WEBVTT
1
00:00:00.740 --> 00:00:04.339
Welcome to the Ask the Experts show on W4CY Radio
2
00:00:04.400 --> 00:00:08.960
and Talk4TV, where we bring you educational information from experts
3
00:00:09.179 --> 00:00:13.660
on such topics as legal, health, financial, and home improvement.
4
00:00:13.859 --> 00:00:16.780
Now sit back and listen to our experts in community
5
00:00:16.820 --> 00:00:23.079
association law, estate planning law, tax relief, Medicare, public insurance adjusters,
6
00:00:23.339 --> 00:00:27.719
neuropathy treatment, business brokers, and personal injury.
7
00:00:27.399 --> 00:00:30.100
Law, along with many other topics.
8
00:00:30.500 --> 00:00:35.460
Now here's your host for the last 17 years, Steve-O.
9
00:00:38.320 --> 00:00:42.759
Texas. Oh, I love Texas. I spent most of my
10
00:00:42.820 --> 00:00:46.549
life in both Houston and Dallas, even though we're in
11
00:00:46.689 --> 00:00:51.350
Florida now. But I love Texas. Some of the nicest
12
00:00:51.969 --> 00:00:54.530
people in the world. Boy, do we have a great
13
00:00:54.590 --> 00:00:58.770
show for you this afternoon. I am telling you, I never...
14
00:00:59.140 --> 00:01:03.259
If you had told me three years ago that Medicare,
15
00:01:04.439 --> 00:01:10.750
choosing a Medicare agent would be our second most successful
16
00:01:10.859 --> 00:01:16.370
show besides tax relief, I would not believe that. Even
17
00:01:16.390 --> 00:01:21.609
though I'm on Medicare, it is amazing how many people
18
00:01:21.629 --> 00:01:27.040
want to learn about Medicare now. And what made this
19
00:01:27.140 --> 00:01:31.500
even better is we got lucky and found, I say,
20
00:01:31.540 --> 00:01:36.810
the top agent in the state of Texas, the Belvin
21
00:01:36.989 --> 00:01:41.430
Insurance Agency. Jill Belvin, good afternoon, Jill.
22
00:01:42.750 --> 00:01:44.870
Hello, Steve.
23
00:01:44.890 --> 00:01:47.530
I love, first of all, you look wonderful today. I
24
00:01:48.489 --> 00:01:52.640
love doing your show. If you've seen the numbers, they
25
00:01:52.739 --> 00:01:58.170
keep just growing fast. And I think people just love
26
00:01:58.209 --> 00:02:03.750
the way you explain Medicare because, Hey, the government's involved.
27
00:02:04.010 --> 00:02:11.289
That means, you know, how do we, I didn't. So
28
00:02:11.389 --> 00:02:15.550
first tell everybody, we've got so many new people, people
29
00:02:15.610 --> 00:02:16.830
about your agency.
30
00:02:17.430 --> 00:02:21.090
So the Jill Belvin insurance agency has, I've been an
31
00:02:21.169 --> 00:02:23.400
insurance for 30 plus years.
32
00:02:23.750 --> 00:02:25.960
Um, I was five when she started.
33
00:02:26.879 --> 00:02:32.699
I know. Thank you for that compliment. But I focused
34
00:02:32.759 --> 00:02:36.360
a lot of years on property, casualty, commercial insurance. I
35
00:02:36.419 --> 00:02:42.750
have dedicated the past six years to really focusing in
36
00:02:43.009 --> 00:02:49.460
on helping Medicare beneficiaries navigate the maze of Medicare. That's
37
00:02:49.500 --> 00:02:52.599
to put it mildly, the maze of Medicare. It is
38
00:02:52.759 --> 00:02:57.860
very confusing. The government doesn't really help explain it to
39
00:02:58.240 --> 00:03:01.479
folks who are needing to make choices on plans and
40
00:03:01.960 --> 00:03:04.939
what route they want to go. So it is a
41
00:03:05.020 --> 00:03:09.219
passion for me to help people do this and understand
42
00:03:09.259 --> 00:03:13.430
their choices. It is a very important to know what
43
00:03:13.449 --> 00:03:16.789
your options are when you're choosing a Medicare plan. And
44
00:03:16.990 --> 00:03:20.219
if you don't have the right agent, you might not
45
00:03:20.280 --> 00:03:22.960
get all of your options. You know, for instance, if
46
00:03:23.000 --> 00:03:26.520
you're speaking with someone who works directly for a company,
47
00:03:26.539 --> 00:03:29.719
a certain company, they're only going to provide you the
48
00:03:29.780 --> 00:03:35.909
information from that particular company. I represent 17 companies with
49
00:03:36.030 --> 00:03:41.810
over 150 Medicare plans. Licensed in multiple states. So you
50
00:03:41.889 --> 00:03:45.069
do get to know your options and your choices with me.
51
00:03:47.169 --> 00:03:50.550
One of the things I want to just notice, when
52
00:03:50.590 --> 00:03:57.150
we put up on our scroll, sometimes it bleeds in.
53
00:03:57.229 --> 00:04:02.819
I'm just looking now if I can get one where
54
00:04:02.860 --> 00:04:07.180
it says the email somehow sell because her cell phone
55
00:04:07.199 --> 00:04:10.680
was on there. If we can take the CEO off there,
56
00:04:11.659 --> 00:04:19.459
I want to make sure that it's jillbelvin at yahoo.com. God,
57
00:04:19.600 --> 00:04:24.500
you remind me. When you tell people about your company,
58
00:04:25.120 --> 00:04:28.709
you remind me so much of what I went through.
59
00:04:29.389 --> 00:04:33.310
I felt like a fool not knowing it was time
60
00:04:33.410 --> 00:04:37.930
for me to enroll. Absolutely. I felt embarrassed, but after
61
00:04:37.949 --> 00:04:41.569
doing these shows, there's a lot of people who don't know.
62
00:04:42.069 --> 00:04:43.980
There are. There are a lot of people who don't
63
00:04:44.040 --> 00:04:48.839
know that if you are turning 65 and you're not
64
00:04:49.060 --> 00:04:53.970
on a creditable health insurance plan, and what that means
65
00:04:54.129 --> 00:04:58.110
is you're on a large group plan above 20 employees
66
00:04:58.170 --> 00:05:01.250
that is as good as Medicare's, If you're not on
67
00:05:01.290 --> 00:05:05.220
a plan like that, you are required to enroll in
68
00:05:05.259 --> 00:05:08.680
Medicare at that time. And if you don't enroll in
69
00:05:08.720 --> 00:05:12.759
Medicare at that time, there are penalties involved. And some
70
00:05:12.779 --> 00:05:16.850
people don't understand that. They don't realize it. And they
71
00:05:16.889 --> 00:05:19.629
do end up in a situation where there are lifetime
72
00:05:19.689 --> 00:05:22.209
penalties associated with their Medicare payments.
73
00:05:23.250 --> 00:05:27.899
Well, something else that people don't understand is The first
74
00:05:27.920 --> 00:05:30.180
thing I'll go when we get, what is this going
75
00:05:30.220 --> 00:05:33.120
to cost me? They think they're going to have to
76
00:05:33.189 --> 00:05:37.629
write you a check. Right. Which is amazing.
77
00:05:37.930 --> 00:05:42.170
Yeah. I'm an advisor. I'm an insurance agent. It is
78
00:05:42.269 --> 00:05:44.930
just like, you know, if you were purchasing your auto
79
00:05:45.009 --> 00:05:49.019
insurance from a property casualty agency, if I can help
80
00:05:49.079 --> 00:05:52.759
you navigate the maze, find the appropriate plan that fits
81
00:05:52.779 --> 00:05:56.459
your needs and, The company that you enroll with will,
82
00:05:56.600 --> 00:06:00.279
you know, they take care of the agents. And I
83
00:06:00.360 --> 00:06:02.759
don't require that anyone pay me a fee for my
84
00:06:02.879 --> 00:06:03.819
expert advice.
85
00:06:05.279 --> 00:06:08.759
That's pretty amazing after all the work you do. And,
86
00:06:08.800 --> 00:06:13.019
you know, we're seeing all these commercials now and local
87
00:06:13.160 --> 00:06:17.660
calls coming in. And I want something that's really great
88
00:06:17.879 --> 00:06:23.529
about Jill's company. So if you call... I don't want
89
00:06:23.550 --> 00:06:25.170
to use a name. Let's say you call one of
90
00:06:25.209 --> 00:06:28.990
these major companies. They are only going to tell you
91
00:06:29.089 --> 00:06:34.329
about their company. You represent many companies. So you can
92
00:06:34.970 --> 00:06:40.939
show someone two, three, maybe four different plans to choose from. Yeah.
93
00:06:41.060 --> 00:06:42.800
And, you know, what we do is we do a
94
00:06:42.819 --> 00:06:46.259
needs assessment. We find out, you know, what your doctors
95
00:06:46.439 --> 00:06:51.800
that you like to go to. your medications, what's important
96
00:06:51.860 --> 00:06:55.500
to the client. Like, is it important that you have
97
00:06:55.560 --> 00:07:00.360
dental coverage? Do you need over-the-counter items? Is that something
98
00:07:00.379 --> 00:07:04.089
that's really important? We try to match a plan with
99
00:07:04.149 --> 00:07:07.990
what's important to you. There's so many different needs out there,
100
00:07:08.170 --> 00:07:11.110
you know, with the Medicare plans. We want to make
101
00:07:11.170 --> 00:07:14.639
sure that it is customized to what you need. It's
102
00:07:14.759 --> 00:07:19.019
not a one-size-fits-all when it comes to Medicare plans. Everyone
103
00:07:19.040 --> 00:07:23.319
has a preference of what they need for their best
104
00:07:23.399 --> 00:07:24.579
health care options.
105
00:07:26.100 --> 00:07:28.600
Well, I'm going to ask this because I'm learning now
106
00:07:28.720 --> 00:07:33.089
as we get closer to October. Have you learned anything
107
00:07:33.189 --> 00:07:34.649
new about 2027? No.
108
00:07:36.040 --> 00:07:40.990
The new plans for 2027 are introduced on October the 1st.
109
00:07:41.750 --> 00:07:45.370
No enrollments or changes can take place until the 15th.
110
00:07:46.089 --> 00:07:50.050
They don't give us a lot of information before the 1st. However,
111
00:07:50.250 --> 00:07:55.120
something that's really important, if you are on Medicare, your
112
00:07:55.240 --> 00:07:58.819
company that you're insured with, especially this is for Medicare
113
00:07:58.920 --> 00:08:05.459
Advantage recipients and prescription drug plans. you will receive a
114
00:08:05.519 --> 00:08:11.279
letter from your company. The letter will outline the changes
115
00:08:11.319 --> 00:08:16.519
that are coming in 2027. It will typically put coverages
116
00:08:16.639 --> 00:08:20.959
and benefits and co-pays side by side for 2026, and
117
00:08:21.000 --> 00:08:25.389
then it will show you what's coming in 2027. Those
118
00:08:25.470 --> 00:08:29.490
letters come out this month or at the beginning, the
119
00:08:29.529 --> 00:08:33.990
very beginning of October. So anyone who is on a
120
00:08:34.000 --> 00:08:38.269
Medicare Advantage or prescription plan, they definitely should be on
121
00:08:38.289 --> 00:08:42.990
the lookout. Now, as far as changes on the prescription
122
00:08:43.029 --> 00:08:46.860
drug plans, there have been some things out there, you know,
123
00:08:47.019 --> 00:08:52.799
things rumoring around about some premium drugs. adjustments on the
124
00:08:52.840 --> 00:08:57.929
prescription drug plans. There's an average, I think, of about
125
00:08:57.929 --> 00:09:00.990
$ 40 of increase, but per plan, it should only maybe
126
00:09:01.029 --> 00:09:05.490
be about $ 10 per increase on the cost of prescription plans.
127
00:09:06.149 --> 00:09:09.840
There is a max out-of-pocket or like a, I don't
128
00:09:10.159 --> 00:09:15.460
know what they call it, it's their catastrophic coverage for prescriptions.
129
00:09:15.539 --> 00:09:18.940
So if you have a lot of high-tier Prescriptions, the
130
00:09:18.960 --> 00:09:24.580
catastrophic coverage in 2026 was 2,100. It is going up
131
00:09:24.679 --> 00:09:29.529
to 2,400 in 2027. So there is a little bit
132
00:09:29.649 --> 00:09:34.070
higher catastrophic coverage. That only really impacts people who are
133
00:09:34.269 --> 00:09:39.240
on high-tier prescriptions that are very costly. If you are
134
00:09:39.379 --> 00:09:44.419
on generic prescriptions, there usually is no cost involved with
135
00:09:44.440 --> 00:09:48.779
generic prescriptions or very little. But those are two changes
136
00:09:48.820 --> 00:09:54.120
that are definitely coming in 2027, mainly centered around the
137
00:09:54.419 --> 00:09:59.429
prescription drug plans. Now, there are always companies for Medicare
138
00:09:59.450 --> 00:10:04.200
Advantage that pull out of markets, no longer offer plans.
139
00:10:05.120 --> 00:10:08.440
That always happens somewhere from year to year.
140
00:10:10.120 --> 00:10:13.059
I got to tell you, Jill, that's what I'm worried about.
141
00:10:13.080 --> 00:10:18.440
I'm on Medicare Advantage, and I read an article. There's
142
00:10:18.500 --> 00:10:24.299
like big companies that are pulling out of.
143
00:10:26.019 --> 00:10:30.320
There is a company in my area that is pulling out,
144
00:10:30.379 --> 00:10:33.139
and I know it, but I can't repeat that at
145
00:10:33.159 --> 00:10:34.139
this time.
146
00:10:36.409 --> 00:10:41.090
But that's scary, though, because what I've learned, Jill, is
147
00:10:41.570 --> 00:10:46.029
our little bit older demographics that you deal with, they
148
00:10:46.169 --> 00:10:50.899
toss the mail. Because they get so much, excuse me,
149
00:10:50.960 --> 00:10:54.559
crap in the mail that a lot of people don't
150
00:10:54.879 --> 00:10:57.690
take the time to read. And this is going to
151
00:10:57.730 --> 00:11:00.370
be the time you want to read, right? Absolutely.
152
00:11:00.450 --> 00:11:04.909
Yes. Don't toss anything that is from your company that
153
00:11:04.929 --> 00:11:08.320
you're insured with. Please read it. Take the time to
154
00:11:08.340 --> 00:11:10.830
look over it. Open the mail and look at it.
155
00:11:10.960 --> 00:11:15.179
It's extremely important at this time of the year. I
156
00:11:15.330 --> 00:11:19.590
always send out memos and emails and text messages to
157
00:11:19.629 --> 00:11:24.269
my clients reminding them, be on the lookout for the letter.
158
00:11:24.769 --> 00:11:27.120
This is the time when you're going to be receiving your,
159
00:11:27.600 --> 00:11:32.799
it's called an annual notice of change document. A-N-O-C, ANOC
160
00:11:33.179 --> 00:11:37.220
is the definition or the abbreviation. But I always remind them,
161
00:11:37.240 --> 00:11:41.129
be on the lookout for this document. It's extremely important
162
00:11:41.710 --> 00:11:43.090
to take a look at that document.
163
00:11:44.149 --> 00:11:45.970
Well, I got to tell you, we've got so many
164
00:11:46.009 --> 00:11:50.350
people asking questions, but it looks like the biggest question
165
00:11:50.370 --> 00:11:55.330
that people have is, what is the difference between Medicare,
166
00:11:56.549 --> 00:12:01.690
which starts next month enrollment, and Medicare Advantage? Okay.
167
00:12:02.230 --> 00:12:06.720
So when you are initially enrolling in Medicare, you have
168
00:12:06.740 --> 00:12:11.460
a choice to have your traditional Medicare, which is your
169
00:12:11.539 --> 00:12:15.529
Hospital Part A, and your medical part B as your
170
00:12:15.570 --> 00:12:20.389
primary coverage. That can be supplemented by adding another policy
171
00:12:20.769 --> 00:12:24.509
because Medicare A and B only pay 80% of major medical.
172
00:12:25.049 --> 00:12:29.690
So the additional policy pays the additional 20%. That leaves
173
00:12:29.730 --> 00:12:33.389
your traditional Medicare A and B as your primary coverage.
174
00:12:34.690 --> 00:12:38.269
Having it that way gives you more flexibility with doctors
175
00:12:38.289 --> 00:12:41.909
and You can see any doctor that accepts original Medicare
176
00:12:42.029 --> 00:12:47.429
anywhere in the United States. The Medicare Advantage, on the
177
00:12:47.509 --> 00:12:52.669
other hand, it is going to take over if you
178
00:12:53.029 --> 00:12:56.860
opt for Medicare Advantage. The Part A and B, you
179
00:12:56.940 --> 00:13:01.000
still must have it, but it does not participate any longer.
180
00:13:01.120 --> 00:13:04.580
It is on the sidelines. They don't pay for any
181
00:13:04.600 --> 00:13:09.200
of your medical coverage anymore. So Medicare Advantage, the company,
182
00:13:09.580 --> 00:13:12.090
which is funded by the federal government, is going to
183
00:13:12.120 --> 00:13:16.110
take over. They're going to be the primary coverage. Really,
184
00:13:16.169 --> 00:13:19.950
differences between those, they operate completely differently. There is a
185
00:13:20.090 --> 00:13:25.169
charge on the first, for the 20% umbrella that you
186
00:13:25.190 --> 00:13:29.450
get to cover the 20%. There's a monthly charge. With Advantage,
187
00:13:29.490 --> 00:13:33.860
there's no monthly charge. There's all that doctor flexibility with
188
00:13:33.980 --> 00:13:38.720
the traditional Medicare and a supplement. With Medicare Advantage, you
189
00:13:38.759 --> 00:13:42.399
have a lot less doctor flexibility. You have to stay
190
00:13:42.419 --> 00:13:45.960
in the network with your providers. I think one of
191
00:13:46.000 --> 00:13:51.899
the biggest differences is having to get prior referrals and authorizations.
192
00:13:52.059 --> 00:13:56.230
With Medicare Advantage, if it is an HMO, you do
193
00:13:56.309 --> 00:13:59.789
have to get prior authorization and referrals to get any
194
00:13:59.850 --> 00:14:05.679
kind of treatment tests, surgeries, anything like that. PPOs on
195
00:14:05.700 --> 00:14:09.179
the Medicare Advantage are more flexible. They don't require as
196
00:14:09.259 --> 00:14:15.120
much prior authorization or referrals. With the traditional Medicare and
197
00:14:15.159 --> 00:14:19.490
a supplemental policy, that's not required. You don't have to
198
00:14:19.529 --> 00:14:19.929
do that.
199
00:14:21.350 --> 00:14:25.769
One of the things I was warned about when I
200
00:14:26.100 --> 00:14:30.590
did the Medicare Advantage is is I might not like
201
00:14:30.690 --> 00:14:34.830
the doctors that I have to use, but I got
202
00:14:34.889 --> 00:14:40.679
to tell you, I have had three surgeries and the
203
00:14:40.759 --> 00:14:44.100
doctors have been wonderful. Oh, that's excellent. Yeah.
204
00:14:45.000 --> 00:14:49.419
And the thing is, you know, some of the larger carriers, um,
205
00:14:49.600 --> 00:14:54.460
do have a lot of, uh, the doctor network. So,
206
00:14:54.840 --> 00:14:56.720
you know, if you're with a larger carrier versus a
207
00:14:56.779 --> 00:14:59.600
local carrier, there are a lot of options to choose
208
00:14:59.639 --> 00:15:01.539
from there with the doctor network.
209
00:15:01.720 --> 00:15:04.120
So I got to tell you, this is one of
210
00:15:04.179 --> 00:15:08.679
the reasons why it's so important to have a good agent, Joe,
211
00:15:08.750 --> 00:15:14.169
is because I saw my orthopedic surgeon, the network, and
212
00:15:14.210 --> 00:15:17.029
that's why I went with them. But then I found
213
00:15:17.289 --> 00:15:23.899
out that that group, is not part of my main provider.
214
00:15:24.159 --> 00:15:26.220
They have their own separate group.
215
00:15:26.559 --> 00:15:27.460
Right, right.
216
00:15:28.200 --> 00:15:30.720
And if I would have had a good agent, they
217
00:15:30.740 --> 00:15:33.649
would have been able to explain that to me.
218
00:15:33.990 --> 00:15:34.289
Right.
219
00:15:34.309 --> 00:15:38.889
So I lost my orthopedic surgeon even though they were
220
00:15:38.970 --> 00:15:40.830
in network. Oh, boy.
221
00:15:41.289 --> 00:15:44.620
Yeah, that does happen sometimes. Are you on an HMO
222
00:15:44.669 --> 00:15:45.750
or a PPO, Steve?
223
00:15:45.769 --> 00:15:46.200
HMO.
224
00:15:46.419 --> 00:15:51.070
HMO, yeah. More restrictive there. a little bit less restrictive
225
00:15:51.120 --> 00:15:54.669
on a PPO. But, you know, pros and cons from
226
00:15:54.950 --> 00:15:59.669
HMO to PPO Medicare Advantage plans, PPO has a lot
227
00:15:59.769 --> 00:16:03.070
higher maximum out-of-pocket. So if you do run into some
228
00:16:03.110 --> 00:16:07.029
severe health situations, you can expect that you're going to
229
00:16:07.070 --> 00:16:10.529
pay a lot more because of that max out-of-pocket. Usually
230
00:16:10.590 --> 00:16:14.149
PPOs have a little less benefits as well and higher
231
00:16:14.210 --> 00:16:16.529
co-pays for your services.
232
00:16:16.590 --> 00:16:21.870
So I know everybody is different, but what is the
233
00:16:22.269 --> 00:16:28.730
average amount of plans you show your new clients? Well,
234
00:16:28.789 --> 00:16:29.230
we do a.
235
00:16:29.269 --> 00:16:33.029
Pretty good needs assessment, so we can usually narrow it
236
00:16:33.080 --> 00:16:35.799
down to about two to three plans that will fit
237
00:16:35.840 --> 00:16:38.929
their needs. Yeah, you don't need to show them 15
238
00:16:38.929 --> 00:16:42.159
or 20 plans. That just gets everyone confused, to be
239
00:16:42.200 --> 00:16:45.980
honest with you. So we do the needs assessment, narrow
240
00:16:46.019 --> 00:16:49.820
it down, and present them usually two to three plans
241
00:16:50.210 --> 00:16:50.830
to choose from.
242
00:16:51.629 --> 00:16:54.750
This is from Melvin. He said, I have watched your
243
00:16:54.789 --> 00:16:59.649
last three shows. I really like the way you educate us.