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 2 00:34
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 Sedahl 00:38
Welcome in everyone. This is Secure Money Health Radio, where Medicare matters, with Lisa Lauro. My name’s Steve Sedahl. Lisa, of course, President of Secure Money Health she works in conjunction with Secure Money Advisors, a licensed agent specializing in health insurance for old folks like me – retirees, folks getting into that Medicare world. And it’s complicated. It’s exciting, but it’s, it’s complicated. Lisa, how are you?
Lisa Lauro 01:09
I am well, Steve, how are you?
Steve Sedahl 01:11
Very good. Seems like we have, you know, when I first started think, doing these shows, I thought, there’s, there’s only so much you can talk about. Guess what? There’s not! There’s endless things to talk about with Medicare. It never, there’s always something going on. There’s always something changing. And I know that in your part of the world, you know, veterans play a huge role, right?
Lisa Lauro 01:35
They do. Yeah, they do everywhere, but we do have a lot of veterans in our area, and yeah. So there’s something for everybody.
Steve Sedahl 01:45
Let’s talk about veterans and Medicare, because they can actually work together.
Lisa Lauro 01:50
They do, yes, yes. So, there are Medicare Advantage plans. They’re called MA-only plans. And the reason why: so what the what the MA stands for is Medicare Advantage, but there’s also MAPD, which are Medicare Advantage Prescription Drug Plans, right? So, for the vet, veterans, they have MA-only, meaning that they don’t have the Prescription Drug piece to the plan, and they’re geared for folks that are veterans, so that because knowing that they go to the VA to get their prescription drug coverage, right? So, these plans are really nice plans for them, because, and then, what, you know, one thing over the years that I learned is that the veterans have different levels of what they can get in terms of benefits, right? So, so what, the, what these, these plans do that, you know, the veterans go, they have, they can go, they go to the VA for their hospitalization, they go for their doctors appointments, and they go for their prescriptions, but the Advantage plans that are offered to them allow them to have dental benefits, vision, hearing, they get the over the counter benefit, which is really nice, and for folks that aren’t aware of that, that is the over the counter – each Medicare Advantage plan or company kind of handles that differently, but overall, to generalize, it’s an allotment of money that they give you, whether it’s quarterly, monthly, and you can use it for things that you would get at a pharmacy. Not the prescriptions, but the things like, that you see on the shelves, whether it’s pain relievers, yeah, pain relievers, or first aid, or it’s allergy medicine, stomach medicine, all that stuff. I mean, literally, it’s like a 30-page catalog of things to choose from. I’ve even seen compression socks available, so you know. So, that’s a nice, really nice benefit: the over the counter that they can use. And so, it gives them the extra things that people love about the Advantage plans, in conjunction with also using the VA.
Steve Sedahl 04:20
So, when we’re talking about veterans and Medicare, you don’t really think of that, you know, together. My brother realized that – he was a Vietnam vet and was on Medicare – and then realized that, okay, he could get this hearing take, he could get his hearing taken care of. He could, and, I mean, it became, you know, there wasn’t something that that was widely known. He just sort of stumbled into it and was able to take advantage.
Lisa Lauro 04:46
Right. That’s the thing. A lot of folks don’t realize that they have these plans that are geared for them, and that’s what they’re meant for. So, you know, you can, you can go to get your hearing checked. You can get a pair of hearing aids. You, they have great dental benefits. You know, you’ll have your two, two cleanings a year, your preventative, your oral exam, and then they have benefits for the comprehensive, which is the major work that you know, like root canals and crowns and fillings and extractions. Dentures are often covered, which is nice. So, there’s a lot of extras that people love. And then they also are very generous on the vision side of things too. So, you know, often they’ll give you, you’ll get your one annual eye exam, and then you also have an allotment of money on most plans that they’re, they give you for glasses or contacts. And…
Steve Sedahl 05:40
Well, yeah. Well in fact, in my brother, he got LASIK from the VA. Yeah.
Lisa Lauro 05:44
Did he? Yeah. So, the VA probably gave him the LASIK, and then he can use the MA plan, the, to get a pair of glasses, right, if you need, like, a reader or something like that.
Steve Sedahl 05:54
Yeah, that’s exactly what he did.
Lisa Lauro 05:56
Yeah. So, these plans are really, really nice plans. And the other big one that we didn’t mention, that’s offered on most of the Advantage plans, is A, it’s called a Part B Give Back. And what that is, is it’s an allotment of money that they’re going to give you. They call it a, Give Back. It’s for your Part B; you pay a premium for your Part B, right? This year’s standard premium is 185 a month to have Part B, right? Well, a lot of the MA-only plans, since the veterans are not using the prescription drug piece of it, they give them money back on their Part B, and so it could be, you know, maybe they give them $50 back on their Part B. So now, instead of paying 185 they’re paying 135 for Part B, right? So that’s another thing that, that a lot of these MA-only plans offer that are, is very, a very nice, generous thing for the veterans.
Steve Sedahl 06:57
Sure, and… All right, so veterans are taken care of in ways that we probably weren’t aware of. So, if you’re a vet and you’re wondering and you’re getting Medicare at that age 65, let’s sit down with Lisa and have the conversation. 724-293-6653, let’s touch on health savings accounts and HSAs. That’s that is something that boy, the more I learn about them, the more I kind of like them.
Lisa Lauro 07:24
Yeah, yeah. You know, quite a few people have them too. You know, I wasn’t really familiar with them when I was teaching, but now I realize that it is a pretty popular thing. So, these health savings accounts you get, they usually are, it’s a high deductible health plan. So that’s the caveat to get in. That’s the caveat to get in is the high, high deductible health plan, and the employer usually contributes, and then you contribute and then, and then, with that, you have this, this, you know, little bank account, kind of, sort of, or this little savings account, let’s say, of money that you can use to pay for specific, you know, medical bills. But it’s very specific as to what you can pay for with the HSA. So, so some of the things that, that the HSA covers, you can pay your Part B premium. So that 185 if you’re in the standard range, you can pay for that you can pay for your Part D premium, so the Prescription Drug Plan premium, you can pay for your Advantage plan premium. Okay, so what, one of the premiums you can’t pay for is the Medigap Supplement Plan premium…
Steve Sedahl 08:47
Ah, okay, so there’s rules.
Lisa Lauro 08:48
…For some reason, I don’t – there are rules, that, they’re very specific rules. So, if you do have or elect to get an HSA plan through your group insurance, just make sure that you know how you can use it. Okay? You can pay deductibles, you can pay co pays, you can pay coinsurance. But as far as the premiums for the Medigap Supplement Plans that, those are your plan G and Plan N, you can’t pay for those.
Steve Sedahl 09:18
Okay, but, so, with an HSA, the disqualifier, if you will, is when you turn 65 you’re no longer able to contribute to an HSA, to a Health Savings Account. So, the key is to start early and fill that sucker up.
Lisa Lauro 09:32
Yeah, yeah. I think that, if I may, if I may, correct you, I think you continue to have the HSA, so long as you’re still working and continue, can continue to contribute to it, beyond 65. However, when you decide to come on to Medicare, okay, whenever you leave, okay, then you need to stop contributing six months prior to going on to Medicare, because Medicare goes back for six months, and so there’s some type of tax implications, and that would be something to discuss with a, with an accountant, on, what are the implications of, you know, signing up for Medicare and having an HSA. So, the rule of thumb is always to – and this is my guidance for folks that are getting ready to retire – pick a date, which is very hard for people. I’ve learned people get, have a hard time picking a retirement date, because, I think, they’re just not sure, right? But anyway, you pick a date and then work backwards six months and then stop contributing to your HSA so you don’t have any tax implications. And then I help guide you from there on how to, what I call it, the exit plan, right? So, yeah.
Steve Sedahl 10:54
All right, sure, sure. But so, what you, so you see people that, that are retired and they have built up a balance in that Health Savings Account that can really help them. But the key is to do it before you get there. And then the beauty on the, on the, on the financial side of this, the HSA, I mean, that’s tax, tax-free, you know, there’s no taxes going in, there’s no taxes going out, and there’s no taxes on the growth. I mean, that’s win, win, win. As long as you’re using it for medical.
Lisa Lauro 11:21
Right. You have to use it for the medical. Yep.
Steve Sedahl 11:23
Yeah, yeah. And so, it’s so, for a lot of folks, that really is our only option, isn’t it, with Health Savings Account, to take advantage of that?
Lisa Lauro 11:31
Yeah. And I think you know what, like you said to get in young, for those young folks that are listening today, if you get in young, you know, and hopefully you’re relatively healthy as you’re younger. That’s the key, because you have this high deductible. So, if you have an $8,000 deductible and you get sick, you got to absorb that 8,000 before, you know, your insurance is going to pick up anything, right? I’m not talking about any type of preventative visits, but if you had to have a surgery, you’re out eight grand. So, the key, like you said, is to get in early, while you’re while you’re healthy, you’re young, and you just load that little savings account up, and then you be sure that you follow all the rules when it’s time to actually use it.
Steve Sedahl 12:17
Sounds good. Sounds good. 724-293-6653. 724-293-6653, give Lisa a call. She’d love to hear from you. We have to take a quick break, and when we come back, we will continue the conversation here on Secure Money Health Radio, where Medicare matters with Lisa Lauro.
Hey, welcome back, everyone. This is Secure Money Health Radio where Medicare matters. Lisa Lauro’s here. My name is Steve Sedahl. Lisa is president of Secure Money Health, working alongside Brian Quaranta at Secure Money Advisors. Want to remind you, you can find, let’s see securemoneyadvisors.com, securemoneyhealth.com, that is your website, Lisa, and then for the book, which I hold in my hand, The Ultimate Medicare Book is available for you free of charge. medicarebookoffer.com and it’s an actual book that you’re going to send us. You’re going to pay for the postage. You take care of everything. We appreciate that.
Lisa Lauro 13:36
That’s correct. Yes. Well, you’re welcome.
Steve Sedahl 13:40
So, as we get into this segment, Lisa, let’s get into again questions that I had HMO and PPO, I know, Health Maintenance Organization. And then let’s what are they? What are the differences, and why do we like one more than another?
Lisa Lauro 13:56
Yeah, so Health Maintenance Organization, and then PPO stands for a Preferred Provider Organization,
Steve Sedahl 14:01
okay? And then so an HMO, I think we know what that is. I mean, I grew up in Minnesota, that’s where the first one was born. Yeah,
Lisa Lauro 14:10
Yeah, so, but there are different requirements for each one. So, we’ll go through each one. The Health Maintenance Organization actually requires people to have a primary care physician that is, like, dedicated to them, right? Okay, so, whereas with the PPO, it’s not required, so you don’t have to – so, because the way this works here is with the Health Maintenance Organization, the reason why the PCP is required is because they are sort of, let’s call it the quarterback. They’re the ones going to be calling the plays, right? So when you, when they say you need to go see a specialist there, you have to see them first, okay? And they have to write the referral for you, and you need a referral. So everything runs through the PCP on a Health Maintenance Organization plan,
Steve Sedahl 15:02
Okay, the primary care physician – PCP. Yep.
Lisa Lauro 15:05
Yep, that’s right. Whereas you have a little more flexibility with a PPO, you don’t have to have a primary care physician established with you. I mean, everyone probably should have one. In general, I feel like everyone should have a doctor that they’re working with, right? But it’s not a requirement is the difference.
Steve Sedahl 15:25
Okay? Well, it’s peace of mind, and for me personally, yeah, I want, I want my guy.
Lisa Lauro 15:29
Me as well, and I want my guy to know me and know what’s best for me, right? So, so, yeah, so I understand that, but not everybody feels like us, Steve.
Steve Sedahl 15:40
Understood. So let’s talk network coverage.
Lisa Lauro 15:42
Yeah, so, network coverage is, people kind of confuse the, what a network is. And so, network isn’t always a specific area, okay? People think like network is, is relates to an area, but really, network relates to who, who these companies are contracted with. Okay? So, we have, you know, it just depends on who their contractor – it could be a hospital that’s in Cleveland, here in Pittsburgh, right? But they’re part of the network, so, you know. So that’s one thing to know about networks, is that it’s who they’re contracted with, not necessarily always an area. But with the HMOs, you are limited to a network provider; so that means that you do have to find a doctor within their network. Okay, if you see a doctor outside of the network on an HMO, it’s not going to be covered, (
S.S. “Not at all.”) Not at all. It would be an out of pocket, be as if you didn’t have insurance, and you’d have to pay for it. Okay, with a PPO, you have a lot more flexibility, because PPOs allow you to go in and out of network, so meaning you can see doctors that they’re contracted with in network, but you can also go to a doctor that’s not in the network. The only difference is, though, there’ll be a separate price for that doctor who’s out of network. Okay, so it could be, I’m just going to use this as a random example, but it could be like, maybe you see a specialist in network and it’s $20 or you go out of network and it’s $50 so sometimes it’s a copay, it’s a flat rate, and other times it’s a coinsurance, it’s a percentage, where in network you pay a set amount, $20 and out of network you’re gonna pay 30% of the cost of the visit. Sure, okay, like, the nice thing is, they don’t, they don’t stop you from going out of network. You’re allowed to do that. You just pay more,
Steve Sedahl 17:41
Sure, all right? And so out of network. So then costs overall are, you know, HMO is going to be a little less than a PPO.
Lisa Lauro 17:50
I think in group insurance, HMO’s a little less, but with the Medicare Advantage plans, it doesn’t always run that way. Could be; HMOs are a little bit less, but they’re pretty competitive now. I’m seeing where, you know, just kind of a mixed bag.
Steve Sedahl 18:05
Well, I know, with premiums on Advantage plans, I mean, they vary a lot. And, for example, mine went down by $25 Wow, yeah, from 50 to 25 it’s like, oh, okay.
Lisa Lauro 18:16
Yeah, I’ll take it right, yeah.
Steve Sedahl 18:19
But that’s, but that’s an Advantage plan,
Lisa Lauro 18:21
Yeah. And then we talked about flexibility, so that’s good. Cost sharing generally lower. Cost sharing amounts on an HMO versus a PPO, so sometimes the cost share is a little bit lower. And then, and we talked about coverage area as well, yeah.
Steve Sedahl 18:39
So, and with an Advantage plan with the PPO, you know, we talked about traveling, you know, and from like, within the United States, on certain Advantage plans, you still can travel, and you can still go to any doctor you want, and it’s still covered, depending on the plan.
Lisa Lauro 18:55
You can’t go to any doctor you want, actually. On an Advantage plan, you, you’re gonna go, what, if you’re out of the, out of, like, let’s say, your network area, you’re going to have to go to an urgent care or an ER.
Steve Sedahl 19:05
Urgent care, right. That’s what you can do. But you’re going to be seen.
Lisa Lauro 19:08
You’re going to be seen. Yeah, you just have to, you can’t just walk into like, a PCP office, though. You have to go to an urgent care. They are contracted to deal with both urgent care and ER.
Steve Sedahl 19:17
Okay. And so is, so how do we, so, is it then more with the, and I know we’re not going to, we spent time on that in the last show about the supplemental coverage. The supplemental gives you a little more travel kind of ability, right?
Lisa Lauro 19:33
Yeah. I mean they can you have 80% coverage. Okay, all right, on that, but the Advantage plans, you know, you like, we’ve talked about going to an urgent care or a ER, but with a PPO, there are a few here, here in Pittsburgh area, there are a few Advantage plans that you can choose where you can piggyback off of the national network. So, if it’s a PPO and it’s one of those that is a national company, there’s a few. If you’re a big traveler and you want an Advantage plan, you may want to ask whomever you’re working with, hey, is there a plan that I can choose, that I can use the national network and then see doctors? And that’s key for folks that are snowbirding, because you know you if you’re going to be living somewhere, you might not always want to go to the urgent care or an ER, you might want to actually have a doctor for the for the four months that you’re somewhere, or five months, and in those cases you can, you can get an Advantage plan that you can piggyback off the national network.
Steve Sedahl 20:53
Okay, so, but that’s a question to ask you.
Lisa Lauro 20:55
That would be a question to ask me as well.
Steve Sedahl 20:57
Yes, oh man, to try to do all this yourself, I think is, I mean, really intimidating and just such a mess, it seems to me. And to be able to sit down with somebody like you, you’re going to take care of me. I mean, you know, you’re independent, yes, but also you fall under that fiduciary rule that that all of the Secure Money and Secure Money Health falls under. I mean, you’re looking out for us, you care.
Lisa Lauro 21:20
Right, right exactly. And, you know, Steve, it’s important to know, like, I get paid the same amount no matter what you choose. So, like, I really am here just to guide folks in the right direction. And another thing that’s important is – what’s good for you isn’t always good for your spouse either, because, oh, wow, yeah. Everybody has different doctors. Everyone has different needs. Everybody has different health conditions and different medications, and so when we take all that into account, we need to pick the plan that’s right for you, not what’s right for your friend, not what’s right for your spouse or your sister or your brother, what’s right for you. And that’s where I come in, and try to guide, guide people in the right direction.
Steve Sedahl 21:57
And that’s, that, you bring up an interesting point. Because if it’s a couple, and, you know, there’s an age difference of any, of any kind, that’s a whole different discussion. When it comes to one, one partner getting on Medicare, on another, who is still working? Do you stay on that? I mean, again, those are decisions that have to be made.
Lisa Lauro 22:14
Yeah. And they’re big decisions, you know, but, but I do – I am appointed to also work within the Penni Health Marketplace, which is the Affordable Care Act plans for individuals that are under 65 so if somebody really wants to retire and they’re concerned about their spouse being younger, we can help walk you through that process as well.
Steve Sedahl 22:38
Wow, that sounds great. 724-293-6653, I just, the more I do this show with you, the more I realize, oh my gosh, I’ve got a lot of questions. And I’m hoping that the, the listeners are having the same kinds of questions. And folks, if you’d like those questions answered, it’s 724-293-6653, so just to kind of sum things up, let’s, let’s just kind of give a broad overview again, of what we’ve talked we talked about HMO and PPO in this segment, yes, and then a little bit on travel and how to take advantage of that. But to me, the biggest, what’s the biggest takeaway that that we’ve talked about do you think?
Lisa Lauro 23:14
Wow, the biggest takeaway? I think, you know, I think the biggest takeaway here is all goes back to knowing your plan, knowing what you can and cannot do, and being able to maximize the plan, because the more you know about it, the more you can use it properly, right? So, if you’re going to travel, where can I go? If you have an HMO, which doctors are in the network? You know, if I have a PPO and I want to see somebody out of network, how much is it going to cost? So, the more you educate yourself, the more you do your due diligence in learning your plan and preparing yourself, the more you will be able to use that plan, maximize it, get the most of your benefits.
Steve Sedahl 23:57
Sure, all right, fair enough. 724-293-6653. Lisa, as always, it’s a pleasure to spend this time with you, and certainly to help, you, know, spread the word that Medicare is not something that, I mean, that you need to be afraid of.
Lisa Lauro 24:11
Oh no, you don’t have to be afraid. There’s, there’s definitely help out there, and, and, and another thing is, you know, we offer seminars, which is a great thing to do, go, you know, you can always call the office say, find out when we’re coming, when we’re gonna have another seminar. And we do a monthly – join us. Come, come, you know, come to a seminar. Learn. The more you can do to learn and understand the process, the less painful it feels to you.
Steve Sedahl 24:40
Again, it starts with that phone call, 724-293-6653, or just visit the website that is securemoneyhealth.com; securemoneyhealth.com is your direct connection to Lisa and again, you’ll find the book there as well. Lisa, as always, a pleasure. Let’s, let’s get together in a week.
Lisa Lauro 24:58
That sounds great. Take care.
Speaker 2 25:00
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.
Outro 27:09
Coach P Radio.
