My Healthcare Audit - Selecting the Correct Medicare Plan

Hey, well, welcome back. This is Craig Weir. As the nice little intro probably told you, you know, when you get ready to get into retirement or you're already retired, there are all these what next questions that we have to ask ourselves. What happens next? What happens with my career, what happens with my entertainment? What happens with my travel, my kids, my life, my wife, my work? All those kinds of things. One of the big what next questions that we have to ask ourselves is what happens when it's time for that dreaded Medicare? I mean, I don't know what happened, but, you know, I think Yesterday I was 45, and this October I turned 65, and my wife turned 65 the month after that. And so, you know, all these decisions I've been helping clients try to figure out on what to do with Medicare. Craig's face with those right now. And so now I got to deal with it. Well, look, I found a lady that has a fantastic business that I want you guys to be exposed to. It's a very interesting business in that she does similar to what we do. They just help people make better decisions, but they do nothing but Medicare consulting. So they help you maximize the decision you make around Medicare, the supplements, the plans, all those kinds of things. And I just thought, you know what? Let's just, Craig, be the guinea pig, because Pam and I have that decision to make. So what I did is I attended a webinar. I clicked on a little ad like you guys click on to see my webinars. I clicked on an ad, I listened to a webinar. I was very intrigued. I made a phone call, and boom, before too long, I thought, man, this is a heck of a deal. I got to know what the right answer is, and I don't want to spend the time and the hours of trying to get it close to right when they already know what they're doing. So I have invited Emily, the Medicare coach, onto the program with us. So. So, Emily, thank you so much for being willing to do this with me.

Yeah, thanks for having me on, Craig. It's a pleasure.

Yeah. So I feel a little bit like I'm going to the doctor here, you know, and like, in front of thousands of people that are going to listen to this, it's like, okay, here's my life. But it'll be fun and I'll learn a lot about it. And full disclosure, I've only perused the document that you sent me of the evaluation and the recommendations that you're making. And I did that on purpose for the benefit of the audience so they would get to see my genuine reactions and our genuine conversation instead of being scripted. Right. So you and I haven't really talked about my situation at all. Right. You'll agree with that? Yeah. For everybody.

I would agree with that. Yeah, I would agree.

So, look, I have paid Emily to do this. This is not something she's paid me to come on the show and do. I've paid her for her services. They're worthy of being paid for. And so we did that. And my hope is that today you get educated and you get informed in a way that maybe you haven't been before. So if you're facing that Medicare decision here this year or so, you probably are going to really benefit from being a part of what we're doing. There's probably other benefits. If you're already on Medicare, Emily's going to tell you about maybe some things that, that you need to take, you need to take into consideration or she can help you with. So anyway, without further ado, Emily first, let's, if we can, let's kind of just tee up big picture. I know I've given a little brief description, but just as a way of intro, tell everybody, what do you do? Tell us about your business.

So we are an independent Medicare consultant, as you said, helping people through Medicare. So as I think of us like what a CPA is to taxes to help people meet the rules with, but to get the most out of it, to save themselves money, we do the exact same thing. And just a quick background about me. I got this got into Medicare from my dad. I spent my first seven years of my career at Goldman Sachs managing risk. And I was pretty overconfident that I knew everything about retirement. And it wasn't until my dad was approaching his decision, like you are, that I was like, holy cow, right? People work hard to get that retirement savings in place. And I felt like this. The government wasn't super helpful and there were so many ads and plans being pushed out there that wasn't really in the best interest for my dad. And so we turned to the Medicare coach to help us do this thing as well, because we wanted to be 100% confident that we were doing the right thing. He's worked so hard on everything else. Let's just get this one little thing buttoned up so our shift's not going to sink, you know?

Yeah, yeah, well. And I remember the story you told during your webinar about that and how that turned out and how just enlightened you became of the options and how difficult it is. And saying that the government doesn't help a whole lot is kind of the understatement of the day, Right? Yeah. My dad went through a totally different end of life thing, but my dad went through some dementia and ultimately passed a couple years ago. But, you know, it was like, if you ask the right question, the keys to the kingdom opened up. But if you didn't ask the right question, you never would have known that benefits are out there. So let's just back up a step and for the benefit of just the program and people listening in. I've already told you that I clicked on an ad. I thought this sounds reasonable. I attended a webinar. I was very engaged, by the way. You do a great job of presenting information. Your webinar was very informative to me. And I'm a guy that's pretty critical because I do webinars all the time. And so. But I was very into your presentation, and it was very interesting. You kept my attention the whole way through, which was great. And then what happens is they sent you. You guys sent me a link to complete some information. Right. So. And it wasn't onerous. It was just, you know, how's my health? What. What kinds of meds do we take? Fortunately, we're pretty healthy where we don't really take anything. But who are your doctors? Who your preferred providers? What do you like to do? So we did that. We did all that. Right. And then I submitted that. And within about a week and a half or so, I get a phone call from somebody on your staff that said, hey, we got all your stuff and we're ready to get you scheduled to talk to one of our folks. Right?

Exactly.

Did I miss any steps? Is that.

Nope. So to that one, I know while we haven't talked about you, I know about you. Right. I know. I'm coming at this lead to having an idea of which angle we're going because everyone is slightly different.

Yeah. And so what you did with that info is you plugged it into your knowledge base and your database of available plans and everything. And what you're going to do live today is we're going to show actual. The actual report pieces of the actual report that you prepared for me. Right. That's what they're seeing. Is that right?

Yep.

Okay. So if you're listening. Go ahead.

Go ahead.

Yeah. So I was just going to say, so if you're listening to this on a podcast, you probably want to go. If you're interested in the subject, you probably Want to go back and you want to watch the podcast when you got a few, a few minutes because we're going to be going through the live information. One of the challenges that we, that Pam and I have, the good thing about our life is that we're both very healthy. Other than compounded hormone stuff that my wife takes, we don't really take any other meds and you know, have a very healthy lifestyle and eat healthy and exercise and do all those kinds of things. But one of the challenges is I don't plan on retiring anytime soon. And so my income is really high and that's going to, that's going to play havoc on me with Medicare Part B and Part D. And I'm sure we'll, we'll talk through that a little bit. So let's, let's get personal. Let me share my screen for the benefit of everybody else here and. Okay, so perfect. Okay, so we're good to go. So this is kind of page one. I'll just let you tell me where you want me to go on all these pages.

Sounds good.

And just lead me through it and then, you know, tell me what we need to do.

Yeah. So if we go back to the workshop you joined, we have a five step process and step one is when to join Medicare. And Craig, you alluded to this early, but Medicare rules say by the time you're 65, you either have to be on Medicare, are on an employer plan that meets Medicare rules. So while Craig, yes, you have an employer plan because the company does not have 20 employees or more, it does not meet the first rule of Medicare requirements and so on. That because of that, we're going to a different path. So, so I, I want to just be clear on step one. It's, we have to have you join Medicare because your employer plan does not meet Medicare rules. So.

Right.

I just want to start off with that.

And the good news is, the good news is I'll pay a lot less in premium for Medicare than I'm paying for my existing plan. Yeah.

And look, sometimes Craig, and you can talk about your benefit people too, but sometimes they'll do like an FSA for you or some other situation where you can somehow write off your Medicare premiums as well. There's different strategies between your accountant and your benefits company to look at. But because people don't love the fact that you have your company pay for your premiums and now you don't, and so there are things around there to be thoughtful about that we can continue that conversation as well.

Okay, good.

But once we kind of confirm. Oh, go ahead.

No, go ahead, go ahead.

But once we confirm that you're, you're joining Medicare, we then go into slide two, if you want to go there. And, and the key thing here is it's about choosing which program fits you best. So you might not have these yet because you've recently moved, but most people your age, Craig, are getting bombarded with mailers around Medicare Advantage or Medicare supplement plans, and you're not really sure what it is or what to do. So step number two is about choosing which program fits you best. So on the left hand side, we have original Medicare and on the right hand side we have Medicare Advantage. So let's kind of break that down quickly. No matter which path you go down, you have the basic part A and part B benefits of Medicare. We'll go into detail in a second about that. If you're on original Medicare, you'll have a Medicare supplement and likely a part D drug plan. And if you're on the right, you're just going to have Medicare Advantage. So one thing, the ads that you're seeing in the mail, you're only going to get Advantage or supplement. You can't have both. You're not allowed to have both. So we go back up to the high level. The question is which path is best for Craig and Pamela? And there are things that we ask, right? Like which doctors do you see? Right. Do you even care which doctors you see? I want to know what's your overall goal on original Medicare? You tend to have higher premiums, but when you have health issues, it tends to have a lot lower out of pocket costs, which is important to the financial advisors we work with because they want to protect their clients overall risk. Right? We can't afford to spend ten grand a year on medical costs. We want to really understand that original Medicare does not require prior authorization and that it can be customizable based on your unique needs. On the other side, we have Medicare Advantage. If a client comes in, which you didn't say this, Craig, but if a client comes and says, you know what, Emily, the most important thing to me is a free gym membership, free dental, free hearing, say Advantage is the way to go, or if your doctors only take advantage, then that's the way to go as well. Kaiser Permanente, for example, only takes Medicare Advantage. You're not at Kaiser though, right? So my point is that the initial decision is kind of which path you want to go down. Based on our conversations and your information that you provided, you want to see Mayo Clinic, if you were to have health issues and your wife sees Dr. Davis. And I had to summarize on the next page, you don't have to go to it, but I think the key thing is that Mayo Clinic does take original Medicare. It kind of goes in and out of which Advantage plans they accept.

Yeah.

And the research I did the other day, they don't currently take any Advantage plans.

Yeah. And, and we, before our telephone, I mean, before this meeting, I pretty well had already made up my mind that we want to stick with original Medicare for the flexibility it gives us. And the clients I've had who have had Medicare Advantage were not real crazy about it a few years into it. And that, that doesn't, that's not necessarily an incrimination on the Advantage plan because there probably are people that love it, but they didn't. They were, they were. And I don't, I couldn't even tell you what they were. But there were, there were limitations in their life that the Advantage plan created that they really didn't know going into it, which is another reason why they need to talk to somebody like you ahead of time. Right.

Yeah. Again, it can fit some people well, but if we have a thoughtful conversation about it, most people will go down the original Medicare route. But those commercials don't show you the full story, I guess, is my, the key takeaway here. So we want, we want to be thoughtful about this.

Okay, great. Okay.

So, so again, I think we're firmly on the original Medicare route, so we're going to ignore, for your case, any Medicare Advantage option. If we're good with that.

Yeah. And if somebody who's listening or watching thinking thinks that they want to do Medicare Advantage, then I think what they need to do is schedule a call, hire you to do their thing, and really talk through whether that's really best for them. It's the, you know, it's like, I think our fees are. I think it's the best money I've spent this year is getting to have this conversation and you give me advice on this kind of thing.

Yeah.

Okay.

Okay. So if we go to page four where it says parts of original Medicare, this is what you're going to have.

All right.

You're going to have your Medicare Part A coverage, which is also called your hospital coverage. It's going to cover inpatient hospital stays, some skilled nursing or home health. This does not replace long term care, though, as well as hospice. I think the key takeaway here is that because you have worked 40 quarters equivalent to 10 years, you will pay nothing for your Medicare Part A premiums. That's free. You've. I like laughing. It's free because you've paid for it for so many years.

Right.

And there are CO pays for all of these services, depending on what you're getting and how long. So there are CO pays for hospital stays as well as skilled nursing, home health, hospice, all of those things. Okay, we'll talk in a bit though, how we're going to cover those CO pays. That way it's not a burden on you. The second thing you're going to have is Medicare Part B, as in Bravo, which is your main Medicare coverage. It covers doctor's visits, lab tests, durable medical equipment, physical therapy, basically all the things.

Right.

Now Medicare Part B for Most people costs $174.70 a month. Yours is going to be more than that. I'll talk about that in a second. But because you have a higher income, you're going to pay more for that than Medicare for your Medicare Part B. Now, Medicare Part B has an annual deductible at least this year of $240. So when you go to the doctor, let's just say in November, and you get $1,000 medical bill from your doctor's office for whatever it might be. And I'm over generalizing this, but let's just go with it. For the example, you're going to pay that first annual deductible of $240 and then after that, Medicare will instantly pick up the remaining 80% of your expenses. But then you or Medigap plan, also called Medicare supplement, is responsible for that remaining 20%. So if you only have Medicare Part A and B, you're still financially exposed. And 20% of cancer treatment or even of a knee replacement or whatever else might happen can be a lot of money.

Yeah, a lot of money.

And so we want to look at other plans to help really protect us financially. There are also things called excess charges. We don't see them happen often, but I bring this up because some Medigap plans will cover it. And it's simply a 15% extra charge that a doctor can charge you for certain services. And does that make sense about Medicare Part A and B at a high level?

Yeah, I think it makes, I mean, it makes a lot of sense. And you know, some of the people listening to this have already experienced those Medicare Part B premiums being higher. And you know, in our business, when we get people to do conversions, Roth conversions, well, we, we force their income into A higher bracket on purpose because the tax benefits are well worth the extra. But. And then they go down once their income stops. But in my case, where I continue, I plan on continuing to have our business and to continue to help people the way we have. I'm going to be on Medicare and I'm going to have a high income for who knows, the foreseeable future. And there's just nothing that I can do about that Part B. And I'm sure you'll cover part D also or a premium or income based premiums. So we're just going to have to pay a higher amount. But I, I think it makes a lot of sense what you're saying.

Okay, you're also going to have a Medicare supplement called a Medigap plan. That's column three. And again, these will work alongside Medicare part A and B.

And if I remember right, you're actually giving me some recommendations specifically of plans that I need to look at. Is that right?

Correct.

Yeah. Good.

The thing with Medigap plans is that when you first join Medicare. Right. Because you're. Right now in Colorado you might be moving, but. And that's okay. We'll talk about that in a second. But in Colorado and in most states, you only have the first six month window when you can first join one of these plans without asking for your health history. So we want to be very thoughtful around the Medigap plan that we pick because while, yes, if you're healthy, we can switch it. We most people don't really care what they have until they're not healthy.

Yeah, right.

And so when they want to switch, it's usually too late. And so I want us to be proactive about this conversation and just know that we're going to, we're going to kind of live with this decision probably forever, maybe not, but, but probably so. Because again, we don't do things until we want it to change and then it's too late, usually.

Okay.

And then the final piece is your part D drug plans. So Medicare requires you to have creditable prescription drug coverage and Medicare Part D is a way to do that. Now this plan though, you can change every single year. So we're just locking you until, I mean, it's gonna be a couple months for, for you and your wife. But, but we can reset it every January 1st. We make that enrollment decision between October 15th and December 7th. So.

Okay.

The key thing from this side is that you're going to have four pieces when it comes to Medicare. Medicare A and B through the government Medigap and Part D are from private insurance companies and likely different insurance companies. Are we good there?

Yeah. And just so I make sure I understand what Pam and I get from your company, not only are you going to help us make these decisions now, how does that work for us next year, when it's. When enrollment's open, are you going to. Are you guys there to help? I make a phone call or you're proactive or how does that work?

We're proactive. So you'll hear us start talking and reaching out to you in August for any medication changes. And then we'll be working with you through that enrollment period to find that next new plan for you. In your case, it will be for 2026.

And so for how long are you going to help us with that?

You get your first annual review for free, and then after that, you can opt in or opt out of them at a really low price. So our annual Reviews are usually $500 per person. As of now, they're around 200 person for. For an annual review.

Awesome.

Yeah.

Okay.

Okay, if we go to page five, we'll talk about your high income penalty. So Medicare looks at your modified adjusted gross income, and they always look two years back. So in your case, you're making more than what you were in 2022, but they're still only going to look at your 2022 income. So again, every year they're gonna look two years back. Now, what I tell my clients, Craig, is if your income's dropping, we want to be proactive in asking the government to change that. But if your income is increasing, we're not going to tell them anything, right? We're just gonna. We're just gonna let it be, right? Because the rule is technically two years back. So the more you make, the more you pay. And this chart has your part B higher income penalty, and page six has your Medicare part D high income penalty as well.

Okay.

Now, I think it's worthwhile for us to go into page seven, though, about appealing IRMAA penalties. IRMAA is income related Monthly adjustment amounts. While this won't apply to you right now, it could eventually apply to you. Medicare allows you to appeal income penalties when you have a certain qualifying event. Qualifying event tends to be retirement or work reduction. So why is this important to your clients? When we have clients who do Roth conversions at, say, 64, but they don't retire until later, you could end up paying more for your Medicare coverage because a Roth conversion is not an appealable event. But if we have the income, the Roth income, happen the same time as a retirement event. We can lump it all together and say retirement was my trigger. So if people are doing Roth conversions, I'd say 63 or later, at least be aware of the implications on Medicare. It might be fine. But I hate when people have surprises later on. And two, there could be some timing around retirement and when the Roth conversion happens to have Medicare implications. But let's be honest, Craig, you save your clients a lot of money. So paying an extra thousand dollars, look, depends on what level they're at, but it might be an insignificant factor when you think about the tax benefits from your Roth conversion strategies.

Yeah, it definitely is. And you're making a good point. I mean, you know, our average client has around a million and a half to 2 million in IRAs. They do conversions and they're going to save, in total, our average client saving about $3 million of income tax over their lifetime. And they'll actually save 80 to 100,000 in Medicare premiums. But they don't save it the first few years. What we're able to do is is they, they front load the Medicare premiums because of those conversions, like you're talking about. But to your point, when that income from the conversions goes away, worst case scenario, that takes two years and then they're back down to the minimums for the rest of their life. But we've actually had clients call Social Security and appeal and tell them we are no longer doing this. And they've actually had the Medicare premiums, the surcharges dropped, which was kind of astounding to me, but it's actually happened on a number of occasions.

That's great. That's great.

Probably has a lot to do with who you get to talk to, right?

It could be. And we'll keep. We always tell clients to appeal multiple times, but we've had some cases where they get denied. So I think it's your point, it's who you ask as well.

Yeah.

Okay. Any questions on the irmaa, the high income penalties, Craig?

No, I don't. And I think, you know, we've talked about this a lot with our clients, that there's a lot of other podcasts they can go and webinars we do where they can learn about how that works. Bottom line is if you have more taxable income, you're going to pay higher premiums for a season and then you're going to go back down to the minimums. If in our case, if you don't do the conversions, you're going to pay higher premiums for the rest of your life because you're always going to have those required minimum distributions taken into higher part D and part D threshold.

Yeah, that's a good point. Which is why I love talking to people like you, Craig, because it's fun to have those strategies around, how it all comes together.

Right.

Like things, there's so much overlap across, across the strategies.

Yep, there is.

Okay. And let's go to page 8, which is your part D research.

Okay, great.

So in your cases I recommend. Let me rephrase that. If you were to join a part D drug plan, I would have you consider what's called well, care value script, at least for this year.

Okay.

And I recommend this because it is the plan that covers your medications at the lowest cost. That's our goal. Our simple goal with part D research is which plan covers your medications at the lowest cost.

Okay.

Now you don't take medications, so yours is simple. And the frustrating part with PAMs is that Medicare part D plans don't cover any of them.

Yeah, yeah. No plan has ever covered it for her.

So. So we have options and we don't decide this today, but you can either get a part D drug plan at a $0 premium, but you're also going to have your high income penalty on top of that. Or on page nine we talk about Medicare part D penalties. I have clients in your shoes who, if they decide to do so, might decide to take the part D late enrollment penalty rather than pay the high income part D penalty. So the part D penalty is not very much. It's 1% of the national base amount, the base premium for every month you don't have coverage. So it does change every year. But let's just say, Craig, you didn't have your coverage for part D coverage for a year. You would pay around $6.20 once you do get a part D plan total on top of your part B premium on a monthly basis.

Okay.

So if your plan had a premium of $10, you would pay your $10 plan premium plus a $620 a month part D penalty if you were to delay your part D coverage.

So then would that mean that we would just keep our existing drug plan that we have through our company plan or nothing? Or nothing. Just pay all the meds out of pocket if they come up.

And that's the risk. Right. And again the nice thing is that we have almost six months until you join Medicare. Right. So we have kind of think about this.

Right.

But it's a strategy that I want us to be aware of because if you look at a numbers basis, in some cases taking the part D late enrollment penalty makes more sense. But there is a risk, right? There's a risk. You get crazy medication next year and you don't have a part D drug plan and we, we can't get you a new one until the following January 1st.

Do I have to qualify for it?

Everyone is guaranteed to join a new Medicare part D drug plan between October 15th and December 7th. And that plan will then start January 1st.

And no medical qualification.

Correct. There's no existing pre existing conditions they care about. Everyone's guaranteed to get a plan.

Okay, so in my case, if we just went with kind of the plan A that we're thinking about, where we just kind of, pardon me, but run naked on prescription drug coverage and then seven months from now, life throws us a curveball. If it's February of a year, I can't get into a drug plan until October of that year.

You could enroll in October, you couldn't start the plan until January 1st.

But if it's February, when life throws us a curveball, I wouldn't be able to get any coverage for drugs until the following January.

Correct.

Yeah.

Now we have coupons like Goodrx. Right. There's places you can go to get discounts as well. So I guess I at least want to present to you what your options are. And there are clearly pros and cons to each side.

Yeah, we'll definitely think about all that. I mean, I would have never thought about skipping it and just pay the penalty, but I can see where it might make sense. We just, you know, like you've already said, we just need to think through it over the next few months to figure out what's going to be what we're. What we feel most comfortable with.

Because based on your income right now, your monthly penalty for high income for just Part D is $33.30 a month.

Well, actually, I don't, I didn't really, I didn't put the total income in there. So it's probably, it's going to be a little bit higher. But the thresholds, I mean, even at the highest threshold, it's not a crazy dollar amount. Anyway.

I think the one thing to know if we do, if we forego a part D drug plan, I'm not saying about vaccinations. You do you. But part D covers some vaccinations. And so if you get those vaccines, they're about $100 a piece usually. And so that could be an extra out of pocket cost if you don't have a part D draw plan.

Yeah. Okay, that's, and that's, you know, just from a total transparency issue. Those aren't big deals for us. We're not real big believers in vaccines. But I agree with you. You do you, I'll do me. Right.

Okay. Any questions about high level part D at this point?

No. That's really good. I mean, those are really good thoughts. Really need to give it some, give it some consideration over the next few months and decide what we're going to do.

Okay. So the next step is talking about your Medicare supplement plan. And this first slide on page 10 really talks about what do we look at when it comes to recommending companies. Not all companies are made equal.

Yeah.

And because of how the rules work, we can't switch companies every year in most states. So we want to take a really long term picture at how we pick a plan. I mean, this came from my financial, my investment banking days. Right. It's like, how do you, how do you rate a company? Right. You see it like, how do you pick investments? So we want to get the financial rating of the company. How long have they been in the market for? What's the history of the rate hikes? Do they have good customer service? How is the contract price? The loss ratio and the market share can also be an implicator, an indicator of how well they're going to do it.

Yeah, I just, I want to point that point out to people that I really. Not that you, not that you need my approval on it, but you're really going about selecting the company in the right way. Most people focus on price first and they go down a rabbit hole and they end up with a company that has poor customer service. They have incredible rate hikes and maybe they're not even around three years from now. So I appreciate the fact that you're looking at, are we going with somebody stable as number one? That may mean I pay a little bit more, but I'd rather pay a little bit more and know that they're going to be there when I need them.

And there are some big name brand companies who are somewhat new to the Medicare space, who are, who are cheap and I don't trust at all. And we've seen big rate hikes recently. And so that's, that's why we do it this way. So it's, again, it's the same as what you, it's, it's the same view as what you all have Craig, which I appreciate.

Yeah.

Page 11 is quick. Right. But it's reminding ourselves that when you first join Medicare part B, you have a six month window where you're guaranteed join any supplement plan. But then after that we're not guaranteed to have anything. Okay, so page 12. You know, there's a lot of different supplement letters out there that begin with A as an apple to end as a Nancy. And each letter is, has a mandate as to what they can or cannot cover and mainly what they, what they do cover. But every company, every company that offers a plan G will have a different price. So my point is this. There's a lot of different letters out there for your situation. I recommend we look at three of them. Plan G, Plan high deductible G and plan N. If we look at plan G in that first column, it has the most coverage. It's going to cover your part A CO insurance, it's going to cover your part B coinsurance. It will not cover your part b deductible of $240. That's not a huge deal. Right. But it's going to cover excess charges. Going to cover everything. Plan G works really well for people who have a lot of health issues. It's more expensive, but it does provide quite robust coverage. High deductible G is similar to G. However, as the title says, it has a high deductible, which is for this year, $2,800. What does that mean? It means that if you, Craig, get a thousand dollar bill, Medicare will pay that first 80% once you hit your deductible and then you pay the remaining 20%. And your 20% has to add up to $2,800 before you ever truly hit your deductible. So, so it's different from your employer health insurance. Right. When an employer health plan, we assume that if you have a 2,800 deductible, you're going to pay for all of that on day one. But because of how Medicare's 8020 rule works, it actually takes quite a while to even hit your $2,800 deductible.

Okay.

I think that's a big difference that people should be aware of. And the final plan to consider is plan N. The premium is usually between G and high deductible G, but it does have CO pays. So every office visit has a $20 copay and the ER is 50. So they're all a little different. But I think it's important to one know a high level, what it looks like, because, Craig, if you were to come to me and say, emily, I have stage four cancer, I'd be like, G, hands down, G. Right. But you don't have that. And so I think we should explore other options that people don't usually look at.

I noticed that plan G and high deductible G both cover part B. Excess charges you referred to earlier, too.

Correct. And again, you could go to Mayo Clinic. If you move to Texas, this will go with you as well. All those things.

Yeah, we plan on being in Colorado. We grilled the kids really big. Okay, you guys and your wives are here. Is this where you're going to stay? Of course. You know how that, how that works. They'll. They'll do life and we'll just let them go do whatever they're going to do. But we. We plan on being here, so.

It'S a great place to be. I'm. I'm here as well with you. But. But again, we don't. Life happens. Right. And even if you stay here, you want to go to Mayo Clinic or you want to. At least for my dad and I, we want to go to the best of it. If we have to have it. You know, we want to have that optionality.

Yeah. We just have had really good luck with them. There are a lot of other places. They're probably not the best for everything, but I had emergency retina surgery a couple years ago, and, man, they were just phenomenal. And we're part of their executive health program where we go in, we can go in every year, and they just kind of go from front to back and really, we really enjoy it, but we probably wouldn't use them for everything. Right. Because who wants to fly to Rochester or Scottsdale every time you need something?

Yeah. So to that point, too. And I should talk about this with your wife. Even though doctors don't take Medicare, all of those tests that you're referring to through, say, a lab core or the MRIs or whatever else that they're doing.

Yeah.

Those are usually covered by Medicare.

Okay.

So even people who have doctors who don't, who don't take Medicare, I think it's still worthwhile to have Medicare coverage for many reasons, especially for those tests that we tend to run. So if you were to go with plan G, I would recommend Mutual of Omaha for you based on your zip code. Based on the other companies. I like Mutual Omaha. They're not a usual company that we hear about, but they've been in the market for a long time and they have a Competitive price for you. Okay, so if we were to go with Mutual Omaha, the premium for Pam would be around 133amonth. And for you, 154. So Colorado is one of those states where your gender impacts what you pay.

Okay.

But 133 for her, 154 for you.

And that covers all the plan A is free, so that covers B. Right.

It will cover all your part B co pays, so it'll cover that entire 20% once you hit your deductible.

Okay.

And it would cover all of your code A part A co pays as well if you were to be in the hospital.

All right.

If you were to go with a high deductible G, I'd recommend United American. And that plan's around 45amonth. So it's a hundred dollars cheaper, more or less than your plan G. And then the only plan N, I.

Let me ask a question. So the difference between G and high deductible G is only that deductible, that $2,800 deductible amount, right?

Correct.

Okay.

And then plan n is around $90 a month for each of you as well. Now, I don't recommend if plan N was a lot cheaper than plan G, even more so I'd say it's probably worth it. But I don't recommend plan N for you because that premium's so close to a G. If you wanted more coverage, if you want more coverage, go with G. If you want less coverage, go with high deductible G. But those N the co pays with N can just quickly add up. If you were to need it and there's not enough of a premium savings, I don't think it's worth it. But ultimately, it's up to you and what you want to do.

Yeah, well, you know, the context that my wife and I come from is I've always been self employed, and so I've always paid much higher premiums than what most people pay for health insurance. Even now we have a small group plan, but between Pam and I, she's employed by the company, so she's an employee. Between the two of us, our premiums are $2,700 a month. Emily. So for us to go to a plan g and pay $250 a month, that. That seems like a cakewalk. I mean, that's. That's the lowest premiums I will have paid for my whole life. But to your point, I paid for it my whole life too. Right. And Social Security benefits. I mean, premiums yeah.

So again, we're not deciding on anything today, but I want to at least have you get your head around the prices and the pros and cons and a way to at least have an idea, to your point, of not being scared of Medicare. Right. Because people, Craig, have this like idea that Medicare is bad and expensive or whatever else. And Medicare can be great. And for your case, you're going to save a lot of money on Medicare, but we have to know how it works because not all plans are great.

Right. So are there any of the other pages that you produce for me that you want to look at right now?

Let's go to page 14 and talk about dental, vision and hearing.

Oh, okay. Yeah.

Medicare covers basically no dental. So if you want dental, my usual recommendation is talk to your current dental plan or maybe even the company will offer you your dental still because that could be kind of parsed off.

Yeah.

But if, if your company won't cover your dental, ask if you're at say, Delta dental, if they'll roll over an individual plan for you. And they usually will. And what's great about that is that they'll waive that 6 month or 12 month waiting period for any extra services, but see if your company will keep paying for you.

Well, I know the guy that owns my company and I think they'll probably do that.

Yeah. Vision's a little bit different. Medicare covers medically necessary vision, cataracts, glaucoma, all those things.

Okay.

So you might want to keep your company's vision plan as well as you. I mean, it's going to cover eye exams and eyeglasses or contacts if you wear those. So it's not a ton of coverage, but it's something. But I'd say if you can stay in your company plan, do that.

Okay.

And then hearing is just hard to cover. Hearing aids are. If you have ear issues that are with, have to do with balance or something medically necessary, sure, Medicare will cover it. But Medicare does not consider hearing to be medically necessary. And so they're not going to cover hearing aids. So most of our clients will just self pay for that through a place like Costco or another inexpensive hearing aid option.

Okay.

So let's go to next steps. So, so where do we go? I want to kind of lay out the steps for you. So we have an idea of the timeline. Because you could Join Medicare on October 1st. Since your birthday's in October, you can apply for Medicare part A and B as early as July 1st. And since Pam's 65 in November. She could apply in August. I do recommend that we at least get your paperwork in early August, and we can do it together to make it more simple. But the government can be a mess, and so by doing it early, it just makes everything easier. Okay, so that's kind of the timing for that big piece. Step two is confirming which plans you want. Right. We're going with original Medicare to confirm your Part D plan and your Medicare supplement plan. Number three, extra dental, number four, payer premiums, and then five. I put it in there in case. I think this is final, though. But if you were to move, just let me know because we'd have to make changes if you were to go to a different state.

Okay. Is it. Is it state related or is it zip code related?

Both.

Okay.

It's usually. We may usually make changes still if you move within state, but there's usually bigger changes if you move out of the state. So if you're staying in your general region, Craig, Mutual of Omaha will cover all of that.

Okay.

Now, the one question I have for you, though, is when do we cancel your employer coverage? It's nice because you and your wife are a month apart, right? We probably can't cancel your coverage until she joins Medicare.

Why do you think that?

Because in most cases, if the employee cancels their coverage, the spouse loses their coverage as well.

She's an employee of the company, though, so she's on her own employee plan.

That makes it easier. So we can cancel yours to end. End of September because Medicare will start October 1st, and then we'll cancel hers the end of October, and Medicare will start November 1st. So that's nice that you're both separate.

Yeah. Okay, good.

We covered a lot, so.

Yeah, we did. That's great. So we got. So we got a couple things to think about, right. In terms of Part D, the Mutual Omaha makes sense. I think the Plan G is probably what we're going to do. But Pam and I will sit down and talk, and I'll have her listen to this podcast where she can learn from you instead of from me. Right. And we'll. We'll have info. So the next thing that we need to do is in sometime right before July, your folks will reach out to me, say, hey, it's time. We got to get. We got to make a decision. Let's go. Right?

Or we'll have another call. We'll regroup and say, let's talk through this. Right. What are your questions? Where are you at? And if anything comes up between now and then reach out, you know, how to get a hold of me. But we went through a lot right now, and so it's a chance to kind of absorb it and think about it and see if anything changes or whatnot.

So just. Do you have any final kind of. This has been great. Worth every penny as far as I'm concerned. I know I have a lot of confidence now. I got the right plan. Instead of me having to evaluate A through N and then having to figure out of all the different carriers A through N and what are the differences. I mean, dozens of hours, because I know me once I would, once I started down this rabbit hole, I'd want to know what is the best. And I would end up trying to get as educated as you. And it probably took you a few years to get where you are, so it's been great. So thank you for that. So what do the listeners need to know that we maybe haven't covered yet? Is there any final thoughts that you have that maybe they need to be aware of?

I think the next thing is just executing it. Right. And I'll walk you through all the steps to get you enrolled in all the things. We're not an agent, so we'll talk about how that works. So I don't enroll you in your Medicare supplement plan, but we're going to go through how all the enrollments happen. My biggest thing, though, too, is once people enroll, please do not forget to pay your premiums. I know it sounds silly, but people do all this work to, like, get the plan in place, and they forget to pay their bill and it's an absolute disaster. And so make sure you're following through to get everything in place, because when those plans get canceled, it's really hard, if not impossible, to get them back.

Oh, wow, that's, that's good to know, too. So, Emily, we'll, we're going to put links to how people can maybe tune into one of your webinars, how they can get ahold of your folks to have a conversation. We'll put that in our show notes. And if people are watching this on YouTube, it'll be down in the notes on their YouTube channel and Instagram the whole, the whole thing. So we'll make sure that we get all that taken care of. Thank you so much. I, I, you know, it, it's, I hope people that are listening in or watching got something out of it. Although it was about kind of this is my Life, But I hope, you know, they're in similar circumstances. They got their own things. And my takeaway for our listeners is it. This is a very customizable solution for every person. And so just because the guy on the golf course is in ABC plan doesn't mean that ABC plan is best for you just because he's happy with it. Is that right?

Absolutely. And you and your wife are similar. Most couples are on different plans because they don't. They take medications and they have different doctors and they have all the other stuff. And so your situation is quite unique in that. In that perspective.

Yeah. Good. Well, thank you guys for listening in and watching. If you, if you like this kind of content and you want to know when the next great thing comes out, make sure that you subscribe to the podcast. If you happen to be watching this on YouTube, why haven't you smashed the subscribe button? I mean, I got great stuff. We loved it. Resource. You give you great information. You know, just like, just like Emily, we don't sell the financial products. We don't want to manage your portfolios and your investments. We just want to give you great advice. And if we can help you craft your perfect solution, your great financial plan, then we do that. And we do that oftentimes by bringing experts in that know things that we don't know. And Emily clearly has a specialization in the Medicare part of this, and so we're introducing more and more of our clients to her, and this will be one of the ways that we do it as well. So, Emily, thank you again. And I guess we'll be in touch, right?

Sounds good. I appreciate it. It was fun today.

You bet.