 My name is Tracy. I am actually with White Financial Ratings and Grey House Publishing. We do independent and unbiased financial safety ratings for banks, insurance companies, which we're going to focus on today and also investments, stocks, mutual funds, things like that. We don't take any compensation from any of the companies that we rate. Our ratings tend to be more on the conservative side, so that will become important later when we start talking about some of the ratings of the particular companies. We also don't allow any of the companies that we rate to see their rating beforehand, and if they don't like their rating by themselves off the list, please come join us. So it's information that you can trust and count on. So first we're going to talk about the major expenses that Medicare doesn't cover. Open enrollment and what does that mean? Why Medigap usually is a better choice than Medicare Advantage and how you can get lower premiums and potentially save some money, which is always a good thing, right? So for most people, Medicare eligibility has a seven-month initial enrollment period. It goes for the three months before your birth month, the month that you actually turn 65, and then the three months following that. There's also an open enrollment period from October 15th to December 7th, so we are kind of smack in the middle of that right now. And we're also going to talk about if you're still working and covered with your employer's insurance. How does that affect you? So if you enroll in the three months prior to your birth month, you should have coverage on the first of the month that you actually turn 65. If you enroll in Medicare during the initial enrollment period, either during your birth month or the three months following, there is a potential that you can have a gap with no coverage, so that is something to be aware of. The open enrollment period, October 15th through December 7th, allows you to make any changes that you wish to your current Medigap plan. So if you want to change plans, now is the time to do it, and you can do that every year. And there's no penalty during the open enrollment period. If you change plans outside of the open enrollment period, there can be penalties. So what if you're still working and have coverage, some coverage, of insurance through your employer? Then Medicare would become a secondary insurance to your employer's insurance. If you don't have insurance through your employer, then Medicare becomes your primary insurance. So let's kind of understand what the different parts of Medicare are. The four main ones are part A, which is your hospital insurance, part B, which is medical insurance, part C, also known as Medicare Advantage, and part D, the prescription drug coverage. So let's talk about the three main parts. So part A covers hospital-related services, emergency care, inpatient hospitalization, home health services, skilled nursing services, and hospice. Part B covers a lot of your deductibles, copays, coinsurance, doctor's office visits, lab services, ambulance fees, diagnostic services, such as MRIs, EKGs, CAT scans, etc. So that sounds great, right? I'm covered, not so much. When you don't have a Medigap policy to supplement parts A and part B, there are some out-of-pocket costs that you will be responsible for. These are based on 2018 costs, but you can see there's a hospital deductible, there's a part B annual deductible, first three pints of blood, skilled nursing facility care, etc. Hence the name Medigap, because it fills in the gaps of your original Medicare. And then there's part D, which we're only going to touch on a little bit about today. There's more information in the back of the room for you to take later. And part D covers your prescription drug coverage. Part D is not mandatory. It is a compulsory part of Medicare. However, if you do not sign up for part D during your initial enrollment period and you sign up later, there is a penalty for that that will be ongoing based on how long you waited. You do have some other options if you've waited a long time to sign up for part D, and that, again, is covered on some of the sheets in the back, because that could be a whole discussion unto itself. So some of the hidden costs for Medicare, prescription drugs, those aren't covered, vision care, emergency care abroad. So if you have saved a lot of your working career and you want to travel to do genealogy research, vacation, go see family, whatever it might be, you get sick or injured overseas, original Medicare will not cover you. Any dental care and hearing aids. So where does that leave us? Medicare was never meant to be everything to everybody. It wasn't meant to be the all singing, all dancing policy. It was meant to cover the most basic needs for our senior years. And so it leaves us with some gaps. Your options are Medicare Advantage, otherwise known as Part C, or Medigap, otherwise known as a Medicare Supplemental Insurance. So let's talk about the difference between the two of them. So Medicare Part C or Medicare Advantage is offered through private insurance companies. They combine the benefits of Part A and Part B and often Part D, excuse me, the prescription drug coverage. There can also be additional benefits and programs built in gym memberships or reduced gym memberships. Some of them have vision care or dental care included in them. So they can add on a bunch of benefits in addition to the regular Parts A and Part B. Medigap, or Medicare Supplemental Insurance, is offered through private insurance companies as well. And it helps to fill in some of the gaps between Parts A and Part B and what they don't cover. Some of those things that we talked about in the earlier slide that you would be responsible for. Medicare Advantage, as I mentioned, is provided by an insurance company, but coverage is limited to a defined network of doctors and providers. And sometimes these plans have no or very low monthly costs, so they can initially seem very appealing. However, the more coverage that you get, usually the higher premium, and you do tend to have higher out-of-pocket costs for deductibles and copays. Medigap plans also offered by private insurance companies, and you pay a separate premium for the coverage, but they're designed to fill in those gaps and you are covered anywhere in the United States. You don't have a specific network that is local to you. So Medicare Advantage generally lower premiums, but does have copays. Restricted network. You do need referrals most of the time to go see a specialist, which then can incur more copays. It can include extra benefits, as I mentioned, like vision, hearing, fitness, gym memberships, etc. And outside of your immediate network coverage, it's emergency care only. Or with Medigap, you do pay generally a little bit more every month, but you have the freedom to choose your own doctor. Referrals aren't necessary to go to a specialist. Some routine services aren't covered like vision and hearing, but you are covered anywhere within the United States. Medigap also tends to be a good choice for what we term as snowbirds. Anyone who may have a home here but also has a home in another state, so you're traveling between two locations, or you travel quite a bit and tend to be in multiple locations, that also tends to be a better choice than Medicare Advantage where outside of your initial network, you would only be getting emergency care. So that brings us to our first secret. Medigap plans provide identical coverage. So there are currently 10 plans in the United States that you're eligible for. Each one is represented by a letter A through N. And for every lettered plan offered by an insurer, the coverage is exactly the same. So for instance, every company that offers you plan A insurance is giving you the exact same set of benefits as another company that's offering you plan A. This means that you can actually line them up and compare them side by side. They follow federal standards and regulations. The government insisted on that. Unfortunately, you can't do that with Medicare Advantage. The Medicare Advantage plans come by different names in different states, in different areas with different benefits, and there are no federal guidelines or regulations within those plans. So as I mentioned, there are currently 10 plans A through N. And each one has different benefits. And that allows you to choose the plan and the coverage that you want and need, can afford, covers your health concerns, et cetera. And you can then choose the insurer knowing that your coverage is going to be the exact same as everybody else that offers it. So let's say that foreign travel is important. We know that we need to choose one of those companies, one of those six companies, that lists foreign travel emergency care. If in addition to that, we want to make sure that Medicare Part B deductible is covered, then that narrows it down even further to plan C or plan F. If we don't care about that, but one of the other concerns is important, it allows you to narrow down your choices based on this handy chart. No. Metagap. There's a bunch of handouts and this information will also be in a report that you'll be able to generate at the end. So you'll have this information. No, no, no. No, no. You don't need to copy this. You'll have all of this in a handy packet at the very end. Foreign travel is not covered by Part A and Part B of Medicare. If you happen to, like, you were vacationing or you have a second home in Alaska, and you're driving back to California through Canada and something happens to you, then you would be covered because you're on your way back. But if you're in France doing genealogy research or on vacation in the Luar Valley and something happens to you, Original Medicare Parts A and Part B will not cover you. One of those six programs would cover you. Yep. Yep. My understanding is that if Medicare refuses a certain medical charge, Medigap won't take it either. Is that different from overseas emergencies? It is with one of those six plans. So because foreign travel isn't covered under Parts A or Part B of the original Medicare, but it is covered under one of those six plans. If something happened and you had one of those, it would cover 80% of your foreign travel emergency. And the six are? C, D, F, G, M and N. And those will all be in the report too, so don't feel like you have to write that down. So that brings us to secret number two. The Medigap plans are standard, but how much those insurance companies can charge you for each one of those plans is not standardized. They can charge you whatever they want. And this is one of the biggest secrets because the insurance premiums can literally vary thousands of dollars a year. And the premiums aren't just because of where you live, although it does play a part in it. Your age, your gender also play into it. And because the plans are the same, you can really line them up. So I did an initial report for a 65-year-old female living here in California, and she went out and asked an insurance broker for a quote on plan F coverage. She wanted something extremely comprehensive. They quoted her $4,193 a year. Now, the lowest premium that she could have paid by utilizing this program would have been $1,848. That's a savings of $2,345 a year. That's over $23,000 in 10 years that she could have used for whatever she wants other than paying them, be it healthcare costs, reinvesting in a longer retirement, living expenses, travel, whatever it is. Yes, ma'am. I'm going to show you. We're going to get to the good part, I promise. So I talked in the beginning about the WICE financial ratings. We have been around for almost 35 years doing insurance and banking financial strength and safety ratings. And the safety ratings speak to the financial strength of the company. So are they financially strong? How well do they pay out their claims? Do they pay them on a timely basis? All things that are important. It has nothing to do with how nice they are to you on the phone or what their customer service is like. But at the end of the day, if I had a choice between a stronger financial company and that I knew was going to pay out those claims after paying my premiums every month versus somebody who always gave me a hard time about paying my doctor, but was so nice on the phone to me every time they did it, I would choose the first one. I would put up with a little aggravation. That's just me. Again, remember, you guys got to make the choice. So we did our ratings on a very easy to understand system. A is excellent. E is very weak. C is fair. Not great. Not terrible. Average. So you might be wondering if paying a higher premium means you get a financially strong company. I mean, that would be logical, right? But I didn't I didn't list the premiums here because they recently changed in the fourth quarter. But as I mentioned in the example with the 65-year-old woman here in California, the $1843 plan, that was a B-rated company. The company that was charging her over $4,000 was a C-rated company. So that brings us to secret number three. Safer insurers who are more financially secure insurers are not necessarily more expensive, even though it makes sense that they might be. Sometimes those higher premiums, as I mentioned, are coming from companies with a lower financial strength and safety rating. Sometimes you can get a lower premium with a much higher rated company. So higher premiums don't mean you're getting coverage from a stronger, more financially stable insurance. And that brings us to secret four. Again, you get to make the choice. You have the ability to compare the plans, look at the premiums, stack them side by side, and actually make the choice on which one is best for you. So you can balance the financial safety of the insurer with whatever plan you tend to choose. So you could decide that you're on a very fixed income and you want to reduce your premium by going with something more basic, or you can get more coverage with a more comprehensive company, sometimes for just a little bit more. So let's look at the four secrets again. Metagap plans are all identical in coverage. The plans are standard, but the rates are not. Safer insurers, not necessarily more expensive. And you guys get to decide. We get to make the choice on what's best for us. Yes, ma'am. Financially, yeah, the financial stability of the company. That's one of the parts of the review that goes into what makes them a higher rated company than one of their competitors. They report quarterly to the NAIC, which is a regulatory insurance organization, all of their financial numbers. And there's a lot that our analysts take a look at as far as their liquidity, stability of finances, et cetera. And they compile it by putting all the information through the algorithms and really digging down and analyzing the company itself. Yeah. So with one simple step, you guys can have a little bit more confidence that you have the right coverage, more importantly, at the right price for your particular situation. And what might be right for this gentleman up front might be completely different for this lady in the back. We all have different needs, both financially as well as health. So what we're going to do today is create a customized buyer's guide that's going to be customized to each and every one of you based on your age, sex and zip code. It'll show you absolutely every provider under every plan that will give you coverage based on your age, gender and zip code, which hopefully ends up saving you a lot of time and money, calling a lot of people, getting that information. And it's also going to give you the safety rating of every company provided. So with the report, you get a complete list of carriers in your area and what they're offering. Each one of the plans explained with the current premium costs. And we get told all the time that those costs that are listed are almost to the penny what patrons have actually paid come January 1st for the premiums. So they're pretty spot on. We check them monthly. And it'll also have the safety ratings for each one of the carriers. Correct. But a lot of times the research has shown that if you sign up for Parts A and Part B, including the Part B premium, which you can't get out of unfortunately, you sign up for a Medigap plan that is actually customized to what you are going to need and use and the Part D, even though you end up having three separate cards, ultimately it ends up saving you money out of pocket between co-pays and whatnot. Sometimes that lower premium seems very enticing and seductive in the beginning. And then the co-pays just end up eating what you could have saved. You guys are able to access this report at any time for free with the San Francisco Public Library card. And you can do it not only from here in the library, which we're going to do for anyone that wants to generate a report, but you can also do it literally in your pajamas from the comfort of your couch at home if you so choose. So in library you can simply click on the link found on the database page of the San Francisco Public Library web page. It's under W for WICE ratings. If you were out of library you would go to the same link and click on it and then it would ask you to input your card and your PIN number and you would hit submit and then it would allow you to access the page. So some typical questions that I get. Can my spouse and I use the same report? I don't usually recommend it. It's best if each one of you generates a report individually because the gender thing can change it slightly. You're not paying any extra to get to so you might as well each one have your own. How can I review the report? Well if you go to the link and you click on the page and you fill out the information the report is going to pop up immediately. It's going to ask you for an email address. If you put in a valid email address there will be a link to the report that will also be sent to your email address. You can access it from home at a later time or on a tablet or however you'd like but you will have immediate access to the report on your computer. We don't collect any of your information so if you do put in your name and email address we aren't going to collect it and spam you at any time. It's just to customize the cover page of the report itself and to send you the link. If you don't want to put in an email address or you don't have one in that box you can simply type in info and we can get to that in just a minute. So how many of you have AARP? I do and they're great and they send me the magazine every month and I get terrific discounts on all sorts of stuff and I hear from people all the time. They sent me great information on Medigap and Medicare Supplemental Insurance and so you know they've always been good to me. What about AARP? As we're going to see very shortly from the report AARP has a commercial contract with one insurance company and one insurance company only. It's currently United Healthcare which is a C rated company for financial strength and United Healthcare does not provide every one of the 10 plans for every gender in every zip code. So there are some limitations so it's not necessarily your best choice for Medigap's sign up. So what if I have Medicare Advantage and I want to switch? You can drop the coverage and enroll in Medicare Parts A and B and Medigap if you so choose during the open enrollment period which as I mentioned was October 15th through December 7th or during Medicare Advantage Disenrollment which is January 1st through February 14th. But during that time you may undergo medical underwriting to determine if you will have to pay more or if you're even eligible for coverage. So are there any changes coming up? Yes there are. On January 1st 2020 so not this January but a year from now plans F and plan C are going to be closed to new enrollees. If you have them you will be grandfathered in if you want to keep them but Congress has decided to get rid of them in part to reduce government spending. In many cases if plan F is something that is interesting to you because of the comprehensive coverage that it has plan G is also a good plan to take a look at to compare and it will be a great option for any new enrollees in 2020. The only difference between plan F and plan G is that in plan G you have to pay the $183 one-time annual deductible for part B. In many cases if you line up plan F premium against plan G premium for a high-rated company in plan G you're going to end up paying a lot less than just $183 so it ends up behooping you to choose that option anyway. So you're saying that every year under plan G you have $183 to pay? Correct. Yeah but no additional premium? Correct. Where is the plan F you're going to have monthly premiums? No with plan F they would cover the plan B co-pay of the $183 but many times just for sake of example plan F might cost you $4,000 plan G might cost you $3,700 you have to pay the $183 but at the end of it you're still only paying $38,000 you know it's a little bit less that you save which with costs of everything these days a little bit goes a long way. Okay so who would like to generate a report? You guys with me? We're going to do it with the computer. Okay I don't have it with me. That's okay we have a bunch here that you can use.