Talking Medicare, Health, Life, and Ancillary plan Options

Hi guys, oh yeah, my name is Matt Koppin. I'm here with Piedmont Insurance Services. This is our webpage. We help folks with Medicare insurance, health insurance. We do life insurance along with annuities. Overall, we do a lot of different products inside Medicare alone. On our front page of our website, it talks about Medicare in general where you can get free quotes. Also do Zoom meetings with us in group settings or individual consultations. Uh, personalized options for a lot of our folks because they have— everybody has different situations. You know, always different choices of coverage because we want to be able to be versatile to all our customers. We've been doing this, I guess, combined almost 50 years, uh, between all of us. And services we offer Um, we do Medicare Advantage plans, we do Medicare Supplement plans, and we do the drug plans. These are all Medicare. Um, as far as the Part D, we do, we do handle it pretty much all. And we do the health insurance from the marketplace. We do have some association plans, group insurance, and we also do, um, hospital indemnity plans or like supplemental insurance, like cancer, critical illness policies. Um, or a lot of the, the private side of insurance. Um, we do do a lot of the public fund, like Medicare Advantage is public, the Affordable Care Act is public. Um, so we do also have those options. We also do multiple lines of life insurance. We do have several plans that are guaranteed issue. So if your health, uh, persists that it wouldn't be eligible for underwriting, We, uh, we do have some guaranteed issue policies. Uh, we do do term, whole life. Uh, we do universal life, final expense as well, which is simplified underwriting. And we also do return of premium plans. Most of those are on term. And we do like 10 or 20 paid life policies as well as we do single premium paid life. Uh, we do do some ancillary benefits, which are dental, vision, and hearing. And all those benefits. They can be network-oriented or non-network. We primarily do non-network, uh, just because there's more options and more availability of coverage outside of higher populated areas. Now you can also click on these quote areas. You can see here we're located in Toccoa, Georgia, at 256 North Broad Street. There's our telephone number. We also have it 1-888-779-5038 as well, or you can also email us. You can also follow us on Facebook and on YouTube. As far as these highlights go, we will jump into Medicare here. And Medicare, you can get your free quote on Medicare There's also Part A hospital insurance. Part A is basically your hospital confinement. It's given to you if you work 40 quarters or more, or if a spouse works 40 quarters or more, and will be given to you at no cost. Part B has a premium. That's your medical side of it. If you wanted to have a Medicare Advantage plan, you have to have Part A and Part B. If you just want a drug plan, you have to have either Part A or Part B to get a drug plan. Standalone drug plan along with a supplement. If you want Part A and have Part A and Part B to get a Medicare supplement, some supplement both Part A and Part B covering hospital and your doctors, labs, ER visits. On original Medicare, it keeps primary Medicare primary, so your Medicare is your network, whereas, you know, most of the times they don't come with extra benefits like dental, vision, prescription drug plan, whereas Medicare Part C, the Medicare Advantage, does come with those. So here's a little illustration, kind of talks about Part A and Part B, and you can have A or B to get Part D, whereas here you have to have Part A and B to get it. And so that Part D drug plans kind of illustrated here how you can get them on a standalone drug plan or inside the Medicare Advantage side. This kind of gives you an idea of like how many people are on group insurance, retirees, VA coverage, and then standalone Part D along with Part C of Medicare. So these numbers have changed over the years. This is probably a few years back. So, um, that's just a good idea of like kind of what changes have occurred over the years. Um, group plans really went down. Or as it used to be the most, um, but a lot of it's because they're turning to more Advantage side, Advantage plans and VAs like CHAMP and things like that that are covered. Um, also VA coverage doesn't have to be CHAMP VA or, or essentially a, um, retirees of VA, just somebody has VA benefits. Is counted in that too. So a lot of times they may need a supplement or may require or want a Medicare Advantage plan instead, so they could fall in this range even though they had VA coverage. This talks about the penalty if you don't start a drug plan. And essentially, if you had a drug plan, your Medicare Part A started 90 days after your Part A starts. If you don't enroll into a drug plan, you can get a penalty, 1% per month, and you can only enroll more than likely inside the, uh, annual enrollment period, which is October 15th through December 7th, if you don't hit your initial enrollment. Now, Part C of Medicare Advantage— I'm talking about Part A and Part B. Along with having Part D included. You can have plans that just have Part A and Part B. A lot of VA members just have Part A and Part B under their Part C plans. So a lot of times these will just cover the medical in the hospital but not the drug plan. A lot of VA veterans will get VA benefits, and a lot of times their medicines get delivered to them. Of course, if you ever move outside your area where you live, um, over 6 months, or if you come off any Extra Help or any changes like that, that could initialize a special enrollment period. There's also other special enrollments like coming off group coverages, um, maybe a move, of course, and any changes to Extra Help. Those are the initial things. If your plan was to leave an area, you also get a special enrollment. Usually that only happens during the end of the year, but there are some companies that have went out in the middle of the year and you're eligible for a special enrollment at that time. Now, something new that's been occurring is FEMA. FEMA is a federal issue, usually creates a disaster, a natural disaster. Hurricanes to tornadoes, just power outages in general. Anytime that can make a Medicare beneficiary have to, you know, get outside of their area they live or do business, then they will qualify for an extra, you know, special enrollment period during the year. And usually it's about 15 to 30-day window outside of that period of when it actually occurred. Um, but then they'll get like between 30 to 60 and even up to 90 days of a change eligibility for that, primarily because they might be uprooted from the area they live. Now, as far as, as like these plans go in general, um, we do do a lot of different VANEs plans. They're called, uh, special needs plans. And they can be due to critical illnesses or ailments, and basically taking a particular drug for an illness can also create that. And those folks get special enrollments into those plans. Also, if you had dual enrollment, which is Medicare Medicaid, you're eligible for what they call a special enrollment period all year round. Uh, primarily there's 3 extra special enrollment periods between January and March and April, then to basically June and then July all the way to September. Uh, they give you those 90-day special enrollment periods. Also, there is an open enrollment period that happens January through the end of March. If you do not like a particular Advantage plan and want to go back to Medicare, you can, and that is a particular option. Now, if you're not on Advantage— if you are on Advantage, you cannot get a supplement. I get asked this question quite a bit, but Medicare Part D is also standalone in these situations, and it will take out your Medicare Advantage plan. You only have one Part D drug plan at a time, and that's the easiest way to get rid of an Advantage plan is to sign up for a Part D only, and you can get back on Medicare. Now, once you get on Medicare, you can apply and get a supplement. Now, supplements are private insurance, so they do have underwriting guidelines. If your health doesn't permit during the time of enrollment, you will probably be declined. And in that situation, when you are declined, you may have to wait until you're eligible based on the health questions. Some people will never can get back to be eligible. For a Medicare supplement. So you have to be very careful on— outwatch of what plan you're in, because if you were to have a health issue come up and arise, um, let's say for cancer instance, you have to be in remission for a period of time, at least 2 years to 3 years minimum. Some, some companies are up to 5 years on that. So every plan is different how it works. But one of the things we like to illustrate is is the Plan G and the Plan N. And it's primary because Plan N and Plan G are what's eligible for folks after 2020. Um, back in 2016, there's a MACRA bill that passed and stopped allowing us to be able to offer Plan F to folks that are turning 65 after 2020, or essentially their Medicare Part A and B started after 2020. So if you're a Medicare beneficiary and you started before 2020, then you're eligible for Plan F still. You're grandfathered in. But anybody else after that period will no longer be eligible for Plan F. A Plan G has a Part B deductible. It changes every year. It's over $200, like around $226. It's been in that area for a while, between $230 and so forth. Now, both Plan G and N have to have that deductible met, and then Plan N requires a $20 copay for primary and specialist unless the bill is under $100. And a lot of times under primary, you may only pay like $15 to $17, $18 based on the final cost of what Medicare approves, and you'll pay 20% of that bill. Now, if you were to go to emergency room, it's a $50 copay. Now, if you get admitted from the emergency room or within 24 hours, they will essentially consider you confined. And if you're confined, then they waive the $50 and you got 100% coverage in the hospital. Now, the other thing is excess charges. Excess charges are non-participating Medicare providers. So anytime a non-participating Medicare provider, they don't accept Medicare, so your primary insurance with Medicare will no longer be primary. I mean, basically it's primary, it's no longer covered as in-network, so they can actually charge up and above what Medicare approves. And in that sense, they can charge excess after that approved charge. And that approved charge that is allowed, the max allowed amount usually, usually 10 to 15% up above what Medicare approves. Medicare will pay that portion of the— what they're going to pay, but then that 10 or 15% is what you're allowed to be charged. And so that's where the excess charges come from. Now, if that were to happen on Plan G, the plan would pay 100% of that. But on anything under Plan N, then you would be required to pay those excess charges. And it might range between, you know, a couple hundred to $600 depending on the provider and what procedure or what actually, uh, bill was charged to you as far as itemization goes. Now, as far as all the supplements go, we usually offer quite a bit of these, but like I said before, Plan G and Plan N are the primary ones we offer. And over here it kind of gives you that guideline on C and F. If you're eligible for 2020, you can get Plan C or Plan F. Of course, here's our free number here, toll-free is 1-888-779-5038. And if you ever have any questions or think anything you might have on information on here, some information we've sent up on YouTube to, uh, you know, give you connections on some of the plans and some of the options that are available. And we just like to help people like yourself. And when you're eligible and when you're new, it's all about basically helping you get to the points that you need, you know, help with. Because like we have a situation right now where specific people are on group insurance, but now they're required to take out Medicare Part A and Part B. And so that's happening more and more often. Um, and states, states are like that already. So when you become eligible at 65, they require you to get Part A and Part B so you can be eligible for those new health benefits coming up the first of that next coming up year, or in the time when you need to be to get those started on the first of the month. Medicare always starts the first of the month. Now, if your birthday is the first of the month, you're actually going to start a month early. So if your birthday, say for instance, is December 1st, you're going to start November 1st on Medicare. So Part A and Part B would start November 1st. If you're born on any day after that, from November 2nd to the first of the next month, your month will fall. So if it's December 2nd to, to basically January 1st, you'll fall December 1st of that year. And so when your Medicare starts on the 1st of that month, your benefits can start even if you are 64 at the time. Essentially, your benefits will always start before you turn 65. Now, on Social Security, they like to pay you a month later. Medicare likes to take out the premium a month early. So if you're eligible for 12/1 effective date, essentially you're going to have that taken out of your Social Security check, or you're going to get billed in the month of November for the month of December. It's coming out— they're requesting the money earlier, and then they're actually, you know, charging you for Part B, um, on those earlier dates, but you're not going to get paid on Social Security till the month after. So if you started your Social Security, let's start in December, well, they wait the whole month and make sure you, you stay alive the whole month, and then they pay your paycheck the month of January. So that's how benefits are paid to you on Social Security, and that's how you pay for Medicare when your Part B starts. Now, we do do other insurance. We usually bridge people to Medicare, and that's what we kind of specialize in, helping folks You know, with health insurance, we do quite a different bit of different options in health insurance, and we try to help folks with different, different products, different plans. We do the Affordable Care Act. It's our first little icon here, and essentially the Affordable Care Act is a thing that makes health insurance affordable for those with, you know, income thresholds and what the government test for. Now, if you're on a health, you know, if you ever need extra benefits or supplement to health plans, we do this health savings supplement. It's not necessarily an indemnity, but, um, we do do indemnities and critical illness plans. This particular plan here is what they call a health matching account. It helps fill in the gaps of all health insurance, Medicare insurance, or anything else that you would have out of pocket on like prescriptions or going to the eye doctor or the dentist. Um, so those kind of things are covered as well as like hearing aids. Um, they do cover some cosmetic stuff like laser eye surgery underneath these supplements. Um, they are funded, funded by you, but they also supplement money to you. So it's kind of like having an extra benefit, uh, savings for your for your health. Um, as far as mental essential coverage goes, we use these plans, um, essentially to help folks keep their costs down overall. Um, they are guaranteed issue, but they cover like preventive visits or screenings, like cancer screenings and colonoscopies, um, mammograms. They'll cover, uh, your doctor visits. Going to a primary or specialist as well. But there's different guides to, to those plans overall. And then we have association plans, and essentially they do have health questions if you're an individual seeking health coverage. But if you're basically wanting to look in a group, we— these association plans do have groups, and you can qualify inside that group. Essentially no health questions on the group side. But if you are on an individual setting, they have about 8 questions that are health-related, and if you can answer no to those or fill in the yes and, and give them the best response you can on that situation, uh, they do take on quite a bit of different pre-existing conditions, but there's quite a few they don't take on. Uh, you know, as far as ones that don't, is insulin diabetes, um, if you're dependent on that, as well as if you have like sleep apnea, um, or if you have like congestive heart failure, cancer, strokes, um, TIA, some of those things can trigger you and knock you out of getting, uh, the association plans on an individual setting. Uh, as far as other programs we do, we do Christian Healthcare Ministries. And we just refer people to them. Um, it's actually what I currently have, and that's how we do referrals. Um, but they do have pre-existing condition checks. Um, Mama Medishare does the same thing as SEDERA does. So if you have some health-related issues, these plans can be more, um, effective if you don't have any pre-existing conditions. Um, most of the time we look at these because if you have association plan, It can easily be, it can be about half the cost of those association plans, if not less, more like a third sometimes or a quarter of the cost. Overall, like MediShare and Cedera, they all work, all of them work differently. Christian Healthcare Ministries and Cedera run on more like a sliding scale. They have several different plan options, but if you were to have something happen, um, you have to meet a certain amount out of pocket, and they're both, um, more likely related to— I guess each, each, uh, health-related issue could cause it, you know, you have to meet their out-of-pocket again. Uh, MediShare includes all of them, so If you have one issue and another issue and another, Medishare combines all of them in one calendar year and you can get them all met in one year. And they actually include that with all the family. So you might have higher, let's say 3, they have 3, 6, 9, and 12,000, what they call annual household portions on Medishare. And if you were to meet that threshold on the household portion, the plan will pay 100% outside of any copays you may pay for like doctor visits or ER visits. But Medicare will pay, pay after that household portion's met. The ministry, Christian Healthcare, they have like a gold, silver, and a bronze. It's like $1,000 gold, $2,500 silver, $5,000 on bronze. And if you meet that and get it written off, you wouldn't pay anything out of pocket. So if you had like a $20,000 bill and got $5,000 written off of it, all 3 plans would pay 100%. Of that $15,000 that's left. So any portion that's written off on the bill, Christian Healthcare Ministries will take care of that, and then they'll pay the remaining balance of that bill. Um, but each incident is taken out, uh, separately. So you could have another bill where it's a couple hundred dollars and you still owe, even though you're being paid 100% of another bill. Well, that was much larger. It's mainly there for major catastrophic. All three of these are. Now, SEDERA has a thousand, they have a 15— well, they have a 5, a thousand, 1,500, 25, and then a 5,000 plan. And there is no thing like the ministry where they could write off anything. You essentially meet that, and then if there's an individual that has this plan and they had like a $1,000 plan, they would have to meet 3 of those incidents in a year that they could be responsible for, and they could be out $3,000 on a $1,000 plan. So that's their total out-of-pocket. Um, but if you had an incident, that incident kept occurring, Sodera is more generous and will keep paying on that incident until it's completed. Um, as far as Sodera goes, if you had a family, they have 5 5 incidents per year for the whole family. So if you had 1,000 plan it, you can have as many as 5,000, uh, for the family total out of pocket on that versus the 3. So a very generous plan. And there's a lot of the companies we do in health insurance, um, quite a few more also too. But, and let's say we're doing life insurance, this generally you can get a quote Um, why you need life insurance, types of life insurance. That's all we do. Guarantee issue, we do, do term guaranteed, new term return of premium, guaranteed issue whole life, and then regular whole life. We also do final expense at the top here, and we do 10, 20-year pay, single pay. And then our team here, this is all of us here. What's neat about this is you can actually click on one of us, go to our old page, and you can shop Medicare plans and find out options in Medicare, uh, plans that are available. So they also look at those plans throughout the time, see which ones best for you. Now mine, I got probably the most little links here. Got Medicare, got Cigna's drug plan, WellCare drug plans, um, and then I got life insurance and health insurance. And you can get quotes on all these along with the Medicare, on Advantage drug plans, and probably has one for Medicare and shop plans for Medicare. Michael, Tim's got his on here for HMA and the Medicare. Now he can choose his options. And then Michelle's got hers listed here. We got dental, vision, Medicare. She's got a benefit store here that helps with the dental, vision, and then also we do, um, HMA. I do have a Dental Vision page here. These are my links, uh, at VSP, Spirit, Delta, um, UCT has went out now, but, um, we do, um, Spirit is actually owned by Emeritus, and we do have some Emeritus plans available. Uh, we also have one called Renaissance. It's inside this Delta as well as VSP., we do different benefits on. There's our contact page, so you can contact us and reach out to us regarding any information or any types of questions you might have. And we have group, group health thing here where you can get a group insurance from the Smart Plans and downloads from participating, uh, with the Chamber of Commerce through Georgia and our local chamber. And so we do allow folks to, to qualify and see if they qualify for these plans through, through the Chamber of Commerce. And that's our website. Appreciate you watching this video and going through the website. If you have any questions, feel free to reach out to us. Uh, you can call us on our phone number here, 706- 779-5038. Can email us. Also, don't— feel free to follow us on Facebook and on YouTube. You can subscribe to our channel. We appreciate that. But thank you for joining us today on this video. You have a good day.