Galatians Part 2 and Ephesians Part 1

0:00 Welcome to the Ask the Experts show on W4CY Radio and Talk4TV, where we bring you educational information from experts on such topics as legal, health, financial, and home improvement. Now sit back and listen to our experts in community association law, estate planning law, tax relief, Medicare, public insurance adjusters, neuropathy treatment, business brokers, and personal injury. Law, along with many other topics. Now here's your host for the last 17 years, Steve-O. Texas. Oh, I love Texas. I spent most of my life in both Houston and Dallas, even though we're in Florida now. But I love Texas. Some of the nicest people in the world. Boy, do we have a great show for you this afternoon. I am telling you, I never...

0:59 If you had told me three years ago that Medicare, choosing a Medicare agent would be our second most successful show besides tax relief, I would not believe that. Even though I'm on Medicare, it is amazing how many people want to learn about Medicare now. And what made this even better is we got lucky and found, I say, the top agent in the state of Texas, the Belvin Insurance Agency. Jill Belvin, good afternoon, Jill.

1:42 Hello, Steve. I love, first of all, you look wonderful today. I love doing your show. If you've seen the numbers, they keep just growing fast. And I think people just love the way you explain Medicare because, Hey, the government's involved. That means, you know, how do we, I didn't. So first tell everybody, we've got so many new people, people about your agency. So the Jill Belvin insurance agency has, I've been an insurance for 30 plus years.

2:23 Um, I was five when she started. I know. Thank you for that compliment. But I focused a lot of years on property, casualty, commercial insurance. I have dedicated the past six years to really focusing in on helping Medicare beneficiaries navigate the maze of Medicare. That's to put it mildly, the maze of Medicare. It is very confusing. The government doesn't really help explain it to folks who are needing to make choices on plans and what route they want to go. So it is a passion for me to help people do this and understand their choices. It is a very important to know what your options are when you're choosing a Medicare plan. And if you don't have the right agent, you might not get all of your options. You know, for instance, if you're speaking with someone who works directly for a company, a certain company, they're only going to provide you the information from that particular company. I represent 17 companies with over 150 Medicare plans. Licensed in multiple states. So you do get to know your options and your choices with me.

3:47 One of the things I want to just notice, when we put up on our scroll, sometimes it bleeds in. I'm just looking now if I can get one where it says the email somehow sell because her cell phone was on there. If we can take the CEO off there, I want to make sure that it's jillbelvin at yahoo.com. God, you remind me. When you tell people about your company, you remind me so much of what I went through.

4:29 I felt like a fool not knowing it was time for me to enroll. Absolutely. I felt embarrassed, but after doing these shows, there's a lot of people who don't know. There are. There are a lot of people who don't know that if you are turning 65 and you're not on a creditable health insurance plan, and what that means is you're on a large group plan above 20 employees that is as good as Medicare's, If you're not on a plan like that, you are required to enroll in Medicare at that time. And if you don't enroll in Medicare at that time, there are penalties involved. And some people don't understand that. They don't realize it. And they do end up in a situation where there are lifetime penalties associated with their Medicare payments.

5:23 Well, something else that people don't understand is The first thing I'll go when we get, what is this going to cost me? They think they're going to have to write you a check. Right. Which is amazing. Yeah. I'm an advisor. I'm an insurance agent. It is just like, you know, if you were purchasing your auto insurance from a property casualty agency, if I can help you navigate the maze, find the appropriate plan that fits your needs and, The company that you enroll with will, you know, they take care of the agents. And I don't require that anyone pay me a fee for my expert advice.

6:05 That's pretty amazing after all the work you do. And, you know, we're seeing all these commercials now and local calls coming in. And I want something that's really great about Jill's company. So if you call... I don't want to use a name. Let's say you call one of these major companies. They are only going to tell you about their company. You represent many companies. So you can show someone two, three, maybe four different plans to choose from. Yeah. And, you know, what we do is we do a needs assessment. We find out, you know, what your doctors that you like to go to. your medications, what's important to the client. Like, is it important that you have dental coverage? Do you need over-the-counter items? Is that something that's really important? We try to match a plan with what's important to you. There's so many different needs out there, you know, with the Medicare plans. We want to make sure that it is customized to what you need. It's not a one-size-fits-all when it comes to Medicare plans. Everyone has a preference of what they need for their best health care options.

7:26 Well, I'm going to ask this because I'm learning now as we get closer to October. Have you learned anything new about 2027? No. The new plans for 2027 are introduced on October the 1st. No enrollments or changes can take place until the 15th. They don't give us a lot of information before the 1st. However, something that's really important, if you are on Medicare, your company that you're insured with, especially this is for Medicare Advantage recipients and prescription drug plans. you will receive a letter from your company. The letter will outline the changes that are coming in 2027. It will typically put coverages and benefits and co-pays side by side for 2026, and then it will show you what's coming in 2027. Those letters come out this month or at the beginning, the very beginning of October. So anyone who is on a Medicare Advantage or prescription plan, they definitely should be on the lookout. Now, as far as changes on the prescription drug plans, there have been some things out there, you know, things rumoring around about some premium drugs. adjustments on the prescription drug plans. There's an average, I think, of about

8:57 $ 40 of increase, but per plan, it should only maybe be about $ 10 per increase on the cost of prescription plans. There is a max out-of-pocket or like a, I don't know what they call it, it's their catastrophic coverage for prescriptions. So if you have a lot of high-tier Prescriptions, the catastrophic coverage in 2026 was 2,100. It is going up to 2,400 in 2027. So there is a little bit higher catastrophic coverage. That only really impacts people who are on high-tier prescriptions that are very costly. If you are on generic prescriptions, there usually is no cost involved with generic prescriptions or very little. But those are two changes that are definitely coming in 2027, mainly centered around the prescription drug plans. Now, there are always companies for Medicare Advantage that pull out of markets, no longer offer plans.

10:05 That always happens somewhere from year to year. I got to tell you, Jill, that's what I'm worried about. I'm on Medicare Advantage, and I read an article. There's like big companies that are pulling out of. There is a company in my area that is pulling out, and I know it, but I can't repeat that at this time. But that's scary, though, because what I've learned, Jill, is our little bit older demographics that you deal with, they toss the mail. Because they get so much, excuse me, crap in the mail that a lot of people don't take the time to read. And this is going to be the time you want to read, right? Absolutely.

11:00 Yes. Don't toss anything that is from your company that you're insured with. Please read it. Take the time to look over it. Open the mail and look at it. It's extremely important at this time of the year. I always send out memos and emails and text messages to my clients reminding them, be on the lookout for the letter. This is the time when you're going to be receiving your, it's called an annual notice of change document. A-N-O-C, ANOC is the definition or the abbreviation. But I always remind them, be on the lookout for this document. It's extremely important to take a look at that document.

11:44 Well, I got to tell you, we've got so many people asking questions, but it looks like the biggest question that people have is, what is the difference between Medicare, which starts next month enrollment, and Medicare Advantage? Okay. So when you are initially enrolling in Medicare, you have a choice to have your traditional Medicare, which is your Hospital Part A, and your medical part B as your primary coverage. That can be supplemented by adding another policy because Medicare A and B only pay 80% of major medical.

12:25 So the additional policy pays the additional 20%. That leaves your traditional Medicare A and B as your primary coverage. Having it that way gives you more flexibility with doctors and You can see any doctor that accepts original Medicare anywhere in the United States. The Medicare Advantage, on the other hand, it is going to take over if you opt for Medicare Advantage. The Part A and B, you still must have it, but it does not participate any longer. It is on the sidelines. They don't pay for any of your medical coverage anymore. So Medicare Advantage, the company, which is funded by the federal government, is going to take over. They're going to be the primary coverage. Really, differences between those, they operate completely differently. There is a charge on the first, for the 20% umbrella that you get to cover the 20%. There's a monthly charge. With Advantage, there's no monthly charge. There's all that doctor flexibility with the traditional Medicare and a supplement. With Medicare Advantage, you have a lot less doctor flexibility. You have to stay in the network with your providers. I think one of the biggest differences is having to get prior referrals and authorizations.

13:52 With Medicare Advantage, if it is an HMO, you do have to get prior authorization and referrals to get any kind of treatment tests, surgeries, anything like that. PPOs on the Medicare Advantage are more flexible. They don't require as much prior authorization or referrals. With the traditional Medicare and a supplemental policy, that's not required. You don't have to do that. One of the things I was warned about when I did the Medicare Advantage is is I might not like the doctors that I have to use, but I got to tell you, I have had three surgeries and the doctors have been wonderful. Oh, that's excellent. Yeah.

14:45 And the thing is, you know, some of the larger carriers, um, do have a lot of, uh, the doctor network. So, you know, if you're with a larger carrier versus a local carrier, there are a lot of options to choose from there with the doctor network. So I got to tell you, this is one of the reasons why it's so important to have a good agent, Joe, is because I saw my orthopedic surgeon, the network, and that's why I went with them. But then I found out that that group, is not part of my main provider. They have their own separate group.

15:26 Right, right. And if I would have had a good agent, they would have been able to explain that to me. Right. So I lost my orthopedic surgeon even though they were in network. Oh, boy. Yeah, that does happen sometimes. Are you on an HMO or a PPO, Steve? HMO. HMO, yeah. More restrictive there. a little bit less restrictive on a PPO. But, you know, pros and cons from HMO to PPO Medicare Advantage plans, PPO has a lot higher maximum out-of-pocket. So if you do run into some severe health situations, you can expect that you're going to pay a lot more because of that max out-of-pocket. Usually PPOs have a little less benefits as well and higher co-pays for your services.

16:16 So I know everybody is different, but what is the average amount of plans you show your new clients? Well, we do a. Pretty good needs assessment, so we can usually narrow it down to about two to three plans that will fit their needs. Yeah, you don't need to show them 15 or 20 plans. That just gets everyone confused, to be honest with you. So we do the needs assessment, narrow it down, and present them usually two to three plans to choose from. This is from Melvin. He said, I have watched your last three shows. I really like the way you educate us.

16:59 Thank you so much. I will be calling you next week. You're so welcome. I am getting rid of my agent. Oh, no. Listen, you know what? When people feel comfortable with you, maybe they don't feel as comfortable with their other agent. Right. I've got to tell you, Jill, there are agents out there that just go through the motions. Right, right. Because I had one of those. Jill doesn't do that. I mean, customer service... is so important to you. It is important. Customer service is key. Anybody out there that's licensed and certified can present you with plans, but actually getting a needs assessment, knowing your needs, making sure you're there when the customer has something come up, that's the most important thing you can do for your clients.

17:53 And there are things that come up. There's a constantly, you know, people have questions. They don't understand, you know, why this was, you know, this particular thing happened or this doctor wasn't covered or that bill wasn't paid. So I always get involved and try to help out with these things. Just want to make sure everyone is taken care of. I am so sorry about all the questions people have out there, but I've got to ask. I love questions. I'm getting robo calls. Oh, yes. But I'm also getting some live calls. And this is what they're doing. They're covering up who they're with, first of all. And they're saying, we have got benefits you haven't taken advantage of yet.

18:42 You have your $ 3, 000 grocery. Yeah. I've learned. You probably learned the hard way that that's not really available. Because they hear all these things on TV. Yes. What are some of the scams out there that people have to watch out for? I think the main scam is the fact that they will call you and say that you have not qualified for all your benefits. That's the one that my clients contact me and say, why are these people telling me this? And the grocery card. But the thing to remember about, and there are some plans that do offer assistance like that. However, in order to qualify for assistance with a grocery card, you have to be a Medicaid plus a Medicare recipient.

19:36 So not only do you have to have Medicare, but you also need to have Medicaid in most instances. There are a few exceptions to that, and that would be on some of the chronic condition plans. if you qualify. The only chronic conditions that the companies will recognize would be heart disease and heart failure. It would be dialysis, receiving dialysis, And diabetes, those are the main three things. And not even all of the chronic plans in those situations will offer you those kind of benefits, especially not $ 3, 000 a year. It's more like, you know, just a few dollars a month. It's definitely not $ 3, 000 a year. So don't be led to believe these folks who call you randomly out of the blue offering you these things. it's typically not going to work out. And really their main objective in calling you is to persuade you that whatever plan you have right now is not the right plan for you, whatever it be. They want to get you switched to something else. And why do they want to do that? Well, quite honestly, because it pads their pockets.

20:54 So I wouldn't, you know, I don't, I don't do that to people. If someone calls me and they want an honest review on their plan, I would be more than happy to do that. But if they are in the plan that best fits their needs, I am not going to suggest another plan for them or for them to move to something different. Some people just push you to do that, and that's not necessarily the right thing to do. So I shared with you before I had a horrible agent. And just let me just tell you to me what a horrible agent is. A friend of mine who was with the same company said, oh, are you getting your benefits?

21:40 I said, wait a minute, what benefits? He said, oh, you've got $ 100 benefit. You just have to go into their website and What are you talking about? Right. Showed me I got like $ 100 of benefits that agent never told me about. Right. They didn't go over the benefits with you. What you're referring to is called the over-the-counter benefits. And a lot of plans will offer something on a quarterly basis for you to purchase or get over-the-counter products. It could be things like Tylenol or Band-Aids or blood pressure cuff or heating pads. And a lot of the companies will offer something in that capacity. But the key is when a customer is enrolling into a plan, you have to go through each of the benefits of that plan with them.

22:35 And I do that every single enrollment. I go through every copay at a specialist office. copay for a hospital, copay for surgery, all of the benefits, how much they get for the dental, the vision, over-the-counter, the hearing benefit in a Medicare Advantage plan. These are all Medicare Advantage benefits because they kind of throw in a lot of stuff in the Medicare Advantage plans. But I go through each and every benefit and each and every copay. I also send out, you know, like by email or mail or whatever they require, Evidence of coverage document, which has all of that information in the document so that they can have that information.

23:19 Jill, your show goes by so fast. Tell people how they can reach you. You can reach me by calling the office number, 832-281-4474. You can go to my website, www.insurewithbelvin.com. In my website, there is an appointment form. You can complete that and schedule on my calendar. You can email me at jilllovesmedicare at gmail.com, J-I-L-L-L-O-V-E-S-M-E-D-I-C-A-R-E at gmail.com or jillbelvin at yahoo.com. I have a couple of emails you can get me, phone number, website, any of those you'll get to me.

24:05 Jill will be back with us the second Tuesday at 1 o'clock Central Time, and then we will let you know when this show is going to be replayed. Jill, thank you so much. Thank you. Have a blessed weekend. We'll see you soon. All right. Take care. That's Jill Belvin, the Belvin Insurance Agency. We're going to go to break. We'll be right back. Thanks for tuning in today to the Ask the Expert show on W4CY Radio and Talk4TV. Tune in next week and every week to hear more from our experts on personal injury, insurance, air condition repairs, estate planning, Medicare, and many other topics in the areas of legal, health, financial, and home improvement.

24:50 See you next week.