Understanding Medicare Options, with transcript

Understanding Medicare Options, with transcript

Sara Finkelstein was educated on the east coast with a degree in Business Management. She joined the financial arena in 1996 and her financial industry experience encompasses employment with a major insurance company and banks.

In 2018 she published her first book, “Wisdom for Women, Discover the Challenges you Must Overcome to Live the Life and Retirement You Deserve.”

Sara works together with her husband Paul in helping clients reach their financial needs, goals, and dreams.



Frank Samson:              Welcome to Boomers Today. I'm your host, Frank Samson, of course, each week we bring you important and useful information on issues facing baby boomers, their parents, and other loved ones. Today we're going to be talking about Medicare and we have with us Sara and Paul Finkelstein. Sarah was educated on the East Coast with a degree in business management. She joined the financial arena in 1996 and her financial industry experience encompasses employment with major insurance companies and banks. In 2018, she published her first book, Wisdom For Women, which as we'll learn more about, help you discover the challenges you must overcome to live the life and retirement you deserve. You can get that on Amazon. Sara is joined today by her husband, Paul. Together, they help clients reach their financial needs, goals and dreams. So Sara and Paul, thank you so much for joining us on Boomers Today. Really appreciate it.

Sara Finkelstein:           Thank you, Frank. Thank you so much for the opportunity, we're glad to be here with you.

Paul Finkelstein:           Great to be here with you. Thank you.

Frank:                           I’m glad to have you on. Now, many of our listeners may be aware of Medicare already, but I wanted to hear it from you. Can you talk about what Medicare is, exactly? And what is the difference between Medicare and Medicaid?

Sara:                             Sure. Medicare is the federal health insurance program for people that are 65 and older, also covers people that are younger who may have disabilities, but it's primarily for the 65-plus age range.

                                    A lot of people mistakenly believe that Medicare covers long term care, but unfortunately it does not. Medicare does cover some home health care, but it has to be skilled care. Medicare does not pay for custodial care, which are the activities of daily living that one might need help with as we get older. So it does cover up to a hundred days in skilled nursing facility, but it also has to be skilled care. So that is the major difference between the two. Long term care can be extremely expensive, especially if somebody hasn't done the appropriate planning and for many Americans, it could potentially wipe out their whole retirement nest egg. So that's why it's so important to plan in advance. The younger you are, the healthier you are, the better it is to start planning.

Frank:                           Let's talk about that. You know, there's an enrollment process, all right, for Medicare. When should someone start to think about Medicare? Let's assume they're not someone with a disability, they're just getting to that age, right? When should someone begin enrollment process?

Paul:                            That's a good question, actually. If you don't mind, I’ll chime in and Sara, you can piggyback on it. Since I know the answer to this question, actually. Most people, it seems that a nice window of maybe six months before they turn 65 gives you some time to prepare and learn and educate. We do Medicare online workshops now through Zoom. Before the pandemic, we were actually holding workshops in person and in a conference room where we'd have 20 seniors. 

Sara:                             Yes, six months in advance is a good time. However, what we're finding is a lot of people start getting solicitations even before six months. They get bombarded with literature in the mail from various insurance carriers. They may get bombarded with telephone solicitations. Sometimes we hear other people tell us that they've been getting 10 phone calls a day. So they get inundated and it's confusing. A lot of them tell us how confusing and overwhelming this Medicare decision is, but it's a very important decision that they have to make because there are different choices and options, and they need to have a clear understanding so that they are in a position to make a wise decision.

Frank:                           Why are they getting bombarded by so many people? If this is something that when you turn the age of 65 and you've earned it, don't you just get it? I mean, why are they hearing from so many people, "Sign up with me?" Why is that?

Sara:                             Well, because everybody wants their business at this point. All the insurance companies want their business and it's public information. Sometimes people will ask, "How do they know?" Well, it's public information that you're turning 65 and every insurance carrier wants to be the one that enrolls you in a plan.

Frank:                           Got it. Because the insurance companies can provide a plan, and that plan comes with a cost. Tell me, could this have anything to do with the supplemental plans that some individuals have the option of adding onto their main plan?

Sara:                             Yeah. It's not just the Medicare supplement plans, which work hand in hand with original Medicare, but it's also the alternative, which is the Medicare advantage plans. So individuals have an important decision. They're either going to go with a supplement plan or they're going to go with a Medicare advantage plan. And it's so important for them to understand the differences.

Frank:                           Why don't you explain that? Yeah, explain that, explain the difference between the supplemental plan and the advantage. That'd be great.

Sara:                             Okay. Yeah, absolutely. So the supplement plan works with original Medicare. Original Medicare allows the individual to go to any Medicare provider anywhere in the nation. Think of it this way. When they have original Medicare, they're in the driver's seat. They are the ones who are deciding where they get their healthcare, who they get to see. When somebody has original Medicare, there are no networks. Basically again, they can go to any Medicare provider. That means any doctor, any specialist, any hospital, and God forbid any cancer treatment hospital that accepts Medicare.

                                    On the flip side, they have the option to go with a Medicare advantage plan which is a replacement to original Medicare. So those plans are managed care. They are network based plans. They're designed to use the providers in the network and they're calendar year plans. So the plans change from one year to the next meaning that the benefits could change, the copay structure could change, the providers could change. It's all different from one year to the next, whereas Medicare supplement plans are standardized.

Frank:                           When you hear the term Medigap, what does that mean to you?

Sara:                             Yeah. The terms are interchangeable. Medigap plans or Medicare supplement plans. They're the same thing.

Frank:                           Got it, got it. Okay. So, you know what would be helpful if it's okay with you, there's different parts of Medicare, right? You got part A, part B, part C, part D. Listen, I'm sure we could talk for hours about the subject matter, but maybe you could give us a little briefing, either one of us, if you each want to take a part or whatever it is you want to do, but A, B, C, D, and anything else you want to discuss. What are the differences between these parts?

Sara:                             Okay. So plan A is the hospital portion. When somebody is admitted into the hospital, it's plan A that comes into play. And for most individuals, there is no premium for part A, because we pay into it during our working years through payroll deductions. But that doesn't mean that there's no cost attached because there are. There's a deductible. There are daily copays for longterm hospital stays under part A. There's also skilled nursing facility. Some home health care and blood hospice care, blood as in blood transfusions.

                                    Then Medicare part B does have a premium attached to it. And again, some people are not aware that there's going to be a premium. They feel that they've paid into the system. So now they're surprised that there's a cost attached, a monthly premium for Medicare part B, but part B covers a lot. Doctors visits, outpatient procedures, lab work, diagnostic tests, cancer treatments and chemotherapy, diabetic screenings and supplies, physical therapy, and a whole bunch more. I always simplify it by saying, think of Medicare part B as everything that may happen outside of the hospital. And there is a premium for Medicare part B, and some people pay an extra premium based on their income level.

Frank:                           Got it. Got it. Right, right.

Sara:                             And Medicare part C is the Medicare advantage plan, which again is an alternative to original Medicare. And then Medicare part D, easy to remember, D for drugs. It's a standalone drug plan if you're going with original Medicare and a supplement plan, or if you're going with a Medicare advantage plan, it's embedded into your plan, but there are copays for drugs in either case.

For each zip code, there may be 20 to 30 different standalone drug plans. So when we help clients in that situation is we start with a list of their medications because each standalone drug plan has its own formulary list and we need to do our research to find out which is the most appropriate plan for them.

Frank:                           Now, can you give us a sense for what the premiums for each part are? You went through very eloquently part A, B, C, D, and gave us a good understanding of those various parts, but what are the premiums that could be associated with it? And I know it probably varies on the person and all that, but maybe give us a feel for it.

Sara:                             There are premiums attached to Medicare supplement plans, and there are premiums attached to the standalone part D drug plans. Let me start with the Medicare supplement plans. It really depends because it depends on your zip code. Different parts of the country is totally different pricing. For instance, one couple that were living in Boca Raton, Florida ended up moving to Tennessee. Their premiums were half the price in Tennessee that they were in Florida. So it really depends where in the country, the zip code. Also depends on age when they go onto their Medicare supplement plan. We're aware that some people work beyond age 65. They might stay on their group health insurance for another couple of years and then they're older, so it depends on age.

                                    Also depends on the supplement plan that they select. There are different letter plans, A, B, C, D, F, G, N, K, L. All of those different plans have different premiums and different types of cost sharing. So I hate to be so vague, but there's so many variables that come into play, also whether or not the individual is a smoker. So there's a lot of variables.

                                    But what we do is we do a quote for the individual based on their age, their zip code, and we provide them a whole list of carriers and what they're charging and we always trust that the Medicare supplement plans are standardized, so there's no difference between one carrier's plan G and another carrier's plan G. That's the beauty of original Medicare. There's nothing really to compare when somebody is looking into Medicare advantage plans, they're all slightly different from each other so it requires a little bit more time and thought as to which is the best one to go with.

Frank:                           So then how does Obamacare, or as I like to call it the Affordable Care Act, affect Medicare?

Sara:                             That's really an excellent question. Because both programs, the Obamacare and Medicare, are both government programs, if somebody is on Obamacare and they're turning 65, they can no longer stay on their Obamacare. They qualify for Medicare. They have to go onto Medicare.

Frank:                           Got it. Thanks for the clarification, I know that these things can get confusing sometimes. Just so people know if they're utilizing a service like yours and we'll share with people in just a moment how they can get ahold of you, but is there a cost to them for your service? And if not, then how do you earn your money?

Sara:                             Oh, another great question. So we do not charge for advising and helping seniors. The way we get paid is when we enroll a senior in a plan, then we get paid by the insurance company that we represent. So it doesn't cost them anything. And actually it'd behooves people to use an agent. We're not the only agents on the planet. We realize that, but it's better to use an agent as opposed to doing it yourself because an agent can provide so many other benefits and be there to answer questions and hold your hand and guide you along the process and provide you with so much more input than just trying to do it yourself.

Frank:                           All right. You kind of took the words of my mouth. Who's ever listening to this, don't try to do this to yourself. I mean, there's good advisors out there, like the Finkelstein's and have somebody, either them or somebody like them in your area help you through this, because you're talking to someone who is on Medicare and it was very confusing to me and I got an advisor to help me and my wife, both. So, tell us, you're located in Florida, so maybe you could share with us how people could get ahold of you, but what happens if they're not in Florida? I mean, is it possible that you can help people through this?

Sara:                             Absolutely, definitely. We are licensed in multiple states, so we are able to help people across the nation. And we also do workshops now, of course, they're being done virtually, but at least once a month, we do a Medicare Made Simple or Medicare Made Easy workshop where people can join in, learn from the comfort of their home and it's a good idea to do that because they get so much literature. We make it easy to understand, simplify it, and people walk away having a much, much better understanding. And they're in a position to make a wise decision.

                                    One thing I want to bring up is there's a misconception that Medicare pays for long-term care. It does not, and people really need to start thinking and planning for long-term care, before they turn 65. In terms of Medicare, they can't do anything until they get to that age. But in terms of long-term care planning, the younger they are, even in their fifties, is a perfect time to start planning for it because Medicare and long-term care planning are both part of very important parts of retirement planning and the sooner, the better for long-term care, because the younger you are, the healthier you are and the more reasonable the premiums can be.

Frank:                           Right. So is there a website or any contact information? Feel free to go ahead and share it with our listeners.

Sara:                             Yes, absolutely. So the website is www.signatureadvisorygroup.com and there's a Y at the end of advisory. We could also be reached by telephone, (561) 302-5760. And we do our Medicare workshops. So call us or text us. We'll be happy to let you know the next dates that we're having it and we're here to help.

Frank:                           Great. Well in the last few minutes I want to get into a discussion about the book you wrote, Sara: Wisdom For Women: Discover The Challenges You Must Overcome To Live The Life And Retirement You Deserve. What was the catalyst for you writing that book and tell us a little bit about it?

Sara:                             Absolutely. So the title of course is very, very long, but it brings the point home. And the reason that I wrote the book is because I've been in the insurance and financial industry along with Paul, we've been in for about 24 years, each of us. And I discovered that even today, where the workforce is comprised of many women, there are still women who are not actively involved in their own financial planning. Sometimes they just let either their spouse or another important person in their life deal with and handle their finances and they really don't know what's going on. And what happens is women typically are the ones who end up alone at some point, whether through becoming a widow or through a divorce, and all of a sudden, now they have to understand and be on top of what's going on with their finances. So why not start earlier rather than waiting for a catastrophe to happen? Also, women typically take time out from the workforce to raise children, so they end up with a smaller social security check and they have less in qualified monies and all of this affects their financial future.

                                    The book is available on Amazon. It's a very, very easy read. It's about a hundred pages and it breaks everything down into simple, easy to understand. There's actually a whole chapter on Medicare and there's a whole chapter on long-term care planning. And I felt it was important to get the message out, but the book is also for men too, although it doesn't state so in the title, but most of the information in the book does apply to men as well.

Frank:                           Great. Great. Well, Sara and Paul, thank you so much for joining us on Boomers Today. You're a wealth of information. I really appreciate it. I'd love to have you back in the future, because things change, as you know.

Paul:                            Thanks so much, Frank, and I sent you an email of the very first Medicare card from Truman in your email.

Frank:                           No kidding. That's great. All right.

Sara:                             Thank you so much, Frank. We appreciate it.

Frank:                           Thank you. And be safe out there everybody and we'll talk to you all soon.


Understanding Medicare Options, with transcript