Talking Medicare

Episode Transcript

Speaker 1 (00:00):
And you know the music, you know the opportunity, you
know the telephone number six oh eight three two one
thirteen ten. That's six oh eight three two one thirteen ten.
Love to get you on the air this morning with
your retirement related question for our retirement planning professionals from
Class Financial, the website COSS financial dot com. That's COSS
k l Aasfinancial dot com. Telephone number for the office

(00:21):
right here in Madison, six oh eight four four two five,
six three seven. No charge for that initial get to
know your appointment tech Loss Financial. It will be complimentary
to you again their number six oh eight four four
two five six three seven, And again phone lines are
open for your question. Six oh eight three two one
thirteen ten. That's six oh eight three two one thirteen ten.

(00:41):
Joined this morning by CJ Class and Eric Schwartz of
Class Financial. CJ. How you doing this week?

Speaker 2 (00:46):
I'm doing great.

Speaker 1 (00:47):
How are you, Sean, I'm doing really well. Great to
hear from you, Eric, How have you been?

Speaker 3 (00:52):
I am doing great. Falls back and I'm happy.

Speaker 1 (00:54):
I know that was a weird week we had there,
but well, you know, we'll take a little extra heat
in summer and sunshine as well. And yeah, we've got
an important conversation. We're talking about medicare this week, a
very hot topic and I know there's going to be
a lot of questions, a lot of great information and
answers as well for folks. And again, phone lines are
open three two one thirteen ten. That's three two one

(01:14):
thirteen ten. Website for Class Financial it is Cossfinancial dot com.
You can learn more about the folks at cost Financially.
You can learn about their separate divisions. You can also
sign up for their weekly market Pulse newsletter. Again, that
all available to you at Klassfinancial dot com. That's Coss
Klaas Financial dot com and they're telephone number six So
eight four four two five six three seven. Before we

(01:34):
talk about this week's topic, let's actually take a look
back at last week's show. Of course, each and every week,
do the Class Quiz question the week your chance to
win a fantastic prize. This week, no exception, our friends
from Class Financial have provided a twenty five dollars gift
card to Darden Restaurants. Listen close to the program because
just about every show, the question and answer come up
during the program. And let's actually look back at last

(01:55):
week's show and get the question and answer there.

Speaker 3 (01:59):
Absolutely, thank you to everybody as always for listening, and
big congratulations to our winner from last week, which was
Patricia from Waterloo. True or False in twenty twenty five,
you can gift up to nineteen thousand dollars per recipient
without triggering federal gift tax reporting. And the answer to that,
Sean is true.

Speaker 1 (02:19):
Excellent, And if you missed any part of that program,
really good show, you can always listen back at Clossfinancial
dot com. That's Claus k l Aasfinancial dot com. So,
as mentioned this week, we're talking medicare, which is a
very hot topic of course in the news. And you
know you probably heard and I've heard a lot about
about medicare over the years, and you know a lot
of us and including myself, don't really understand all the

(02:42):
specifics and CJ, let's talk a little bit about some
of those specifics and kind of help us understand what
exactly medicare is.

Speaker 2 (02:50):
Yeah, you're not alone, Sean. There's a lot of a
lot of confusion, a lot of questions as it relates
to medicare because it often comes up in political debates,
usually around funding and and government involvement and healthcare, and
certainly everybody has an opinion about this, but today we
are going to be steering clear of the political elements
of this and instead just give you a practical understanding

(03:12):
of how Medicare operates, especially as you approach age sixty five.
So let's just begin with a quick disclaimer. We are
a financial planning and retirement planning firm. The reason I
bring this up is because we are not your insurance specialist.
We do have individuals on our team who are insurance licensed,
but we actually don't sell any insurance. It allows us

(03:33):
to speak from a place of authority without having the
conflict of interest. So good news is we're licensed to
kind of discuss some of this. Bad news is we're
not going to basically give you, ultimately the suggestions. At
the end of the day, you would have to work
with an insurance agent to actually execute on obtaining Medicare
insurance or life insurance or anything like that. Now, another

(03:54):
quick side note, Class Financial is actually hosting a what's
called a COSS Education in webinar series next Tuesday afternoon,
October fourteenth, and believe it or not, our topic on
that webinar is Medicare. So we have a specialist in
the Medicare field coming to join us, and you can
call our office to get signed up for that webinar

(04:15):
if you're interested in a deeper dive, because today, obviously
in a twenty minute show, we're not going to be
able to take the deeper dive.

Speaker 1 (04:21):
Did I see did I see two? CJ? That Eric
is one of the co hosts.

Speaker 2 (04:27):
That's I was.

Speaker 3 (04:28):
Actually just going to bring that up. Yes, I will
be I will be there, So give us a call
and and join it.

Speaker 1 (04:34):
Oh fantastic. Get to see Eric on the online so awesome. Yeah,
so I'm sorry sort of interrupted that, but I know
you wanted to get to some of the basics here, CJ.

Speaker 2 (04:44):
No, it's great, it's great. Yeah. So so call in,
sign up and you'll get to you to see Eric
a little bit, actually get to see us face because
you to see our faces on the radio. So for now,
let's start with the basics. Medicare is a federal health
insurance program that many people are to jump into as
soon as they meets either the age criteria or other
applicable criteria. So to become eligible for Medicare, you need

(05:08):
to fit one of these eligibility requirements first is be
age sixty five or older. This is by far the
most common way that people become eligible for Medicare. Or
be disabled and receiving SSDI Social Security Disability Insurance payments,
or have end stage renal disease or have ALS. So

(05:34):
there's four criteria. Sixty five, be receiving SSDI and stage
renal disease or ALS. Three of those four you don't
really want to become eligible for Medicare that way. It's
a blessing. By the way, I am thankful that we
live in a country where we have some of these
social safety nets in place in case you do end

(05:55):
up in one of those horrible situations. But far what
we see in our space, at least the most commonly
is when people turn age sixty five. Now, in addition
to those criteria about how you've become eligible for Medicare,
you must also generally be a US citizen or a
lawfully admitted permanent resident who has lived in the US

(06:17):
for at least five continuous years. A great resource to
learn even more about this program can be found at
medicare dot gov. And then beyond that, if you and
your spouse have worked and paid Medicare taxes for a
certain amount of time, which is typically ten years, you'll
likely qualify for premium free Medicare Part A, which is

(06:38):
the hospital insurance segment of Medicare.

Speaker 1 (06:42):
Verly good stuff. This mornings we talked with CJ. Closs
and Eric Schwartz, our retirement funding professionals from Class Financial
online Class Financial dot com. That's Class k l a
as Financial dot Com. Great website resource startel for number
six so eight four four two five six three seven,
No charge for that. She'll get to know your appointment
dech costs financial. It will be complementary to you again

(07:05):
the number six so eight four four two five six
three seven. Eric, how do we then, when it comes
to kind of that overall structure of Medicare, how is
it put together and how do folks enroll in it?

Speaker 3 (07:17):
It's a great question, Sean, and the most basic way
to look at it is Medicare is structured in two parts.
So traditional Medicare is made up of Part A, which
is your hospital insurance. So this is going to cover
in patient care, nursing facilities, hospice, in some level of
home care. And Part A is usually premium free if

(07:40):
you've worked and paid Medicare taxes for at least ten years.
On the other hand, we have Part B. This is
your medical insurance. This is going to cover outpatient care,
your doctor's visits, preventative services, and any durable medical equipment
that you need. Now, Part B does have a premium.
In twenty twenty five, the state entered premium is one

(08:01):
hundred and eighty five dollars per month. Now, that comes
with an annual deductible of two hundred and fifty seven dollars. Now, Sean,
I think that sounds like a pretty good deductible. I
would like to have a two hundred and fifty seven
dollars deductive. Yes, So after you hit that first deductible,
Medicare generally pays about eighty percent of your costs after that,

(08:21):
which leaves you responsible for the remaining twenty and we're
going to talk in a moment here about how to
handle the remaining twenty percent. But that's traditional Medicare. So
with regards to enrollment, if you're already receiving your Social
Security benefits at least four months before you turn sixty five,
you'll typically be automatically enrolled in Medicare Parts A and B. Now,

(08:44):
if you're not taking Social Security yet, maybe you're still working,
maybe you're just delaying it. To have it increase, you
actually have to actively sign up for Medicare through the
Social Security Administration. So honestly, the easy way to do
that is online rather than trying to get an appointment.

(09:05):
But the timing does matter, especially if you're still working
or you have employer coverage, So pay close attention to that.

Speaker 1 (09:11):
Really important warnings and information there as well as a
lot of this stuff. Dealing with government agencies sometimes can
be difficult, not only to start, but also if you
do something wrong to correct some of those areas errors.
You really want to make sure that you are knowing
what you're doing as you're doing it. As we talk
this morning with our retirement planning professionals, Eric Schwartz and CJ. Closs.

(09:33):
Of course, they come to us from class financial website
Cossfinancial dot com. That's Coss k l Aas Financial dot com.
Tell for number six oh eight four four two five
six three seven no charge for that initial gets to
the appointment dech Loss Financial. It will be complementary to you. Again,
they're number six oh eight four four two five, six
three seven. You heard Eric mention that twenty percent that

(09:54):
can probably add up to quite a bit. We'll get
some details from Eric and of course talk a little
bit more with CJ as well about ways that folks
manage some of those out of pocket costs. We'll get
that information next as Money in Motion with Coss Financial
continues right here on thirteen ten doll will you IB
eight talking with our retirement planning professionals CJ. Coloss and
Eric Schwartz. Of course, they come to us from Coss

(10:15):
Financial website Coss financial dot com. That's Coss k l
aas Financial dot com. They're tell forh number six oh
eight four four two five six three seven. Don't forget
no charge for that initial gets to know your appointment
at costs financially. It will be complementary to you again
their number six oh eight four four two five six
three seven. And something that I noticed on the newly

(10:35):
redesigned website Coss Financial dot com you can actually schedule
complementary conversation right at the website as well, so they
make it real easy for you at cost Financial to
start that conversation. Just before the break, we started talking
of course about Medicare and how exactly it's structured. And Eric,
you had mentioned that Medicare generally covers eighty percent, and

(10:57):
of course then you're responsible for that extra twenty percent,
and depending on on how things stand, I'm guessing I
could probably add up quite to quite a bit of money.
How do folks then kind of manage those out of
pocket costs?

Speaker 3 (11:11):
Yeah, it certainly can add up. And that's where Medicare
supplements or meta gap plans are going to come into play.
So anybody who is close to the age of sixty
five advertisements for Medicare supplements, that is what is flooding
your mailbox right now. That is what you are being
inundated by Medicare supplements and probably some Medicare advantage plans,

(11:34):
which we'll talk about later in the show. But these
are meta gap plans, are private insurance policies, and they're
designed to fill in the gaps of original Medicare, especially
that remaining twenty percent co insurance from Part B. Now,
the important thing to understand about these plans is they
are standardized. Okay, so private insurance companies offer these plans.

(11:55):
They may charge different premiums. They may offer different service,
but at their core, the coverage is the same. Okay.
Because they are standardized compliments to traditional Medicare, they're generally
generally going to be labeled by letters, so you might
be like a Plan PART, a Plan G, or a

(12:16):
Plan N, So you're really going to want to talk
to an insurance professional about this. In my opinion, it
just makes the process a lot easier. But let's look
at just a couple of these in particular. So Plan
G is the most comprehensive option available to new enrollees.
It covers everything except that part be deductible, so that's

(12:37):
that two hundred and fifty seven dollars. Plan N is
a lower cost alternative with similar coverage, but it includes
some copays, so you might have twenty dollars for an
office visitor, fifty dollars for an er visit if you're
if you're not admitted. So while the benefits are identical
for each plan letter, no matter, no matter the providers,

(13:00):
and customer service can vary widely between companies, so that's
why it's important to shop around, compare quotes, and consider
factors like rate stability and customer support when choosing a
metagap provider. The other thing to understand about these CJ
and I see this all the time. This is something, unfortunately,
that it's beneficial to shop around your provider on a

(13:24):
regular basis, not unlike your home and auto insurance. Right
the premiums just will go up over time, not necessarily
due to increased coverage or anything like that, and just
shopping around and switching to a new provider can save
you a lot of money. So don't be afraid to
do that. Talk to an independent agent and make sure

(13:44):
that you're still getting you're still getting a good deal.
And the final thing I'll note here is Metagap plans
do not include prescription drug coverage, so you'll still need
to enroll in a Medicare Part D drug plan separately
if you're going to be going with original me care
and a metagap plan.

Speaker 1 (14:01):
Really good stuff to know there. As we talked this
morning with Eric Swartz, CG, COSS or retirement planning professionals
from Class Financial Online, Cossfinancial dot com that's COSS k
l A A S Financial dot com and CGI here CG.
I hear about these kind of bundle these Medicare advantage
plans what exactly are those What am I hearing there?

Speaker 2 (14:22):
Yeah, great question, Sean. So you know, Eric did a
great job there of lining out kind of what we
call traditional medicare. It's the Part A, the Part B,
the metagap plan also know as Medicare Supplements, and then
the Part D prescription plan also known as RX plans. So,
by the way, you just have to understand the terminology

(14:44):
just to try to function in this space. But what
Eric outlined there is what is called traditional Medicare. It
is going to be the typically the most costly of
all of the routes to go when you get that
meta gap and a prescription and sometimes you have to
work on getting separate dental and but it's also going
to have the lowest amount of out out of pocket components,

(15:05):
and it'll give you the broadest network. You'll be able
to go almost anywhere in the world, certainly anywhere in
the United States and get coverage. We see most commonly
traditional Medicare AB, a metigap plan, a D plan with
low out of pocket costs besides the higher premiums. Where
it changes is when you get into Medicare Part C.

(15:26):
And I hate this naming methodology's people are like wait,
ce that comes before D, But listen. Medicare Part C
is known as Medicare advantage, which we would also call
going off of traditional medicare. So these are run by
private companies. They do typically include Part A, Part B,
and Part D. These Medicare advantage plans often have lower

(15:51):
monthly premiums, but they come with networks and more restrictions.
Think like hmo versus PPO right, kind of more local networks.
In some circumstances with more restrictions. Some people prefer to
the flexibility or they prefer, i should say, the flexibility
and predictability of original medicare with a medicap plan, while

(16:13):
others appreciate the convenience and the extras that advantage plans offer.
So for those of you who are wondering, like, oh
what do I haven't how does this work? Well, listen.
You'll often hear like on the TV, oh, look, you
can change this Medicare Medicare advantage plan and you'll get
dental envision and trips to Hawaii and like all these
thingsering what is happening that is often going off of

(16:36):
traditional medicare, And the key there is premiums are lower.
You do get more bells and whistles, but you will
have more out of pocket expenses if you become unhealthy.
So we're not actually here to say which one is better.
We would say work with an independent insurance agent because
there certainly can be circumstances under which medicare advantage could

(16:59):
better for you or traditional medicare could be better for you.
But the key here is to educate yourself and then
to make sure you're working with a competent independent agent
to give you guidance.

Speaker 1 (17:10):
Really good information this morning from CJ. Closs and Eric Schwartz.
They are our retirement planning professionals from Coss Financial. Talk
a little bit about enrollment when it comes to the
rules for metagap plan what you need to know there well,
also do our Coss Quiz question week. Will do that next.
In the meantime, I've been to the website yet, head
on over Cossfinancial dot com. That's Coss k l A
A S Financial dot Com. Telephon number six O eight

(17:32):
four four two five six three seven. No charge for
that initial get to know your appointment tech Coss Financial.
It will be complementary to you. Again, their number six
oh eight, four four, two, five, six, three seven. More
of money in Motion with COSS Financials next year On
thirteen ten wib A Talking This Morning with CJ Closs
and Eric Schwartz. They are our retirement planning professionals from

(17:52):
Class Financial. Got a great website, cossfinancial dot com. That's
Coss k l a a s Financial dot com. Against
Schedule Apployment. Try it online. You can sign up for
the weekly Market Pulse newsletter. You can also listen back
to this in previous shows podcasts. Get more information as
well about Class Financial all at class financial dot com.
That's Class k l a a Sfinancial dot com. Talking

(18:14):
Medicare this week with CJ and Eric and CJ. What
about enrollment. There's probably I've got to guess some rules
for enrollment when it comes to metagap plans.

Speaker 2 (18:24):
Yeah, a lot of people who have who are on
medicare know that there's this kind of what we call
open enrollment period that's you know, in the fall, which
is actually coming up here starting October fifteenth. But there's
some confusion around this and we want to try to
clear it up a little bit. So so metagap or
Medicare supplement plans do not follow the same open enrollment

(18:45):
rules as Medicare Advantage or Part D prescription plans would.
There's no annual re enrollment period for these Medicare supplements
slash Medicare or metagap plans. So again, just whenever I
say metagap, it's the same thing as Medicare supplement. Whenever
isa I Medicare supplant, the same as medicap, just so
you're away. But instead of these enrollment periods, you generally

(19:06):
have a one time meta gap open enrollment period, which
is the six months after you turn sixty five and
are enrolled in Part B. During that window, you can
enroll in any metagap plan without answering health questions or
being denied for pre existing conditions. But after that six
month period, you can still apply or switch metagap plans

(19:28):
anytime throughout the year, but insurance companies may require medical
underwriting that means you could be turned down or charged
more based on your health history. So, unlike Medicare Advantage
in Medicare Part D, which have a defined annual enrollment
period which is at October fifteenth to December seventh, metagap

(19:51):
changes can technically be made at any time, but you
may not be guaranteed acceptance. So what I just outlined
is not only the enrollment windows you need to be
aware of, but is a critical component because here's often
what Eric and I will hear in our offices. Well, hey, guys,
I would rather jump on Medicare advantage because it's cheaper,

(20:14):
it gives me more bells and whistles, I dental envision
and other things like that, and yet it has a deductible.
But if I get unhealthy, I'll just change and we
go oh whoa, whoa, whoa, whoa. You're right, you can change.
You can change back to the metagap plan with lower
deductibles and lower out of pockets. But what did we

(20:34):
just get done saying there could technically be some underwriting
that happens, because you can imagine there's some adverse selection
issues that can happen. If somebody goes onto Medicare advantage,
ends up with, you know, on dialysis, and then says, hey,
I'm going to switch back to traditional Medicare and now
not have those out of pocket expenses. There can be
issues with that. Now, again, in all of what I

(20:56):
just said, speak to these specialists. We know enough to
be dangerous. We know how the system works, we know
some general guidance to provide, but down in the weeds,
these types of plans are changing constantly, so we just
can't suggest enough. Make sure you find a specialist who
can dig in deep with you and provide you some guidance.

Speaker 1 (21:15):
Really great, really great information. This morning's CJ. Closs and
Eric Schwartz, And as we talked then about that understanding
timing and health status really important when it comes to
UH to switching metagap plans, isn't it.

Speaker 3 (21:27):
Eric, Exactly? And some people mistakenly think that they can
switch metagap plans every fall like they would with Medicare
advantage or drug plans. That's not necessarily the case. That's
why it's it's really important to choose carefully during your
initial enrollment window and to review your options periodically if
you are considering a change, because there are there are

(21:50):
some extra steps and requirements that you have to meet.

Speaker 1 (21:54):
I know a lot of folks think and I know
we can we all do this, like I'm gonna find
a way to out smart the insurance company.

Speaker 3 (22:01):
Good luck.

Speaker 2 (22:02):
Yeah, you're exactly right, Sean and let me just kind
of say here at the end, if we deal in
the space, I'm actually insurance licensed. As I mentioned, we
don't sell insurance, but I am insurance licensed, and I
can tell you all that if I were sixty five.
I'm not yet, but if I were sixty five, I
would not enter Medicare without a Medicare specialist. So listen,

(22:26):
I'm in the space, I'm insurance licensed, and yet I
wouldn't pursue Medicare plans without a specialist. So I hope
that's just a testament to you. And by the way,
that's not self serving, because we don't have anybody on
staff who can even fulfill this for you. So I'm
only telling you that just to make you realize how
complicated it is and how much you should probably seek

(22:48):
out competent guidance for somebody to help you pick the
right plan for your needs based on your health conditions
and your finances.

Speaker 1 (22:56):
A lot of really good people out there and a
lot of really good resources as well to help you
make great decisions. And speaking of helping out making great decisions,
don't forget the website class financial dot com. That's coss
k l aas Financial dot com no charge for that
initial gets know you appointment at COSS Financial. It will
be complementary to you. Of course, you can set a
schedule appointment right on the website coss financial dot com,

(23:17):
or if you prefer, give give them a call telephone
number six O eight four four two five six three seven. Again,
no charge for that initial get to know you appointment.
That conversation at cost Financial will be complementary to you.
That number six oh eight four four two five six
three seven. Wan hold on to that telephone number. Now
it's time for the Coss Quiz question in the week.
It works like this, just a moment, I'll ask you
the class quiz question of the week. You will then

(23:38):
have thirty minutes from the end today's program to call
the Class Financial office right here in Madison at six
oh eight four four two five six three seven. If
you are the first call with correct answer, you'll win
this week's prize, which is a twenty five dollars gift
card to Darden Restaurants. This week's class quiz question the
week is this true or false? Medicare is structured in

(23:59):
two parts, Part A and B. Is that true or
is that false? Tell phone number six oh eight four
four two five, six three seven first go out, correct answer.
Win that twenty five dollars gift card to Darwin Restaurants.
Don't forget as well. That's Cross Financial Office right here
in Madison again their number. Six oh eight four four
two five, six three seven CJ.

Speaker 2 (24:18):
Eric.

Speaker 1 (24:18):
It's always great talking with both of you. You guys
enjoyed this fantastic day. We'll talk real soon.

Speaker 2 (24:23):
Thanks Sean, Thanks Sean.

Speaker 1 (24:25):
News comes your way next here on thirteen ten l
w u IB eight