Welcome to another episode of the Dr. Friday Radio Show! In this episode, tax expert Dr. Friday has invited Nathan Wright from https://medi65.com back to the show. Below are several topics discussed in this episode.
- Medicare overview – Explaining the different parts of Medicare (Part A, B, C, D) and options like Medicare Advantage and Medigap/Medicare Supplement plans.
- Medicare enrollment – When and how to initially enroll in Medicare and make changes during the open enrollment period.
- Medicare penalties – Penalties for not enrolling in certain parts of Medicare when you are first eligible.
- Comparing Medicare plans – How to use online tools to compare different Medicare plans based on your doctors, prescriptions, etc.
- Plan changes – Reasons to review your Medicare coverage annually as plans and costs can change year to year.
- Getting help with Medicare – Using an insurance broker/agent to understand Medicare and make the best plan selections.
- Medicare and retirement – Transitioning from employer insurance to Medicare at age 65.
- Medicare coverage gaps – Parts of healthcare that original Medicare doesn’t cover like vision and dental.
- Medicare Advantage pros/cons – Discussion of the tradeoffs between Medicare Advantage and Medigap plans.
- Medicare savings programs – State programs to help pay Medicare costs based on income.’
- And much more!
Part 1: 00:00
Announcer: No, no, no, she’s not a medical doctor, but she can sure cure your tax problems or your financial woes. She’s the how-to girl. It’s the Dr. Friday Show. If you have a question for Dr. Friday, call her now, 737-WWTN. That’s 737-9986. So here’s your host, financial counselor and tax consultant, Dr. Friday.
Dr. Friday: G’day, I’m Dr. Friday and the doctor is in the house. We have a really good show scheduled for today. And as you know, you can always join our show live at 615-737-9986. And we today are going to be talking with Nathan Wright. Many of you guys have been listening to me for well over 10 years now. And Nathan’s been on the show a few times and he is my go-to when it comes to Medicare. And it’s probably one of the more confusing. People think taxes, Nathan, are confusing. First I should say, hello, Nathan, join the show.
Nathan: Hey, how you doing, Dr. Friday?
Dr. Friday: I am good. I was just gonna say that, you know, Medicare is a subject in itself. I know a lot of people think taxes can be complicated, but having to deal with Medicare, in my opinion, is just so much advice out there. and some of it can just seem like it’s more confusing than probably it needs to be. So I’m hoping today we can always take your calls if you’re dealing with Medicare or if you have a family member and you might be helping them make decisions. Remember, this is, I don’t know, this is the time when people can start getting ready to make changes, right? ‘Cause there’s only a certain time of the year, Nathan, that people can do adjustments to their Medicare?
Nathan: Yes, you are absolutely correct. This is the annual election period which starts on October 15th and runs through December 7th. So we are almost there.
Dr. Friday: Yeah, so this is the time. So if they’re wanting to add or if they feel that they have too much of something, this is the only window of time that they can really do that. They can’t like, if I don’t like my insurance today, I can go out and change my insurance. You can’t do that in Medicare.
Nathan: That’s generally correct. Although there is what’s called special election period. So there are sometimes life events that fall outside this time of year that you can have and you can make changes during the year, throughout the year. But this is the time typically everyone thinks about Medicare. Okay. So let’s take and explain a few things, Nathan. I’m going to work my way down a basic little checkoff list of either things people have asked me and or just typical questions I think I would have. So first thing is, what is Medicare Supplement Plan or Medigap? I don’t even know what that is. Okay, so I like this question because Medicare Supplement Plan is basically the new term and Medigap is kind of like the old ancient term. But Medigap though is kind of a better way to even think about it because it basically fills in the gaps of Medicare. So for instance, Medicare Part A has a $1,600 deductible. So you’re going to go in the hospital, you’re going to pay $1,600, except if you have a Medigap or Medicare supplement plan, they’re going to cover, they’re going to fill in basically the gaps. And then if you think of the Part B side of Medicare, you’re on the hook for 20% and Original Medicare pays 80%. So that Medigap plan comes in and it will pay that extra 20%. So just kind of, kind of in a simplistic term, if you are on a Medicare supplement plan, original Medicare is gonna be in primary position.
Dr. Friday: Right.
Nathan: – Supplement plan will be in the secondary position, if that makes sense.
Dr. Friday: Sure, I mean, it’s a lot, I mean, it makes sense. Medigap, like you said, does kind of, the terminology makes a little better sense to me because it’s the gap between whatever you’re paying in Medicare and that apparently there are some holes. That’s one of the reasons I’ve always enjoyed my health savings account because I have some place where I can set that money aside a little bit so when we always have a gap, right? I mean, no one ever pays 100% with the first insurance, at least it doesn’t seem like it. There may be some exceptions out there. I’m certainly not an insurance expert, but let’s explain a little bit then what is, let’s, we’re all jumped down to what are, ’cause you always hear about all the letters of the alphabet, Medicare A, Medicare B, C, and I think is it B that we have to take, like that’s the one that you are kind of signed up with when you go on to Medicare or am I wrong? I could be wrong.
Nathan: So it’s, that like you said earlier, is a little bit complicated. So Medicare Part A, so this is what folks wanna kinda realize is when you take Social Security before age 65, you will automatically be enrolled in Part A when you turn 65.
Dr. Friday: Okay.
Nathan: And then they’ll also automatically roll you into Part B. you just have to opt out if you decide to not. And I don’t see any reason why not to, why to opt out of part B because you definitely gonna want both part A and B. But really to kinda just simplistically, you know, answer your question as far as the difference between A and B, A is gonna cover your basic hospitalization and B is gonna cover your doctor or your like your outpatient visits and what have you. So just original Medicare, I count original Medicare as kind of like the foundational coverage. And then there’s all these other things, as we just talked, like Medicare supplements, Medicare, Medigap, Medicare Advantage, et cetera, et cetera. Right. But there’s also again, my sister went on Medicare just last year or whatever, so I had more of information than I probably wanted in this. But what is C and D? Because they were really pushing initially, you know, you need to get A, B, C and D to cover everything. What are those? Do you know what C and D cover?
Nathan: Absolutely. So that’s a great question. So like I just said, your A and B, I think of that as kind of like your foundation. And built on top of that is you can take C and not to be confused with, a lot of people say, well, you need to have your Part C of Medicare. Part C of Medicare is actually another terminology for the Medicare Advantage Plan. You do not have to. In fact, if you get a Medicare Supplement Plan, you do not need Part C of Medicare because that is the Medicare Advantage Plan. So, and that’s personal choice. You know, what we do is we educate folks in the differences between the Advantage and the Supplement Plan so that you, you know, you make the choice, but don’t let anybody tell you, hey, you have to take C because if you get a Medigap or Medicare supplement, you can’t take C. Now to contrast that with D, just remember D for drugs. So D is gonna cover your drugs and many Medicare Advantage plans have C and D built in together. So a lot of times if you get a Medicare Advantage plan, you actually have the full package. You got A, B, C, and D with a Medicare Advantage plan. But again, that’s a personal choice. If a person would rather have a Medicare supplement or a Medigap plan, they would need to pair that with a Part D, a standalone prescription drug plan.
Dr. Friday: Okay, so you brought in a Medicare Advantage plan. What is that compared to, I mean, is that a secondary insurance, the Medigap that we were talking about, or is a Medicare Advantage plan a completely different plan than just a B and then a Medigap?
Nathan: So the Medicare Advantage is a whole separate animal. So your difference is, you know, if you do Medicare, basically you have two choices. When you start Medicare, you’re gonna wanna look at either the Advantage or the Supplement. You can’t do both. So if you go with the Advantage plan, to answer your question, is it’s a private, you name, you think of any major insurance company out there, you know, you name ’em, they have a Medicare Advantage plan. And they are gonna operate traditionally like either a PPO or HMO. In most in our market, we’re fortunate enough to be in a market that the majority of the Medicare Advantage plans are a zero premium. So you don’t have to pay anything extra for an Advantage plan. But the difference between an Advantage and supplement is while you may not pay a monthly premium on an Advantage plan, you will have co-pays. We will have co-pays. The flip side of that on a supplement plan, you’re gonna have a monthly premium and either little to no co-pays, depending on what type, and there’s different types of supplemental plans. But it’s basically, I tell people to kind of just in a very simplistic term, the Advantage Plan is kind of a pay as you go, pay when you need it. A Supplement Plan, you’re gonna pay a monthly premium whether or not you need it or not. So it’s just depending upon how risk averse you are to which way to go. And I will add too that there’s certain folks in my profession that lean either one way or the other. You get on YouTube and most of the guys are gonna be pushing Medicare supplements. You get on TV and most of the guys are gonna be pushing Advantage. I do neither. I am right down in the middle of the road. I give folks an education on what the difference is between the two and let you as the consumer decide.
Dr. Friday: See, that’s why I always love about you, Nathan. I mean, seriously, is that, you know, even when we met years ago, whatever, and we started this conversations and I’m like, this is what my listeners need to hear because so often people are usually pushing what they sell. Let’s be honest. They sell a product, so they want to sell that to the audience or the people listening to them. And it’s not that you don’t sell product, but that’s not, I mean, we all have products to sell, but you give people the advantage to understanding, you know, I’m not only selling, this is the only package. It’s the best package ’cause it’s the only package. You know what I mean? Where if, you know, and some people, like you just said, some people may have more money and prefer to have a zero pay now through the month, every month, and then be able to come up with $10,000 if they have to co-pay for an emergency. Where other people may prefer, you know, I’d rather build it in my budget and know that I have to pay this much a month but I’m not gonna get hit most likely with that big $10,000 payment if I end up in the hospital. You know what I mean? You have to figure out what each person, and I like that option because no two of us are exactly alike and each of us have different risk aversions to that kind of situation.
Dr. Friday: Okay, so now let’s talk about, so we’ve got A, B, C, and D, basically, you get your drugs, you can figure out if you want to go with the Advantage or a secondary Medigap kind of thing. But how about dentist and eyewear? Now, is that usually included in these kinds of deals or do we need to be thinking that we think we have it and then we realize we don’t because they’re not in A, B, C, or D?
Nathan: So, an original Medicare does not cover like your secondaries like vision, dental, or hearing. So if you go the supplement route, you’re either gonna have to self-insure or buy a standalone dental or vision plan. Now, the beauty of the Medicare Advantage plan is it’s kind of all in one package. So many of those have generous dental benefits, vision, hearing, depending on the company, and they’re very competitive, which is good for the consumer because they’re all trying to outdo each other. So they definitely have some good dental benefits built into the Advantage plans.
Dr. Friday: All right, we’re gonna take our first break here. Again, this is Nathan Wright with me, Dr. Friday in the house. I’m gonna give you Nathan’s number, is not the studio number, but if you would like to call Nathan, 615-823-1322. If you have a question and you wanna join the show today, ’cause maybe you’re in the midst of trying to understand what’s the best deal for you, and it may not necessarily be, we can give you the answer directly, but if you’ve got some questions concerning how Medicare is affecting your life, you can reach us in the studio, 615-737-9986. 615-737-9986. We’ll be right back with the Dr. Friday Show.
Part 2: 13:00
Dr. Friday: We are back here live in studio. And again, if you wanna join us here, maybe you have some questions about taxes, which is always available on this show. But if you have some questions about insurance, Maybe you’re thinking about changing or maybe you’ve never actually, you’re getting ready to sign up and you don’t know where to start. Because I tell you, there is a lot of choices. Nathan makes it seem simple, which is what we all love. But when it comes time to us making these decisions, and especially for many of you guys, you might even be helping parents or loved ones, helping to make these decisions or keep these decisions as life changes happen. So if you have a question, you can join us here in the studio. 615-737-9986.
Dr. Friday: All right, Nathan, we are back to my questions and here’s one that I thought was a good question. So how can you compare these different plants? I mean, how do I, you know, it’s not like there’s a chart that gives it to them next because I’m assuming, you know, there’s different costs like you just said. So is there a way of really making a fair comparison with the different options?
Nathan: Absolutely, and I suggest that everyone do that. So you can actually really simply go to my website, medi65.com, and then click on shop plans. You enter your zip code and it will show you every plan available in your area. You can even go as far as putting your doctors and your prescriptions, because let’s just face it, we were talking before the break about all the benefits, and this is something that we see time and time again. Some people will get hooked on, you know, there’s plans out there that give $5,000 in dental, but they don’t cover your medications. That’s not good. That’s not a good trade-off. So it’s very good to, you know, use this tool. And if you’re not tech savvy, we can help you with it ourselves, you know, but we do have that right on our website.
Dr. Friday: Perfect. All right, we have Kathy on the line that has a question concerning prescription plans. Kathy, thanks for joining the show.
Caller: Thank you.
Dr. Friday: And go ahead and ask your question. Let’s see if we can’t get you an answer.
Caller: Okay. My question is, Part D, when you initially sign up for Medicare, typically A and B, as he was speaking of, but on Part D, I found out that there is a penalty if you do not sign up for that. And I want to confirm that or see what he knows about that.
Nathan: So this is a perfect question. Yes, so there is no penalty for part C There is a penalty for part D. So that may be where it’s coming in So you can like I said earlier some C has D built in but you have to have some type of prescription drug coverage or there will be a penalty and Unfortunately, and this is something that kind of breaks my heart when people come into my office and they have been on Medicare for ten years and then they go ahead and sign up for a drug plan or a Advantage plan with a drug plan built in They’ve got a 1% penalty that they have to pay for the rest of their life on that unfortunately So it is the D side that the penalty is incurred
Caller: Right and that’s not something that’s readily available when you enroll at least it wasn’t when I did And I kind of found out by accident. Luckily, I caught it only a few months late. So my penalty is not that much.
Dr. Friday: So you’re still penalized for something that no one tells you that you need to do in the first place, which is the crazy part of that.
Caller: Exactly. For something that I did not and I did not need any prescription drugs at that time. So I still don’t.
Nathan: Yeah, and that that’s a that’s another thing too. Yeah I’m very grateful this question because like I said, I see this every day the folks that that have that penalty and you know I hate because if I had a caught them before, you know years ago I could have stopped that even and you know, a lot of folks don’t like you said don’t take prescriptions So they’re like well, why do I need a drug plan? But if you just take the minimum like their drug plans that are very inexpensive The minimum cost that’ll at least keep you out of the penalty
Dr. Friday: Okay, so I have to ask a quick question between both of you, but is this right when we sign up for Medicare? You know, when we’re doing, you know, at 65, when we’re joining in unless we’re working or whatever, do we have to make that decision then or we are late?
Nathan: Yeah, well you’ve got a small window. You have grace period. There’s a three month after your birthday month, but if you don’t do that, you’re penalized 1% of the average national premium per month for the rest of your life. So if you just wait, you know, you’re only a couple months, you’re paying like 65 cents a month or something. It’s a penalty and it’s ridiculous.
Dr. Friday: Oh wow. That’s something I had not heard any. Kathy, thank you so much. Cause I mean, I’ve heard people say, if you don’t sign up for Medicare on the right time, you know, just regular Medicare, there is a penalty. But I didn’t realize that the other letters of the alphabet were also, Well, some of them, right, Nathan? Not all of them, but some of them, like this, Schedule Part D has a penalty. I did not, we’ve been talking about this for years.
Nathan: And I will throw something else out in there. So sometimes there are some advantage plans that this is gonna blow your mind. Not only are they zero premium, they give a little money for those folks that have penalty issues. They give you a kickback of some are $50, some up to $100 a month in kickback. Now you do, there’s a trade-off. You trade off some benefits for that, but that option is out there.
Dr. Friday: Great, thank you, Kathy, for asking that question. I think that’s been helpful.
Nathan: Yeah, great question. Thanks, Kathy.
Kathy: Oh, you’re welcome, ’cause I’ve run into so many people that were unaware of that, so.
Dr. Friday: Yeah, perfect. So while we’re on that subject, Nathan, what is, I mean, there is a penalty if you don’t sign up for Medicare as well, correct? Like you just said, after your birthday or whatever the rule is.
Nathan: So, yeah. And it’s all about the ABC and D, isn’t it? So, um, it does, right. So the B and the D can incur penalties if you don’t sign up right when you’re eligible. So that’s how that works.
Dr. Friday: I know. Cause initially my father, when he went on to it, he was under regular insurance and they were a part of, you know, The whole thing is I don’t want anything from the government. I don’t want any handouts kind of thing and all this. But we got past that very quickly when you found out how much at 65 you pay for health insurance when you’re not on Medicare. Anyways,
Nathan: …and the fact that you’ve paid into it all your life anyway.
Dr. Friday: I know it’s not exactly. You know, that’s a great point. I mean, it’s like Social Security. These are not handouts. These are people. I mean, these are actually things we have paid in. We’ve paid the taxes. These are benefits to being working and that’s a really good way of putting it because I have some people that don’t really like because they get these, I mean, they think of them as handouts, but a handout is something you hadn’t actually funded. These we funded for 10, 20, 30, 40, depending on how many years you worked, years. So yes, I am wholly on board for that one.
Dr. Friday: All right, so let’s see. So on the cost side, I think we kind of covered that because they can go to your website. You want to put that out there again, Nathan, the website that they can go to?
Dr. Friday: Okay, cool. For comparison. Yep. All right. So we have another person on the phone. We’ve got Todd. Todd in Tennessee. That’s a big state, but hey, Todd, what you have happening?
Caller: I’m in Carthage, Tennessee. I’m east of Nashville. I wanted to make your listeners aware of another penalty that I have had happen to me. I was with a company, I guess I’ll remain nameless and I got on their drug program and they were supposed to send me my blood pressure meds once a month. And for almost two years, they were late with my prescription. And without getting into way too many details, I ended up canceling their drug program. And I just had my doctor write me a script and I went to Kroger and got my blood pressure meds there and it only cost me like $25 every three months. Well I ended up changing coverage with a different company and it took about a year or so to catch up to me but all of a sudden I start getting these bills saying that I was late what do they call it, I was late for enrollment, which I wasn’t. And what happens was, since I canceled my drug program, they are now charging me $7.25 a month for life because of those two years.
Nathan: That is what is referred to as the late enrollment penalty. That’s exactly right. Right. That’s painful.
Caller: Even though I paid it, even though I was paying it myself, I’m getting charged, I’m getting fined a penalty for paying for myself for two years. Right. And so, and I can’t get out of it. I have, I have written in and you are stuck with it for the rest of your life unless you cancel your, your social security.
Nathan: Yeah. Yeah. That’s a good example. It is definitely unfortunate.
Dr. Friday: There are, thank you so much, Todd, for sharing that. Seriously, that helps a lot of people.
Caller: – Thank you for what you do.
Dr. Friday: No problem, Nathan. And that’s, I mean, this is what you say you hear all the time, these same situations where people are getting, I mean, just like that, he canceled because they weren’t doing their job, not realizing when he did that and not immediately going with another drug service, he now is gonna be penalized, whatever, it’s $7 now, but there could be other penalties depending on the rates, right? It’s basically a penalty based on a percentage of national standards or something.
Nathan: It’s a percentage of the national. We’re not allowed to say exactly, but we can say it’s 1% of the national average of the drug plan per month, though, that you don’t have it. So I’ve even had a lady, you know, she came into my office and she was about a hundred dollars a month because she hadn’t had it for 20 years.
Dr. Friday: So I mean, it’s, I mean, I think IRS and I know about some of the silly penalties that can happen. And I realized that, but normally in most cases, the penalties are because we actually did something by not paying, not filing, whatever. This is just nut gentlemen. I mean, he’s like, I’m just going to pay my own bill because no one else seems to know how to do it on time. And yet he’s still there in the IRS. There is some loopholes, right? We have some ways around this, I guess. You know, well, you know what, we’re all take a quick break here. and we come back, I may ask you, Nathan, is there any way of getting this penalty removed under unique circumstances? I’ll let you think about that ’cause we’re gonna take a quick break here and we get back. You guys can join the show at 615-737-9986. We’ll be right back with the Dr. Friday Show.
Part 3: 25:05
Dr. Friday: All righty, we are back live here in studio with Mr. Nathan Wright, the insurance expert, especially when it comes to Medicare and all these crazy loopholes. So let’s get back to that question because I have a tendency to talk right over myself. So Nathan, I’m gonna bring back, is there any way of bringing or removing these penalties under unique circumstances? And just so you know, Nathan, your mic is off. All right, well, Nathan may not be with us right this second, guys.
Nathan: – I’m back, I’m back. –
Dr. Friday: Ah, there’s my boy. Okay. You know, I have my own issue this morning. So, all right. So what is there, is it pretty much road and stone? If you don’t do it in this time clock, you’re out.
Nathan: – Yes and no. So there is unique circumstances. It’s gonna be income related. So if you fall under a certain income and let’s just face it when you retire your income changes. So, you know, that’s a service I provide a hundred percent free to my clients. You know, if there’s some kind of program where we can apply to get it removed, we will apply and get it removed. But just like I said, it’s gonna be a lower tier income. So, and then the other option is like we discussed earlier, there are some plans that give a, it’s called a Part B give back. So, you know, instead of paying the 165 a month for your Part B, you might can reduce it down to 115 or something so that can offset some of those penalties as well.
Dr. Friday: Well, it’s good to know. I mean, I’m not surprised. I mean, you know, I mean, and again, I get the fact that we have to have a set of rules. I mean, you know, I’m not a big person that likes rules, but I will tell you, I understand why we have them most of the time, keep the world from going crazy. But that being said, it just seems like this is one of those where, you know, if you don’t need it, like, you know, then why do I need it? I mean, why do I need to sign up? But they’re saying, We need to know who’s going to be under, apparently a drug plan, no matter what. Um, so that they can use that information in some amazing way. I’m pretty sure Nathan.
Dr. Friday: All right, Nathan, why don’t you share with everyone really quick? I didn’t really introduce you very well. So you want to tell everyone why I think you’re so amazing. Go for it.
Nathan: You want me to tell everyone why you think…
Dr. Friday: You caught that very quickly. Yeah. Well, maybe you should think why they think you should be so amazing. But Hey, what can I say? Why, why should you be talking about insurance? What’s your background a little bit? So they understand I didn’t just pick you off the street and said, Hey, you know, let’s talk about insurance today.
Nathan: Well, I tell you what, so I fancy myself as a very simple person that is, has become an expert in Medicare. And I don’t say that lightly because when I have tax things going on, I call Dr. Friday. Okay. So, um, you know, when there’s Medicare things going on, there’s got to be someone in that lane. So I’ve actually been, you know, uh, practicing Medicare insurance for about eight years. Um, I got into it, you know, I had other friends in different fields of insurance and I decided, you know, let’s just specialize in health insurance, not try to be an expert on everything, but you know, focus on that one thing. So, you know, um, I, I feel like, you know, I try to stand out between, you know, all the noise of, you know, let’s just face it. Folks are just bombarded this time of year with every message under the sun and every company says, buy me, I’m better. So I take a very simplistic, laid back educational approach and say, let’s just sit down or we can do it over the phone, whatnot, and let’s just go over your options and let’s just kind of, you know, eliminate things like we talked earlier about, you know, doctors, hospitalization. If there’s a doctor that you have to see, well, there’s about five plans that don’t take that doctor. So we need to eliminate those options. So we just kind of work our way step by step and, you know, to then arrive at what’s right for you. And these plans, like I always say, they’re not like shoes. I mean, they are like shoes in that, um, you know, everybody has different styles, taste, preferences, needs, et cetera, et cetera, because what’s right for me might not be right for you.
Dr. Friday: So, you know, that’s kind of the reasons why, okay, so we went through this, we’ve got the perfect plans, but I’m assuming I know the answer, but just for people that are listening, because, you know, insurance is one of those things that we kind of just let, I mean, I’m insured, I don’t need to look at it. I know my insurance, it’s there, I pay it every month, boom, boom, boom. But what would be some reasons why people might want to be revisiting this again, every year, of a few years, whatever, Nathan, you know, why would we want to make any changes?
Nathan: So this is definitely something that’s always brought up, you know, there’s always changes in Medicare and that is unfortunately sometimes used as a sales hook, you know, there’s big changes in Medicare, you need to call this number right here, but there is what a person really needs to do is things can change in networks. Things can change in prescriptions. There are certain folks that have prescriptions that are vital for them to take and this particular drug plan may not cover that or may have moved that into our more expensive tier. So it’s very important for someone to sit down and review. And even if you don’t make a change, at least get a no cost, no obligation review to say, “Hey, you’re in a great plan,” or, “Hey, you know, you could save, you know, $50 a month in medications because this one company has changed their, you know, formulary.” So that is true. There is annual changes. They’re not big changes like they like to make them out to be, but there are annual changes in each plan, and that’s going to be on your advantage and your drug size. Now, the Medigap plans, the only thing I can say critical about them is the only change they usually make is they go up. Unfortunately.
Dr. Friday: I mean, and that’s, I mean, that was what I was thinking. Two things. I mean, I know my health insurance every year goes up by clockwork every year. And then gosh forbid, you hit one of the big numbers, 55, whatever. And then it goes up again because of your age. I mean, I am one of those people that are blessed. I’ve never used it with exception of having to go and get my steroid shots for poison ivy or something, you know what I mean? So I haven’t had, but guaranteed you’re going to go up every year. So, and that’s what I was thinking that in life changes, right? As we get older, we have maybe more need for prescription than when we were younger. Or like you said, my sister, one of her big things, she did have set doctors. She did not want to lose the doctor she had built relationships with, you know, for her, her life. So that was one of the big things she had to go with was to make sure she stayed in whatever was going to allow her to go see these said doctors. And some of the plans did not allow, or the doctors didn’t take those plans, whichever way that might happen. So I think that would be one of the more important things is if you know that you’re heading towards, I don’t know, hip replacement or something that’s going to be bigger and better, you might want to double check and see, are you really covered? Is it something that you can do without more cost to you? ‘Cause I’m assuming some of these plans may or may not cover everything that happens in life. That’s my guess.
Nathan: This is true. And like we said, the Medicare Advantage plan sound great ’cause there’s zero premiums, but if there is that life event, like you said, or a hip replacement or what have you, there are some co-pays that you’re gonna have to pay. And there’s even options out there called hospital indemnity which actually will help you pay the big co-pays that Advantage Plan do not cover or that you incur. So, I mean, you can almost, you know, have the best of both worlds if you have a Advantage paired up with a hospital indemnity. Yeah, I don’t mean to throw more terms out there, but it is a good option for sure.
Dr. Friday: That is one of those things, because again, the biggest concern to me would be, it’s not so much that, I mean, again, I’m healthy, but one never knows, right? So if you end up in the hospital and you now, and gosh knows it’s not cheap to be in the hospital from everything you hear and read. So it would be great to have that backup. I mean, to have something where you have the ability because if you end up with a $10,000 bill and I’ve had clients, that guy broke his leg, cost him $150,000 because he was not insured. It was not the best plan in the world, obviously. And it took years for him to get that settled and to pay it off and to me it made a huge life change In this particular individual and that was you know, because you think you’re invincible So again, I think one of the things people really have to come back is think about What kind of things may be coming down the line and are you covered and you know? I’m always for anyone that’s going to give me a free evaluation and I feel you know Nathan’s really cool because he’s going to give you the options. He’s not going to sit there and press you. You got to buy, you got to buy. If you don’t do this, you’re going to regret it. That’s not it. You can tell guys, that’s not his real sale approach. It’s not my nature. It’s not his sale approach, which makes it easy for you to sit down and say, “Hey, here’s what I have. Could there be a better, or this is what I think might be coming. My doctor keeps talking to me about this or this. Am I in the best plan? Am I in the best situation?” All right, we have Milton in Nashville. It might be my boy Milton, one of my loves. If it is, he’s got a question for us. Hey, Milton.
Caller: Hey, Dr. Friday. Happy October.
Dr. Friday: Ah, this is my boy. All right, Nathan, you’re in for it now. This is one of my long time clients. Okay.
Caller: Hey, Dr. Friday, I always enjoy you bringing Nathan in every year about this time. I’ve listened to him for the last two or three years that you brought him in and he always come in so knowledgeable and enlighten us to everything that’s going on. And I really, really appreciate you having him and Nathan, I appreciate you being there.
Nathan: Yes. Well, thank you for that.
Caller: Okay. Hey, my question is number one, uh, being a retiree state employee, and they always say people that retire from the state have the best plan. I searched over the last three years and as far as premiums of what we pay, it always seemed like we do because everybody else was higher. I also wanted to know from you, how do you make your money? Because if I brought, if I brought my plan in and said, Hey, Nathan, take a look at it, you know, you got to earn a living and make a living too. So how do you earn your money as relates to looking at the plan that I’m in versus the plan that I could be in that’s more reasonable and best for me and my family?
Nathan: I love this question because, um, we are actually paid by whatever plan you choose. Now, having said that, I mean, you know, I am, you know, always in for just looking at folks, whether or not, you know, you decide to do something with me or not. I mean, that’s a free service that I provide. So whether or not you go ahead and there’s been many cases I’ve had folks come, you know, see me or I went to see them and I say, “You know what, you’re just in the best plan possible, stay there.” Or, you know, I will say, “Hey, you know, you could actually benefit by going to this other plan.” So it’s, you know, it’s given in a very, you know, laid back format to where, you know, “Hey, these are your options, you know, then you make the choice there.”
Caller: Maybe I’ve missed it, but I still didn’t get, or understand how you are getting your money.
Dr. Friday: He gets paid by selling insurance, Milton. Just like I get paid when you pay me for your taxes. He’s an insurance salesman.
Nathan: Yeah, so the good thing is though, especially when it comes to the Advantage plans, they have fixed it to where there’s no real incentive for me to push one company over the other ’cause we get paid the same. So that’s a good thing. I can give you an unbiased, there’s no one giving me a cruise or anything for saying, “Hey, sell plan X.” You know, that’s illegal. So the Center for Medicare and Medicaid Services actually regulate what we get paid. So, you know, we can give an unbiased, you know, quote or an unbiased comparison.
Caller: Okay, I understand. Hey, well, I’ll be giving you a call to see about coming in.
Nathan: Please do.
Caller: And Dr. Friday, thanks again for having Nathan there. We really, really appreciate it.
Nathan: Thank you.
Dr. Friday: Thank you.
Caller: Okay, bye-bye.
Dr. Friday: All right, we’re gonna take our last break for the show here. We’ll be back in just a couple of minutes. If you want to join the show, you can at 615-737-9986. We’ll be right back.
Part 4: 38:25
Dr. Friday: All righty, we are back. And if you’ve been wanting to try to get on the show, well, now would be the time, 615-737-9986, 615-737-9986. And we’re gonna go right to the phone lines. We’ve got Steve in Cookville. Hey Steve you got a question about medicare for us
Caller: Yes i’d actually do uh… but it’s regarding my mother of this week uh… last week she received a letter stating uh… said we’re writing to you concerning your social security benefits the state of Tennessee will no longer pay your medicare part b so they started deducting it uh… of her her Social Security check for the Part B because she received her Social Security check this week and it was less this $164.90. So how does that, do you know how that all of a sudden?
Nathan: Yes sir, absolutely. So this is something I do every day in my office. It’s called the the Medicare savings program. If you make under a certain amount of money per month, the state of Tennessee through the TennCare program will actually pay your Part B. And what happens is they send out renewal letters and some folks, let’s just face it, that we get so much junk mail, we throw them away or what have you, or don’t see the renewal. And if she still, the good news is, if she still falls below that income threshold, we can reapply or we can actually contest, you know, their decision, but we can actually reapply and get that reversed where she won’t have to pay that Part B premium, but it is income based though.
Caller: Ooh, I like that. So this is something that we might be able to fix.
Dr. Friday: What do you think about that, Steve?
Caller: Well, I think it’s great. I think it’s just ironic. My mom gives this stuff to me. I’m started helping her with her stuff I just was making a drive across town and turned on Supertalk and boy, here it was. Yeah, good clean living got me here. So, I appreciate it. Hey, Nathan, can I get your office number real quick?
Nathan: Yes, sir, absolutely. That’s 615-823-1322. And like I said, that’s a free service I provide, so I’ll be glad to help you with that.
Caller: Hey, thank you for what you’re doing that you know just helping my mom with this stuff It is absolutely crazy Yes amount of mail she gets things that I mean, it’s it’s just way over selling and people it almost Most of them seem like scams. Yeah, you know, I’ve talked to a few people and it’s like well, you know, they read It’s like they circle you around the problem, but they never get you right to what you need. So I got, you know, on behalf of folks that are helping their parents, uh, Nathan, thankful what, thank you for what you do in the service you provide.
Nathan: My pleasure.
Dr. Friday: Thanks for calling Steve. We do appreciate it. And, and, and that’s exactly Nathan. I mean, that’s where I feel, cause a lot of times people come in a lot like Steve, then, you know, the children of, and, and they don’t know where to go, which is why I seriously, I do appreciate that you do the radio show every year for us, because I think it’s important that people realize that there are places to go, because if they’re trying to call Medicare, they’re going to pull their hair out. It’s like calling the IRS. It’s so frustrating. And they’re going to get talked in circles and they’re going to be told no, yes, when they don’t, you know what I mean? They don’t really know the answers or the questions to ask. So it’s so important for people to truly have someone to be able to ask these questions, just like, you know, Steve, he’s just trying to help mom out and he’s not sure what he can do and that letter makes it sound like you know again sounds so much like the IRS you know well you know you did something wrong so we’re cutting you off um so it is important so um we’re going to uh be quitting here in a moment here because Nathan and I have managed to throw a whole hour aside and this has been awesome. Nathan why don’t you one more time send out the information on how people can reach you directly through your email or website or phone number or all three.
Nathan: Yeah, absolutely. So you can either simply call 615-823-1322 or simply visit my website medi65.com. That’s M-E-D-I-65.com. There’s plenty of resources. You can compare plans. You can make an appointment with me and I also will come to your home or you can meet me in my office in Hendersonville. If you’re in the Hendersonville area, I have an office in the city square shopping center.
Dr. Friday: Awesome. All right. So if you want to join our call, Dr. Friday, and I have all of Nathan’s information, that boy cannot hide from me. Just let you know that. Not that he’s ever tried, but just saying, you know, we have, I’ve got all of his contacts. So for some reason, if you just want to contact our office, or if you have tax issues, which we didn’t cover today because you know what you need to file your taxes.
Dr. Friday: October 15th is the deadline for any individual that hasn’t filed but hopefully filed an extension. The extension ends on 10-16. I should say the 15th is the I think a Sunday. So you need to file by that time otherwise you are late but if you didn’t file an extension you’re already late. So if you need help with taxes or dealing with the IRS. You guys know me. I’m an enrolled agent licensed by the Internal Revenue Service to do taxes and representation. So if you’ve got love letters, you have issues that you want to deal with and you need help doing it or just a direction, which way should I go? Like Nathan does for insurance, I do for taxes and you can join. You can call our office at 615 367-0819-615-367-0819. You can catch me email friday at drfriday.com web drfriday.com. You know, we we will help you try to get back on track sooner you do that easier. It is on life issues because if you have a child trying to go to college, which is usually or you want to get married, those seem to be the big ones that get people back to wanting to just get organized and and start doing what they need to do. And if you are interested again, October 15th through December 7th, am I right, Nathan?
Dr. Friday: That’s the time period that people have to make these choices. So now would be an awesome time to give Nathan a call, set up that free consultation, find out if you need to be considering any changes to your insurance. You know, it’s no different than if you’re looking at your homeowner’s insurance, your cars, or even looking at tax resolution. It’s always better to get that review. Make sure you have a second opinion. You may have a spot on plan that’s perfect for you, but you also may need help just knowing that because it’s just so much to take in. Do I need whatever letter of the alphabet they’re throwing out there? And how does that apply? So again, Nathan directly is 615-823-1322, 615-823-1322 or go to medi65.com. Nathan, thank you for joining me today. We will do this again, but I really appreciate it for my behalf as well as my listeners. And if you want to contact Dr. Friday again 615-367-0819. 615-367-0819 or the easiest way is always email Friday at drFriday.com. That’s Friday at drFriday.com. As we always say in Australia, cop ya later.