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 mymedicarebook.com.
Speaker 1 00:30
It’s time to secure all your health care needs, and we will really simplify the process. Welcome to secure health with Lisa Lauro.
Steve 00:38
Hey, welcome in, everyone. This is Secure Money Health Radio with Lisa Lauro. My name’s Steve Sodall, and this is where Medicare matters. Lisa, nice to see you again and sort of dig in. Boy, the last couple weeks we have gone through basically Medicare 101.
Lisa Lauro 01:00
Yes, we have. It’s been, you know, just a process of A, B, C and D, right? And now we’re going to get into something a little different today.
Steve 01:10
So, let’s get into it right away. I mean, it’s so this is Medicare. We’re, it’s where Medicare matters. And I think that at this point in time, and we were just talking before the show, and I got a letter from Medicare, and it’s like, wait a minute, there’s always something going on, isn’t there?
Lisa Lauro 01:24
Yes, it’s a very confusing process.
Steve 01:27
And you’ve got to stay on top of it!
Lisa Lauro 01:28
You do! You really do. It’s a confusing process. People, you know, I try to simplify things as best as possible, but every now and again, you might get, you know, something a little random in the mail, and you need some help, kind of deciding what to do with that. So
Steve 01:43
Exactly why. Why you’re there. You’re independent. You know, you’re not beholden to anyone. You can look at the big picture and get some clear answers for us. And that’s what it’s all about, folks, 724-293-6653, give Lisa call. She’d love to hear from you, and we’re going to talk about supplement plans – filling the gaps in Medicare. That’s and I was surprised as I began to put this together and we were talking; there’s a lot to this whole Supplement Plan thing.
Lisa Lauro 02:09
There are, yes, there are several different plans to choose from, and there’s just a lot that comes with it that people need to understand.
Steve 02:20
And so, the supplements, when we say filling the gap, it’s Medicare, Part A and B doesn’t cover everything. It covers a lot, but not everything, right? That’s the beauty of this.
Lisa Lauro 02:29
That’s right. And so, um, on the you know, we talked about last week, Part B is the medical piece and A is the hospital piece of Original Medicare, and Part B covers you roughly 80% so you have to pick up some type of a supplemental plan, whether it’s your advantage or your Medigap supplement plan, to cover that 20% and so that’s where these Medigap supplement plans come in. They’re going to cover that 20% gap.
Steve 02:59
And how does that work? How do we know what to choose? How do we know what’s covered?
Lisa Lauro 03:02
So, there are several different Medigap plans to choose from. They’re a part of Original Medicare through the government. The plans are standardized plans. So, what that means is – and the two plans that we focus on are G and N, because those are the ones that give you the most comprehensive coverage, okay; and so when they say they are standardized, what that means is, a G is a G is a G. So, whether you get it from Joe’s insurance or you get it from Bob’s insurance, the plan is the exact same. The government says if you’re an insurance company that wants to offer our Plan G or our Plan N, you have to abide by this is the plan. Can’t change it, okay? So that’s what they mean by standardized but they do allow these insurance carriers that offer these plans to set the premium where they’d like. So that means that the premium for Plan G with Joe’s insurance might be different than the Plan G with Bob’s insurance, but yet you’re getting the exact same plan. It’s kind of like when you get car insurance, and you write down all your coverages for your car that you want, and you give one to, let’s just say, Progressive or Allstate. You give the other one to Liberty Mutual, whomever it may be for your car insurance, right? And the quotes always come back different, yet the coverage is the same, so it’s the same concept here.
Steve 04:41
Okay, that’s interesting. And, boy, that’s interesting to know. And I’m not sure that that’s widely known. Is that fair?
Lisa Lauro 04:47
Right. People think that they’re shopping, you know, when they’re shopping around for the plan, they’re going to get a better plan if they’re paying more for it. But that’s not the case here. Right?
Steve 04:56
Wow. Okay, right.
Lisa Lauro 04:56
So, then it comes down to when we’re quoting folks. Folks on these plans, they also think that if, you know, if they go with Joe’s insurance with me, it’s going to be a different price with Joe’s insurance with somebody else. And that’s not the case either. Joe’s insurance prices things based on, you know, there’s, there’s different criteria, whether it’s how, it’s how the plan is rated. So it’s going to be the same price whether you get it from me, or you get it from some, another broker.
Steve 05:23
Okay, so that, I mean, that’s good to know. And, and so it’s, it’s still a little tricky path to walk down. And why I think it’s so important to sit down with someone like you at, you know, Secure Money Advisors, Secure Money Health, and really have these conversations. And if you want to get a head start, let me give you a number, folks – it’s 724-293-6653, Lisa’s there for you, and that’s really why you’re here. I mean, you’re it’s about education, and the more we know, the better off we’re going to be
Lisa Lauro 05:52
Right, right. And I do pride myself on being able to really explain things in layman terms and break it down in a way that’s understandable for everyone, not just folks that are in the insurance industry.
Steve 06:04
All right, so we’ve got, we’ve got the supplement plans out there, we’ve got the Medigap plans, or that’s the, that’s what we’re talking about, to cover that gap. So, what, how do we base our decisions? In other words, as we start to look at this, you know, I mean, you know, the options out there, how do we decide? All right, based on, what is it, based on our health, based on what?
Lisa Lauro 06:24
so when, when we’re looking at these plans, you know, like I said, we focus on both G and N as being the most comprehensive coverage on on the Medi app side. Okay, so, interestingly enough, there are only two differences between G and N, so they’re very, very similar, okay? And you know, when we are making that decision, it’s really based on how often do you go to the doctor. Because one, the two differences are copays. One has no copays, the other one has copays, and one covers what’s called the Part B, excess charge, and the other one doesn’t. So, if you’re traveling a lot, the excess charge would refer to if you were out of Pennsylvania, in a state that allows for excess charges, which many do. So, travel is a big thing that we would discuss, okay? And, and then how often do you go to the doctor? Because when we price it out, N is roughly usually 30 to $40 cheaper a month than Plan G, but then you have copays with N. So, we break down everything based on your needs. What does your health look like in terms of how often do you go to the doctor? And then when picking a plan, I also look at market analytics, which is very important. So, the software that we use allows us to see projections for the next five years. You know what these companies are projecting in terms of increases. So that’s another thing. I look at how is the company rated when we pick a plan, and what do they, what are they projecting over the next five years in increases of premium? So, there’s a lot of different factors that come in, and that’s where being an independent broker is important, because we can, we can compare several plans and prices and also look at projected increases, and that those are some little nuggets that most people don’t know about or don’t really know to consider
Steve 08:27
Well, and boy, I’m grateful that you’re there for us to be able to make sure that that we kind of get that and understand the differences. Because, like you said, if you’re relatively healthy, even though you know you I mean, obviously Medicare-eligible, but even if you’re relatively healthy, if you’re not going to the doctor. I mean, for me, I feel very lucky. I get my annual physical, I do what they suggest, and you know, life goes on, right? My wife, on the other hand, she’s younger than I am, but, but she’s got more medical issues, so, right? These are the decisions, right? These are the
Lisa Lauro 08:57
Right, very important.
Steve 09:02
724-293-6653, and so as we, as we choose a plan when? When do we get to drug coverage? Is that part of the supplement as well?
Lisa Lauro 09:10
No, it isn’t. So that’s another thing that’s important to mention here. So the Plan G and Plan N are basically medical plans, so they’re going to cover the 20% that’s not covered on the hospital side, right? They’re going to cover the 20% in skilled nursing that’s not covered because Medicare will cover roughly 80% they’re going to cover the hospice care. And then on the medical side, they’re going to cover all your doctor’s visits, but roughly 80% so there is no these Medigap plans do not cover dental, vision, hearing or prescription drugs. Aha, okay. So, and Medicare, Original Medicare, your Part A and your Part B, does not cover. Foreign travel. But these plans, plan G and N, cover 80% of foreign travel with a Mac maximum lifetime amount of 55,000 Okay, okay. So as far as dental, vision and hearing, that would be a separate policy that you would need to tack on. And there are many different to choose from. So, you know, we can help with that and then. But there is no, there is no penalty not to have dental, vision and hearing coverage that is completely optional. Some find the benefit in it. Some don’t. Some dentists work out discount plans. So, it just, that’s kind of one of those things. We just kind of have to decide, you know whether you want it or not, and how I can help you. And then with the prescription drug plans, there is a penalty not to have that. So, whether you take medications or not, it is imperative that you tack on some type of a prescription drug plan so that you don’t face a Part D late penalty later.
Steve 10:59
Okay. Oh, well, yeah, wow, there’s a lot of subtleties here. And really, not so subtleties in terms of, and I didn’t even think about a penalty, but, but again, that that makes sense. So, let’s talk about the dental and the vision and the hearing. So, there are supplements or there are policies that you can get. Are they reasonable? I mean, are they in the scheme of things, are they? Are they affordable?
Lisa Lauro 11:22
Yeah, they, I think they are. You know that there’s a good range. I think they’re very affordable. Some obviously better than others. Some of them are really geared more for just your preventative visits, and don’t cover a whole lot of the comprehensive; which, you know, your comprehensive is going to be like your root canals, crowns, major work. But there are some, you know, I’d say you can get a decent dental vision together for 50 bucks. You know, with that’s both, if you want a decent dental plan, you’re looking at like, 35 to $40 and, you know; so I think they’re pretty fair.
Steve 11:57
Okay. And then, and then, so again, the premiums on the other one, that’s going to vary a little bit depending on, obviously, where you are and what you want
Lisa Lauro 12:05
for Plan G and Plan N? yeah, yeah. So the criteria for Plan G and Plan N, what they when we put it in our quoting tool, we put in your age, we put in your zip code, whether you’re male or female, and whether you smoke or not, those are that’s the four criteria, wow. And then it tells us what the what the premium will be,
Steve 12:31
Okay, fair enough.
Lisa Lauro 12:32
And it does vary per county.
Steve 12:33
Okay, per county, all right, 724-293-6653, Lisa, let’s go ahead and take a quick break. We’ll come right back and continue our conversation on Medicare and why It matters right here on Money Health Radio,
We are back on Secure Money Radio, Secure Money Health Radio. I get used to talking with Brian and it’s Secure Money Advisors, but we are Secure Money Health. This is Lisa Lauro. Lisa is – again, you have the – you are really the Medicare person. You are the spot at Secure Money Advisors, and it’s so nice that that you’re there for us.
Lisa Lauro 13:25
Yes, you know, there was definitely a need to have somebody on staff, because as people were retiring, they needed someone full-time to help transition them with their health care. So I’m so happy that I’m here, although you don’t have to be a client of Secure Money Advisors to come and see me. So yeah, and all visits with me are complimentary as well. So I don’t charge a fee. I really am here to help guide folks through this very confusing process of Medicare.
Steve 13:56
Well, no, and again, that’s what a great feature that you know that Brian and the team at Secure Money Advisors have said, okay, hey, Lisa, what let’s, let’s bring you in and so tell me your background. Catch us up of how you ended up here.
Lisa Lauro 14:10
Yeah. So, I was a teacher for 20 years, and taught mostly between kindergarten and third grade. And I love teaching. I love helping people. It’s sort of, it’s my heart, you know, and I moved up to Pittsburgh to be closer to my family, and I ended up working with my brother, so I kind of retired, so to speak, from teaching, and ended up working with my brother; and he’s also a financial advisor, and then he’s very good friends with Brian. And so it just naturally happened that that there was a spot for me here, and I learned the Medicare and still feel like I’m teaching, which is wonderful. So, you know, we have, we have seminars that we do. And that’s a really, you know, great opportunity for me to get up there in front of folks and teach and so, it’s, yeah, it’s been a great, it’s been a really good transition for me, and I absolutely love what I’m doing,
Steve 15:10
And you – and you you’re an author at this point, The Ultimate Medicare Book. And I want to encourage folks to check it out. It’s medicarebookoffer.com; medicarebookoffer.com; go to the website, just put in your name and address, and Lisa is going to send you this book free of charge. You’re not going to charge anybody. Comes in cool gold envelope. You sent this to me. It was great, yeah. But, and the book, it’s, it reads really quickly, and it’s – to me, the book was, you know, like, chapter nine is kind of what we’re talking about here when we’re talking about Part D and the medic…, all of that. And, you know, you start going through and you realize, oh my gosh, this is, this is enlightening. And it’s not, you know, it’s not a deep, deep read. But, I mean, it’s, it’s, you know, again, I’ve got it right here, chapter nine, honoring, yeah, oh yeah. We’re talking about chapter nine. I’m sorry I got ahead of myself. That’s veterans, and I do want to get to that.
Lisa Lauro 16:04
Yes, and we will.
Steve 16:07
But, but my point is, is that if the book just reads so quick and it’s good and it’s informative, and just visit medicarebookoffer.com. All right, so we’re talking about Part D prescription drug coverage and that we’ve got to have that, right? I mean, there’s no question, but we’ve got to have it.
Lisa Lauro 16:26
Yeah, you know, they say it’s optional, but if you’re going to get a penalty that never goes away, is it really optional? You know, I don’t think so. So, so, yeah, so, so I always recommend, you know, we need to pair your Medigap supplement plan, whether it’s G or N with a prescription drug plan and that goes for all people, no matter whether you take medications or not if you’re not on Medicaid. And this is very important too, Steve, let me mention this. You know, we here at Secure Money Health, have an amazing software that we put all your prescriptions in with dosage, amount and how often you take it, and then it will literally populate plans based on that information. And it really takes a lot of the guesswork out. So, it’ll recommend plans that that are going to be right for you according to the medications that you take and the pharmacy that you go to. And so, you know the name of the game here is to try to find, you know, a prescription drug plan that covers all your meds and is reasonably priced, so that you’re not, you know, medications can be awfully expensive. You know.
Steve 17:36
Oh, gosh, yes. And so, when you start making the comparison. So, one of the things that I remember my mother-in-law talking about, oh, is the, is the donut hole? Oh, the donut hole. And I didn’t fully understand it, and, but the good news is: there, it doesn’t exist anymore, right? This year?
Lisa Lauro 17:51
Right. Yes, that was most people’s, you know, biggest concern was the donut hole year over year, and rightfully so, honestly. So, so the good news is, like you said, the donut hole went away. For those folks that aren’t familiar with that, it’s people would have to spend a certain amount of money each year on their medications, and then once they hit that amount, they would fall into what’s called the donut hole. And during the time they’re in the donut hole, they’d have to pay more, and then they’d have to keep paying until, the way it was in 2024 they hit $8,000 in prescription drug costs. Now that’s retail costs, and your cost share together. And so, the good news – and then the company would pick up your medications at 100% but they had to pay a ton of money. And what was happening was people weren’t falling into the donut hole till six seven months, and then it took six seven months to get out of the doughnut hole the year ended, because there’s only 12 months, and they’d have to start all over again. And nobody was really reaping the benefits of getting that, you know, 100% coverage. So what, what they did now is they revamped the system. We no longer have a donut hole, which is great, great for the consumer, and they capped all prescription drug costs at $2,000 now, the one caveat to that is, with your prescription drug plan, the prescriptions have to be on the formulary.
Steve 19:20
All right, let’s define what that means.
Lisa Lauro 19:22
Okay, so formulary is their fancy name for their list, okay? And so, they have a list of medications that they cover. These prescription drug plans. Every plan has a different list, okay? So, they have a list they cover, and then within that list the medications are tiered one to five. Tier one is going to be a preferred generic. Tier Two is a generic, then three is brand name. Tier four is non preferred brand. And then tier five is specialty meds that would be like cancer medications, you know, really unique type of medicines. So. So they go from least expensive your tier ones all the way down to most expensive. Okay? So, the drugs have to be on the formulary to be considered a part of that $2,000 cap.
Steve 20:16
Okay, but that is a big, big change.
Lisa Lauro 20:19
It is a big change. It is, you know, so, so once you hit that $2,000 which some people, if you’re on Ozempic or some other very, very expensive medication, you might hit that in March or April, and then be done paying for your prescriptions for the year.
Steve 20:37
That’s nice. It is. So, are people kind of excited about that? I mean, especially if you’re on any number of meds, even if they’re generic, it’s still, it still can be costly.
Lisa Lauro 20:47
Well yeah, I mean, people that are retired are on a fixed income, you know. So it is a big relief for many folks out there that you know are struggling to pay their medications, you know. So, so it’s a big relief. People are much happier and we’ll see how it goes. This is the first year. Just started in January, so I’ll be, I’ll be anxious to talk about it again, you know, this time next year, and see, you know, you know what people are saying.
Steve 21:15
One of the things that I got, and I was a little puzzled, not puzzled, but was the payment plan option that they’re talking about. And so you get this from your insurance, and it says, Hey, if you want to spread out the cost of your medicine, if you’ve got, you know, high priced medicine, is that that that’s something new as well, isn’t it?
Lisa Lauro 21:33
It is. So, the payment plan option is something that they added in, but the – honestly, I think it’s gonna (this is just my own personal opinion); I don’t know if I’m allowed to say that on the radio or not, but it’s my opinion. Take it for what it’s worth, right? So, my opinion is that it’s actually going to be kind of a mess with this, because what, what they’re doing is, you’re they’re putting folks that are on expensive medications on if they elect, if they elect to, it’s completely optional. But if they elect to do this payment plan, you’re going to pay, like, a certain amount each month, and then it’s going to be the rest of, it’s going to be broken down over a 12 month period, is my understanding. I’m not too well versed in this, right? But nevertheless, what’s going to happen in my what I think is going to happen is it’s just going to keep amounting to more and more and more, and you’re going to end up paying a lot by the end of the year. So, I don’t know that it’s and I think on the on the backside, on the pharmacy side, it’s going to be very difficult to track that, so we’ll see how it goes. But I think, I think it’s going to be kind of a nightmare.
Steve 22:47
Okay. Well, I mean, that makes sense to me too just, and again, I’m certainly just as someone who’s involved in the program, you know, who’s on Medicare, and I got that information, and I thought, is this something I even need to deal with? And this like, Yeah, I’m not going to, because I, I choose not to.
Lisa Lauro 23:02
Yeah, yeah. I think, I think the, I think it’s meant to be a good thing. I think they had very good intentions in setting this up for folks, but, um, but I think it’s going to, over time, just keep building, and you’re going to end up at the end paying a lot because you’re not paying the full amount. And each month, it’s getting divided over 12 months, and then it just so, I don’t know, we’ll see. We’ll see how it goes.
Steve 23:24
Bottom line is the biggest change for 2025 as far as Medicare goes, is the elimination of the donut hole. And right? Boy, that is worth celebrating.
Lisa Lauro 23:32
Yes, it is. It is.
Steve 23:25
And again on that. No, we are what we’re gonna have to call it a show. Lisa, this is gone by so quick.
Lisa Lauro 23:40
Man, has it ever
Steve 23:41
So, just, folks, we need to remind you, give us a call at 724-293-6653, come on in. Sit down with Lisa, have that conversation. It really is just a conversation, isn’t it? And there’s no cost, there’s no obligation. That’s the beauty of working with you. And really the whole team at Secure Money Advisors, Secure Money Health.
Lisa Lauro 23:58
Yeah, we are blessed. We have such a great team over here, and that’s how it is at Secure Money Advisors like you mentioned, we’re all just really friendly people. We just want to help. We want to help guide folks in the right direction, whether it’s retirement planning or it’s your Medicare and your health insurance. So yeah, we’re blessed to work with each other and blessed to help others in the community,
Steve 24:22
and folks, if you want to jump in and be a part of it, 724-293-6653, that’s 724-293-6653, don’t forget, get the book, medicarebookoffer.com that’s medicarebookoffer.com, Lisa will send you that book, and you will be on your way. We are going to take a quick break. Well, no, we’re not going to take a break. We got to call it a show.
Lisa Lauro 24:41
We got to call it a show this week.
Steve 24:43
All right. Well, let’s do that. Let’s; and reconvene in a week. What do you think?
Lisa Lauro 24:47
That sounds great.
Steve 24:48
Thanks for listening, everybody. We really do appreciate it. We’re going to be back next week. We’ll have new topics and questions and a whole lot more right here. On Secure Money Health Radio with Lisa Lauro.
Speaker 2 24:59
Investment advisory services are offered through Foundation’s 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 expressed 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 in 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.
