Better Financial Health in 15 Minutes (or less!)

Navigating Medicare: Choosing the Right Plan and Avoiding Common Pitfalls

• Stacey Hyde

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Unlock the secrets to navigating the often-confusing world of Medicare with Stacey Hyde. As open enrollment kicks off, we'll guide you through the complexities of Medicare supplements and why choosing the right plan can be a game-changer for your financial health. Get the lowdown on why Plan G stands out as a top choice for those seeking minimal out-of-pocket expenses and long-term security. Wondering if a Medicare Advantage plan is really to your advantage? I’ll shed light on the potential drawbacks that might make you reconsider.

Still working at 65 and confused about which parts of Medicare to sign up for? Tune in to hear Stacey break down how to avoid costly mistakes and penalties while balancing employer health insurance. Gain clarity on the distinctions between Part A and Part B, and learn the strategic moves that ensure you have coverage without unnecessary complications. By the end of this episode, you'll be equipped with the knowledge to make informed decisions about your Medicare options, setting yourself up for a stress-free healthcare experience in the years to come.

Envision Financial Planning. 5100 Poplar Avenue, Suite 2428, Memphis TN 38137. (901) 422-7526, This communication is strictly intended for individuals residing in the United States. Advisory Services offered through Envision Financial Planning, a Registered Investment Adviser.

Speaker 1:

Hi, I'm Stacey Hyde and I'm back for another episode of Better Financial Health in 15 Minutes or Less, and with open enrollment for Medicare upon us and the airwaves getting ready to be covered with talk of Medicare Advantage plans, saving money on your Medicare, I thought I would weigh in with my thoughts on those types of plans and what you do need to be doing A little bit of a background. So, when you turn 65, you become eligible for Medicare. However, if you're still working for an employer that has over 25 employees and the key is still working you're not on COBRA, you're not on a retiree health plan. You have a window around your 65th birthday to purchase your Medicare supplement without answering any health questions, which means you're going to get the best rates because you're automatically going to be bumped into that, what a lot of people mistakenly do because they hear that you've got to sign up or there's going to be this penalty. They're still working for their employer. They want to keep their employer health insurance because it's actually less expensive on a monthly basis than getting a supplement. So they mistakenly sign up for Part B. Or maybe they signed up for Social Security because they were full Social Security retirement age and they wanted to start taking that even though they were still working, and if that's the case you're gonna be automatically enrolled in Medicare unless you opt out. It's fine to take Part A as long as your healthcare at work doesn't have a health care savings account. But you don't want to elect Part B because then you're going to be subject to that window to get your supplement without health questions. So that's just a little key thing there, that you are not going to be subject to a penalty. If you're still working, you're covered by employer health insurance and you don't elect Part B. Sure, go ahead and take Part A, there's no cost to it. It would actually be secondary to your health insurance if you had to be hospitalized and would help pay some of those out-of-pocket costs.

Speaker 1:

Now I'd like to kind of circle back to the difference between a Medicare supplement and Medicare Advantage. Full disclosure I'm a huge fan of Medicare supplements, particularly Plan G. So what you need to understand is that there are hundreds of companies that offer Medicare supplements and all of them offer the same core benefits and they're all set up. There's a Plan A, there's a Plan B, there's a Plan C, and if you buy a Plan A from Mutual of Omaha or Blue Cross or Aetna or UnitedHealthcare, they're all going to have the same benefits. The reason we recommend Plan G is it's going to be the most comprehensive. Your only out-of-pocket cost for doctors and hospitals and testing is going to be the Part B deductible, which right now is right around $200. Everything else is going to be the Part B deductible, which right now is right around $200. Everything else is going to be paid at 100%.

Speaker 1:

Some people are starting to move to Plan N, as in Nancy, because it's less expensive than Plan G. But as Congress struggles with deficits and things like that and reimbursement of doctors, more doctors are choosing to bill more than just the Medicare allotted amount. And if you have a plan N you could be on the hook for those additional charges because your Medicare supplement is not going to pay them. If you have plan G, then you are not going to pay them. If you have Plan G then you are not going to owe those funds. And so I think, because this is a policy you're likely to have, you know, 20, 30 years even, I think it's important to make to go ahead and pay the small extra amount and get a Plan G.

Speaker 1:

That's my personal opinion and I would also steer clear of Medicare Advantage plans. The nice thing about being eligible for Medicare is you no longer have to worry about the network of doctors and hospitals. If a doctor accepts Medicare, they're effectively in your network so you can see them and you're going to have a lot less trouble getting authorized for a procedure that you and your doctor believe you need. If you're on Medicare Advantage, you are going to have a limited set of doctors. It can also be very problematic if, say, you live in the Memphis area but you have a beach house and you spend a lot of time down there in the Memphis area, but you have a beach house and you spend a lot of time down there. It could be that if you went to see any doctor at your second home, that's out of network and it's not going to be covered. Not all of them are like that, but enough to make me say be very, very careful. You also can be subject to them not approving treatments that you need. The Wall Street Journal other articles are pretty full of horror stories about the rationing of care and not being able to get the care and then also finding out that they've been diagnosed with a more extreme health condition because that gets the Medicare Advantage insurer a higher reimbursement rate. Humana actually was dinged on their Medicare quality ratings for doing this excessively and then you could have trouble if they documented this in your medical file and then you decide you don't want Medicare Advantage, you want traditional Medicare to supplement. Well, if they've documented you with some sort of health condition, you could have trouble getting the newer policy, the new supplement, to go back to traditional Medicare. So I would really caution against it. Unless you never travel, you know your doctors are in network, maybe you live in a rural area and everybody takes, say, blue Cross, blue Shield. Be really, really careful with that, and I would. My recommendation is to err on the side of caution and paying a little bit more and sticking with traditional Medicare.

Speaker 1:

You also will need to shop your prescription drug plan each year on Medicaregov. It's actually a great website that the government's put together. You'll need your Medicare card to log in or you can do a guest account. You put in your prescription drugs, you put in your home zip, you put in your home zip code and where you want to go to the pharmacy and it will actually show you all the plans that are available for your specific set of parameters. Now, if you are on Medicare Advantage, your drug plan is going to be included in your health plan. But if you're on traditional Medicare, your drug plan is going to be included in your health plan.

Speaker 1:

But if you're on traditional Medicare, you'll also need to get a drug plan. Even if you don't take any medications, you still need to get a drug plan. Just pick the cheapest one, because likely you're just going to maybe get your vaccines and an antibiotic if you got sick or something, and that's going to be very inexpensive. So you definitely want to do that and that is something you should shop every year. And right now is the time you can do that, because you can shop for your plans that are going to be effective January 1, and you can also, on that website, choose to have your Part D premiums deducted from your Social Security check, which is super convenient. But there's a lot of things to look at there.

Speaker 1:

On our website we have a blog post at Envision E-N-B-I-S-I-O-N, f-p, as in financial planning, tennessee T-Ncom, so Envision, f-p-t-ncom, envisionfptncom, so envisionfptncom. Go to blog and you will find an article on medicare that kind of goes through all of this. It actually walks you through how to shop your rx plan. But definitely do this if you've got older parents or grandparents or a friend of the family that's not super tech savvy. Help, help them out. Help them do this. They will be very appreciative and you will be helping them and making their lives better. Thanks so much, and if we have a current client that's listening to this, give us a call. We'd be happy to walk you through this. Thanks so much for tuning in. This has been another episode of Better Financial Health in 15 Minutes or Less.