Joanne: We often hear that one of the most frustrating things when it comes to Medicare is where to find answers to many of the common questions that people have. In this episode, we'll go over and answer several questions recently asked by our podcast and TikTok audience so you can get some answers to the Medicare questions that you might have. 

Cameron: But before we start, My name is Cameron Giardini, and together with my cohost, Joanne Giardini Russell, we operate Giardini Medicare, which is an independent insurance agency based out of Southeast Michigan. Although we are based in Michigan, we do work virtually over the phone to directly help consumers in about 13 states find the right Medicare coverage for them.

If we do not work in your state, we will connect you with another trusted independent agent who will be able to help you find the coverage you want. We also now have a free online course available for you that you can register for, to learn more about many Medicare topics and get even more answers than what we talk about in today's episode.

You can access the course by going to gmedcourse.com, which is GM. edcourse. com. So today, again, we're going to go over answers to your Medicare questions. As always, we want to make it so that you don't have to enter your phone number into a website or give up personal information to learn about Medicare options or to get your questions answered.

So that's what we are striving to do in this episode. In addition to this episode, again, we have that free online course, but you can also email us. at info at g medicare team dot com with medicare questions that you have and we will do our best to answer them we might also feature them in future episodes don't forget to find us on TikTok and YouTube by searching Giardini Medicare and one last thing to note before we dive into this we are going to be doing Q&A episodes once every couple months going forward so make sure you tune in for more of those and again send us those questions so we can help you and feature them to help others Yeah, this 

Joanne: was fun, Cameron, because I just had to put on TikTok, you know, hey, we want your questions for a future podcast and we got four pages of questions. So we picked out seven of the top most consistent, most common ones. 

Cameron: So the first question that we were asked was, how can I get quotes without having to leave my phone number to avoid a barrage of unwanted calls? And I think we all want that when it comes to Medicare. So we'll do our best to talk about that right now.

 First, if you're on a website that wants your phone number in exchange for quotes or information about Medicare coverage, do not do it. Don't give your number out. That's by far the easiest way to avoid this. We will include a link in the show notes for also adding yourself to the national do not call registry, but we'll be honest that even this will not eliminate calls from bad actors or overseas call centers, the web pages asking you for your phone number.

They also exist. Not just to try to call you and sell you a plan, but even worse, they're trying to sell your data, which is your phone number to other third parties. People will sell your data to brokers or independent brokers like ourselves, often multiple brokers. They might sell it to 10 different brokers and they might all try to reach out to you to sell you Medicare Advantage or Medigap plans.

Many of these people might be legitimate independent brokers, but it's almost impossible for you to tell when your phone is ringing nonstop. So, to get quotes without having to put your phone number out there, when it comes to Medicare Advantage plans, Medicare Advantage quotes are surprisingly easy to get without giving out your personal data.

One option is you get a physical copy of the Medicare You book, and there will be tables in the back of the book showing all the Medicare Advantage plans in your area. This is a place to start, but it's still a little bit confusing, so, the second option to better narrow down your options is to go to Medicare.gov and use the online plan finder tool to input your medications and sort all the different Medicare Advantage plans based on how they cover your prescriptions. And you can also see copays and other extra benefits they might offer. Now finally, with number three, once you do have a grasp of the Medicare Advantage plan options that are in your area.

We do recommend, of course, reaching out to a trusted broker to check doctors and provider networks and to talk about the nuances of the plan to find the specific one that's right for you. Now, in addition to everything we mentioned, we also have other videos about how to choose Medicare Advantage plans, but there's a lot out there online without having to give up your personal information.

And then last but not least, what if you want a Medigap and Part D quote instead of Medicare Advantage? So when it comes to Part D prescription drug coverage, those quotes are all so easy, that you can use Medicare.gov. You can input your zip code into the plan finder tool, as well as a list of your medications.

And it will sort plans that work well based on your specific medication needs. This is exactly what we use for our clients. So you have the same tools available that we're using now. Number two to talk about is Medigap quotes. These are actually pretty shrouded in mystery. I would say when compared to Medicare Advantage or Part D quotes with every site.

When you're trying to find a Medigap quote, usually they're asking you for your phone number in exchange for that quote. I searched a few of them trying to do some research for this episode, and I really couldn't find any good ones that would let you get a quote without at least putting in a phone number or something else.

Now, medicare.gov is one of the few sites that is available to the general public, and it will give you an overview of Medigap options and prices, but it's not as accurate as it should be in our opinion. We are really not aware of a good way to find good Medigap quotes without using an independent broker like ourselves or others, since we have access to specific Medigap quoting software that's not usually open to the public.

We do have other videos about choosing Medigap policies, but if you have questions about getting a Medigap quote, we'll continue to try to find resources. We'll have more in our course, but unfortunately, at a certain point, you do want to reach out to an independent broker. Don't put your phone number somewhere, but find somebody you can trust.

to provide those quotes for you. And then Joanne is up for question number two. 

Joanne: All right. Number two. I'm planning to move to a new state in three years. Should I consider this when I'm choosing my Medicare coverage? Yes. So moving can impact your Medicare coverage and it's an often overlooked decision as you're going into the Medicare process.

When you have original Medicare. And that, remember, that is Part A and Part B. When you move to a new state, this does not impact your Part A and B coverage at all. The monthly premiums and the coverages are the exact same across the entire United States. Medicare Advantage, if you have a Medicare Advantage plan, these are plans that are offered in service areas.

These are usually specific geographic areas where specific plans are offered as an example. In Michigan, a service area might be a couple of metro Detroit counties or maybe the whole lower peninsula of Michigan. And if you move out of your plan service area, out of state or not necessarily out of state, you're going to be disenrolled if you're out of that service area from that current Medicare Advantage plan.

However, luckily, you will have a special enrollment period to select a new Medicare Advantage plan. in the new location, but what is much less known is that you also have guaranteed issue rights to select certain Medigap plans without health questions or pre-existing conditions coming into play. Now that's huge.

So I will repeat that again. If you leave your Medicare Advantage service area, that does give you guaranteed issue rights to get a Medigap plan without health underwriting in most cases. 

Cameron: Yeah, it's not all Medigap plans, but it is a lot of the main ones that people think of.

Joanne: Meaning not all letters are what Cameron means there.

So, that's correct. So let's say you have Medigap in Part D and you're going to make that move to the new state. Part D plans are going to work like the Medicare Advantage plans because they are also tied to service areas. So moving to a new state will mean that you also have to change to a new Part D plan that's offered in the new state using a special enrollment period as well.

Medigap plans, on the other hand, are portable. And they can move with you to the new state. However, some Medigap companies will keep your monthly premium the same as the state that you move from, while other companies might adjust them to your new state, causing the monthly premiums to increase. And I've actually seen decreases.

We always recommend reaching out to an independent broker at least a few months before you plan on moving. 

Cameron: Absolutely. But definitely take it into account when figuring out your Medicare options. Question number three is what type of education, training, or background does a person need to become a Medicare agent?

So, education-wise, it can really be anything. There's no college degree requirement. A lot of insurance brokers come from very diverse life and education backgrounds. Joanne did marketing. I am a failed pre-med student. Well, I didn't fail, but didn't end up being a doctor, obviously. So, we can all come from different walks of life.

As far as licensing is concerned, you are required to have a health insurance license that is authorized and given by the state. So in the state of Michigan, they require a pre-licensing course, which usually consists of dozens of hours of study. Then you have to pass a standardized licensing exam.

The problem is that the health insurance license curriculum teaches you pretty much nothing about Medicare. So just having a health insurance license, really means nothing. Now, certification-wise, this is where you get more of that specialized training when it comes to Medicare and Medicare products to sell Medicare Advantage and Part D plans.

Most brokers will take a certification course called a hip. You don't need to know exactly what it is, but basically, this is a self-study course that takes a couple of hours per year. to review and it requires passing a standardized test. In addition to AHIP, we do have to take certification tests with each individual insurance company that we represent to offer their plans.

This will make sure that we are up to date with the products they are offering, but again, it's really not enough to fully understand what's going on with selling Medicare products. If somebody is only licensed and certified, it just does not mean as much as you think. So overall our thoughts are being a licensed and certified agent.

It really doesn't mean much when it comes to knowledge, and this should all be considered by far just the bare minimum when you're trying to find a broker to work with. Try to work with somebody with at least a few years of experience, or even someone if they're newer, you just wanna make sure they clearly have a grasp on your situation and your Medicare options.

If you find that a broker can't answer basic questions or gives you incorrect. information about basic Medicare eligibility, enrollment, or coverage questions, that should be a huge red flag to you. Also, not every broker's knowledge base is going to suit everybody. For example, we don't handle people with both Medicare and Medicaid who are eligible for dual special needs plans.

So although we think and we know we're really good at what we do. We aren't right for all Medicare beneficiaries in all situations. And I don't think there is any broker that is right for everybody. So just keep in mind that certifications and licensing are one very small step to actually understanding the Medicare landscape.

Joanne: Question number four. I'm five years away from getting Medicare and I'm wondering if the Medicare Part B premium will be going up every year. Number one is the fact that it can be good to get a general overview of Medicare when you're a few years out, but try not to focus too much on specific plan numbers since they're 

absolutely going to change in five years. We are all about Medicare education and learning as much as you can. We often find it's better to get a general sense of numbers, maybe a few years before your Medicare eligibility, but don't stress about exact details really until about one year before you begin Medicare.

Here's an example. So five years ago, We didn't know that the covered insulins would be capped at $35 for a one-month supply, or we didn't know that an Alzheimer's medication would change Part B premiums. We didn't know the Inflation Reduction Act would put a $2,000 cap on Part D prescription costs down the road, and we sure as heck didn't know COVID was coming, right?

So those are just good examples of why you're just too far out at five years. Secondly, As far as the question is concerned, yes, the premiums and the out-of-pocket costs for Medicare will likely increase every year. For example, in 2023, the monthly Part B premium is $164.90 and the yearly Part B deductible is $226 a year.

For 2024, this will be increased to $174.70 per month for the Part B premium. and $240 per year for the deductible. Lastly, the Medicare trustees report that we're going to link to the show notes has yearly projections for future Medicare costs. And according to their most recent report, five years from now in 2029, the Part B premium is estimated to be 240 and 10 cents.

It will be different than that, but that is the estimate today. The Part B deductible. It's estimated at $335/year. Again, we're going to link to the trustee reports that show the cost projections. 

Cameron: Like Joanne just mentioned, those are pretty big differences with the projections. Just think five years ago is 2018. So if you're trying to project up to, you know, 2029 at this point, we don't know what's going to look like for Medicare costs. Okay. Question number five. In August, I turned 65 and I started with a Medicare Advantage plan. And just so you know, they're talking about August of this year, 2023.

Do I get one full-year trial period to switch to a Medigap plan? So yes, in this situation, you likely do. It's a really good question. Understanding the Medicare Advantage trial rate period is very important when it comes to deciding between Medicare Advantage and Medicare Supplement coverage. If you are eligible for a Medicare Advantage trial rate, It means that you may have guaranteed issue rights to enroll in certain Medigap plans with no health questions or pre-existing conditions coming into play.

This is not the same as your Medigap open enrollment period though, so just keep that in mind. Overall, there are two types of trial rights when it comes to changing from Medicare Advantage to a Medigap plan, and you should be familiar with both of them. So the first one is, again, just like this situation or this question, you join a Medicare Advantage plan when you are first eligible for Medicare at age 65, and within the first year or 12 months of joining, you decide you want to switch to Original Medicare.

You have guaranteed issue access at that point to any Medigap policy you are eligible for that's sold by an insurance company in your state. This is important. In most circumstances, your Medicare Part A and Part B dates must match your Medicare Advantage effective dates to be eligible for the trial right.

For example, if you turned 65 in August of 2023, and your Part A Part B, and Medicare Advantage effective dates were all on 8/1 of this year, that's when you might be eligible for trial rights. However, let's say you delayed Medicare past age 65 due to active employer coverage, and you apply for Part B for the first time when you're 68 years old, and you also join a Medicare Advantage plan.

At that point, you don't have access to that trial right period, so it's only for people when you're starting Medicare Advantage. right when you're first eligible at age 65. Now the second option for a trial right is you drop a Medigap policy to join a Medicare Advantage plan for the first time. So if this happens and you've been in that new Medicare Advantage plan less than a year, And you want to switch back.

You can do so using the trial, right? The key here is that it's a little bit different because it gives you access to the same Medigap plan that you left. If the same insurance company you had still sells it. For example, if you had a Medigap plan G with a company, you went to a Medicare Advantage plan and you want to go back to that plan G.

And it's still available. That's how you can do that. Now if your former plan is no longer available, depending on eligibility, you can buy plans A, B, C, D, F, G, K, or L. But really when it comes to that, plan F or plan G will probably be the most common. And these can be sold by any insurance company in your state.

Again, only if your former plan is no longer available. Finally, an important note, the trial write period, does not apply to those eligible for Medicare before age 65, then when you're turning 65, but you still have access to a Medigap open enrollment period in this case. So that is always good to know if you are eligible for Medicare before age 65.

Now question 

Joanne: six. Why is there such a price difference with all of the Medigap Plan Gs? Don't they offer the same thing? How can you tell which one is the best? A super common question, right? So although Medigap plans with the same letter, as we're referencing Plan G here, they do have the same standardized benefits.

They will have different monthly premiums, as you might already know. These standardized benefits are the ones that you see on the chart on page 76 of the 2024 Medicare NU Handbook, although some plans will offer extra benefits. Medigap premiums do have to be approved by the state's Department of Insurance, so usually they are within a similar range of price, but this can still easily vary by 20 to 30 a month or even more.

Insurance companies, do try to price plans to be both competitive in the market and profitable. They have to do that. So, don't just choose a plan with the lowest monthly premiums even though the plans are standardized. Often insurance companies will create a new Medigap plan with prices that are the lowest in the market just to attract as many people as possible since they know people are likely to want cheaper plans, knowing that the benefits are standardized, only to have those premiums increase after a couple of years, while not being able to qualify for a new Medigap plan So it's relatively easy to create a new Medigap plan for an insurance company since the benefits are standardized and both large and small companies can outsource the customer service and the administration of the plans to third party administrators. For an example. Many life insurance companies will create and offer a Medigap plan as a relatively easy way to get their name out in front of you and acquire new customers.

So please work with a broker to pick a plan with a relatively large number of Medigap enrollees and with at least a few years of relatively stable premium increases. However, at the end of the day, everyone is just using their best-educated guess. Remember, in most cases, you will have to qualify based on your health to change to a new Medigap plan in the future.

So long-term premiums are much more important than chasing the newest and cheapest plan out there. 

Cameron: Exactly. Yeah. Kind of to answer that question. How can you tell which one is best? Unfortunately, nobody knows. Yeah. Joanne said it perfectly. We can try our best, but. It's just an impossible question. Now, last but not least, we will end with question seven.

So question seven is whether I have good health coverage through a company with 14 employees. Do I still have to pay for part B? The answer is almost certainly yes. The reason is that if you are covered by active employer coverage at age 65 or older, if that employer coverage has less than 20 employees, then due to Medicare rules, Medicare becomes your primary coverage in this situation.

It's not, if you sign up for Medicare, it just does that regardless. This means if you keep the small employer coverage without enrolling in Medicare, Part A, and Part B, you would be without proper primary insurance, which can lead to denied claims or large hospital bills going uncovered. This means if you stay with your employer coverage, you will likely want to have Medicare Part A and Part B as primary coverage.

To your employer coverage, which becomes secondary again, if it's below that 20-employee threshold, when it comes to determining the employer size, it can get slightly complex, but it includes both full-time and part-time employees in previous years. There can also be unique situations. If your employer.

Participates in a multi-employer plan, but overall, just make sure to check with your employer and or your employer health insurance provider to confirm whether or not your employer group health plan coverage will be primary or secondary to Medicare. When you turn 65 as a broker. We really can't give you a definitive answer since we don't have the exact details behind the scenes of your employer coverage.

We can talk about the guidelines and the rules, but we don't know exactly how many employees or anything a plan has because we don't administer the plan. Make sure to connect with an independent broker though, to compare the cost of Medicare coverage with. a Medicare Advantage plan or Medigap plan compared to your employer coverage with Medicare to see if you should even continue with that employer coverage.

Just make sure you don't forget to consider your spouse or other dependents if you have them covered by your employer plan since that can greatly skew the decision and the math from one side to the other. So as you can tell by this episode and likely your own experience trying to navigate the Medicare system, there is never a shortage of questions you may have.

We will of course be doing more episodes like this in the future. So please send us an email to info at g medicare team dot com with any questions you have. So we can both email you an answer if possible. And highlight them in future episodes to help others. Just remember that because everyone's situation is unique, it is very important that you reach out to an independent broker who can help you navigate the specific questions you have since it's basically impossible to answer them perfectly during a podcast.

As always, please leave us a review on your podcast app and subscribe so you can listen to future episodes. You can also find more Medicare content from us by going to YouTube and searching Giardini Medicare. Or by doing the same thing on TikTok, if you want to schedule a one-on-one call with one of our licensed brokers, you can do so by going online at g medicareteam.com, So thank you for listening, and have a great day.