Medicare Advantage and Medigap Plans Transcript

Speaker 1  00:00
No need to lose sleep over planning your Medicare coverage. Lisa Lauro and the team at Secure Money Health want you to get the best, most customized service when planning your Medicare coverage. In fact, Lisa wants to share her new book with you, The Ultimate Medicare Book. It’ll help you choose the right plan, understand your benefits and avoid common pitfalls. Go to mymedicarebook.com. That’s my medicarebook.com.

Speaker 2  00:30
It’s time to secure all your health care needs.

Lisa Lauro  00:34
And we will really simplify the process.

Speaker 2  00:37
Welcome to Secure Health with Lisa Lauro.

Steve Sedahl  00:46
Welcome in, everyone. This is Secure Money Health Radio. It’s where Medicare matters. Lisa Lauro is here. Lisa, president of Secure Money Health, works in conjunction with the good folks at Secure Money Advisors, Brian Quaranta, of course, and she is a licensed agent specializing in health insurance for retirees. That’s what we need. We need help, and she’s the one who helps Medicare make sense. Lisa’s an author. She wrote the book called What My Medicare book? It’s more than, it’s different than that, right?

Lisa Lauro 01:13
It’s The Ultimate Medicare Book.

Steve Sedahl 01:14
The Ultimate Medicare Book, but you can visit mymedicarebook.com and get a free copy. I want to talk about that as we get into the show. But this time we were talking about, I know, in the last show, last week, we were talking about the different types of plans, so HMOs and PPOs and all of that with the Advantage plans, but we only scratched the surface. I think there’s they go pretty deep, and there’s other reasons I think that motivate people to go with Advantage.

Lisa Lauro  01:40
Yes, yeah, I think that would be a great place for us to start today.

Steve Sedahl  01:44
Sure. So, let’s talk about it. What are the kinds of well, I know what for me, I was, one of the things that sold me on an Advantage plan is, you know, dental, eyes, hearing those three things in and of itself, so I can go to the dentist every six months. I mean, otherwise, and there’s no cost to me.

Lisa Lauro  02:02
Right, right. So, what people like about the Advantage plans is it’s that it’s a little more all-encompassing. It has, they, they, they’re very, they run very similar to group insurance, like, what people are used to having absolutely where, you know what I mean? So, I think people see the parallel, you know that it’s very similar to what they had, but what’s nice is that they do have, like you mentioned, benefits for dental. You know, you get your teeth cleaned every six months. And then there’s, you know, comprehensive dental on most plans where, so, if you had an issue with your teeth, your, root canal or something like that you need to get done. There also have vision benefits. So, and some of them are pretty generous with the vision benefits, and you can get some glasses or contacts.

Steve Sedahl  02:54
In my case, it’s 600 bucks. It’s amazing

Lisa Lauro  02:56
Amazing. Yeah, so you know. And then there’s hearing benefits as well. So those are the three big ones. Um, but aside from that, another one that I hear about all the time is people want a gym membership. Yes, they do, you know. And most often, these Advantage plans offer a gym membership of sorts. You know, each carrier uses a different program, but it’s available. And that’s, you know, people love that about those Advantage plans. And then the other big one is the over the counter benefit, and that is a benefit where you get, you know, money, often it’s quarterly, that you can use to get things that you would get at a pharmacy. So not the prescription side of things, but more, think about what’s on the shelves at the pharmacy. And you can get pain relievers, you can get first aid, you can get allergy medicine. Oftentimes it’s like 20-30 page catalog of things you can choose from. Do you use yours, Steve?

Steve Sedahl  03:57
Oh yeah. I did for some supplements. I just bought them. You know, you just go online, you look at the catalog, and then all of a sudden it shows up about three days later.

Lisa Lauro  04:04
Yeah. So, some companies you can go right in person to a pharmacy, yeah, others you can order online, so, but people love that. They love the extras. And that’s what the Advantage plans have. They have a lot of extras that people enjoy.

Steve Sedahl  04:21
Sure. And, I mean, yeah, absolutely. But it’s worth having the conversation because, you know, plan, this big company compared to this big company, there may be some things that are that are great on both, but pick the one that’s right for you.

Lisa Lauro  04:34
Right. That’s what people need to do, is you really need to think about what, what are your needs? Sit down and you know what’s important to you, you know, and, and because you can change these plans every single year, you know, sometimes during the annual enrollment period, I’ll sit down with my clients and say, Well, what’s happening for next year? Is this the year you need a new pair of glasses, or do you have a lot of dental work coming up? You know, do you have, do you have a Do you have a. Surgery coming up. Let’s look and see, are you going to have to have physical therapy? You know, let’s see which plan is going to be the best we can curtail it for your needs. I mean, nobody has the crystal ball. We don’t always know what’s coming, right, in with our health in the future, right? We can’t read the future, but sometimes we do know if we need a surgery, or we do know if we have some dental work coming up. Something like that.

Steve Sedahl  05:21
Sure. 724-293-6653, that’s the number. Now, let me ask you this, Lisa, so you’re an independent broker. You don’t take money from us. We don’t pay you for this service.

Lisa Lauro  05:32
Correct. Right. I do not charge anything. I am appointed with these, you know, I think I’m up to 17 or 18 different insurance carriers that I’m appointed with, and yeah, so big, big range of plans to choose from, and they pay me. And on the advantage side, it’s considered fair market value, so we all get paid the same amount no matter what you choose. Okay, that’s really important for people to know, because, you know, I’m really just here to help guide you. It’s, it’s, I want to pick the best plan for you based on, you know, what your needs. And it doesn’t matter to me what you choose, you know?

Steve Sedahl  06:15
Right, and again, I think that’s so important to understand that difference in that – so, I might, I might want to, you know, a Supplement, rather than that an Advantage plan, but that’s okay. And you know what? Again, it doesn’t matter to you at all, correct? And it doesn’t matter to me, because I don’t have to pay you, right? You know what? I mean, it seems like a win, win. Let me, you mentioned in the last show last week about, you mentioned veterans in passing. How does that fit into the thing? To two things. I mean, you know, a lot of veterans out there.

Lisa Lauro  06:44
There are a lot of veterans, and there they do have Medicare Advantage plans that are geared for veterans, which is really nice so that the Medicare Advantage plans are called MAPDs for short, that’s kind of the acronym, and it stands for Medicare Advantage Prescription Drug Plan. For the vets that go to the VA to get their prescriptions over there, they would get what’s called an MA-only plan. And the MA-only they take off the prescription drug plan, because you don’t need it if you’re getting your prescriptions at the VA. And they give them a lot of really nice benefits with these MA-only plans, many of them have a, what’s called a Part B Give Back and so, you know, you pay your Part B premium, the standard rate we’ve mentioned in an earlier show is $185 but they’ll give you money towards that. And for those plans, they’re very generous with that. They also, depending on the – some veterans don’t have dental or vision. Just depends on how long they served, I’ve learned. And so, you know what they get from the VA, can vary per person, but at any rate, you can use those Advantage plans that they have the dental and the vision and the hearing benefits. And so those are really nice plans for people that are veterans.

Steve Sedahl  08:19
Absolutely folks. If that’s you, then give us a call. It’s 724-293-6653, 724-293-6653, set up a time to come on in, sit down with Lisa and just have the conversation. And it doesn’t matter if it’s open enrollment or not, I think just from the peace of mind standpoint, for example, if you’re if you’re working with Brian and the team at Secure Money Advisors, then just come on over, and it’s beautiful, because you’re working with the, with Brian and the team on your retirement plan, and then just walk next door and you’re here. I mean, it’s like all one shop. It’s, that’s pretty unusual for an advisor to have that kind of capability.

Lisa Lauro  08:56
Yes, yes. And that’s why Brian brought me on. I mean, he realized over the years that, you know, as we’re retiring people, we need to help them find health insurance at the same time. Absolutely, you know, so and I do, and I do, I am appointed with the Penny Health Marketplace, so I can also write under 65 plans. I do specialize in Medicare, but I, but I, you know, when we have folks where one spouse is retiring, and the other one is still under 65 sometimes people are holding on, they’re not retiring, and maybe they want to. You know, but they they’re worried about the spouse not having insurance because they’re on the group insurance, so we can help them with that.

Steve Sedahl  09:34
That’s great. I never thought about it, that, about that, because it’s again, in situations where, yeah, I’m just going to keep working because, you know, she’s younger than I am, and she needs insurance, right, right. Wow. Okay, good to know. 724-293-6653, boy, this just keeps getting better and better, Lisa! Lots to learn, lots to learn, indeed, and again, don’t forget, it’s mymedicarebook.com, that’s a great place to start: mymedicarebook.com. Go there, fill it out, and you’re gonna send us a book.

Lisa Lauro  10:53
Yes, I will. Okay, I’d be happy to.

Steve Sedahl  10:58
All right, then let’s do that, get that, get that book headed our way. And so, where we talked about the different kinds of plans, let’s talk just briefly about a Supplement and why we would choose that.

Lisa Lauro  10:20
So, the Medigap Supplement Plans definitely have their place as well, and folks like these plans, some of the benefits of these you can see any doctor in the country that accepts Medicare. Okay, so the Medigap Supplement Plans are through the government. There are many different plans to choose from. The two that we focus on, because they give you the most comprehensive benefits are the Plan G and Plan N and with both of those plans, like I said, you can see any doctor. Now 97% of doctors in the country take Medicare. Wow. Yes. So, odds are, yeah, odds are you’re going to find somebody that takes Medicare and people like that, because, especially for folks that are planning on snow birding. So if you’re going to go live somewhere down south, and you want to not just always go to an urgent care or an ER if you’re sick, if you want to have a set of doctors, you know, where, wherever you’re living for four to six months out of the year, you can do that. So there. So that’s one of the benefits. The other thing with these is there’s no pre authorizations depending on the plan, you know, like Plan G has no co pays, so we should probably go through plan specifics, but just to kind of scratch the surface today on these. People, people really like these plans because of the flexibility that you have. You know, God forbid you got cancer, or, let’s just say you had some unique surgery that you had to have done, and the world renowned surgeon was in like California, you could go to California and get that surgery, you know, if you needed to have more, you know, four or five second opinions, no one’s gonna stop you. You really are on these plans in control of your health care. Good to know, yeah, you know. So, they because sometimes with the with the Advantage plans, there’s considered like a step therapy. So, if you had to have a surgery, they’d say, Well, before we authorize your surgery, we’d like you to try X amount of physical therapy first, right? Yeah. On the other side, on the Medigap side, you’re in control more, because you can say, you know, the doctor can recommend the surgery, and then you go and get it all right, right?

Steve Sedahl  12:43
All right. So, let’s, let’s dig in a little deeper. In the next segment, we’re going to take a break right now. Please give us a call. 724-293-6653, check in with Lisa and really learn about Medicare and have her make it make sense for you. A quick break. We’re going to come right back and continue the conversation.

Hey, welcome back to Secure Money Health Radio, where Medicare matters, Lisa Lauro is here having a great conversation as usual. And so, boy, in the first segment, we kind of broke down a lot of the Advantage plans. We kind of scratched the surface of the Medicare supplements and the Medigap plans. So, let’s dig a little deeper into that one and see what makes sense there. And you know, understand where we’re at.

Lisa Lauro  13:26
Okay, that sounds great. So, you have several different plans to choose from, as I had mentioned earlier, but we do focus on Plan G and Plan N, and I’ll be honest, they’re very, very similar plans. There’s only really two big differences between them, so I’ll go through those with you, and kind of give you an idea what that looks like. So, one thing to note is both Plan G and N, okay, are the supplemental plans for Original Medicare. So, if Original Medicare is covering you at 80% both G and N are going to cover the 20% that Original Medicare, your A and B don’t cover. So that’s covering that 20% gap, which is so important, right? So, the first one is the hospital. All right, you have, if you were admitted into the hospital, both G and N are gonna cover the 20% at 100%.

Steve Sedahl  14:25
Oh, wow. Okay, so that’s good. That’s comforting.

Lisa Lauro  14:28
Yes, yes. And then for part B, the medical piece. So, when you go see your doctor, specialists, both G and N are gonna cover at 100% the 20% the one difference here is that with Plan G, when you go see your doctor, you have no co pays at all. And with Plan N, there are co pays, 20 to the doctor and 50 to the ER, okay. Seems reasonable. Yep, both of these have a $257 deductible. So, you. That’s, that’s nothing – annual deductible, right? So, with group insurance, if you’re on a family plan, it could be $3,000 or more. You know, if you’re an individual, it could be $1,500 deductible that you have to pay first before the plan is going to pay anything, unless it’s, of course, preventative. So, a $257 deductible really isn’t a whole lot. No, the blood work, let’s say you needed a blood transfusion. Both G and N are going to cover the first three pints of blood, where Original Medicare doesn’t cover blood work, it doesn’t cover any kind of transfusions is but these plans will cover at 100% up to the first three pints, and then Hospice Care is covered at 100% skilled nursing is covered at 100% and the skilled nursing is really important here, because the first 20 days that you’re in a skilled nursing facility, Medicare pays for that, okay, but days 21 to 100 you could have to pay $214 a day if you’re on an Advantage plan. Whoa, most plans. That’s how it is. So, days 21 to 100 could be very, very costly. Whereby here on these plans, G and N on the Medigap plans, days 21 to 100 are covered.

Steve Sedahl  16:19
Sure. Okay, yeah, again. But so, you’re, you’re, it’s so important to have this education. Lisa, it’s really, because there, it gives you pause, it makes you think, and I guess that’s what it’s all about, because if you just believe what you see on TV, then you could be going down the wrong rabbit hole!

Lisa Lauro  16:36
Right. That’s exactly right. I mean, it’s sad to say, but you know, you have to. I’m a big I really believe in, you know, you doing your due diligence, and really, you know, educating yourself on what you need, and if that means to sit down with someone like myself, who can explain it in layman terms for you, so that it’s understandable. Because, I’ll be honest with you, Steve, I was a teacher for 20 years. I taught kindergarten to third grade for 20 years. I know, right? So everyone says I, they have a lot of patience, but I do pride myself on being able to explain things, and I love when I get to sit down and teach, because that’s my heart. You know, I love to help people. I love to teach people and so, you know, I, if it’s I really believe that you have to sit with someone and educate yourself, because how can you make such an important decision without doing so?

Steve Sedahl  17:35
Sure, well, and again, we do it in the financial shows all the time, and talk about how important it is to really understand and to and to work with someone who does have the heart of a teacher like you, because that’s what it’s all about education. Brian and I talk about it every week. You’ve got to, you know, it’s about education. That’s where your passion is, right? You love to help, right? Right? That’s exactly right. Folks. 724-293-6653, 724-293-6653. All right, so I’m curious. So, you taught for 20 years, and then you decided, all right, I’m gonna keep helping. But how did you wind up here?

Lisa Lauro  18:12
I know. Isn’t that strange? I know I was down when I was teaching. I was down in Fort Lauderdale. So that’s, that’s another big one. Everyone says, Lisa, you went the wrong direction. So cold up here, and it is, but I am the baby of six, okay, and three of my siblings live here in Pittsburgh. We grew up in Long Island, so we’re not originally from here, but we all somehow made our way here. So, there’s so, I have three brothers here in Pittsburgh, and I have a sister in Cleveland. Oh, wow, yes. And I, and I remember, you know, all the time down in Florida, though, it was so lovely to be there with the weather, calling up here on football Sundays and saying, Hey, what are you guys up to? And they’re all together having fun. And I’m like, feeling really like I’m missing out. So, I have an eight year old, and my daughter loves to play with her cousins as well. So they, she, you know, it was just a great fit for us to come up here, be with our family, spend some good quality time and that’s how I learned the Medicare world, because I have a brother who is also a financial advisor, but he taught, and he does, you know, he sells Medicare on the side to, you know, he helps his clients retire. And so, he taught me the business. And then my other brother has an agency up in Butler, and so I got to work with him for, you know, a couple months, as I was learning.

Steve Sedahl  19:36
Sure, and now with Brian, I mean, Secure Money Advisors, those guys have been around a long time, and you’re no stranger to this industry. I mean, right? I mean, you’ve been doing this a day or two.

Lisa Lauro  19:46
Oh, yeah, yeah. So, it’s been four, four and four years. I think this is my fourth or fifth AP that I that I just got through. So, wow, yeah, yeah.

Steve Sedahl  19:55
So, is that a crazy time?

Lisa Lauro  19:57
It is, it is, it’s very it’s kind of like a tax season for an accountant, you know, I don’t know why they bundle it all up in an eight week period, but, but, yeah, it’s, it’s long days, but so rewarding, you know?

Steve Sedahl  20:15
And so, what should we do when we come in and sit down with you? What should we prepare? What should we have? What should we bring when we come and see you?

Lisa Lauro  20:21
So, what, I’ll request that you send me a copy of your doctors and your prescriptions beforehand, because then I can load all that into our awesome software that will help us, you know, narrow down our search really easily. Aside from that, trying to think what else I really would need, really, that’s it, I mean, and then, and then the first meeting we’ll really just kind of go through Medicare very thoroughly so that you understand your options. If there’s time, we’ll start going into some of the plans as well. And then, you know, we’ll go ahead and choose which plan, either that day or the next meeting. So it just depends on how you know, how much time we have.

Steve Sedahl  21:08
But it’s important to, I mean, as part of that process, I mean, it’s important to have that meeting, to have that that face to face.

Lisa Lauro  21:14
I think that’s, yeah, and I think just make a list of questions. I think that’s huge, you know, because, because I need to know kind of what’s important to you, what are your needs? So come with questions. Come with you know, these are my needs. These are my doctors. These are my prescriptions. This is what’s important to me, so that we the more I know about you and what your needs are, the more, the better I can help you.

Steve Sedahl  21:37
Sure, and I understand if the if one of the, if it’s a couple, and one of them is retiring and the other one is continuing to work to find that that insurance company that insurance for the spouse, to fill that gap until they turn 65 that’s an art that you have as well.

Lisa Lauro  21:51
Yeah, so, I mean, I can help you with your Penny Health Marketplace under 65 insurance. So, the same way we would help choose a plan for Medicare. We would also do that for your spouse, if, if you’re wanting to retire, but yet they’re not 65 yet and not able to get on to Medicare, we can help fill that gap, sure.

Steve Sedahl  22:14
All right, well again, that those are the kinds of things that that people need to be aware of. 724-293-6653, we’ve been talking about the Medigap, the Supplement, the Medigap Plan. We talked a bit about the Advantage plan. I mean, it’s, it’s a complicated process. There’s no question about it. And it doesn’t matter that it’s open, not an open enrollment right now, I could still come in, sit down with you, Review my plan and understand how I can really maximize what I have today?

Lisa Lauro  22:41
Yes, absolutely. You know, there’s a lot of times people will pick a plan, and maybe they didn’t have guidance and they don’t know how to use it. And so, if you needed to come in and have me help you understand what you have and then what you need from there, or what how you can use it, that’s fine too. We can sit and talk and have a conversation and just make sure that you’re using, you’re maxing out, right?

Steve Sedahl  23:06
Yeah, absolutely. And again. So, in summary, so give me just kind of a high-level view of kind of what we talked about and a couple of takeaways. What is the takeaway from all this?

Lisa Lauro  23:18
What’s a good takeaway? I think the biggest takeaway is just to really take a deep dive into, you know, sit down, think about what your needs are, right, and then take a deep dive into, you know, making some questions and then educating yourself as best as you can. But there is nothing like sitting with someone like myself, a you know, an independent broker who is not captive to any one insurance company, who’s well versed and who does this every day. You know, we Brian and I kid around all the time. We say, you know, the people that call Joe Namath’s 1-800 number is they could get somebody in Hawaii talking to them about Pennsylvania plans. And honestly, what do they know about Pennsylvania plans? Exactly. They’re just going to read the book to you the same way that you can do that at home. But when you deal with someone who’s local, who can help you, guide you through this process, who does this every single day, not only will you have good guidance, but you’ll have somebody locally that you can call when you have a question. You know, if you call Joe Namath, you’re gonna you’ll never talk to that same person again. You’ll have no point of reference in the future when you have a question. Very important.

Steve Sedahl  24:27
All right, Lisa, this has been a really fast show, but we got to wrap it up. Please give us a call at 724-293-6653, or visit the website securemoneyhealth.com or mymedicarebook.com and get your free book from Lisa. Lisa, as always, it’s been a pleasure. Let’s get together again in a week.

Lisa Lauro  24:44
That sounds great. Steve, take care.

Speaker 3  24:59
Investment advisory services are offered through Foundations Investment Advisors, LLC an SEC-registered investment advisor. The content provided is intended for informational and educational purposes only. The views, statements and opinions expressed herein are those of the individual speakers and are not necessarily those of Foundations and its affiliates. The information contained herein does not constitute an offer to sell any securities or represent an express or implied opinion or endorsement of any specific investment opportunity offering or issuer. Any discussion of performance or returns is not indicative of future results. Any discussions of specific strategies are for informational purposes only, and have been provided to help determine whether they may be appropriate for your specific situation. If applicable, the primary goal in converting retirement assets into a Roth IRA is to reduce the future tax liability on the distributions you take in retirement or on the distributions of your beneficiaries. Each individual investor situation is different, and any ideas provided may not be appropriate for your particular circumstances. Comments regarding a particular client’s experience may or may not be the same as another client’s experience, and is not an indication that any client or prospective client will experience the same or a higher level of future success or performance. Foundations only transacts business and states where it is properly registered or is excluded or exempted from registration requirements. Registration as an investment advisor is not an endorsement of the firm by securities regulators, and does not mean the advisor has achieved a specific level of skill or ability. Nothing herein constitutes a recommendation that any security, portfolio of securities or investment strategy is suitable for any specific person, no legal or tax advice is provided. Please review your retirement tax and legacy planning strategies with a legal or tax professional before transacting or implementing any strategy discussed herein. Any comments regarding safe and secure investments and guaranteed income streams refer only to fixed insurance products. They do not refer in any way to investment advisory products, rates and guarantees provided by insurance products and annuities are subject to the financial strength of the issuing company, not guaranteed by any bank or the FDIC. This is not endorsed or affiliated with the Social Security Administration, any federal Medicare program, nor any US government agency. If applicable. We do not offer every plan in your area, and contacting us at the phone numbers provided herein will direct you to a licensed insurance agent. Any information we provide is limited to those plans we do offer in your area, please contact medicare.gov, or 1-800-Medicare to get information on all of your options. All rights reserved.

Outro  27:01
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