PROJECTED: Social Security Increase & Part B Premium for 2025 - Live Event + Q & A

welcome back everybody to the live stream this evening we're here at Medicare school.com to talk about some topics this evening concerning projected Social Security increases and Part B premiums for 2025 my name is Evan Cruz I am a license sales agent here at Medicare school.com here with the co-founder of Medicare School Marvin music and we're here to talk about your answer your questions this evening and talk about what's going on with new with Social Security next year in 2025 so we'll be happy to figure out what's going on with those and answer any questions you might need also let us know where you're from so be able to take a look at everybody who's uh call sending in questions from around the country kind of get a feel for where everybody's at and obviously be happy to answer any questions that you have during this live stream and anything that you may need uh to know that's what we're here for is uh your information resource so go ahead Mar all right very good well let's just briefly talk about uh tonight's topic and that is uh the Social Security increase and Part B premium first off uh the numbers I'm going to share with you are just projections uh we are not confident of either one of these just yet getting very close but uh uh the way the um cost of living adjustment works is actually tied to the Consumer Price Index um W which is for uh Urban wage earners and clerical workers and so what Social Security does is of course they're calculating this um uh uh index every month but to determine what the cost of living adjustment will be for Social Security they're going to look at the third quarter of 2023 and then uh if there's been an increase in that same index in 2024 whatever that difference percentage increase is will be the cost of living adjustment that will be applied to uh the new Social Security checks so again it's third quarter 2023 to third quarter this year uh and so we'll we'll be at the end of third quarter at the end of this month so very soon uh but those that track this and do the projections right now are saying uh about a 2.6% increas is what they're expecting a little lower than last year last year was 3.20 uh so we're expecting about a 2 .6% again we'll know that for sure here in just a couple more weeks um that means this the average social security recipient is getting just a little above $1900 that's average I know there's some getting less obviously some getting more but uh if we apply that 2.6% increase that means the average person will get an additional $50 uh in their um social security benefit of course and they would see that uh in their first check in January all right so that's what we're expecting again anxious to see the final number but it should be probably pretty close on that and then the other thing uh we want to talk about is the Medicare Part B premium and again folks uh we don't know this for sure yet uh these are just uh projections this actually comes out uh from the Medicare trustee uh report uh but what we're anticipating right now would be uh the part be premium somewhere around $185 a month for 2025 uh right now that is $174 70 and so that'd be an increase of about $10.30 so 185 is the projection uh now um let me tell you how that's calculated what happens is every year Medicare uh decides um what they believe and again it's just a projection as to what they believe the cost of covering the average Medicare beneficiary will be um for 2025 now this number they've been working on uh they actually work on during the spring and summer so uh that number certainly has been finalized but they have not published it yet so what they do is they take the billions and really now probably trillions of dollars it takes to cover everyone in Medicare here divide that by all the recipients which this year about 70 million people and they come up with a a monthly amount and uh they're what they're saying is they believe that's going to be somewhere around uh $740 a month to cover the average Medicare recipient and so the average Medicare recipient has to pay 25% of that cost and that's where that 185 comes from it's not just plucked from the air there really is a Formula behind it so again uh uh the average recipient is going to pay if it's 185 they're paying 25% of what it cost the government to to cover them and again the Medicare budget covers the other 75% however uh when I say average I keep saying that because it's actually tied that number is actually tied uh to what we refer to as the modified adjusted gross income modified adjusted gross income and so if I'm on Medicare in 2024 uh the government looked back at my uh income tax return in 2022 they always look back two years uh and so they they establish what we call thresholds for modified adjusted gross income and that formula is line 11 which is your adjusted gross income plus line 2A which is your tax exempt interest and so they take line 11 plus line 2A and that's the number that is then reported to uh Medicare uh to determine Your Part B premium and so this year uh those thresholds for a single filer is 103,000 or less as you know a married couple filing a joint return is 2 6,000 or less and so if we're below the thresholds again we pay the standard part me premium this year 17470 next year uh $185 now because we're projecting the uh the premium to go up so will the thresholds and again projections are right now a single filer uh that is at 105,000 or less uh or a married couple that would be at 210,000 or less would pay than $185 if we're above the thresholds then we have additional charges those are called IRAs They Se charges that are added to our Part B premium as well as Part D premium uh if we're considered to be high income and so there's actually five different brackets of income that are above those thresholds I mentioned so our irit would vary depending upon how high it's going to be anywhere from that you know if it's a couple 210 up to you know three4 of a million dollars and so the point is some people are going to pay more than that base premium just depending upon uh where the her is land in for 2025 all right so those was again projections uh we should know the exact numbers for Part B within about a month and then a c just a couple weeks of course for uh the cost of living adjustment all right so um hopefully that's helpful if you have any further questions about that particular subject of course you can put those in the chat and we'd be delighted to answer those for sure yeah um I did have a question that I usually get all the time to with people on the phone which asked me about uh a concern or a um a scare that a lot of people have which is the stability of Social Security moving forward and they say they're are very afraid that they're going to lose it it's going to get taken away my personal experience in talking to the masses of people who are on Medicare or going onto Medicare and Social Security is um there are a significant number of people who they're they're sole income it's Social Security and they don't have a they don't have you know the four-pronged approach of having you know the pensions and having the Investments and and um to have that taken away would be uh not only detrimental but I would consider impossible for that to happen so um the chances of it disappearing I think are are extremely slim so obviously I'll let you expound on that but there was a question here from a particular individual um hi I'm gland from Maryland 61 years old not planning to retire until 67 is social security stable enough for me to wait well uh I am very close to uh Medicare eligibility here in just a little bit of a year and obviously already ready for um Social Security but I am definitely going to wait in fact I'm going to wait till 70 hopefully uh that's certainly my desire so I would say to Glenn I think it's fine to and I'm going to tell you why because uh as Evan was saying there are certain people that this is their only income and so it would be a definite blow to a uh about anywhere from 20 to 30% of the population that lives on Social Security alone and so I just don't think our government really is going to allow that to happen um and so I think what they're going to do probably last minute uh they're going to make some adjustments to uh the stability of the trust fund by raising uh the maximum uh amount that's taxable for Social Security this year that's 168,000 so once we've reached 168,000 uh we don't pay any more money I think it's 1686 but we don't pay any more Social Security taxes on that money so that would be a very quick fix is to raise that amount up couple hundred thousand or maybe even maybe even unlimited I don't think they'll go that high but that's a very uh easy fix those uh who make that kind of money would be disappointed for sure but that's something they can do I think also what they will probably do is not my generation but your generation probably going to see that for retirement age pushed out to maybe even 70 from 67 to 70 and so I think they'll make some adjustments to solidify the trust funds for sure we know that there is enough money in there right now to about about 2033 2034 and then after that we know there's at least 80 cents of R dollar that could be paid that's not enough that people need to get 100% And so I do believe that uh uh Congress will take action to uh firm that up okay and I think we'll see that uh you know it's going to I think probably sometime here in the next couple years I believe they'll make those adjustments so Glenn I'd say wait I'm definitely going to um and wait to for retirement age 67 or wa wait be on that and grow that additional for 24% right and I always tell people the same thing too you know when when to take Social Security is a very personal decision obviously that everyone needs to make and um we don't have an expiration day we don't know a clock we know when everybody's going to pass away um and if we knew that number obviously we could tell you to the day you should take your Social Security um but you know I always tell people you know if you're in a situation where you know you're doing just fine and don't really need the money it's not going to make a difference on your day-to-day life and doesn't hurt to defer Let It Grow be worth more um but you know if you're in a situation you go you know what that date could make money could make a big difference on my day-to-day life I could take more vacations you know live the life I want to live doesn't hurt to consider taking it that yeah I think another thing people need to to look at longevity of life for sure but one of the reasons I am going to wait is because my wife has very little Social Security of her own and so if I wait to 70 I've grown that account and of course she'd be entitled to that you know when I died and so you can maybe if you don't live to break even enough to benefit from uh deferring if your spouse is younger probably will live longer in fact it's interesting have a 95% of of all soci Security survivor benefits today is going to women widows uh so uh I think we need to bring that into our thinking and planning as well right absolutely yeah all righty let's take some questions yeah let see what else we have here here that was a pretty basic one here too um just for some people who are curious here Rose here had asked the question can I get Part D or um or do I also have to get a Supplement Plan at the same okay very good well Rose if you are U going to um go on Medicare I definitely would get a part D plan if you're still working and the employer has 20 people on the payroll or or more you don't have to do anything with Medicare uh but if you're uh going to go on Medicare I'd get a part D plan um regardless if you take any medications or not I've had plenty of people who were healthy as they can be when they started Medicare and 6 months in or one year later they're uh being treated for cancer in fact 1 million people this year will be uh diagnosed with cancer that are on Medicare yeah the average cancer age right now 66 and so uh if you were to get diagnosed with cancer and needed you chemotherapy or you needed U you know some kind of a a medication oral medication for um uh your cancer or treatment you'd be very grateful that you had a prescription drug plan uh especially next year because the maximum cap out of pocket is going to be $2,000 for all Part D plans uh so you want to get a part D plan for sure uh and so as far as a submental plan goes uh most of you who you know are members of our kind of audience they know that we uh believe that subal plans are definitely the best medical coverage as long as people can afford a premium so I would encourage you to get a and b and get a supplemental plan either G plan or an in plan because I we find that most people that get sub metal plans are very very pleased with that especially if they have a health problem right absolutely let's see I see one up there about um Kelly Hall currently I see you CH you can pick them yeah see if I get down there to that one boy they are filling in fast a lot of these here and just kind of going along with what you said there was one lady up here I'd seen a question about um this lady here or from Bob here sorry saying he's a snowbird living in Washington and Arizona during the year um is likely a supplemental plan obviously better than an advantage plan for him I think so because it just gives you a lot more flexibility if you take an advantage plan you're going to be um in a network either HMO or po Network and so with networks come restrictions come limitations and so I think you have uh uh a much broader uh coverage option if you will take A and B with a supplemental plan because then you never deal with the network uh you can go to any provider any Hospital any doctor any specialist as long as they take Medicare uh they will take your supplemental plan as well so if I was traveling I definitely would be doing that y um were you familiar I'm sure you are um with the um you earned it you keep it have you talked about have you talked much about that yet as far as the changes in Congress for the um Social Security uh R reducing or limiting taxation on Social Security yeah yeah well I mean I I know what's going on I I don't know that that's uh fully passed yet okay but if it has that's news to me but I know that um uh there's uh has been some legislative talk about making Social Security uh no longer at least you know sub to federal income taxes so I hope they do that yeah um yeah I think that would be wonderful yeah I'll look at that a little more I think I was I think that had uh was in Congress in um January I think it was supposed to pass for for next year but I'll have to look into that for sure because that's something that somebody was asking me about the other day so I will have to make sure on that one question y there you go yes so if you're $1 over the threshold you're treated the same as someone 20K over the threshold is that the question mark Y no sliding scale within the brackets and that's exactly right yeah they establish it in fact uh well right now let's give you an example right now uh the first level of Irma for a married couple is 206,000 uh up to 258 so you're right if you're over $1 or you know any anywhere within the range you're going to pay that IR they will not give you an adjustment because you're that close I've actually seen that happen before yeah someone I mean literally within $20 of the threshold you'll pay the full Irma right that's right yeah I tell people a lot of times too when they're not quite sure because it's hard to know um when you're projecting projecting income for uh for the next year when it comes to IRAs you know some people don't know exactly how much they're going to make they know it's going to be close um but you know I always tell people you know whenever it comes to applying for an Irma appeal you can always um basically be prepared just in case you were miscalculated when they look back um they're going to you're going to owe the amount that you would have had to pay to you know the next year if they look back and you were being you know incorrect about your assessment but you can't go back and ask for that money back in the future they're not going to give that money back to you um but at the very least if you can make a predic prediction based on your best educated guess um and um you know if you end up having to pay you know some some of the differences from your miscalculation so be it but you can't ask for the money back if you know in case do you um make the mistake so always F figure if it's going to be close it's always worth it to to appeal but be prepared just in case oh yeah yeah comes down to that uh let's see [Music] here quite a bit there there's a pretty good one here actually I talked to a guy with tri care today here we go it's from Linda actually says do I need Part D if I have Tri care okay and you do not Linda uh if you have TR care uh or actually get your scripts to the VA or or through the federal government plan FB uh those are all considered credible coverage plans and a Part D plan is not necessary uh so TR care is going to cover your meds and actually will cover them quite well uh so it's equivalent to a Part D plan so great insurance and Linda if you get it through you or your spouse whoever uh you get the Trier benefits uh thank you for serving our country yeah retired military I like this one here actually this is from Carol says policy premiums for Part D will not count towards $2,000 out out of pocket um when it comes to the part D drug plan so I better off with a less expensive plan even though my Med costs my cost more okay Carol you are right in that um the only thing that's going to count towards the 2,000 will be uh your out- of-pocket spending and actually sometimes people get assistance from um uh State Health uh pharmaceutical assistance and that can at times count towards the 2,000 as well so it's you're out of pocket and sometimes uh if you are all if you are on a state health Assistance Plan uh some of some of those funds will count so premiums do not so that your question about better off with the less expensive plan uh I wouldn't do that what I would do is uh you want to you want to pick a plan based upon the medications that you're taking so you can use our site you can use medicare.gov uh but when you put your meds in let that system actually look at all the plans because it's going to look uh at um uh not just the premium of the plan but also what your out-of pocket expenses will be so I wouldn't do that I'd I'd let the system that you use pick the plan because it's going to it's going to uh give you the mo the best protection right so yeah don't usually a cheaper plan is going to have more uh quicker money out of pocket than vice versa usually we have a higher Premium plan it's because it has a better formula formulary and so um uh let let a system pick it out don't make the decision based upon premium only now hey if I take no meds I definitely would take the lowest cost U plan I could get it's fine you can switch switch them every year anyways M but if you're taking expensive meds um I wouldn't I wouldn't take the the cheapest plan which and all the drug plans this year in 2025 if if I'm uh correcting my assessment on this as well are going to be allowing people to have payment plans because of the max out of pocket being 2000 and people could get hit with that a lot sooner um this being spread out throughout the year do you know how that works exactly and how that breaks down yeah I do uh what what they're going to do is number one you you have to enroll into that uh and you can enroll to begin the year you can roll any attemp throughout the year and so that that's what they're going to do they're going to take that full $2,000 and they'll spread that out so if I enroll in that in that earlier I'll get more benefit from that because it's going to be you know smaller monthly payment but they can enroll uh it's kind of it's kind of a smoothing way to make sure that people that do uh have expensive meds are not going to have to come out of pocket 2,000 their first fill right uh spread those payments out y so they can they they'll have options to enroll in that program good and that's for all drug plans exactly right y yeah awesome that's great um here's another great one here from David it says if a spouse qualifies for spousal benefits do they get that and their full benefit yeah no uh whenever you're taking any form of Social Security you're you're only going to be able to take one type of benefit and so the only reason uh that a person today would um uh be taking spousal is if number one their spouse is already taking benefits and uh it means that the the 50% of their spousal is is greater than 100% of their own account because today when we file for Social Security uh it's called the deeming provision so we file and we have to take the greatest amount that's available for us and so it's not going to be both it's going to be the the greater of the two uh now we'll have sometimes people that will that will take their own benefit and uh uh their spouse is not yet taking so once their spouse takes and then if that 50% is greater then they'll be able to switch from their own retirement to that spousal benefit but it's not both at all and so let's say someone is taking from their spouse ill it's 50% because it's greater than their original then that spouse were to pass away becomes Survivor benefit become the full benefit exactly right they would get 100% whatever that spouse was eligible for at the time they pass away yeah yeah that would be information on that yeah and of course you know that also applies if you take any kind of social security benefit you're you're you're penalized if you take it before your own for retirement ages so even though we would be eligible for 100% dis spousal um if we took before 67 we'll say then we would have a reduction in that benefit okay yeah let's see here what else we got yeah if y'all want to put want you pick them yeah put some more in their um where where you from too not seen a lot of people putting in necessarily their their state and their city where they're from but if you want to put plug that in there too be happy to see where everybody is is watching in from yeah and so Margie as far as appealing an Irma uh you can the form that you use is called an ss44 um and uh what happens is if you have if you have a life-changing event um uh and that would be work stoppage work reduction death divorce uh an enement of a marriage uh life-changing event there's actually eight of those and they're all listed on the ss44 form and so what you're doing in the appeal is let's say I'm AIC here in 2024 they're looking back at 2022 and if I've had a life-changing event either in 2023 or 2024 then I can appeal I can I can tell them hey I've had this life-changing event and that life-changing event has affected my income and it's dropped so if yours moved down 70,000 uh then they could possibly eliminate the Irma or at least could move the Irma level down some so you definitely want to appeal that and when you fill that paperwork out uh Margie you're going to send that to your local Social Security office so you can just Google wherever your area is local Social Security office and you can um you know fax it in mail it in or drop it off uh and they will do a reconsideration and I've never seen an appeal lost ever okay I've I've had people that uh um I didn't think they would you know even win their appeal but they did so take the time to do that it's definitely worth your money right for sure and that life changing can be used for two years since you're always looking back two years uh you can use it two years y y next one there from Janice says my folks have a metag Gap Legacy C supplement plan with Blue Cross Blue Shield and the cost is through the roof why is there supplement more than what is discussed in classes here for FG orn yeah well Janice the reason is because in all states subal plans can go up and so uh you know because they're in the C plan which meant they started Medicare uh before 112020 um uh that group that they're in is probably older the group that they're in is probably shrinking in size and so that's why you're seeing um uh some very um large price increases that's why we tell people if they can if they can qualify uh to be able to switch a plan in some states you have to qualify medically you actually can switch during what they call a birthday Rule and so if you can get off they can get off that c plan and move to something else which would probably be you know the three that you mentioned there then um uh it's well worth your time to do it if their health is bad uh they're probably not going to be able to go to G or an N but depending on where you live live they may be able to move uh to an F plan possibly so um yeah right now really it's it's I don't know how your folks are but but that's that's an older plan that's all there is to it and they just continue to shrink and shrink and Shrink uh and when people stay in those uh policies there's not a lot of holders in the policy so that that that those premiums are not spread out to as many people and that's what uh causes the rates to be unstable I'm sorry to hear that Janice that that's a bummer call us though and if it's something that we can help you with we'd be delighted to do so yeah for sure he looks like Ann Ann coquit here says what what do I have to choose if I am keeping my work benefits I turned 65 in December I was told I have to choose the hospital plan so I don't have the pre-existing challenges when I actually retire yeah yeah and that's uh not accurate I would tell you that it is fine uh to go ahead and enroll in in the hospital party only as long as you don't have an HSA health savings account uh because if you're still working and you want to contribute to an HSA uh then you do not want to enroll into a or b and you will not be penalized I know people he that all the time uh but as long as you or your spouse is paid into the Medicare tax system for at least 10 years 40 quarters most people have you know 30 years paid in as long as we get that Medicare A at zero premium because of 40 quarters you can take a at anytime you want there's not going to be any penalties uh whatsoever and so when you say about uh you know turning 65 in December again if your group plan has 20 employees on the payroll or more you don't have to do anything at all don't have to do a don't have to do B now if you don't have an HSA it is fine to do a in fact I recommend it uh to do a only and in that situation your group plan at work is still going to pay first and Medicare A is going to pay second and in the second payer position a will not pay any deductibles will not pay co-pays but it will pay co- insurance and so if you had a claim where your group plan um left you responsible for some co- insurance Medicare could actually help pay some of the bills so I like a only unless you have an HS hsas wouldn't do a wouldn't do B and you will not be penalized as long as a is free I had a question for you myself actually um so I had a client who had a specific situation where they're continuing to work um Medicare eligible and it was obviously going to be um um a situation where they had uh them and two other people in the company so it wasn't considered creditable coverage as far as that however he still needed to cover his spouse who was under and his disabled child who was uh um in a long-term care facility and it was covering a absorbent amount of money it was incredible how much his insurance was covering so obviously he would never want to drop that it would just be absolutely detrimental to drop it so the situation and he was aware now and and he said he' talked to other people and he never ever was Hur uh given the term creditable coverage he didn't know what never no one ever mentioned that to him he said wow so you're telling me that if I go in a situation where uh something major happens and I go to the hospital because insurance company could come back and say that you know I'm over 65 and they're not going to cover me that's exactly right exactly so so the sit so the question that he had then was because um because in most places employer coverage is considered firstpay over Medicare if it's active employer coverage correct he had 20 or more in the group that's true exactly so if it's under 20 employees this is my this is the question I'm coming to um is and they have Medicare and they have this private almost almost privates right limited Group Insurance is not considered creditable who's first payer in that situation Medicare will be Medicare yeah when we're when we're still working the size of the employee payroll basically decides who pays first 19 or less Medicare takes a first payer position company pays second 20 or more uh Medicare is going to be second and the group plan's going to be first yeah so what I would do in his situation depending upon his deductible or what you know the cost of the plan uh I would probably go ahead and keep that for my spouse and he didn't have to he does not have to disenroll from the plan but since you're going to be enrolled in Medicare if has a high deductible and he has some health problems I'd still get a something metal plan in that in that situation so when he goes to the doctor he's using A and B he's using a subcard but when his spouse and his disabled child go to the doctor or Hospital they're going to use the group plan that's the way I'd handle it so when he goes to the hospital which cards you think he should be handing to the doctor in hospital well if he enrolls in Medicare A and B and then uh if he takes the sub I'd give him that and i' I'd give him the group plan as well just give it to them all absolutely there you go yeah they they'll coordinate those benefits right yeah yeah excellent yeah but but but I know I do know for sure that Medicare is going to pay first sub plan pay second and then group plan would pay third if it's if it's non-editable exact cor right exactly nice okay excellent yep Cheryl looks like Cheryl had a question here does the the Social Security increase for effect in 2025 increase the estimated social security benefit for those not receiving their benefits yet yes it does it does because when uh they they do calculate your benefits uh they will consider that that let's say it is 2.6% increase in uh when they when they calculate your top 35 years of earnings so yes everyone will benefit now now if someone is 55 they're not going to benefit from that but once once we reach 60 uh then anytime there's going to be a cost of living adjustment that will be affected in our future uh calculation when they decide what we're going to get when we take for sure yeah yeah so you will benefit from that all right looks like Jim has a question here too so so staying on the employer plan with the drug cost covered does the does drug cost is 60,000 per year am I being foolish for thinking it is best for now okay so I I certainly I number one I don't fully understand the question um so well it looks like his employer plan is covering the uh extremely high cost of his meds as it is right now so so I think he's asking should he stay on his employer coverage um because is covering the medication so well or should it go into Medicare yeah well it yeah I mean if they're covering it like you know full cost then yeah you don't have to do anything I mean if you're still working group is 20 or more you're not obligated to take a part you know Part D plan at all you're employer plan will be considered credible coverage so uh I don't think you're being foolish I mean I I don't I still don't quite understand the question yeah yeah I think well I think how I would answer that too I think is um um as you know the broker side talking about that too is that the with the new cap and everything with the $2,000 cap and everything um it depends on what his premiums are I mean it depends on how much he's paying for his group coverage overall and if that calculates through with the cost of the medications being you know $2,000 cap versus being completely covered with the employer coverage it could work out to be in your favor with Medicare it's just going to depend ultimately you know on how much you're paying for your premiums and what your deductibles are and if Medicare is superior um even with the higher you know maxed out $2,000 cost versus paying nothing with the employer it could work out to be better just there's there's a few other pieces to that yeah yeah that's what I'm saying I I wouldn't tell you you're being foolish cuz I I don't know enough I don't know yeah what what what size the group is don't know you what your premiums are on the group plan uh if you want to give us some more information um but it sounds like we got a good group plan if they're you know paying that much for your medications that would be wonderful yeah for sure okay yeah Carol looks like has a question here policy premiums for Part D will not count towards the $2,000 print uh we already seen that I think we talked bucker yep we answered that one already okay yeah what is the G plan all right well the G plan is one of the 10 supplemental plans that are on the market right now and it's the one that uh for anyone that is starting Medicare after 112020 it's the most comprehensive coverage available uh and it covers all the Medicare gaps or six total Medicare gaps G covers five of the six gaps so the one Gap Medicare G does not cover will be your your Medicare be deductible and Danny that this year is $240 so the first $240 of any medical bills coming through the bide of Medicare uh would be your responsibility and after that annual deductible is met uh then uh your GPL would cover all the other gaps so it's almost full coverage um uh when I go on Medicare which is a little over a year I'm going to go with a G plant that's that that fits my my style that fits my my thinking uh I like to have as much uh coverage as possible uh there are some people today that are also getting implants which also is a good option especially in some States where there's a big difference between the premiums of the G and the N the N plan uh covers everything but the B deductible and excess charges which are rare but if they do occur in will not cover excess and then you have some co-payments on in so uh G plan uh is I think a wonderful option and there's some people though that want to save a little bit of money and those people are typically going with an inplanted day one average about $40 a month or so some states 100 right uh but in most places about $40 a month on the in plan M okay so it's a submental plan filling in the gaps five of the six so almost full coverage right this next one here which um I believe I actually recognized this particular individual this might be Elizabeth actually one of my clients um what do you think of the indemnity PL well I'll let you answer that yeah um it's very actually uh very near and dear to me actually when I talk about these particular things too when it comes to um the being on an Advantage specifically there are there are certain gaps and things that are left over in the advantage the advantage obviously do their part um when it comes to replacing some of the costs in original Medicare but there are some unmanageable co-pays some things you don't want to be stuck with when it comes to going to the hospital or you know calling an ambulance or U going to the emergency room that you you get a bill for $2,000 you know some people just can't afford that a lot most of us can't afford that just out of nowhere um these co-pay protection plans that do a really good job when it comes to the Peace of Mind of knowing that you know if if you're not feeling well call an ambulance they take you to the hospital you end up in the emergency room and you get admitted for the full amount of days with the um you're having co-pays to your advantage plan you know they're going to write you a check within 48 hours do what you got to do that's what my insurance is for don't hesitate to call an ambulance don't put yourself in a situation where um you're you're worried about costs when it could save your life that's the whole point of an of a co-pay protection plan and the indemnity plans um specifically that would be like a hospital Indemnity you know helping you out filling you in that that that particular Gap um there's a lot of other things that are important too you know cancer writers so for just specifically in your family if you have a history of cancer or heart attack or stroke you know with a critical illness type of policies um specifically people also on supplement policies they can have these plans too they don't do they need them no not necessarily um when it comes to coverage but you know there's a lot of other costs associated you know with um uh heart attack and stroke and cancer I you got you got family you got to fly out you got facilities you got to go to you got things you got to get covered time off I there's a lot of other costs and these particular policies can help you when it comes to having that additional cash or take care of you and they usually are very very very low costs they're very easy to uh to handle that kind of thing I would agree yeah I think people that do decide to get a Medicare Advantage plan if they're not uh comfortable with the risk with the max out of pocket if they don't have the 5,000 or 7,000 or 3,000 whatever it is that will be the max for the year I think it's a good fit uh for what $25 $30 a month or so you can get an Indemnity plan um and I'm with you I I think when it comes to subal plans you don't need it for the health insurance but you could use that that money because Indemnity means it pays you direct it's not going to be paid to the in uh to the insurance company uh you know provider it's going to be paid to you uh you can use that money for whatever you want to right so I think I think they're fine if it's in someone's budget uh do I think they have to have it no if I have a subal plan no but um a lot of people like that additional Insurance in case they wanted some cash money to use on loss of income there's a variety of ways in which that uh would be U would be helpful right so absolutely I think you're fine um we don't want people to be Insurance poor for sure we want you to have the adequate coverage appropriate coverage for your risk tolerance and for your situation right cuz yeah I mean somebody can typically afford $25 a month but they can't afford a $22,000 Bill going to the doctor or going to the hospital right and um that's what I always tell everybody I talk to like I said I I never ever want you to hesitate to call an ambulance because you're afraid of what it's going to cost and if it costs your life it's just not worth it so uh it's really what's great about those it's a pieace of Mind thing with those two yeah his work getting me enrolled yeah Cory is a a wonderful agent he works here um a ton of experience wealth of experience so Cory's a pro yep he really is um he actually worked with Indemnity plans for quite a long time as well too so he actually a knows quite a bit about that we're froze up on AR I don't know if you okay okay very good nope kind of freezing up there okay uh let's see here all right do you prefer it is do you prefer an HMO Advantage plan or a Medicare Advantage po plan I won't qualify for subal plan so if it were me uh I I I would go with a PO if there was a good one in my market because I like the flexibility of having more providers available there's always more providers on a PO than an HMO right and then also if I had to go out on my network I can do so and so I like the flexibility I am not saying for a second hmos are bad uh sometimes hmos are are better fit as long as we can get Doctors Covered hospitals covered uh I know they're a little bit more attractive financially uh hmos versus Po but if I if I lay the two side by side I like my options better on the PO for those reasons yeah I may have a higher max out of pocket but at least I can go to any provider that takes Medicare on on that PO plan so I like that yeah if I'm putting people in plans too I mean it's I'm I'm putting them in a plan that I'd be putting myself in in that situation and if I'm in that situation where an advantage plan makes sense then yeah I'm avoiding hmos as much as I can um in some situations some states in some areas sure it might make sense um but for the most part yeah having the freedom and flexibility and um typically I've seen fewer referrals fewer pre-authorizations fewer issues when it comes to the restrictions that you have on that individual in a PO usually see a lot better okay all right another individual here if a person loses group coverage and wants a drug plan can the effective date be Advanced or does it have to be the first of the following month okay all right well um Can the effectiv be in be Advanced um yeah well if you if I enroll in a drug plan today uh September the 4th uh that plan would go in effect October 1st uh so drug plans always begin on the first day the month now uh depending on when you come into Medicare you actually can put that off about 3 months if you'd like to but it's usually going to start the very next month but when you're asking can the effective date be Advanced so I guess she's saying Beyond one month is that how [Music] you okay yeah uh if if it's uh if you're asking can it be can it be retroactive can it be backd and the answer to that is no uh Medicare there's only one instance that Medicare backdates anything and that's getting real in the weed so I'm not going to do that right but they are not going to back dat anything but the a DAT yeah yeah it's it yeah uh let's see here this one yeah I just I was just looking at that one yep from Bob there I'm turning 65 in De and can apply for Medicare now should I apply for a and b now and then buy a supplemental plan later how about Part D yeah I would not Bob if I were you I'd make all my decisions now because you can uh apply uh in some states actually six months uh in advance but usually around uh three months is the perfect timing so you're within that window where apply for your A and B and make your decision about what's going to be the best submental plan for you grn uh whatever the carrier is going to be and then enroll in the best drug plan uh for sure now what's going to happen on your drug plan is that uh you're going to be on a drug plan just for one month uh so I would I would select a plan that is good for that one month and you may have to switch that for uh uh the plan in 2025 okay what we' like to do is to go ahead and pick out a plan that we're we're thinking about just one month this year and then have the same plan roll over into 2025 that's really the easiest way to do that uh but the new plans for 2025 are now out yet so we're not exactly sure what they're going to look like yet but uh Bob i' do it all right now because that way when you get off the work plan you're transition to Medicare A&B starts something metal starts and your drug plan all December one yeah I have a question for you then on that along that line so let's just say someone has a situation just like his there turning 65 in December and they're on a a few different higher costing medications that a particular drug plan might say they would recommend a $100 drug plan for 25 obviously it's going to be different or 24 rather I'm sorry for the last month um it's going to be different 25 obviously with the changes in formulary and we're looking at 12 months versus one and a whole bunch of factors but let's just say that they go I have a 90day supply of medications that I'm filled up I don't need anything I don't need any medications should they still get a drug plan for that one month or should they just go ahead and pick a new one for January skip that one well they certainly could get by with it but something could happen during that month you know that's I've seen everything so I'd probably go ahead and just get a very lowcost drug plan for one month just to be on the safe side and I think it's good if you have carryover they don't have to do it and if they want to take the risk of not having a plan for 30 days because they have enough meds go for it yeah I've seen plenty of people do that so you just never know what could happen in one month true that's absolutely right yeah so for you know a few do drug plan that cost you know 50 cents or a drug plan that cost $5 or whatever I'd probably I'd probably play it safe if it just to have something just in case yeah pick up an antibiotic who knows you de all the time you know you never know what you might need yeah all right let's see here yeah from St I was looking at next yep have supplemental plan um have supplemental plan for a b and d Plan F and now over $500 a month 6,000 a year for us to mid 70s never been hospitalized still the best decision I don't think so suan uh what I would do is I would I would get off of definitely get off the F plan because that thing is just going to continue to uh go up uh much uh faster you know quicker and more increases than a g or an NW so suan if you're healthy uh go through underwriting and uh we'd be happy to help in fact you see the 800 number there just call us and our agents and you can you can change that plan that Plan F can be changed at any time subal plans are not tied to the Medicare open enrollment uh so call in now and you could if as long you get through medical underwriting you could start a new plan effective October 1 start saving that money uh and your health could change uh so the sooner really the better uh we'll have to ask you some health questions check your meds but it sounds like you're in great health so I think making that switch would be very easy to do right and and probably time with us on the phone what we can do that in probably 20 minutes maybe 30 uh and could take care of both of you so please call in in fact uh those of you that want to immediate assistance our switchboard's still open right now we're open 7 to 7 central Time Monday to Thursday and then on Friday 700 to 6 so switchboard's open uh there's agents that be available to help you through that whole process soon MH I don't know if you mentioned this too um what was the uh Part B deductible for 25 do we know that yet we do in fact I've been saying it wrong because they put out the number a couple months ago uh but but because of the party changes uh and all the bids that came in from the part D insurance companies it it bumped to $590 Part B is premium oh I said thought you said part part B Part B as in bravo my bad I thought you said drug plants I was like whoa we do not know the part part B deductible my bad I thought you said d d yes Part D deductible is $590 right up from 545 so yeah up a little bit there okay gotcha yeah I didn't know if they released that yet for the Part B premium and what we know because it was uh 226 last year so went up about 14 bucks this year right so so yeah we're still waiting I think it comes out in October okay we'll see what that is all right so for uh looks like uh El yeah isacon um you mentioned GN for additional insurance I just want to be clear are they Medicare Advantage or do advantage and supplemental use the same jargon no yeah g&n plans are Medicare supplemental plans uh they're also called medic Gap policies uh so uh what happens when someone does a g or an N what they're doing is they've made the decision to stay in traditional Medicare A and B which pays first and then the g&n being supplemental plans are going to fill in uh some of the gaps that Medicare did not cover G covers five of six n covers four of the six gaps uh and so Medicare Advantage plans are actually called C plans uh so when we think about the different parts of Medicare a c and d a is inpatient B is outpatient C are Advantage Plans and D are drug plans so a little bit of the same jargon but but definitely g&n plans are not Medicare Advantage plans right good question all right yeah Rosal Le here asking I'm married filing single will the Irma be based on my own income or joint income with my husband okay so what you're saying is you're married and you you all file a separate return um and so uh they they hit heras much quicker than what someone would in fact and they're and they're actually steeper as well I have not memorized those numbers and I'm sorry uh we don't run into that situ situation very often but it will be just your return but your your Irma thresholds will be different I think they start hitting Ires right after I mean it's a real steep amount yeah yeah I think I remember seeing that too yeah we normally we normally um I don't see that happen but I just want to make sure to answer your question is it will be just based upon your tax return right yeah I get pretty steep pretty yeah it's called it's called they have they have a chart for it it's called married filing a separate return so we have uh single filers married following a joint return and married following a married but following a separate return uh those are highis yeah y y Katherine's asking I get a monthly infusion due to a rare disease a nurse has to administer the visit will be covered by part the visit will be covered by part by B but will the medication it's about $6,000 a month yeah the answer to that is normally yes uh it should be covered through Medicare Part B and the way to verify that Catherine is whoever you're getting that medication from ask them uh and they'll tell you as going through a drug plan or through part B but normally when it's professionally administered uh it is through the B of Medicare all right there we go from Brian I'm a single income uh home my spouse will not qualify for Social Security stay-at-home mom uh will she be able to collect when I pass away if how what percentage okay yes okay so what happens Brian is if she doesn't have her own Social Security amount uh whatever you are are eligible for or actually taking if you're taking and pass away or eligible for and passing away uh she would be eligible for uh that 100% of that amount uh unless she uh took uh that spousal I mean excuse me that Survivor benefit prior to her own for retirement age which is probably 67 so if she were to wait to 67 uh then she would um get 100% of whatever you were eligible for because some people they're not even taken they pass away so they'll calculate it based upon what your eligibility amount would be okay so my point is if she were to take it prior to her own for retirement age she would get a reduction in the benefit which is right at right at 6% a year less and then that is permanent okay so what would you advise that um because you don't necessarily have to wait until he passes away obviously for her to start taking half so when when would you think the best time that he would but for Brian to have his spouse begin to start taking half well the the rules today are his he's still alive she couldn't take unless he was taking anyways because now he would have to actually file for social security for her to be eligible for spousal benefits okay and so I recommend that they both wait till for retirement age because then there's no reduction of benefit uh because the spous of reduction is actually it's very high uh it's 99.3% a year for the first three years and the L next two are 5% so literally when someone takes a spousal benefits at 862 versus 867 they lost a full 38% of of of their of their income that's that's a hefty penalty so if people can wait financially I recommend that they don't take spous until they've reached their own for retirement age MH yeah it's just too stiff of a penalty now if they need the money take it right uh but I just don't like the fact if you don't need it I would definitely wait and let that account grow or uh at least uh you know have less of a penalty nearly 40% that's that's a lot that's a lot it is for sure yeah 99.3% for 3 years and then 5% thereafter yeah all right so looks like we're from jesta um hello from Orlando Marvin I just wanted to thank you and the folks at Medicare school for the invaluable advice and guidance I'm happy with my advantage plan so far thank you that's great good hey thanks for allowing us to serve you yeah yeah it's our privilege and it looks like there it looks like says hello from Orlando so I mean um typically I do in talking to people on the phone more often than not when I'm talking to people in New York Connecticut and Florida I do typically talk more about advantage in those States than I do in a lot of others um for a lot of various reasons obviously state laws and very very very competitive plans there for Advantage in Florida um can make it um mathematically it can make sense to do advantage in that state um I mean those are the three states I personally would be considering Advantage myself um but um because everybody's situation is obviously a little bit different but yeah it's much much easier to talk about it in certain States and can really really make a lot of sense yeah those competitive markets bring the max out of pocket down a lot and plus the networks I think are very large as well so very large matching in and out of network you have um um some some give back a lot of the plans have so you can help people you know reduce their total Medicare cost to near zero um so it's really really good that's great yeah there's a place for him for sure oh yeah uh yeah John says is an HSA the same or different from a flexible spending account yeah definitely different HSA stands for health saes account and that's part of um the tax code that allows us to put money money into this HSA uh and that money goes in uh tax deductible if it's a growth account it grows tax deferred if you use it for medical expenses it tax exempt and so that's why there are certain rules about those because those those monies continue to accumulate and grow a flexible spending account maybe it's 2,000 a year that is use it or lose it uh you could that those monies will not accumulate so if I put down aside $2,000 in my flexible spending account I have to use that towards some medical expenses because it will not carry over into the next year still some tax advantages it can be deductible but it's not going to be an accumulating type of an account like an HSA so they're totally different so listen if you take Medicare A only you can still contribute to a flexible spending you just can't contribute to an HSA all right yeah looks like Dennis has one here can you take spousal Social Security benefit and let your own benefit um AMT keep increasing and then switch and your own benefit later if it becomes greater than your spousal benefits yeah only if you were only if you were born before January 1st 1954 is that allowable so if you're born well actually let me say January 2nd 1954 so January 1 1954 or before that's possible uh but if you're born after that you cannot do that that's called um uh we called that uh uh restricted applications file and suspend we used should do a lot of that uh but they changed the rules and so all those people that that started again born before January 1 1954 they were grandfathered in anyone coming in after that uh could not do that so that's why I was saying earlier if you once you uh have deemed to take a social security benefit you apply for Social Security in today's system you have to take the greatest amount that's available so it's going to be 50% spousal 100% of your own right the old days we could take spousal in your own account group uh but those days are over talk about uh hitting uh hard on the uh Social Security trust funds that did that that particular strategy yeah it was free money for people it was legal but it was a loophole that was U breaking social security yeah Aloha from Maui is there any coverage outside the states okay well um when it comes to supplemental plans there are um six of the plans um c f g n and I think K&L I could be wrong on that but anyway six of the 10 uh that do offer um uh $50,000 lifetime benefit for foreign travel emergency so outside the states Medicare doesn't pay anything so six of those 10 supplemental plans uh give you this $50,000 benefit and it's it's lifetime it doesn't it doesn't replenish and so if you're out of the states or out of the US territories and you have a claim insurance company what they do is you have to pay a deductible of $250 and they Tak the they take the balance of that that bill and the insurance company pays 80% and you pay 20% but their 80% stops once they've spent $50,000 on you okay and it doesn't refill right lifetime so the answer is yes but it's limited in fact I had a lady call in today not call in but talk to one of the ladies here and she was getting travel in health insurance and she asked well how much should I get I recommended $100,000 policy with a good air evacuation writer uh so if I'm outside the us or US Territory that's what I would get about $100,000 is good if you have a subal plan you already got an extra 50 and then get get an A evacuation right over because that's really where people usually see some steep increases I had a lady had to fly from Costa Rica uh to San Diego the flight was like $280,000 yeah air evacuation wow okay but she had she had a million doll air evacuation writer attached to her um travel health insurance plan and read read this print because they're not all created equal I can assure you that but get a good travel health insurance plan and they're very very reasonable and the uh the 50,000 on the supplement policy is based on a Medicare allowable amount right like so it's it's based on um what Medicare would charge for specific procedures is that correct well not that's not my understanding I I I don't I don't know it could uh anytime I've had people that I've helped with claims it's just well I had a lady in Ireland 172,000 $172,000 hospital bill and so it paid $50,000 so yeah I'm not sure about the Medicare Medicare equivalency I've not heard that could be true no had a lady fall in Australia bill was $9,000 so she paid 250 deductible and they split the balance uh 8020 yeah okay yeah very nice all right from Lee Jones here it says I love my G plan that Marvin's people suggested I paid my deductible and nothing else so I'm getting my cataract surgery this year after my shoulder therapy because I paid my deductible for 2024 very good that's great yeah Lee that's um that's good to know thanks for letting us help you for sure um yeah once youve met that be deductible you're done MH that's why I said it's almost full coverage not quite that's that's an ex another question I had for you too actually um so I had a client who um same kind of thing met her deductible for part for Plan G um and every time she'd go to her doctor hospital they would still insist that she paid this co-pay or that co-pay um and she kept asking me what what should I do about this in this situation um and that would basically I told her I said well obviously they need to be you need to stop paying your copays first of all um and then have them send you a bill um and then that's going to get sent over the supplement carrier and you shouldn't have anything left um but um what would you suggest to that person well yeah I would not pay anything beyond your be deductible that is somebody that's in the building department that must think you have an advantage plan because that's why they're charging co-pays or an implant because you would have $20 co-pay on the implant so I could see that so yeah that's a that's a billing Department problem and what I would do if you're one of our clients we would just have one of our tier 2 agents actually call into that doc's office or whoever's doing it and have that discussion say you know this there should be no billing beyond the the 240 right uh and maybe with us on your side like that maybe we could persuade someone to stop that because yeah that should definitely not happen right yeah yeah it was a it was definitely a one-off situation I'm like that is not how that works you should not be getting anything definitely some incompetence there yep Noe let good on in here yeah s from Natalie Natalie does g cover dental and vision okay well uh let me explain it this way um if when we talk about dental if we're talking about cleanings and uh root canals and crowns the answer is no uh and the reason is because Medicare A and B does not cover dental unlesss real extreme extreme cases someone is um going in for uh you know um let's say they have inage renal disease they're going to get a kidney replacement they're going to go in and see about the health of their teeth because that could have an impact upon their recovery and their surgery so Medicare would cover that uh people that have uh they could have jaw cancer and there has to be some reconstruction of the jaw which affects the teeth Medicare would cover that Therefore your G plan as well okay so there are times limited times when Medicare covers dental and that's when you would see your subal plan also doing that but I think what you're asking is is is G going to have a dental plan the answer is no uh so most people that have a and b with a G plan are going to buy a separate dental plan if they want dental coverage and it's a true dental plan covers you usually somewhere between about3 to $5,000 a year and it cost about $50 a month we write those plans all day long uh and so uh I think it's important I think oral health has a lot to do with your overall health so we encourage people to get a dental plan let me say this the best time to to get a dental plan is within 60 days sometimes 30 days of losing your employer coverage because if you set up your dental plan within 30 to 60 days of losing employer coverage then you have no waiting periods uh you're going to have wonderful coverage right out the gate so you want to get one uh you know sooner than later when it comes to Vision again Medicare covers very well on Vision uh covers everything except eyewear and eye exams for eyewear okay so Medicare covers well uh so um if you um have cataracts you have glaucoma you have macular degeneration you have some kind of an disease then Medicare pays first and your GPL is going to pay right so the only thing that g plan would not cover would be what Medicare does not cover which is um eyewear and uh exams for eyewear everything else great coverage yeah yeah and I worked in Optical myself for about 15 years you know a lot about it should let you answer that question no that's absolutely right yeah and I did a video recently on that whenever that comes out but there's some stuff coming out um it's good to know obviously what what your coverage is when it comes to those kinds of things and yeah so yeah they ref fraction obviously when they're checking your prescription Medicare isn't cover that if you offer retinal photos as opposed to getting a dilation done you Medicare probably won't pay for that as well once again that is is deemed as um election um you know you elected to have that rather than having the medic necessary parts of it um Medicare will pay for you know a pair of glasses after cataract surgery but even then it's real basic I mean it's really not what anybody typically wears I mean $60 frame and some real basic line bifocals that's pretty much it one time um so it's not not really going to cover much in that regard absolutely and basic Vision plans are very inexpensive oh yes yeah you can add want $15 something like that 10 to 16 yeah very very inexpensive and you pick them up whenever you want it's not like d where you got to have that continued coverage like you were saying you can pick it up on a dime and use it the same day very very easy when it comes to Vision that's good yeah yeah all right so from Valerie here says I am also a new client had a wonderful experience with agent Aaron Butler go KCMO all right good you Aaron is a real Pro been in the business a long time yeah so glad you had a good experience Valerie thanks for sharing that with us good shout out to KCMO there too tomorrow as the first regular season Chiefs game I'll be there for to that don't be don't be deceived I will be wearing all red tomorrow that is a red Thursday here so all right from nanner here um I'm in Wisconsin uh since we are different than most other plans do you have certain people who specialize in odd States okay go ahead yeah well here's the our our our agents are right in all 50 states so nanner Wisconsin Minnesota Massachusetts have their own plans they're called waiver States and so if you call in we Rite a lot of business actually in Wisconsin and so what they offer would be u g equivalent INE equivalent type plans and so we can help you with that so all the agents would equally be able to help you yeah from Richie here if you don't get a drug plan in the first two months will you be penalized okay well that would you have 63 days of losing a group plan uh to enroll into a prescription drug plan so if you're you you let's say you come into Medicare after 65 because you kept working and let's say you retire at 67 you have 63 days from when you lose the group plan to enroll into a drug plan after that then they will start assessing penalties and it's 1% per month for every month you go without a penal uh without a drug plan that penalty is minimal it's right now it's about 35 cents a month so if you go without 12 months times 35 cents that would be what $420 penalty per month for life okay so that's that's the issue so it's not a huge huge penalty but my biggest issue is the risk of not having a drug plan that's the biggest penalty because you cannot add a drug plan just when you want to we can if we don't have a drug plan when we first go on Medicare we can only add one uh during the Open Enrollment season which is October 15th to December 7th uh and those plans start January 1 so let's say someone doesn't enroll into a plan and they get diagnosed with cancer in February your you're not going to have coverage now until the following year so the biggest risk of going without a drug plan is if you need an expensive medication and you cannot get a drug plan and the reason you got to get one right now especially the cap next year is 2,000 so enrolling just a very low cost monthly drug plan in case you uh run into a health problem you'll be glad that you had one and then you won't be penalized now I want to clarify something if you're starting at 65 you actually have a little bit longer than that so my birthday let's say it's this month the month of of September uh I could enroll into a drug plan October November I could enroll as as late as December for a January 1 start date and not be penalized because I have that full seven-month window 3 months before 65 once I'm 65 and three months after where I can enroll into a drug plan that starts the next month so I can put it off until my third month of my IEP right no penalties but if I've been working and I'm I'm coming in later than I just have 63 days so that's the way it works all right Tim says U I'll be 65 in April I wanted to know if I can actually be turned down for supplemental care and forced to get an advantage plan no no because everyone has what we refer to Tim as the metag Gap OE uh o oep stands for open enrollment period And this is this is applicable in all 50 states and so your birthday is in April so your oep you actually can apply in Most states uh 3 to six months in advance of your birth month which is April so you have 3 to six 6 months you can apply for a submental plan that submental plan would go into effect when you when you hit 65 when you start your A and B but you still have an additional six months Beyond April so the way we would count that would be April May June July August September so you have all the way up until September of next year to enroll into a Medicare submental Plan and for you that would be a g or an N not not an f um and there would be no underwriting during that period of time so again 6 months before you turn six 5 and then 6 months after is the window where there's no underwriting we call that your guaranteed issue right because all states have to give you that six-month window okay for a metap policy and by the way it's very important in fact probably one of the most important uh uh rules that apply in Medicare don't miss the metag Gap oep and this is one of the real heartbreak situations when people that have to go on Advantage Plans go on a vantage plan they're on it for you know a year or two or three or four five years and they have to get off their advantage and they'd like to go back to original medic and get supplemental supplemental plan they can't because they can't get through medical underwriting they just can't so that's really unfortunate now the exception would be New York con Connecticut Vermont Maine and Massachusetts but all the other states you have to medically qualify to get office that Advantage plan if you've been on it for a year plus right yeah yeah I had actually two individuals in the past two weeks um they were on supplements for quite a while they decided this last January to go on to Advantage um and now they're calling me saying I don't like this um I want to go back to my old plan um which they were one of them had Parkinson's I can't remember the other one situation they were never going to qualify medically speaking but when they were less than a year since they got on I said you know you're going to have to contact your original carrier um they do have to take you back may not be at the premium that you originally had but they will take you back so I said and they asked you know should I be doing I said you know if you were my dad I'd be telling you get off the phone with me and call them immediately get back on there and get back on your plan you know CU you'll never qualify after this this is your only chance to get back and so thankfully there are Provisions in the law that do help people in that situation but if they made any other changes during from that one plan that's it they wouldn't have that typ opportunity again you're right you're right yeah some decisions on Medicare can't be reversed folks and that's why it's important you make the right one right absolutely Bob there said I had a large gain from the sale of my home in 2023 which would affect my premium in 2025 can I appeal that well you can appeal it uh based upon that Bob however um uh I I don't know if you're married but uh if as long as you've been in the home uh at least two years of the last five uh then you should have an exemption of up to $500,000 or that not would be that income would not be taxable anyways so now if it's if it's uh investment property then yes that's that's going to be an issue uh for sure but if it was a a residence because you have that that time where uh you're not going to be taxed on that gain up to $500,000 for for a married couple I think it's up to what 250 for a single Le so um you may not be affected by that anyways but if you are paying an Irma because of a sell of a home uh then it's not going to be appealable there's only eight possible events uh eight eight appealable events lifechanging events and that's death and divorce a noral of a marriage work stoppage work reduction uh loss of an incom producing property which means it's destroyed uh or loss of uh income uh because of a pension plan that went uh bankrupt and so there's eight of them you can go online you can look at all eight reasons those are the only eight it would not be uh the sale of a home all right Christian asks um what are options if you need to move abroad for extended period Medicare won't be usable but still you will have to pay subscription fee till you are back to the USA okay okay so I will tell you all this I'm not I'm not a PE on this we have we we don't have these kind of situations come up often uh so uh do know that um uh if you if you decline your Medicare and can they come back to the States and then start again without penalty or you still penalized because I really don't know um do you know if you have creditable coverage outside the United States with a particular um country country um that that can be deemed as credible so you can come back without a penalty in that situation but it needs to remain unbroken you need to have make sure you have that coverage consistently um and it has to be as good or better than Medicare obviously well that's good well then so it sounds like to me uh based on what he's saying is that I think you mean subscription I think you mean your monthly Part B premium so if you're not going to uh be um using your Medicare and if they allow you to drop the Medicare Part B that's what I would do and then check into to make sure you know the rules when you reenter the country uh you you I guess what you're saying you qualify for an SCP basically okay very good all right so hey call what I do uh Christian is call your local Social Security office and verify all that just to make sure for sure yeah yeah hey I we have people that will move abroad they'll just keep their Medicare active they'll just keep it open because they don't you know they want to come back and they're not sure when so they just don't want to have the hassle of of losing that coverage right and people like I talked to people too who they're they're planning on moving away abroad and they have no plans of coming back okay Y no plans of coming back doesn't mean that they're not going to but you know because you never know what's going to happen in the future um do they say well do I need MediCare at that point well if you do come back you know you don't want to be stuck with a five or 10 or however long year penalty that could be you know exorb an amount so um at those situations you know taking advantage of you know an advantage plan that has Part B give back reducing the amount that you pay you could bring it down to $30 $50 a month depending on what's available in your area obviously um you could reduce that down to paying you know just basically keeping just a basically just a finger in the door just in case you ever did need to come back it's always a possibility for those people that's a good idea too yeah all right all right for Michelle there I'm 75 and never applied for Social Security when I turned 70 um do they have recourse for oo to recover what have been entitled for the past 5 years interesting you know I I don't know that Michelle call your local office and uh I I definitely would be applying I've never seen uh a retroactive case like that I have seen some retroactive but but I I don't think I've ever seen more than six months or even a year uh but I boy I sure hope so Michelle I've just never have had that situation occur so I don't know I know they try to really you know give to you when you turn 70 say please take it but I guess if they can't get a hold of you or there's no way she didn't apply maybe didn't need the money uh but I definitely would be applying ASAP because I know they'll back dat some I'm just not convinced it's going to be that long okay that would be nice payday she got about five years of payments back I hope so I wish I knew the answer that be very nice for her all right so yeah from Danny there if I go for the free quote Medicare welcome appointment what does that visit inail yeah well basically what it is they're going to they're going to check your height and your weight your blood pressure uh and then they're going to do um uh kind of an update of your medications it's not a physical for sure not going to do any blood work or anything like that so it's just a really an update of the medical records to make sure that your doctor uh is uh you know current as to you know your situation so then every year you go back in for that Wellness checkup that's what they do they just continue to update but during that visit if Doc is concerned about something and wants to run some Labs or do something then they can order addition additional test during that visit if they want to and then those would be covered by Medicare just not under the preventive visit that's way you do that yeah it's not physical for sure not like a you know a company's uh U uh plan where you got a lot of things covered uh during an annual physical Medicare is not going to do that right I typically advise people to because you know Medicare won't cover a yearly physical we obviously make sure that the the nuances of it being considered a wellness check is very important for those individuals um but also to make sure when your doctor's asking questions about hey well do you want to run this blood work and this and that question you'd ask the doctor is what do you think do you think I should be running this blood work are you ordering this as something that is considered medically necessary as long as you're ordering a doctor think that's I'm fine with it um but as long as it's elective and it's on me Medicare may not pay for that so you want to be very careful about how you word that and usually doctors are pretty good about that they want to get paid just like the rest of us and they know how to build Medicare properly but sometimes doctors are really good at you know writing down but not realizing paying attention to what the codes are that just goes into the billing office and some are better than others so like I said knowing how your plan works and knowing how Medicare Works um can really help you out in that situation to avoid getting a bill you Medicare get to pay for it all right from Johnny there it said I live in Boston and switched from an MA to Medicare and medic Gap I wasn't required to have underwriting if I move to a state that requires underwriting will they still honor my present metap plan yes they will Johnny because your the metag Gap plan that you picked up um uh is a lifetime it can never be canceled by the insurance company uh other than non-payment of Premium so just because you relocate you take it with you uh we call those guaranteed renewable policies their lifetime so wherever you move take your metag Gap with you now the insurance company that has you covered does have the right to change your rate when you move if if rates are lower or late rates are higher we've seen both they do have the right to adjust the rate but they can never cancel the policy because you're relocated that's one of the beauties of a meds up plan uh someone could have their health changed drastically and they move away you take your Medicare sual plan with you truly lifetime as long as you pay that premium right yep Mike D says if you reach 65 but are still covered by your spouse's workplace medical plan 20 plus employees and she has an HSA does that impact if I roll in part A okay okay uh here's the way it works as long as you uh continue to stay under your um spouse's group plan and uh that spouse has an HSA they can contribute the full amount the full family amount which this year is um uh it'd be 4150 twice that's $8,300 which would be $9,300 as long as they're above 55 okay that's the mouthful let me let me say it again so uh as long as you stay covered by the group plan of your spouse and they're contributing you they you can still contribute up to the full family amount now now if you're not on that group plan then they can they can still contribute to their own individual amount which is 4150 a year plus 1,000 catchup uh so hopefully that helps okay so it's all right in other words if I enrolled in Medicare A only and I'm covered by my spouse's plan then we can make the full full maximum contribution for a family $8,300 plus 1,000 catchup because it's seen as she's the primary that's exactly right because they own it so yeah it so as long as they're the OWN owner of that HSA they can make the full family contribution yeah that's what it works so what say say an individual also is contributing for themselves for their own HSA and they're say 69 years old so well after the age so they're part part A and they haven't done part A obviously it's going to back date six months um does that can that individual knowing um here that they're going to go on Medicare here say in January say four you know three or four months from now um just drop their contributions down to a certain level or do they should they stop it right away entirely knowing was going to back dat pro-rated so they they could they could reduce it I think it's I think it's safer just to go ahead and stop we know six months prior to applying for Medicare you need to stop putting money into your HSA but if you've just been put the minimum amounts in you're probably not going to overfund it but I I wouldn't take the chance yeah okay so got you okay all right so you see the 800 number there if there's anything we can do for you it help you you uh please call in and we'd be delighted to serve you we are Brokers so uh we serve in all 50 states so give us a call and we'll see you next time thanks a lot thank you very much