Well, that's some of
that savings, you can put towards things like home healthcare.
You can put towards things like facility coverage. Right, you
might be able to take a small little life insurance policy. Yeah,
if you don't have any life insurance or funeral plans anymore.
We just had a client here recently. They were paying
almost five hundred bucks a month on the Medicare supplement.
We were able to move them at eighty two to
(20:35):
a Medicare advantage plan last year. Not only was I
were able to save her all that money, but we
add on all those other products to her and she
was still saving like one hundred and fifty bucks a
month once she was paying on the Medicare supplement. It
is a lot more coverage and a lot more coverage,
so much more coverage because you got a member too.
Even with those Medicare supplements, you still got to pay
for your prescription drug plan. She was paying another one
(20:56):
hundred dollars for a prescription drug plan. She was you know,
didn't have dental insurance, she didn't have vision insurance, she
didn't have hearing She did hearing coverage, and all that
stuff is actually covered under the Medicare advantage plan, so's
it's even more valuabfore, because she picked up a lot
more coverage just with the Medicare advantage plan that she
didn't even have offered before. So it was a lot
(21:17):
more coverage for her. And you know, of course, it
is so important to make sure you picked the right
Medicare advantage plan because you know, there's HMOs, there's PPOs.
I'm not a firm believer in HMOs. I always, I
always always poked this out. I got into this business
twenty one years ago. And then then the guy that
trained me goes, John, you won't put your worst enemy
in an HMO. And I've stuck to that. And oh
(21:40):
my gosh, oh my god, especially what we just had
last year where we were losing hospitals. You know, one
of our biggest insurance companies, they were kicked out of
certain hospitals here in our area, like consistently throughout the year.
So if I had somebody on an HMO, they basically
would have turned around. Oh I just lost my doctor
for three months, right, you know, I can't go anywhere else.
I gotta go find a new doctor. Hopelly, the hospital
(22:02):
and the insurance company work it out, so I can
go back to my doctor. I can't imagine if they
had gone through a situation where they actually needed weekly
or monthly treatment. You know, what does that look like
when you can't see your primary care or god forbid
your specialist, right, you know, And you know that's why
we always set them up on PPO plans. But you know,
just kind of getting back to that home health care
situation and long term care, I mean, I mean, like
(22:24):
I've showed you, Brian, these plans aren't that expensive, you know,
if you're doing the right type of plan. And what
most people don't realize. And I ran to a guy
not too long ago on a very very very good
long term care policy, but I mean he was literally
paying like five six hundred bucks a month for it,
and I was like, that's a lot. That's a lot
to pay for that plan. He goes, well, I've had
(22:44):
it for a very long time. It's got a lot
of covers. Is that it really does. And I advise
you to stay there if it's not financially a hardship
for you. But I'm like, you do realize that there
are a lot of facilities, Like when we put my
mother in law, my wife's grandmother. She ended up getting
into a very good facility, but eventually the money ran
(23:06):
out right, right, and a lot of these facilities they
don't kick you out when the money runs out. So
she had enough money to get her into the facility
for a couple of years. But then once some money
ran out, Medicaid kicked in right, so Medicaid started paying
for it. But she never lost her room. She never
lost the nice private room that she had this very
nice facility. They didn't turn around and go, sorry, man,
(23:26):
because Medicaid's not paying for it, because you ran out
of money, we're going to remove you from this facility.
So the nice thing is if you had a plan
that can least get you into that facility for the
first year or two, which a lot of these cheaper
plans can and I'm talking about Brian. This plan that
I'm talking about is like one hundred bucks a month
compared to the one that was six hundred. That's six
thousand dollars a year savings right at that point where
(23:49):
we can get them into that facility. And as long
as you're not one of those facilities that will kick
you out, they'll keep you there, you know. And so
we can start really looking at that as a better
financial decision. So many people Brian when they call in,
they don't think about this in their forties or fifties.
They start thinking about this when they're they're in their seventies,
when these things get more and more expensive, and you know,
(24:11):
they can't do a traditional long term care policy because
it's so expensive, and I'll be honest with you, most
people can't qualify at that point in their life. So
then they're like, well, I can't do anything. We have
those options, and there are a fraction of the price
of those really expensive long term care policies, and for
the most part, they offer the same type of coverage
for those first few years that those big companies that
(24:32):
are charging you five times more, you know, have And
like I said, we're our goal here is not to
get you kicked out once you get you into that
good facility, because they're getting expensive and most people don't
even know what it costs. But it's over ten grand
a month, I mean, and a good one is gonna
be twelve to fifteen thousand dollars a month. A month, yeah,
a month. So unless you have a bunch of money
(24:53):
saved up, got to plan on selling your house or
hopefully you got a great pension, sell security incomement.
Speaker 1 (25:00):
I want to hear that figure. I just just it's
just hard for me to believe.
Speaker 2 (25:04):
Mm hmm.
Speaker 1 (25:06):
We complained about rents being high, but this is I mean,
it's assisted living facilities, but fifteen thousand dollars every single oh.
Speaker 2 (25:13):
I know, but again I remember it's round o'clock service.
Speaker 1 (25:15):
There.
Speaker 2 (25:16):
They have transfer that takes shoots in one of your doctors.
You know some of these great facilities. I mean I've
been in them. They're like they're like spas, you know
what I mean. I'm much to be honest at the
end of the day, Like where I want to put
my mom right, you know what I mean? Thanks Mom,
You took care of me my entire life. You know,
every time I got into a situation, it bailed me out. Well,
you know what, I'm putting you in this place and
somebody might check on you once every week.
Speaker 1 (25:38):
The cut great place.
Speaker 2 (25:39):
Yeah, I'm putting you in the budget motel. I mean,
and you know, and then even more so, you know,
we see a lot of you know, people that are married,
their spouses. You know, they want you to be able
to stay at home, right, And I think that's a
huge thing. Right now. We see so many people when
they have, god for a bit of stroke, or they're
(26:00):
going through something that requires them to become some sort
of this disabled, right, they want to stay at home.
And you know, I look at my wife like I'd
want her to be able to stay at home. I
don't want to put her into a facility and you know,
go see her once in a while. I want her
to be able to be where she feels comfortable. But
the burden of me, like, oh, I couldn't even imagine
having to take care of that, I know.
Speaker 1 (26:21):
I mean that's why I mean you really need to
be forward thinking on.
Speaker 2 (26:23):
That befoward thinking, right. And so even home health care
bringing and aid in or the people that have to
come in and help out. Right, guess who doesn't pay
for that Medicare. Medicare isn't turn around and paying for
all those extra people that have they come to your home. No,
it's you, right. So you know when I kind of
talk about that like dollar a day, that's literally I
can get you a home health care plan even in
(26:45):
your sixties. It's like a dollar a day that you
can have someone come into your house and take care
of your spouse. And you might not need them there
every day, right, but hey, what about well, I'm going
to come in once a week and give you eight
hours off. Hopefully you will.
Speaker 1 (27:00):
Need to access the benefits offered under the plan. I
don't want to ever have to have something coming to
my home to take care of me. But for four
hundred bucks a year, that's a worthy investment. That's why
you have insurance. Nobody wants to use their auto insurance
policy because they got in a wreck, because you got
into a wreck, but there it is just in case.
Speaker 2 (27:18):
No, so yeah, and it's and you're you hit the
nail on the head. I mean, the business that I'm in, Brian,
is I'm selling something to my clients. I hope we
never used right every single day, you know, I hope
in every use health insurance. I hope you never have
to go into the hospital and have a surgery. I
hope you never have to. But it's not really a
question of if, it's when. Eventuality, you know you will
(27:39):
be in this situation, and then numbers don't lie. You know.
Medicine is fantastic nowadays, right, I mean I was reading
reports that you know, life spans have what doubled in
the last like eighty years from where we were, you know,
And it's medicine. It's keeping you alive. The stroke or
the heart disorder that can so you go through doesn't
(27:59):
kill you usually anymore. It's it's gonna be a longer
drawn out process. And a lot of people now are
more and more ending up in some sort of assisted
situation or a facility or living longer. I mean you
see all these people that in their nineties. I mean
eventually you might be in that situation. You want to
make sure that you have that coverage there to protect
(28:19):
you well.
Speaker 1 (28:20):
And that's why you don't wait until October to find
out if you're overpaying or undercovered. Call John Roman and
the team today. Schedule the free Medicare Medicare review and
appointment for this year. Get ahead of the game, learn
about your options, protect yourself from what seems to be
the inevitable. It's five one three eight hundred two two
five five. That's five O one three eight hundred call
(28:42):
or fill the format online at cover since you with
Y or I cover Sincy dot com. I don't care
what state you're in. John and the team can help
you out. It's not just a local, try state thing
for hearing the Spreater Cincinnati area. This has been another
edition of Rethink Healthcare together with John Roman from Cover
since he coversincey dot com
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