Ready to unravel the complexities of Medicare? I'm Danielle Tantone, and in this episode, I'll be your trusty guide through the labyrinth of insurance options available to you as you approach and surpass the age of 65. A seasoned independent agent, I've cultivated an abundance of knowledge about how the whole thing works. Together, we'll fend off the overwhelming influx of information, sidestep deceptive tactics and dodge fraudulent calls.
I like to say that Medicare is the silver lining, the hidden gem of getting older. And my goal is to unpack it in a way that is simple, understandable, peaceful, and even fun.
Beyond original Medicare which only covers you 80% and leaves you with unlimited financial risk, the two principal options are Medicare Advantage and Medicare Supplement Plans. Both have their pluses and minuses, and I'll lay them out for you in an unbiased manner. There's no one-size-fits-all right choice.
Whether you're researching Medicare options for yourself or someone you care about, this episode could be your first step to help you make the most informed decisions about healthcare coverage. So, buckle up and let's get started!
Schedule a free 30-minute consultation with me here:
https://calendly.com/danielle-tantone/30min
Ready to unravel the complexities of Medicare? I'm Danielle Tantone, and in this episode, I'll be your trusty guide through the labyrinth of insurance options available to you as you approach and surpass the age of 65. A seasoned independent agent, I've cultivated an abundance of knowledge about how the whole thing works. Together, we'll fend off the overwhelming influx of information, sidestep deceptive tactics and dodge fraudulent calls.
I like to say that Medicare is the silver lining, the hidden gem of getting older. And my goal is to unpack it in a way that is simple, understandable, peaceful, and even fun.
Beyond original Medicare which only covers you 80% and leaves you with unlimited financial risk, the two principal options are Medicare Advantage and Medicare Supplement Plans. Both have their pluses and minuses, and I'll lay them out for you in an unbiased manner. There's no one-size-fits-all right choice.
Whether you're researching Medicare options for yourself or someone you care about, this episode could be your first step to help you make the most informed decisions about healthcare coverage. So, buckle up and let's get started!
Schedule a free 30-minute consultation with me here:
https://calendly.com/danielle-tantone/30min
Hi there, welcome to Peace of Work the podcast. I'm Danielle Tanton. I'm a nurse, author, coach and survivor. I love inspiring people to live their best life, reach for those big dreams and find joy even in the pain. As I wrote my memoir over so many years, trying to make sense of a story where I was way too often the bad guy instead of the hero, I came to understand that we are all a piece of work, but we're also a work in progress and even in our messiness we are a work of art too. All at the very same time, in fact, we are all beautifully unique pieces of one masterpiece Waves in the same ocean. This podcast will explore the stories and struggles that make us human, the miracles that surround us and all the ways we work to make sense of it all. Welcome to Peace of Work the podcast. Hello, it's Danielle Tanton, and today it's just me.
Speaker 1:I wanted to chat with you today about Medicare. I know so exciting and sexy Medicare, but we are right now in the first week of AEP, which is the annual enrollment period for Medicare, and it's kind of a big deal in the Medicare world. So I thought I'd just give a little brief overview of what Medicare is all about and how it works and how I can help you or your mom or your dad or someone else that you might know who needs help with Medicare. So what Medicare is? It's for seniors, 65 and over, and it's actually the silver lining of getting older as far as I'm concerned. They are able to access such amazing coverage and such amazing options, but it is super overwhelming. So I mostly work with seniors who are just turning 65. And I help them just understand their options and pick the plan that's going to work best for them. So this time of year, anybody sorry when you turn 65, you can sign up for Medicare, and you can sign up within a six to seven month period around your 65th birthday. So when people are about 64, they're getting bombarded by information about it. But this time of year, anybody who's already on Medicare can make a change to their plan. So they're also getting bombarded by ads and phone calls. I, incidentally, somehow someway have. My phone number is associated with my late uncle who died a couple of years ago, and so I get these calls myself and I can't get myself off these lists because I don't know. Who knows they were sold a million times or whatever. So I have an idea, an inkling, of just how many sales calls that they get from all different companies, and it's crazy. So what I do?
Speaker 1:I'm an independent agent and I work with many of the insurance carriers that have Medicare plans and I represent my clients. I don't represent a specific insurance carrier, I represent my clients and I basically just help them figure out what's best for them, because there's really not any right plan. There's a couple of different ways to go and, frankly, a lot of them are really similar. So a lot of times what will happen is if they see an ad and they call in the 800 number, or if they get one of these cold calls they're sort of like a bait and switch thing. A lot of them they have these great ads that sound so amazing You're going to get all this money back and you're not going to have to pay anything and you call in and they're like, oh well, you can't really qualify for that plan, but we have this other one, and this other one might be super similar to what they already have, but they don't really know and they don't really even realize that they're changing plans and they don't even realize that they're no longer have an agent that's representing them. They're just– they have some 800 number person who they could never get a hold of again.
Speaker 1:I actually had one of my good friends, who's also a Medicare client, last year, right at the end of the enrollment period, got one of these calls and he thought it was actually a representative from his insurance company, from the insurance carrier. They made it sound like that the way they worded it. So he recommended I think you might want to switch to this plan. He went ahead and switched. Then he just called me just to let me know that. Hey, I just want to let you know that blah blah blah healthcare called and just thought this plan would be better. I just want to let you know. He called me after the enrollment period was over and I was like no, that was not true. So it was a big headache to try to get that reversed because it was actually pretty fraudulent and pretty manipulative. So, anyway, just wanted to let you know. That's out there.
Speaker 1:So this is the AP. I don't even have regular TV anymore. I don't know about you, but I only have streaming services. So I don't really see the ads, but once in a while I'm a nurse as well. So once in a while I'll be in a patient room and they're watching regular TV and I'm like, wow, there are still so many commercials that I just don't see anymore. So, yes, they are being bombarded. So if you have a friend, family member, relative or yourself who is being bombarded and has some questions about any plan that you see or anything about your plan, please feel free to give me a call. You can always call me 480-236-1861, or email me, danielle, at DanielleTanTonecom, or those are probably the best ways. On my website, danielletantonecom, there is a calendar app that I try to have updated, where you can set up a 30-minute consultation. But other than that, just call or email me and we'll set up a time to talk, and this can be nationwide. So I'm mostly I am in Arizona and so I'm licensed in Arizona, but I have the ability to either refer to somebody else or to get licensed in other states. So most of my business right now is still in Arizona.
Speaker 1:So anyway, just to give a quick overview of how it works and what the options are, the first step when you're signing up for Medicare is to sign up for original Medicare. So that's that red, white and blue card that you might have seen a picture of, and it includes Part A and Part B. So Part A is the hospital and inpatient coverage and that is generally $0 a month for most people as long as you've been working in this country for more than 10 years, which most people have by the time they're 65, then Part A is free. Part B is covers the doctor visits and outpatient care and that one has a monthly premium. It goes. It changes roughly, you know changes every year usually goes up, although this year it went down from last year but and then it also has almost like tiers, almost like your tax brackets. So if you make more money, you will pay a little bit more. But just to give you an idea of the pricing in 2023, it was like $165, roughly $165 a month. So that would be for original Medicare. You'd pay roughly $165 and you'd pay it to Social Security and you'd get that card.
Speaker 1:Now, if you only had original Medicare, that would be 80% coverage. So if you went to the doctor and I'm giving you very general explanation there's a little more to it than that and that we could always get into the nitty gritty if we sit down, but typically I don't, because most people don't care about the nitty gritty, so I'm just trying to give you an overview of how it works. So if you only had original Medicare which no one should ever only have original Medicare, because that would leave you with unlimited financial risk, basically but if you did, you would have 80% coverage. So if you went to the doctor and it was $100, they would pay 80 and you would pay 20, which would be fine if all our medical bills were $100, but, as you may know, they could be $1,000, $100,000, a million dollars. So where I come in is figuring out how to protect you against that risk.
Speaker 1:So there's two different paths that people can go. One is the Medicare supplement, and I actually spent some time I spoke with a colleague of mine, brian, on a previous episode a lot about the supplements. So the way the supplement works and another name. You might hear them called Medigap plans, you might hear them called MedSupp plans, but it's all the same thing. It's a supplement. It basically piggybacks on your Medicare plan. So if you go to the doctor, you'd give them your Medicare card for that 80% and then the supplement for the additional 20% and together you'd have full coverage. What's nice about this is that you'd pay a monthly fee to have that supplement, but for the most part you really have nothing out of pocket, depending on the plan. But again, keeping it simple, you'd pay your monthly premium, which is pretty reasonable compared to what we pay when we're not 65 yet for insurance and you have basically full coverage.
Speaker 1:So a lot of people like that option and what's nice is that you can go to any doctor anywhere in the country that takes Medicare and every different insurance company offers Medicare supplements Well, maybe not every company, but many of them. So these plans are named by letters generally. So the one that's most common, most popular with my clients who are on a supplement, would be Plan G, and you can get Plan G through United Health Care or through a number of other carriers. I mentioned United Health Care because that's the one I probably work with the most, but I'm independently licensed and I'm having trouble talking. Anyway, I am contracted with several different carriers. I don't really do a lot of supplement business and I'm going to tell you why.
Speaker 1:Not that I'm opposed to it, but for where I live, in Maricopa County, arizona, we have an amazing assortment of advantage plans. The advantage plans is almost like a whole separate thing. Like I said, there's two options for your coverage when you go on Medicare. Option one is the Medicare supplement, like I just mentioned. Option two is the Advantage plan. The Advantage plan works totally differently. With this route, you're still going to pay your premium to Social Security and that's going to get you your original Medicare, but you're no longer really on original Medicare for your insurance. You're going to get a plan through various carriers and there's probably 50 or 60 different options in Maricopa County. So it's not one plan per se.
Speaker 1:We a lot of times say the Advantage plan but there's many different plans. But with this route you're going to have an insurance plan that's much more like the insurance plan that you would have had before you turned 65. So it's more of a traditional plan and it's going to cover you from start to finish. So you're no longer going to have that 80 percent on Medicare and then 20 percent on the supplement. It's just going to go right to the Advantage plan. So it's one card. It also includes drug coverage, prescription drug coverage, which is an add-on if you go with a supplement route.
Speaker 1:It also includes a lot of ancillary benefits, such as dental, vision, hearing, gym membership, and those are really popular, especially with people who are just turning 65, who are still pretty healthy, active and really enjoy those perks and they don't necessarily go to the doctor all that much. So what my clients really love about these Advantage plans is many of them are $0 a month, so they have zero monthly premium. It doesn't mean they're free, and that's the next question is how can they be free? And we'll go into that a little bit. So they're not free, but they don't cost anything on a monthly basis. So you're still going to pay your Part B premium to Social Security that $165 a month but you're not paying any additional monthly fee to have your Advantage plan. What you will pay instead is just small co-pays as you get medical services, and they really are small. There's no deductible. So most of us who are under 65 have huge deductibles sometimes, or even if they're small deductibles, they're still hundreds of dollars, usually thousands of dollars. So these plans many of them most of them that I work with have zero deductible, so they start paying right away and the co-pays are like $30, $40, $100, very reasonable. And you have a maximum out-of-pocket that's like a cap, so you can't go over this amount. So what I have found doing this for the past several years is that for most people it would take a lot to even reach your maximum out-of-pocket and it would take a lot of things going wrong to come anywhere near spending a couple hundred dollars a month, which is what you will spend if you go on the supplement. So from a cash flow perspective it makes sense, and then from a more bang for your buck perspective it makes sense, and so most of my clients here in Maricopa County really like the Advantage plans.
Speaker 1:Just to play devil's advocate, though, there are reasons to choose a supplement. There are some you know like. First of all, so with the Advantage plans you have to be aware of the network. There are different types of plans. There's HMO and PPO, and we don't need to get into the weeds on that. But HMOs are generally a more restricted, smaller network, tighter network, and then you don't really have out-of-network coverage at all. And then you also need to go to your primary care provider for any referrals. Anytime you want to go to any other specialist. And a PPO is generally a broader network, many of them. You're part of a nationwide network and you can go out of network as well. You'll pay more for services. So you generally want to stay in network but you don't have to. So PPO offers a lot more freedom and flexibility and some of the plans here where I live are just really great. I mean they have nice big networks and it's going to feel like the best insurance plan you've ever been on for the cheapest amount of money you've ever paid. So that's kind of the general thing.
Speaker 1:Oh, I started to say I'm going to play devil's advocate Like, okay, what's the catch first of all? So those are questions I get asked why is it free? How is it free and why would anyone choose a supplement? So I'll start with that last question first. Why would anyone choose a supplement? The first thing is it depends where you live. So I have done some business in California in the past and in California the networks and the healthcare system is really different than it is here. So over there you might have one doctor and one network and one doctor and another network and they don't really like crossover. So here in Maricopa in Arizona, like our networks, like there's, most doctors will do business at Banner and also at Honor Health and also at Dignity. There's not really as much segmentation as there is in California, so it's not really a problem. Plus, we have many, many PPO options, which again is that broader network that will include multiple healthcare systems, whereas in California most of their Advantage plans are HMO. It used to be all I think now they're starting to get some PPO options.
Speaker 1:So that's one big reason why you might not want an Advantage plan, because you might feel like too restricted by it. So a lot of times you know anybody who can afford it would rather have a supplement. And historically you know the Advantage plans are relatively new. So historically you'd rather like the supplement was kind of known as like the gold standard, like the better option, and I think a lot of people, even Medicare advisors and financial advisors, still think of it that way, like that it's better and if you can afford it you'll get that, but if you can't, there's some good Advantage plans. That's kind of like the mindset that I've heard out there. But I kind of have a different mindset, like to me. I just don't see how that's necessarily better. I mean it's it really depends on your personal situation.
Speaker 1:It might be better for somebody. You know they may not just want to, not want to think about networks, they might want to get, you know, go to a different state to get a second opinion, be able to travel and go to the Mayo Clinic or whatever it is that they want to do, and they just don't want to have to deal with network and making sure it's covered and all that. They want to go to any doctor anywhere in the country that takes Medicare and in that case the supplement is better. There are some, some medical systems that do not really take the Advantage plans. I mentioned, mayo Clinic and that that, if you, that's one of them. So that would be the main reason for the supplement.
Speaker 1:The other one would be, you know, if you are in a, you know managing multiple diseases or you just have a high medical acuity, I guess there it might sometimes it's easier. You know you paying a monthly fee and then you don't have to worry about any out of pocket costs, so you're not like kind of feeling like you're nickel and dime. So some people just like that and they just like to not have to worry about it. Some people might be thinking of moving, or they might move around a lot and not be in one place and it's just easier, and then a lot of times when you're first turning 65, it just makes sense to start that way because you, you're, you're allowed, you're in a guaranteed issue period when you first go on Medicare. So what that means is there's no medical underwriting and anybody can get. They can't deny you access to the supplement. The advantage plans don't really have any medical underwriting so you can join an advantage plan anytime, at least at this point. That may change, but at this point there there's no medical underwriting involved so anyone can can join in your approved, no matter what your health status.
Speaker 1:But the supplements are not like that. You, if you join at any time other than when you first going on Medicare, you would need to qualify and you would, you would pay more. Potentially, if you have some health issues, you might not even be approved at all. So that's another reason why some people are like kind of almost there's a lot of fear in Medicare marketing. I think so, like they're almost scared into going that route. So I just when I sit down with a client, I really just try to take away all the fear and just tell them like it is and show them the options, and I try really hard not to push them in one way or another and to just just tell them the facts and there's not.
Speaker 1:The great thing is that, despite you know the fear marketing that I've talked about, you really as long as you choose a plan and you have some prescription drug coverage, because you're not gonna get penalized if you, as long as you, you know, are somewhat educated and do things right. And I think there's a lot of fear of that of getting penalized for life. And I have seen it where someone is penalized for life because they didn't sign up for Medicare at the time and they didn't have a creditable coverage other than Medicare. So I like to just really help release some of that fear, set people at ease and even make the process a little bit fun. I know that sounds crazy, but it's actually is really amazing coverage and there's lots of options and to me that is kind of fun. So that is the basics of Medicare and I think in the future I'm gonna work on some different things.
Speaker 1:I have been playing around with a brand called Medicare Moxie and I love the word Moxie because it kind of sounds fun to me and it means, you know, kind of like gumption sass, like knowledge, someone giving you the power. So I wanted empower people to really understand how it all works and be able to make their own choices. And so I started to say you can change every year. So right now, aap, anyone can make a change to their plan. So you could be on a supplement and you could go to an Advantage plan. You could be on one Advantage plan and go to a different one. That doesn't mean that you should change your plan, because I think another thing is it's you know there's no reason to change your plan every year unless there's something about it that you don't like. But I'm happy to sit down with anybody and chat with them and figure out what option might be best. So that's kind of my spiel.
Speaker 1:On Medicare, I would like to take just a few minutes to talk about how I even got into this and why I keep doing it, because it's if you know me at all, you know that I do multiple things. I'm a labor and delivery nurse. I used to be a realtor I'm still licensed, but not doing that actively. I wrote a book called Piece of Work, a memoir, and I have a podcast, obviously, and I have three kids and I probably am forgetting like five things that I do. So why Medicare? Well, here's the thing.
Speaker 1:So a few years ago it was during COVID I was just recovering from breast cancer surgery and I had sent out an email to my sphere of influence, just kind of updating them, telling them I was writing this book and just kind of keeping in touch. I've always been in sales and marketing and I knew that down the road I'd be having a book that I'd wanna sell and I wanted to kind of build my email list, and so I was just sending out an email to basically everyone I knew, everyone I'd ever worked with, and one of the people that I used to work with in real estate responded and said hey, my wife and I have recently gotten into Medicare and I think you'd be really good at it. You like to help people and blah, blah, blah, blah. And I'm like are you kidding me? I just sent you this email telling you all these crazy things I'm doing and you think I should add one more business. Well, I was in nursing school, by the way, and he said, yeah, I think you should. So I said, okay, maybe I will.
Speaker 1:It was right in the middle of COVID and I was on a little break from school and from work as well, so I started taking the classes and getting certified. I already had my insurance license because I had done employee benefits for a couple of years and I found that, you know, while it was certainly dry and boring and bureaucratic and overwhelming, if I could make sense of this and actually help people, this is something that everybody who turns 65 needs to do and it's overwhelming and it's scary and, if I can make it easier for somebody, this is almost like the easiest sales job ever, because I'm not selling anything, actually Like I'm representing these insurance plans and I get paid by the carrier, but it doesn't cost, I don't know. Money is exchanged Like unlike real estate, there's not 40 other realtors fighting for their business, there's hardly any of us and I actually can really help people. So and they don't, you know, they don't have to give me any money, they don't pay me a commission, they don't. The plan doesn't even cost that money in most cases. So it's like just really a win-win.
Speaker 1:I really do like helping people and I really do like educating people. It's really gratifying. So it's kind of neat. I deliver babies and watch them take their first breaths. I help people in the later years of their life as well. That's a really cool thing to me.
Speaker 1:So a lot of people have asked if I would stop doing Medicare once I became a nurse and I was like, no, why would I do that? I mean, with nursing I have to show up and I get paid when I show up, but with Medicare I build a book of business and I take care of my clients and it keeps paying me year after year. So that's another thing. If you have any interest in growing your own Medicare business, let me know, because it's a really cool business and it's a really cool thing to do. It does take a little while to build it up. It's not a huge commission for each client, but when you build it up you really can help a lot of people and you get paid pretty nicely for doing it.
Speaker 1:So that is my spiel about Medicare. If you have any questions, reach out to me and I'd love to help. If you'd have enjoyed this podcast, listen back through to some of my other episodes. We'll see a lot of them about several about breast cancer. Lots of them about a couple about addiction, a couple just about, you know, living your best life and dealing with all the stuff that comes our way. So thank you for listening to Piece of Work and please like follow. Share this episode if you think someone might be interested.