 Okay, welcome everyone, and thank you for joining us. My name is Colleen McGinn, and it is my pleasure to welcome you on behalf of Fairfield Alumni Relations Office. With me today is our special guest, Sheila O'Donnell. Sheila is currently a partner with Health Directions, which is a comprehensive health insurance brokerage firm located right, I should say here in downtown Fairfield. We're very excited to have Sheila here to share her expertise and I will turn it over to her in a few minutes to give her official biography. But before we begin, just a few quick housekeeping items on our end, you entered meeting on mute. We asked you to keep yourself on mute just for the beginning of our program to cut down on background noise and possible distraction. As we get further into the program, there will be an opportunity for you to unmute yourself if you wish and ask any questions that you might have. Second, we recommend that you use speaker view instead of gallery view in Zoom, just to keep your focus on Sheila instead of your fellow attendees. You're also welcome to put any questions you may have in the chat. We have a colleague of Sheila's with us who she will also introduce. He will be monitoring the chat for your questions. We also did provide Sheila with all of the questions that were submitted during the registration process. So she's gonna do her best to get to as many of those as possible. This is being recorded and we will be sending a recording out following the meeting in that it will contain some documentation that Sheila's gonna be sharing. So don't worry too much about taking super copious notes. We will share all of that with you as well as Sheila's contact information so that you can reach out if you have further questions. But for me, I will turn it over to Sheila. Well, hello everyone. It is certainly great to meet all of you and I appreciate you taking the time during this very busy time of the year and a special thank you to Colleen and Janet for pulling this event together. My name is Sheila O'Donnell and I am a lifelong resident of Fairfield. And like many of you, I am actually a product of a Jesuit education. So I really treasure having Fairfield University in my backyard. In terms of my professional life, I'm an independent agent and I specialize in individual Medicare plans. And I am part of the team at Health Directions which is an agency as Colleen said right here in Fairfield. And it was founded by Curtis Bentley and his brother Mark about 20 years ago. And the Bentley brothers have a really wonderful reputation in the industry. So I feel very honored to be working and aligned with such great people. And Curtis Bentley is actually on the call with us today and he's going to monitor the chat. So he'll try to answer some of your questions if you prefer to put them there, post them in the chat box. To just to be transparent, I always like to get this off the table. If you do decide to work with an agent like me, please know that there is no cost to you nor is there any impact on the cost of your insurance plan. But rather I am compensated directly by the insurance carriers. And there is absolutely no incentive for me to steer you towards a particular type of plan or to steer you towards a particular carrier. I'll also add that Fairfield, you is not going to share any of your contact information. So again, I just wanna share this with you and hopefully that puts you at ease. Now the reason I got into Medicare is really just based on my personal experience helping my mom and dad with applying to Medicare going back, gosh, 20 years. And we all understand it's a federal program. It's kind of like paying your taxes to the IRS. So it can be very complicated and convoluted. And I just remember going through this process and thinking to myself, I'd love to master this subject and I'd really like to be an advocate for people like my parents. So I care deeply about what I do and I try every day to do the right thing. And I hope you understand what I'm saying. But enough about me. Let's jump into the interesting information. I'm gonna go ahead and share my screen and the presentation should only take about 20, 25 minutes. And then as we go along, please jot down any questions or feel free to enter them into the chat. And then at the end, we'll have a little bit of time for Q&A. So with that, I'm going to share. Can you all see that okay? Yes. Okay, terrific. So my goal is just to share with you sort of the big picture of Medicare. And as I said, there's a lot of layers to it. So when I think about Medicare, I find it helpful to kind of break it down into two buckets. And the first bucket is applying for Medicare. And then the second bucket is going ahead and selecting a Medicare-based coverage or Medicare-based plan. And I think it's safe to say that most of us on this call share something in common. And that is we are either turning 65 years of age or we are over the age of 65, right? We're still working, but we're thinking about retiring and getting started with Medicare. Well, those are your two enrollment options when it comes to Medicare. And for the first little bit, I'm going to focus on that first group of people, those of us who are turning 65. So when do you apply for Medicare? Well, when you turn 65, you are given an initial enrollment period, which simply stated is a seven month window. It begins three months before the month of your birthday and includes the month of your birthday. And then it continues for three months after your birthday. So there's your window within in which you can apply. But my strong suggestion to you is it's always better to start earlier. So I would begin the process three months before your birthday. And the reason being is, you also often can come across an obstacle or a hiccup in the process. So it just kind of takes the stress out of the situation and it just makes for a much more positive experience. And then after we think about, well, here's the when, we answer the question, when? The next question is then, well, should I apply for Medicare? And here's the funny thing. When you're approaching 65, it's you start to think that, oh my gosh, maybe I should invest in a larger mailbox, right? The amount of mail that arrives from the carriers, from Medicare can be pretty overwhelming. I met with a client recently at his home and I'm telling you, he had to stack it must have been six or eight inches high of just literature of all the mail that he had gotten because he was approaching that age. And the poor guy was just like, look at me with like a deer in the headlights. So here's the thing, when it comes to Medicare, sometimes with all of that information coming your way, you feel compelled to act, right? You think you need to do something. And maybe you should, maybe you should apply, but maybe you shouldn't. And every person's situation is unique. So in general, you should apply for Medicare part A, we just earned 65. However, there are exceptions. If you have a health savings account with a high deductible plan, then you're gonna wanna go ahead and delay applying for part A until closer to retirement. And the same thing. Now most of us don't pay a premium for part A because we've been paying into Medicare taxes. But if for someone who perhaps hasn't met the requirement, the 10 year or the 40 quarters of working and paying into Medicare taxes, there could be a premium. So for that person again, they may wanna delay applying for part A until they get closer to retirement. Now in general, most people need to enroll in part B when they turn 65. Again, that depends, right? Most of us are living longer and healthier lives and we're working well past age 65. So if you have credible group coverage for your employer, then there's no reason for you to apply for part B at this point. You'd wanna wait until probably about three to four months before you do a retire. And I'll just note that the size of the employer matters. So if you work for a company with 20 or less employees, then that situation is a little bit different. And that in that case, it may not be considered credible coverage. So that's where you don't wanna have a conversation with either me or through your employee relations person. So all right, so that answers the question should. So now the question is, how do you apply for Medicare? Well, you actually do it through the Social Security Administration. Now that's not to say you have to be receiving Social Security to apply for Medicare, that's not the case. This is just the process or the platform by which you apply for Medicare. But if you're already receiving Social Security benefits, great, you will be automatically enrolled in A and B when you turn 65. But for anyone who is not receiving Social Security, then you need to actively enroll and you can tackle this in three ways. You can do it in person or by phone. And I would suggest that you Google your local security office, social security office. That's certainly a good place to start. I know some people just, they actually will show up at the Social Security office, they'll get there before 9 a.m. and stand in line. And to kind of take their chances, which you can call and make an appointment. But I would say really the best option is to go ahead and to go online and to set up your account through the Social Security website. It takes about 15 minutes. It's really easy to do. And as Colleen mentioned, I'll share these step-by-step instructions on how to set up that account, as well as the link to the Social Security website. And just to give you a sneak peek, so let's say you've gone ahead, you've set up your account, now you get into the Social Security website, excuse me. And you can see they're right in the center of the page. It says apply and underneath that, you see sign up for Medicare. So that's where you can start the process of applying for Medicare. So now let's take a moment and let's focus on that group two, or option two, right? You're over 65, you're working, but you're thinking, I think I'm gonna retire in the next few months or within the next year. So when should you apply for Medicare? Well, these first two bullet points, that kind of outlines for you the general enrollment periods for people in this category. But my general rule of thumb for my clients is go ahead and start the process eight months before you are scheduled to retire. Excuse me. And the way I would begin is I would suggest you reach out to your HR department, talk to the employee benefits person, or reach out to me and just get a little guidance about where to start the process. Okay, well, how do you apply for Medicare Part B? Well, there's two pieces to it. And the first one is what they call the employee information form. And I know this is a photo I've included here. It's not particularly easy to read, but the reason I include it is it's just to show you, it's a simple form, it's one page. And this is something that you typically get from your HR department. The top part, section A, you'll go ahead and complete that. And then the part, section B, your employer's gonna go ahead and complete that piece of information. Once you have that, then you can go ahead and you can complete your enrollment for Medicare Part B. And again, there's the form. It's real easy. It should probably just take a couple of minutes. So now once you have the application for enrollment, you have the employer form, you are good to go. And you could, you have a couple options. You can upload that through the social security website where you can mail or actually drop it off at your local social security office, whatever it's most comfortable for you. So here we go. Now we, now you've applied, you've been approved. And I would say it typically takes about three weeks for you to receive your Medicare card. And this card probably looks a little different than the card that you're securing around in your wallet, right, that you pull out when you go to the doctor. And the reason being, you can see here at the bottom, you have what's called hospital Part A and medical Part B. And what we're gonna do is we're gonna take a closer look at Part A and Part B. And we'll talk about the services that are covered and the cost shares that you're responsible for, for each part, excuse me. So Medicare Part A, that's your hospital insurance. Now, in general terms, I like to think about that is those are the services that you receive inside the hospital walls. And again, these are general terms. So let's say you're admitted to the hospital or to a skilled nursing facility. Those are the types of things that fall under Part A. And what I will point out, a couple of things. One is for most people, they've been paying into Medicare taxes. So there's no monthly premium, which is a good thing. But you do have a hospital stay deductible of $1632. And that's different than the annual deductible that you might be used to, right? So a hospital stay deductible is something that you would be responsible for if you were admitted again and again to the hospital. And there's parameters around that, like a 60-day timeframe, et cetera. But it is possible that you would have to pay that deductible maybe two or three times in one year, God forbid, if you're admitted to the hospital again and again. So I just want you to be aware of that cost share. Now, Part B, in general terms, think about these are the services that you typically get outside of the hospital wall. So you go, for example, to see your primary care doctor for your preventative care. You go to your specialist, the cardiologist, the endocrinologist, the chiropractor. Perhaps you go to Quest to have your blood drawn before your annual exam. Those are the types of things that you would see under Part B. Now, there is a standard premium of $174.80 a month, but you should know that premium can be higher depending on your income. And I can send out those guidelines to Colleen to share with you. There is an annual deductible of $2.40 a year. But here's the kicker. This is the one that's important to note. You are responsible for a coinsurance of 20% of all Medicare approved services. And there's no set out-of-pocket limit. And why that's important is because, you know, God forbid you're in an accident or you become seriously ill, right? That can really put you at financial risk because you have this 20% that you're responsible for no maximum out-of-pocket. So that puts you at certainly financial risk. And that's why you need to add a Medicare-based plan to protect you from that type of exposure. So that's kind of what we're gonna jump into now. We're gonna talk a little bit about bucket too, you know, finding that, selecting that other coverage to protect you. So what have we learned up to this point? Original Medicare, right? It gives you a good foundation. It provides you with some good basic care, but it was never intended to cover all of your medical needs, right? There's no prescription drug plan included. You don't get any dental vision or hearing. And as I just showed you, there's lots of cost shares. So what are your options? You know, what do you do? So let's take a look at that. On the left-hand side of the diagram, we're gonna talk about the Medicare supplement. And this is how it works. And this, if you chose the pathway on the left, you would keep original Medicare Parts A and B, that would be your primary insurance, that would be your first payer. Then you have to add a prescription drug plan, stand-alone prescription drug plan, right? Medicare does not provide any drug coverage, but it is required, otherwise you pay a penalty. And then lastly, you add a Medicare supplement, also known as a MediGap. And let's take a closer look at that. So you get the Medicare supplement through a private company, and I feel like it's a little bit like alphabet soup. And the reason I say that is Med Subplans have a letter attached to them, such as a plan G or a plan N. And each plan with the same letter must provide the exact same benefits. So you're really comparing apples to apples. But here's the difference. The premiums may vary, and certainly based on the state in which you live. So for example, in Connecticut, the monthly premium for a plan G starts at about $230 a month for a plan N. Again, in Connecticut, the premium starts at about 170. So just something to think about, and we'll do some comparisons in a moment. Now, most importantly, how does a Medicare supplement work? Well, it picks up all the cost shares of your original Part A and Part B. Most importantly, it picks up that 20% gap that original Medicare does not pay. Now the key benefits of a Med Subplans, well, your costs are fixed and predictable, right? You're gonna pay, you have to pay that Part B premium. You have to pay that premium for the prescription drug plan. And then lastly, you pay that Medicare supplement. And then for the most part after that, you really don't see any, you don't get any bills. With a plan N, you are gonna have a deductible that you have to meet. And you will have some co-pays of $20. Plan G, it just picks up all the costs. And again, you've firstly, you really should not see any bills after you've paid your three premiums. So going back to the diagram, now let's move on to the right-hand side. And we will talk a little bit about Medicare Advantage. Now the way the Medicare Advantage works, it's also referred to as Part C, okay? And the way it works, it wraps your Medicare Part A, your Part B, and your Part D, Part D being your prescription drug plan, all into one plan. But here's the thing to think about and we'll get into more detail here. Again, you're gonna get a Medicare Advantage through a private company. But, and as I said, this one plan is gonna cover on your hospital costs, your doctor costs, and your prescription costs. But you are restricted to a plan network. And that can either be what they call an HMO or a PPO. And I always, this is the way I like to remember it. So an HMO, those letters are kind of similar to the letters in the word home, right? So an HMO is you're kind of limited to seeing doctors near your home. So for example, your service area might be the state you live in. I would be, if I'm in an HMO in Connecticut, I have to see doctors in the network in Connecticut. Now, PPO is a much better option. And this is where I tend to certainly guide people towards. A PPO is a much bigger network. And more and more of the carriers are making that available. And you can actually get a national network with a PPO. So let's say you want to go to Boston for a second opinion. Or say you wanna go to New York City to get treatment at Memorial Sloan-Kettering. Well, if they're in the network, it's just like you're seeing a doctor in your own service area. So that's a really, really nice option. Another nice option is that many of the plans have a zero monthly plan premium. And people always say, especially around, I feel the New York City area, we're always skeptical. They say, well, how can that be? What do you mean there's no cost? Well, the way it works is that Medicare pays a fixed amount to the insurance company to administer your benefits. And certainly that part B premium that you pay, I'm sure a portion of that also goes to the carrier as well. So what else can I tell you? The other nice thing is kind of like you've been having with your group coverage plan. You will continue to pay some co-pays to see doctors, specialists, that kind of thing. And you will have some co-insurance. But the nice thing, it's up to a set out-of-pocket limit. So a typical max out-of-pocket would mean the worst case scenario, if something catastrophic were to happen, the most that you would ever be responsible for in the course of a year could be something like $6,400. And as I said, Medicare Advantage is all-inclusive and it provides extra coverage like dental, vision, and hearing. So those are real positives. So let's just take a look here at a kind of a comparison of Medicare Advantage versus Medicare Supplement. And a couple of things, when I look at this, a couple of things jump right off the page at me. Number one, the network. I think that's really important to consider. With the Medicare Advantage, you are gonna be limited to a network. But I think that PPO is a great way to go. The cost, Medicare Advantage typically has no monthly premium or perhaps a very low monthly premium. But you always have to pay that Part B premium, whether you're getting a Medicare Advantage or a Medicare Supplement, you're always gonna be on the hook to pay that Part B premium. And then lastly, I'll just mention the Medicare Advantage does include your prescription drug coverage, as well as the vision, dental, hearing. Now, Medicare Supplement, on the other hand, you look at their network, here's the great thing about a Medicare Supplement. You can go to any doctor, any hospital facility that accepts Medicare anywhere in the country. So that gives you tons of flexibility. In terms of the cost, as I mentioned, there is definitely a plan premium that you have to pay in addition to your Part B. And then I'll just note that that prescription drug coverage is not included. So that's why you have to go ahead and add that standalone prescription plan. So as a way to wrap up the presentation, I'll just leave you with a couple of thoughts. First is, every person's situation is unique, right? So what works for your neighbor or for your brother-in-law, may or may not work for you. So just you just gotta keep that in mind before following perhaps in someone else's footsteps. Just really think about your situation, what's gonna work best for you. And I think it's always a great idea to speak with someone in HR when it comes to the process of Medicare or to speak to someone like with me, just to give you a little bit of a guidance. And when it comes to deciding about choosing a Medicare advance for a Medicare supplement, just keep some of these things in mind. Take a look at your budget and your lifestyle. Think about the doctors. How often do you go to the doctor? How many specialists do you have? Are you really married to those doctors? Or would you consider going and looking at, considering other doctors outside of, in terms of the network? And then lastly, medications. How many prescriptions do you take? How do you feel about going, having to go to a preferred pharmacy? Would you consider mail order as a way to save some money? So I'll just say, I think, I've been doing this for a while and I just feel if you spend the time and you're thoughtful and you think about some of the things that we've talked about earlier tonight and you also look at the math, I think you'll arrive at really the best option for yourself. And please remember that nothing is set in stone year. Depending on the plan, you will always have the option to make a change at some point during the year. It just depends when that is with respect to Medicare Advantage or Medicare Supplement. So I just, thank you again for your attention. I am gonna turn it back to Colleen and see if there's any questions that Curtis and I can answer for you. And I'll just mention again that Colleen's gonna follow up with hopefully some good resources that I'll provide and don't hesitate to reach out. And if I can help in any way, I'd be happy to give you some guidance. So thank you again, everybody. Sheila, if anybody does have a question, you are welcome to mute yourself and ask that at this time. There are a couple of questions in the chat. Here we have, what if you are your own employer? Well, I'm sorry, I didn't hear the question. I'm sorry. What if you are your own employer? Yeah, I might, Curtis, you might. My voice is really starting to drag on me. Would you mind jumping in for a minute? Sure, yeah. If you're your own employer and you're turning 65, you're the only employee you're gonna, you need to start Medicare. You can't continue to have an individual health insurance plan, especially through access help CT, the health insurance exchange, and you're getting a subsidy. The government takes the subsidy away. So you definitely wanna start Medicare. Chances are Medicare is definitely gonna be better coverage than your employer plan. I would definitely look into starting Medicare. Great, the next question is, how are the three premiums or how many premiums do you pay and build to you? If you do not get Social Security, are you billed or do they auto pay through your checking accounts? For the Part B premium under Medicare, that's your first cost. So if you're not collecting Social Security, that's gonna be billed on a quarterly basis. So they will bill you on a quarterly basis and they give you a bunch of payment options. You can pay by credit card, you can pay by check, you can set up automatic payment. And then when you do start collecting Social Security, the Part B premium will automatically be deducted from your Social Security check. So it switches over once you start collecting Social Security. Definitely I will say the first Part B premium you get, it's very confusing, especially if you're gonna be charged, it's called an income related monthly adjustment amount charge which is a surcharge. The government charges if your income's on a higher bracket. And the way they determine everybody's Part B premium is they look at your income two years in their rears. So if you're looking to start Medicare in 2024, they're gonna look at your 2022 modified adjusted gross income on your tax return. They're gonna walk over to the IRS app to you apply for your card and they're gonna pull your tax return and then they're gonna send you a letter telling you your Part B premium is either the standard Part B premium because your income was within range or you have to pay that surcharge because your income was high. And there's ways you can get that reduced if you had a life-changing event where you stopped working or you cut back on your hours. So there's different things you can do to get that reduced. Okay, let's see here. Are there financials? Let's just ask a quick question. How do you reduce that? Do we apply somewhere to reduce it? So there's a form, it's called an income related monthly adjustment amount form. And you have to have a life-changing event like a work stoppage or reduction in work or if you got divorced or there's a couple of the ones and you fill out the form, you have to put it in what your projected income is now based on your new life-changing event. And then you have to bring that over to your local social security office and they hopefully will approve it. So we can get that form from the social security office if we need to. Yeah, Marcella can get it to you. Okay. Yeah, that's no problem. Yeah, that'd be available right on the website. Sure. Okay, thank you. A lot of people get the Parpe premium reduced, especially if you reduced working and you're not making as much income. Thank you. Great. Okay, let's see here. Are there physical health requirements to participate in a Medicare Advancing Plan? No. Connecticut, it's a guaranteed, all Medicare plans are guaranteed issued. There's no pre-existing medical conditions, no medical underwriting. Okay. Are Medicare policies rated, or I think maybe that Medicare policies rated for risk, for example, pre-existing conditions are age and are they expensive? Then the state of Connecticut, the way the premiums are set, it's based on a community rating structure. So it's one rate, whether you're 65 or 102, for the supplement plans and the Medicare Advantage plans, they set their own premium rates. So a lot of these Medicare Advantage plans like to do zero premium plans to make their plans attractive for membership. So Connecticut, it's community rated. If you live in a different state like Florida, they're age rated, but it's different depending on the state and where you live. But Connecticut's a great state. It's community rated. Connecticut, New York, Massachusetts. So. Can I ask you a question about rate increases because I have a couple of years before I turn 65 and healthcare rate increases every year for a sole provider, LLC are outrageously high. They just keep going up and there's no negotiation. There's nothing. It's like between 5% and 10% every year. I mean, I know that Medicare is somewhat political because it's taxpayer and appropriations. Is Medicare doing the same? Are those rates going up 5% to 10% every year? No, definitely not. So that's the nice thing with Medicare. So Medicare, the government sets the rate for the Part B premium, which is the medical insurance premium. And actually last year, they lowered the rate. This year, the rate is going up a little bit. So it's going from the standard Part B premium this year is 164.90. Next year, it's gonna be 174.70 or 174.80. So I don't know what the percentage is, but it's probably 1%, 2%. But it's very minimal. Some years they don't raise it. And then the supplement plans, those rates are set by the private insurance carriers like UnitedHealthcare or Anthem or Sayno or Humana. So they're competitive with their rates for the supplement plans, but the government sets the Part B premium rate and the tables for determining everybody's Part B premium, the income tables. Did I answer that question? Yes, I also have another question about the HMNO versus the PPO plans. Those are the Medicare Advantage plans, correct? The HMO and the PPO? That's right. Correct. So when you apply to a private insurer, I'm sure they will send me tons of stuff in a couple of years, all of them that offer this. Do they explain their methodology for co-pays? I have a sister that recently passed and she had outrageous co-pays and she had a Medicare Advantage one with the co-pays. Depending on the procedure she had, like one of them had a $7,000 co-pay. It seems like so. That's the thing with the Medicare Advantage plans and why you wanna talk to Sheila is they sound great on the TV commercials, zero premium, you get dental vision and hearing, but the commercials never talk about what the medical cost shares are for doctor visits, hospital costs, where people can get tripped up if somebody has an expensive medical situation, somebody gets a cancer diagnosis, they need chemotherapy or an expensive Park B, infusion type drug, most of the Medicare Advantage plans are gonna pay 20% co-insurance, whereas with a supplement plan, that would be picked up 100%. So Sheila mentioned the Medicare Advantage plans have what's called a maximum out-of-pocket limit and most of the plans that have zero premium plans, those maximum out-of-pocket limits could start at 5,900 to 6,700 all the way at 8,550 depending on the plan. So even though your pain is zero premium, if you have a lot of medical costs under a Medicare Advantage plan, you could reach that maximum out-of-pocket limit. So that zero premium plan goes from, now you've met the maximum out-of-pocket, say 6,700 to buy that by 12, there's your monthly premium. So there's pros and cons to both sides. That's right. So your sister may have had an expensive medical situation and triggered some high-cost... She had been getting infusions and then she switched over to a different plan and then she was told she had to pay like $8,000 and she was like, I don't have that kind of money. So I mean... Yeah, so she probably met her maximum out-of-pocket because infusions, I mean, after they get repriced, I've seen the repriced amount, like $5,000 and you're paying 20% of that, that's $1,000 and you're getting multiple infusions. You had another sister that it was like, it was about $100,000 a year for the infusions. It was incredible. Yeah, you're not paying 100,000. You'll stop at the maximum out-of-pocket limit. But that's where these Medicare Advantage plans could get pricing. But nobody knows what your health situation is and that's why it's always good to be evaluated. Thank you. You're welcome. Great. Thank you. Next question is, my retired husband's former employer provides what they call a secondary Medicare plan. Is that the same as a Medigap plan? They're unable to get a straight answer regarding that. You said a secondary Medicare plan? Yeah, Barbara, I don't know if you wanna chime in here. This is your question. I wanna make sure I'm reading it correctly for you. Yeah, thank you. Yeah, they call it a secondary plan. And I ask, is that like a Medigap plan or a supplement? And I never really heard back. And so I thought maybe I'd ask and see what you guys thought. But they said a secondary. So some employers do offer retiree Medicare plans. So it could be a group Medicare supplement plan that could be custom designed. They can custom design these retiree Medicare supplement plans. Actually a lot of employers, if they're gonna offer a group retiree medical plan, most of them are leaning and doing the Medicare Advantage plans. And those retiree Medicare Advantage plans, in most cases are usually better than the individual Medicare Advantage plans because they make the benefits a little richer, maybe less maximum out of pocket, smaller co-pays. Yeah, so it's always good to compare the employer retiree medical plan with individual plans. Yeah. I will go back and press for some more information as to what these actually are. Thank you. Yeah, so it's always good to compare. Great. Thank you. The next two are from the same person who asked them together. Can you switch without a problem from Advantage back to Medicare and secondary or Advantage plans cutting back on coverage from year to year? So in terms of switching, Sheila had mentioned this. Every year Medicare has, it's called the annual enrollment period. So that's the period we're in right now. It runs October 15th through December 7th. And that's for existing Medicare members where they can evaluate their current coverage and decide if they wanna switch from Medicare Advantage to go over to the original Medicare side, not a prescription drug plan or a supplement plan. Or you can switch from one Medicare Advantage plan carrier to another Medicare Advantage plan carrier. Or if you're on the original Medicare side, you wanna stay there and you wanna change your prescription drug plan, you can do that. Also, under Medicare, anybody who's on a Medicare Advantage plan, there's one other enrollment period. Not supposed to talk about it, but might as well let you know. It's called the Open Enrollment Period and that runs January 1st through March 31st. So think of that as one additional enrollment period for people who have Medicare Advantage plans where they may, you know what? I think I changed my mind. Changed my mind. I wanna go to original Medicare or I wanna switch to a different Medicare Advantage plan. After March 31st, you're locked and loaded. And then in terms of restrictions under the Medicare Advantage plans, I don't know if Sheila mentioned this or maybe missed it. One of the kind of the drawbacks with the Medicare Advantage plans, there tends to be more prior authorizations where, for example, you wanna get an MRI. The doctor's gonna have to get it authorized usually. That's been a little cumbersome with these Medicare Advantage plans, but the government is trying to reduce these number of prior authorizations. There's been a lot of complaints under the Medicare Advantage plans. So we probably will see some changes next year, 2024, where there's gonna be less prior authorizations under the Medicare Advantage plans. But we'll see. I mean, think about the Medicare Advantage plans as it's private Medicare insurance where companies like Aetna or UnitedHealthcare or Anthem, they're managing and they're acting as your Medicare. You're still in the Medicare program. You're not getting any less hospital part A benefits or less medical part B insurance benefits. They're just the administrator and kind of setting the rules. But they have to follow all the guidelines set by Medicare. They're under contract with Medicare. They can't do whatever they want. They have to follow the rules. Great. If you're gonna change, oh, sorry. No, that's okay. Go ahead. If you're gonna change in one of these periods, who do you contact to change? Sheila. Who? You, yeah. You wanna contact, you wanna talk to somebody like Sheila so you can review. So you contact an agent. Okay. Definitely a broker. Yeah, Sheila. You can certainly reach out. I cover Connecticut. Curtis covers Connecticut and New York. And then we have other agents whose information I can give to you that are in other states across the country that kind of fall under the pinnacle umbrella under which we fall. So I can certainly give you the name of someone that has been vetted and would probably be a good place to start as well. Because the rules are different for the plans in different states. That's why you have to be licensed in the state in which you work. Okay, this might sound stupid, but is the license to a Medicare broker or are you a health insurance agent? We're actually brokers. For Medicare, just for Medicare? Or are you your health insurance? Well, health insurance. We're licensed health insurance brokers, so Sheila's focusing just on Medicare. So she represents you, the consumer, and she's appointed with all the different carriers like Adnan, Anthem, UnitedHealthcare, Connecticut, Sigma, WellCare, Humana. So she can show you all the plans. And she mentioned earlier that we do not charge a fee because we get paid by the health insurance plans. Okay. So that's the term. It's a broker. A broker, yes. An agent is typically somebody who is applying with the carrier and they represent just that one carrier. Okay. Yeah. Great. I think we answered all of the questions in the chat. James, if you're still on the call, those were your last two questions that didn't give you the answer you needed. Please feel free to chime in. I'm looking through what was sent in the pre-registration Sheila. And I think the only one that maybe we didn't answer on is one that says, you have to go on Medicare if you're still working at 70. I apologize if you said that, that one stood out for me. No. No. Once you turn 65 and you're working, you can stay on your employer plan. And the rule is your employer has to have 20 or more full-time employees. If your employer has less than 20 full-time employees, then you do have to sign up for Medicare. But if it's a big company with 20 or more employees, you can continue to stay on that employer plan. And Sheila mentioned the form, the employer form, the reason you have to fill out the employer form when you decide to start Medicare and retire is the government wants proof that you did in fact have coverage from when you turned 65 from your employer. That way you avoid the Part B late enrollment penalty. Also, it's always good to compare your employer plan versus Medicare. We often find Medicare is better coverage and the cost could be lower. So it's always good to compare. Even if you're 65 every year, I recommend it. Great. I think that's all of our questions. We can do one final call if anybody else has anything that they'd like to ask on this. Yes, I have one question. All right. Thank you for doing this. I appreciate it. My husband is turning 65 next summer and he's employed and has health insurance for our family. If he were to, I think they have just about 20 employees. So if he were to continue on that, then we would continue to be covered under that group plan. This was right now covering myself, the spouse and my son who was 21. Now, if he were to force to go on Medicare, what happens to the rest of us? Do we have to go on Obamacare? Bob, we have two options. You could continue on the employer plan through COBRA, which is a continuing operation and COBRA, you're paying the full premium, the portion that your employer was paying towards the premium and what your husband had coming out of his paycheck every pay period. So COBRA can be expensive depending on the plan. So the other option is to look at a plan through the Affordable Care Act. Connecticut has an exchange called Access Health CT and the government under the Affordable Care Act, the government does provide these premium subsidies, tax credits, where you can get help, assistance, paying your premium in the way it qualifies based on your household size, which is the number of dependents on your tax return. And then the other determining factors based on your projected modified adjusted gross income. So there is financial help under the Affordable Care Act through tax credits, premium subsidies to help offset your premium. So we review that and we can help you understand the different options. All right, well, one final question, if you don't mind. So I'm not sure I'm gonna go look into how many employees they have, but let's say they have 21 and somehow they end up at 19 or something. I mean, does he have to constantly monitor how many employees that the company has? That's a good question. I've never gotten that question before. Me? Yeah. I don't know how the government monitors it. To be honest with you. All right. Oh, they're looking into that one. Yeah, I was gonna say, well, you can certainly look into that because I have not heard that question. It's a good one. Yeah. Yeah. Oh, thank you. Again, so very much for your help. You're welcome. Can I just ask one final question? Sure. I had called the UnitedHealthcare for the medic gap policy because I'm gonna be retiring at the end of February. And so then now an insurance agent has called me a couple of times. Is it better to deal with an agent as opposed to a broker or a broker as opposed to an agent? I would recommend a broker because the UnitedHealthcare person is gonna, most likely they are a, what's called a captive agent where they can only talk about the UnitedHealthcare supplement plans. Okay, that's the impression I got. I would talk to Sheila, definitely, because she can show you other supplement plans that way you're understanding all the options and what the premiums are. Okay, great. I'm talking to her. Again, and I'm just, again, I was talking to the client the other day who had called, she had a meds up with you, UnitedHealthcare. And then when she asked about a standalone prescription drug plan, they recommend UnitedHealthcare drug plan. And yet when she and I talked, we found that there were much better options available because I represent all the plans, right? So I can kind of look at what each carrier has to offer. And for a long time, I worked with Anthem as a captive agent. And the reason I'm excited now to be an independent agent because now I can offer people the best plan available. I'm no longer limited to just Anthem. Now, we can look at it at UnitedHealthcare and MANA, et cetera. So I agree with what Curtis is saying. Working with a broker, I think you get kind of the best of the best. Okay, great. Thank you. Sure. Looks like we have one last question. I don't know who I asked one question. Sure. I apologize. Is that me? Yeah. So is it just like a general rule of thumb that the Medicare Advantage plan is less costly upfront, but there's more, maybe not as thorough coverage, where the traditional Medicare with a private supplement cost you more upfront, but it's better coverage. Is that like a general rule of thumb? Yeah, the Medicare Advantage plan, so they like to price the plans where they do not charge a premium. And Sheila said, you do still have to pay that 4B premium to the government no matter what side you get your Medicare coverage. I mean, these Medicare Advantage plans, they want to get members because they get a monthly fee from the government for each member they have. And it's close to $1,000 per month. So they want that monthly fee coming in. So they like to price the plans as a zero premium. And then they break down all the potential benefits you could receive under Medicare into different cost shares. Like for doctor visits, you could pay a zero co-pay for primary care doctor visit. Specialists could be 35, 40, 45, depending on the plan. Hospital could be 395 per day up to five days and then so on and so on and so on based on the medical service that you use. And like I mentioned earlier, the infusion drugs are paying 20% and then they throw in the extra benefits like the dental, vision and hearing. I could tell you right now, based on the Medicare population, there's close to 60 million people on Medicare that just tipped over where about 51%, 52% are on Medicare Advantage plans. They're becoming more and more popular. I mean, the commercials on TV, just we get calls on them all the time. We got to explain the difference. And I saw this and I get that. Well, it depends. Because of the initial less amount out of pocket. That's what's, that's what happens. Yeah, if you're just, you know, a couple of routine doctor visits. I mean, Medicare Advantage plans is great. That was a little more of a risk, but a little, but if you have any existing health conditions, you're probably better to go the other way. Yeah, that's something Sheila would ask, you know, kind of review your health, if you're being treated for anything or any potential surgeries coming up or anything your doctors are watching. That's why you want to talk to Sheila just to understand everything. So there's no surprises. Do you financially in advance? Like, if you have, if you know there's going to be a year where you have a lot of financial challenges, you would go for the one that's less out of pocket. And then the one, you know what I'm saying? Like, if can you would, because you can switch types, right? Yeah, you can switch every year. So if you know you're going to have a knee replacement surgery, you're going to get a lot of physical therapy after and you may want to consider original Medicare. Some people want to go to the hospital for special surgery. They only take maybe one Medicare Advantage plan, but original Medicare, the hospital takes it, not all the doctors at the hospital for special surgery, but yeah, it depends. It depends on what you're going to need. If you think you're going to have something coming up with surgery, you may want to consider original Medicare or evaluate the out-of-pocket costs with the Medicare Advantage plan. Thank you. And I think that's where it's worth having. Sorry, I didn't mean to interrupt, I was going to say. That's why it's worth having a conversation and those are the kinds of questions that we ask and think about and then hopefully from that, you kind of decide what's the best fit based on your situation. Now, none of us have a crystal ball, but certainly we can take all the information to have and think it through and come up with a good option. And then you can always make that change, if you need to. A couple doesn't have to both be on the same plan. A husband and wife could be on two different plans, completely different plans. Correct, yes. Okay. I've seen that. Thank you. I know we've reached the eight o'clock hour. I do want to be conscious of everyone's time. There is one last question in the chat that's been in there for a while. So I do want to get that one out to you guys. And then if there's any additional questions then we will share Sheila and Curtis's contact information in the recap email. Last question is, is there any additional support for dental or vision for folks who've opted for an original Medicare plan versus a Medicare Advantage plan? So under the original Medicare side, original Medicare does not cover a routine exam or any dental or any hearing coverage. But some of the supplement plans do give you access to a discounted eye exam. So for example, like the AARP UnitedHealthcare supplement plans, you can get a discounted eye exam. It's not insurance, but if you go to use a provider through IMED, you can get a discounted eye exam. Dental, you're going to have to purchase a separate policy. Sometimes when somebody's coming off an employer plan, we'll recommend, because they're going to offer you Cobra and if you had dental through your employer plan, we would recommend taking the dental Cobra for 18 months. And then you could evaluate different individual options because usually the employer dental coverage is better than the individual plans. Great. And typically I'll just add with a Medicare Advantage in terms of dental, you probably get maybe $1,000 allowance for both your preventative and comprehensive. So again, depending on what your needs are, what you anticipate for dental care, that's something certainly to consider. Can I ask a question about dental, just one question? I have had the same dental insurance for like 25 years. I'm self-employed and I have my own LLC. And I love it and can I just keep it when I turn 65? I don't have to do, like I don't have to be forced into that, right? No, definitely not, you can keep it. Fabulous, that's great, thank you. Well, thank you Sheila and Curtis so much for your time and thank you everyone for all these great questions. This was super informative and we are very, very grateful that ahead of the big date tomorrow with the open enrollment that you guys gave us your time today. So thank you so much. And again, we will share all of these resources with you via email, if you've read along with Sheila and Curtis's contact information so that you can follow up with any additional questions or if you'd like to work with them directly. So thank you all for your time. Thank you. Thank you all for the noted Medicare commercials, we'll end tomorrow. Thanks everybody, have a great night. Be well. Good night.