Wednesday, October 5, 2022

Saturday, October 1, 2022

What Kind of Medicare Plan Might Fit Your Unique Needs? – Part Three

* * * THIS IS NOT AN ADVERTISEMENT  * * *  

If you are just viewing this article and have not yet read Part One, please go back two weeks to the first of the series; begin there followed by Part Two a week ago. I am sharing this with you as a public service - no monetary or other consideration is exchanged between Tim and myself. Find out more about how we know each other in Part One today!  Al Cannistra


Our Guest Author today:  Tim Allen, BA, MM, CSA

“What Kind of Medicare Plan Might Fit Your Unique Needs?” (part three)



Client Tales – Part Three of a Three-Part Series


Welcome to Part 3 of Client Tales, where we’ve been sharing stories about Medicare beneficiaries, what plans worked best for each one and why. With Annual Enrollment right around the corner, the goal of this series is for you to be able to know which of the various options out there might best fit your unique needs and to help you avoid costly mistakes. 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 your options.

So far in this series we have looked at Medicare Advantage HMO and PPO plans as well as Medigap supplement Plans G and High Deductible G through the eyes of my clients. We’ve shared stories based on my real-life clients to help bring the plans to life and to determine which plan might be better suited in a variety of life situations. I hope that you’ve seen through these true stories that there is no “one size fits all!” 

In this session we will look at plans for people with chronic health conditions as well as for military veterans. We’ll also compare them side by side and end with a short quiz designed to help you determine what might be a good fit for you. 

Below is a chart, which may be helpful to compare the costs of an HMO, PPO, or Medicare Advantage plan (in the 2nd Column) to the Plan G supplement and High Deductible G plans that we talked about in our first two podcasts.  






















The figures you see above are for a female, non-smoker, aged 65 based on current 2022 plan options. Notice that the premium of a Medicare Advantage Plan might be as low as $0, or it could be $25 for some PPO plans. They include Part D and most have no medical deductible. The annual premiums + the maximum out-of-pocket will be $0 if the plan is never used but could be as high as $12,500 with high utilization out of network.



You would pay $2,066.16 with a Plan G if you never use it; If fully utilized, your annual cost would be $2,299.16. 

Now look at the High Deductible G. If never used, your maximum out-of-pocket would be $804.96. In a bad year where everything that could go wrong did go wrong your maximum out-of-pocket would be $3,294.96. 

My wife and enrolled in and love this plan because we have the freedom to see any provider who accepts Medicare and risk of financial loss is reasonably low. 

Medigap Supplement Plans C, Plan F and Plan F High Deductible are still available to people who turned 65 prior to January 1, 2020. 

























Plans C, F and F High Deductible may have a higher premium cost, but they have no separate Part B deductible. If you turned 65 prior to January 1st of 2020 and are interested in one of these plans, please click here to contact me or capture this QR code: 






There is no one-size-fits-all! But when we compare Medicare supplements to Medicare Advantage plans, the light bulb clicks on in the minds of my clients and most become comfortable with what type of plan might fit their needs. For example, the chart below shows that:
Except for a deductible, supplements will cost $0 Doctor & Hospital cost vs Low copays for Medic Advantage plans.
Usually, supplements have higher premiums vs lower or $0 premium. 























You may see any doctor who accepts Medicare in the United States on a supplement vs. no coverage out-of-network on an HMO, and higher cost out-of-network on a PPO. You can receive care in an emergency room anywhere in world on both plans and most but not all Urgent Care is considered in-network for both.
People who travel like the freedom of the supplement vs. cost-conscious clients who prefer low or no premiums.
There is a $233 annual Pt. B deductible vs. none on most Medicare Advantage plans.
Medigap supplements require a separate Pt. D plan but are included in most Medicare Advantage plans.


Most Medigap supplements do not offer value-added services vs. Medicare Advantage plans as in the chart below:























All plans offer worldwide E.R. But know this: The person who has only Medicare and no supplement or advantage plan does NOT have emergency or urgent care coverage worldwide. And remember, if you have only Medicare, you are only covered at 20%, which leaves you at risk for catastrophic financial loss.























If you know anyone who has a chronic illness such as diabetes, heart failure, chronic obstructive pulmonary disease (COPD), cardiovascular disease, or someone on kidney dialysis, Click here to contact me. We carry plans that are especially designed for them. There is a chronic illness form that they will need to fill out so and I’ll be happy to provide more information. 


I reside and work in San Antonio, a great military city. If you are a veteran, kudos to you & a major shout out. Thank you for your service. 

If you’re in a V.A. Health plan, did you know that there are plans available for you that can put money back into your social security check, give you access to civilian providers and give you additional benefits. 





Well, you’ve met 6 clients of mine and heard their stories in these 3 podcasts. I hope that you’ve come to see that there is no one-size-fits-all plan and that a plan that meets one person’s needs does not necessarily fit for others. Each has its place. Capture this QR code or click this link to try out our Medicare calculator and select the option that might best fit you.




I’ve got a question for you: Who would you call if you had a heart pain?
A 1-800# and trust that they would give you the right advice? 
A friend or family member? (Uncle Elmer said he took castor oil & it worked great for him!) Not so much, right?
Are you the kind of person who would google “heart pain” and self-diagnose to self-prescribe based on what you read? 
There’s a lot of slick Advertising out there that catches your eye, tugs on your heart & makes you feel good. So, you grab the phone & call that 1-800# so they’ll send you the new miracle treatment? No, chances are high that you would call the best Cardiologist in town. So why not call a proven, local insurance agent to help you find a Medicare plan? You’d be surprised how many fail to do this and as a result often make costly mistakes that they later regret. 

What sets us apart?
We carry the major plans & stay up to date with changes throughout the year. 
We’ll help you stay with your doctors. That’s one of our highest priorities. We’re not just going to put you on a plan that will pay us a high commission.
We’ll research your medications and find plans with your lowest premium and medication cost. 
We’ll secure a plan which meets your unique needs.
& BTW – We Return phone calls!

Well, we’re going to wrap this up, but can I ask you a favor? If the guidance I’ve given you today was of value, hire me as your agent to help you find the right plan! 

The good news? I don’t charge for my services; The insurance companies pay me when you sign up. So, employ me. I’d love to be your personal agent, your boots on the ground! 

Incidentally, we also offer Affordable Care Act plans for those under 65, and much more. So, check out our website and click on the BBB logo there to find out what others have to say about our service. Then tell your friends & family you’ve found the best agent in the whole state! Just Kidding šŸ˜Š. But do send me the names of family or friends that need our help! We’ll do our best for you and for them!  

I look forward to working with you in the days to come to help you find a plan that is of great value – that’s uniquely you! Thank you for your time!


Tim Allen
This series was written by Tim Allen who has been helping Medicare beneficiaries since 2005, TX License 1355125. He is the founder of Your Retirement Inc and Sales Production Coach at Affordable Health Insurance Agency where he’s trained his agents for the past 14 years. He is a Certified Senior Advisor, a member of both the Multi-Million Dollar Round Table and the National Association of Insurance and Financial Advisors. His bride has stuck with him for 45 years and they’ve been blessed with 2 wonderful children, 6 grandchildren, and one “in the oven.”  Favorite pastimes include performing, composing & arranging music, kayaking, fishing, woodworking and being a Papa to his grandies.


This podcast is his original work and the pictures within are his exclusively or he has purchased the right to use them.

Credits: 


Saturday, September 24, 2022

What Kind of Medicare Plan Might Fit Your Unique Needs? – Part Two

THIS IS NOT AN ADVERTISEMENT   

If you are just seeing this article and have not yet read Part One, please go back one week to the first of the series. I am sharing this with you all as a public service - no monetary or other consideration is exchanged between Tim and myself. Find out more about how we know each other in Part One today!  Al Cannistra



Our Guest Author today:  Tim Allen, BA, MM, CSA


“What Kind of Medicare Plan Might Fit Your Unique Needs?” (part two)



Client Tales – Part Two of a Three-Part Series


Welcome to Part 2 of Client Tales, where we’ve been sharing stories about Medicare beneficiaries, what plans worked best for each one and why. With Annual Enrollment right around the corner, the goal of this series is for you to be able to know which of the various options out there might best fit your unique needs and to help you avoid costly mistakes. 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 your options.

My name is Tim Allen and we’ve been helping Medicare beneficiaries since 2005, TX License 1355125. I am the founder of Your Retirement Inc and Sales Production Coach at Affordable Health Insurance Agency where I’ve trained our agents for the past 14 years. I am a member of the Multi-Million Dollar Round Table and the National Association of Insurance and Financial Advisors. My bride has stuck with me for 45 years and we’ve been blessed with 2 wonderful children, 6 grandchildren, and one “in the oven.”  Favorite pastimes include performing, composing & arranging music, kayaking, fishing, woodworking and being a Papa to his grandies.


So far in this series we have looked at the Medicare Advantage HMO and PPO plans through the eyes of my clients. In this session we will look at two popular Medigap supplement options with excellent value: G Plan and High Deductible G Plan. Would either of these plans work well for you and why? We’re going to share with you some rea-life Client Tales to help make that clear. I think you’ll see through these true stories that there is no “one size fits all!” BTW, the names and pictures have been changed to protect the identity of our clients.

Client Tale #4 


William is our 4th Client. He had a heart transplant 2 years before turning 65 and was on his employer plan. At age 65 he had to leave that plan and went on Medicare. His anti-rejection medications for the new heart were very expensive and he still had many visits each year with specialists.

He did not like having to pay a higher premium for a Medicare supplement, but he chose that option with a Prescription Drug Plan to keep his costs for treatment as low as possible. This was the best fit for him. Many people think they can’t afford a Medicare Supplement. But even if William’s premiums were $2500 a year that would still be much less money than the approximate $3,400  - $12,500 maximum out‐of‐pocket cost of a Medicare Advantage plan when used a lot! As you can see, there is no “one size fits all!”

Medicare Supplements work with Medicare. Generally, Medicare pays 80% of the cost and your plan picks up the 20%. You may also be responsible for a $233 Part B deductible. But otherwise, you pay $0 for medical care. Supplements feature the Broadest Provider Choice. There are no Referrals Required and they are preferred by many Providers.  What’s the downside? There is usually a higher monthly premium, and a separate stand-alone drug plan is required. There are often no (or less) Value Ads such as dental, vision or a health club membership. Health questions are not asked when you first turn 65, leave an employer, move out of state, or have another special election period. But otherwise, you may be denied coverage or charged more based on your health. 


Client Tale #5 

Our 5th Client Tale involves educators in the state of Texas that were on the Teachers’ Retirement System Health Plan (known as TRS), which is a very good fit for some people. But there may be other options out there for others through private health plans that could save them a lot of money and still provide excellent coverage. 

My wife and I are a good example (pictured on the left). When my wife turned 65, she was in TRS. Jane was a retired teacher paying $135 per month in premium and my premium was more than $400. As a couple, we are saving more than $400 per month on a Medigap High Deductible G supplement with a Part D plan. There is no network, so we can go to any provider that accepts Medicare without a referral. If you are interested in this, there is a form that you will need to send to TRS and we’ll be happy to tell you more about it.   









Please capture this QR code or contact us at yourretirementinc.com.      




The G High Deductible Medigap Supplement plan may be one of the best‐kept secrets out there. Just like Plan G it is accepted by any provider who accepts Medicare. There is no Network to worry about. 
It has a low premium:
• $35 Month for a female, 65-year-old non-smoker ‐ $76 Month at age 80
• $40 Month for a male, 65-year-old nonsmoker ‐ $88 Month at age 80.
It has a $2,490 Deductible which may function like an 80/20 Plan with a $2,490 Maximum Out-of-Pocket: Medicare will always pay the first 80%. Your 20% cost share accumulates toward the $2,490 deductible and when you reach that point you pay no more for the year and are covered at 100%. But your premiums are far less than plan G rates. This may not be the best alternative for everyone, but it provides an excellent value for many. It’s like having a Rolex watch on a Timex budget! See the illustration below regarding how it works:






















Final Thoughts

We covered the Medicare Advantage HMO and PPO in podcast 1 and explored two of the Medigap Supplements in podcast 2. Do you know which plan will work well for you? It may not be possible to make that decision with the limited information that we’ve explored so far.  So, tune in again for our third and final podcast next week where we will explore more options. We’ll also compare the plans sided by side. Finally, we will have a short pop quiz to confirm what you’ve learned. Again, there is “no one size fits all” – but which one is a perfect fit for you? 







Click on this link or capture this QR code to watch a 25-minute
video that will explore these options in more detail: 




This podcast is my original work and the pictures within are mine exclusively or I have purchased the right to use them.

By Tim Allen, BA, MM, CSA


We will publish Part Three one week from today. Make sure you come back for more great information.
Al Cannistra



Other pictures and/or charts created by Tim Allen..


Saturday, September 17, 2022

What Kind of Medicare Plan Might Fit Your Unique Needs?

SPECIAL: This is a repost from one of my other blogs:  www.SanAntonioRealEstate.blog


Introduction

My regular readers know that we keep this blog pretty much to real estate and posts that are unique one time articles. We are breaking all norms with this first post of a 3 part series - our very first trilogy if you will. And there is good reason for that.

I have known the author for more than a decade. Tim and I were introduced by a mutual acquaintance at a time of need for our family. I had an aging parent struggling with many medical expenses and high out of pocket costs. We were in need of a solution. 

The first meeting was by phone and during that time Tim took note of all the current doctors and agreed to research an insurance plan that keep the medical providers intact. A couple days later, he came out to the house and presented the options. If memory serves me, his systems searched something near 500 plan options.

He found a plan that met all the criteria and that was my first introduction to a Medicare Advantage plan. It was an outstanding option and proved to be the solution we needed. Since then, Tim has helped me personally with the right plan, which we review every year and I have literally referred dozens of friends and associates to his office knowing that they are in good hands.

So, I hope you enjoy this series and if you have a need, please give Tim a call. In the interest of full disclosure, Tim is not paying for us to publish this article nor do we receive any sort of commission or other form of payment. Call this a public service from us and I hope it will help you or someone you know.

Al Cannistra


Our Guest Author today:  Tim Allen, BA, MM, CSA

“What Kind of Medicare Plan Might Fit Your Unique Needs?”


Client Tales – Part One of a Three-Part Series

Welcome to Client Tales, where you will read stories about Medicare beneficiaries, what plans worked best for each one and why. With Annual Enrollment right around the corner, the goal of this series is for you to be able to know which of the various options out there might best fit your unique needs and to help you avoid costly mistakes. 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 your options.




Tim Allen, presenter, has been helping Medicare beneficiaries since 2005, TX License 1355125. He is the founder of Your Retirement Inc and Sales Production Coach at Affordable Health Insurance Agency where he’s trained their agents for the past 14 years. He is a member of the Multi-Million Dollar Round Table and the National Association of Insurance and Financial Advisors. His bride has stuck with him for 45 years and they’ve been blessed with 2 wonderful children, 6 grandchildren, and one “in the oven.”  Favorite pastimes include performing, composing & arranging music, kayaking, fishing, woodworking and being a Papa to his grandies. 

Sometimes the best way to get your arms around a concept is through a story! So, we’re going to present six different client tales about two popular Medicare supplement options with excellent value: G Plan and High Deductible G Plan.

We’ll also share about Medicare Advantage HMO and PPO Plans that are used by many of our clients, plans for people who receive extra help, plans for people with chronic illnesses like diabetes or chronic heart failure, plans for Veterans, and plans for Retired Educators. 

Which plan would work well for you and why? We’re going to share with you some rea-life Client Tales to help make that clear. I think you’ll see through these true stories that there is no “one size fits all!” BTW, the names and pictures have been changed to protect the identity of our clients.

Client Tale #1 

Rosita and Carl are married with a monthly income of $2,000 and resources of $12,500. 


male female couple on a nike













Resources include checking, savings, investments, and cash value of life insurance. They do not include residence, car, your personal belongings. Rosita and Carl are on Medicare. They didn’t know it, but they could apply for Extra Help as eligible Qualifying Individuals and did not have to pay the $170.10 Part B Premium.

We helped them get Part B and the Extra Help as Qualifying Individuals so they could receive Part B at no cost. They have the full benefit of Medicare and saving a lot of money on medical and drug copays as well!  

Check out this chart to see if you might qualify:


Medicaid Extra Help Chart

If you are eligible, you may receive Extra Help in the Medicare Savings Program which may pay your $170.10 Part B premium. You’ll receive all those extra benefits - and you may pay less for medical and drug costs!

If you think you might be eligible for this program or one that may possibly pay far more, we will help you apply but we’ll need your written authorization - Please capture this QR code:  



BTW - What plan do you think worked well for Carl and Rosita? It was an HMO, and we’ll take a closer look at that after our next client.) 





Client Tale #2 

When client #2 Angela turned 65, she had become a Real Estate broker. Prior to retirement as an architect, she had designed and built a beautiful Padre Island home on the bay, and had a small yacht tied to her pier out back.

cabin cruiser docked at pier













She could afford the most expensive Medicare plan available. What plan do you think she chose? Most people in my seminars tell me that she must have bought a supplement! But Angela chose an HMO Medicare Advantage plan. Here’s why: all her physicians and hospitals were in network, she would receive dental, vision and coverage for hearing aids. Also, she would pay no more premium at her fitness center, which would now be a part of the Silver Sneakers program. She did not mind needing a referral from her Primary Care Physician to see a specialist because she always did that anyway. She was excited that she did not have to pay the high monthly cost of a supplement. Do you see? There is no one size fits all!

What is a Medicare Advantage HMO?

An HMO is a Health Maintenance Organization which features care managed by a primary care physician who coordinates beneficiary care with specialists and puts a high priority on preventive care. People on HMO plans tend to have better health outcomes than those on other plans. Most HMO plans have $0 premium, the lowest copays, the richest benefits, and the most value-added services. So, why doesn’t everyone have an HMO? Some do not care for the required Primary Care Provider referral to see specialists. Compared to the PPO or Medicare Supplement, these plans also have smaller networks – and except for emergency room, urgent care, and travel plans with some HMOs, beneficiaries must stay within the network or insurance will not pay. 


Client Tale #3

Client Tale #3 is Sally. She had an HMO when she first turned 65 and was very happy with it. She had no health issues and saw her doctor once a year for her annual physical, mammogram, pap smear and blood work.

portrait of a woman reddish blonde hair















Then she came down with Multiple Sclerosis and the specialists who were recommended to her were not in her HMO network. She didn’t have confidence in her new specialists. She started going to rehab 3 days a week at $480 per month. Her plan had a maximum out of pocket of $5,900, which she quickly used up from all the doctor and hospital visits and she worried as she saw her small savings account dwindle.

She now wanted a Medicare supplement but did not qualify because of her illness. What plan did she move to during Annual Enrollment to see the specialists that she really wanted to see?  

Sally Moved to a PPO – a Preferred Provider Organization. 

They have larger networks than HMO plans. No referral is required. They can be used out-of- network, although that may be at a higher cost. That means an increased risk of financial loss if highly utilized: Based on the current plans in Texas, their maximum Out-of-Pocket, could be more than $12,000 if out of network. They have less value-added benefits than HMO plans. But on a positive note, some plans have national networks; Like some HMO plans, certain PPOs will even put money back into your monthly Social Security checks to help toward your Part B premium. 


Final Thoughts

Do you know which plan will work well for you? But what about a G Medigap Supplement? What about a High Deductible G Medigap Supplement? Most people – even many agents are not aware of this little gem. Again, there is “no one size fits all” – but which one is a perfect fit for you? Watch for the second podcast in our series to explore more Medicare plan options. Click on this link or capture this QR code to watch a 25-minute video that will explore these options in more detail: 




This podcast is my original work and the pictures within are mine exclusively or I have purchased the right to use them.




By Tim Allen, BA, MM, CSA


We will publish Part Two one week from today. Make sure you come back for more great information.
Al Cannistra