Tom Basey Understand Your Medicare Insurance

Tom Basey

[00:00:00] Ed Watters: Another big issue that a lot of people talk about is when they go to the doctor, and they are very budget oriented, many senior citizens and people of disability are, they want to know up front, what is my cost going to be for these procedures? Because a lot of them have the procedure done and then, here, there's a bill that they're expecting not to be there. How can you avoid that and know what your cost is up front when you go to that doctor?

[00:00:40] Tom Basey: Uh, you know, you, I think avoid is a great word. I dunno if you can always know a hundred percent, but both versions kind of give you, methodologists know that, for example, on the Medigap side, there's a list of Medicare, this is what we pay and these are the deductibles.

[00:00:53] And then there's a list from the Medigap policy that shows we cover those. So often, for many times it's gonna be zero. For example, when I, when the numbers I was throwing out there, I was really talking about the G plan. There really is an alphabet suit, but G Plan is the most thorough Medigap policy you can get.

[00:01:06] Basically there's a chart that shows how a G plan is designed to cover the copays and the thing, and the deductibles that Medicare doesn't cover except for a part B $230, uh, deductible. And so you don't know exactly what it's, but it's very close. But on my, but, so that's one way on that. So the Medigap side, the way you know is cause there's very little, it's mostly covered. On the Advantage side, even though there will be copays, actually, they're supposed to give you what they call an exclamation, an E O B, an exclamation, Explanation Of Benefits,

[00:01:35] or an Explanation Of Coverage. And so you can look and see, so you can see how much a outpatient surgery or how much a colonoscopy. They've literally got a book of stuff so you can kind of see that. You never know for sure, I'm a proponent of checking with the care provider for them. But the good news is I don't find

[00:01:50] that to be that much of a problem these days.

[00:01:57] Ed Watters: To overcome, you must educate. Educate not only yourself, but educate anyone seeking to learn. We are all Dead America, we can all learn something. To learn, we must challenge what we already understand. The way we do that is through conversation. Sometimes we have conversations with others, however, some of the best conversations happen with ourself. Reach out and challenge yourself. Let's dive in and learn something right now.

[00:02:50] Today we are with Tom Basey. Tom is a Medicare expert and he is an insurance sales person. Tom, could you please introduce yourself, let people know just a little more about you, please?

[00:03:05] Tom Basey: Certainly, number one, good to talk to you, Ed, and it's nice to have everybody listening. You know, to reiterate what you said, yes, I love Medicare and I help people. Actually, I like to refer to myself as a Medicare educator or a detective even. I don't like to sell, nor do I like to be sold to. So, Yes, that is me. I've actually a long career in corporate America as an engineer and a project manager, but four years ago I switched, and I am in Medicare now.

[00:03:28] I didn't know what Medicare was when I worked in corporate America, so I had to learn about it. And so what I help people is, yes, I'll help people get Medicare, what you get from the government, and then actually where I come in as an independent broker is, I help you find some solutions to go along with that.

[00:03:40] Either the Advantage plans people hear about or the traditional Medicare supplement and drug plans. Uh, I'm in the Texas area, but I'm licensed in states, the southern portion of the states, I have eight total. I can get licensed in other states, but I kind of don't feel the need to do that. As I find someone I need to help, I'll get licensed in their state. A

[00:03:57] In Florida, in California, I chen ca I can take care of them as well. So that's a little bit about me.

[00:04:07] Ed Watters: That is excellent. Thank you, Tom, for sharing that in another language. Because we're in America and we're a melting pot, people have to remember that. Uh, Medicare, it is a very tricky and sometimes a very sore subject, uh, to help navigate those waters.

[00:04:32] People just getting in Medicare really need professional help with this because it's so tricky and confusing. Medicare and Medicare supplemental plans, Medigap is what it's called, that's, that's very tricky when you first get into it. What is the best way to start off your Medicare journey?

[00:05:00] Tom Basey: You know, I use that same word, so number one,

[00:05:03] the, the oversimplification, it is for people who are 65 and US citizens. But that's not necessarily always the case. If you've lived here continuously legal in the US for five years, you can be eligible and then you can actually get on Medicare, or also, [easy-tweet tweet="for example, if you were disabled. But as a general rule, we're talking about US citizens that are 65. There's an initial enrollment period where you can actually get in three months before the month of your 65th birthday." user="freecircle3" hashtags="#Podcast,#Insurance,#Medicare" template="user"] So for a lot of the people I help, they're already getting their medical insurance from somewhere, typically an employer. Often that's expensive. The older you get, that often costs more and it's not that great in that there's typically a good size deductible there and some copays.

[00:05:38] So many people enjoy getting on Medicare and they will get there early. So to start it, that's saying, you'll talk to some licensed professional like me. I mean, you can dial 1-800-MEDICARE, you can talk to them as well. But my message is, When you are, when you're, once you turn 64, start the journey, start investigating, looking at it, and then the thing is, the earliest you can join unless you've been disabled, for example, is three months before. But that, that's three more months that you won't have to pay $500, a thousand dollars a month that you're paying perhaps through your employer and, and get insurance from the government as well.

[00:06:08] So you can get, part A is often already paid for if they've been taking FICA tax outta your paycheck that is for Social Security, kind of your long term pension, if you overlook government, and then this health insurance from the government, which is Medicare. And so you've already paid for part A, which is hospital.

[00:06:23] Then you have the option to start Part B, which is the stuff that's not in the hospital. The outpatient doctor's visits, tests, urgent care, medical stuff that you do that's not in the hospital. So part A and part B comes from the government. I'm a proponent if it works out for you to start it three months before your 65th birthday, that's the soonest you can get on it as a general rule.

[00:06:41] Ed Watters: When you start receiving your Social Security retirement, I, I've been told there's a six month waiting period for that. Is that no longer true, or how does that work?

[00:06:55] Tom Basey: Well, you'll exceed my expertise a little bit when you talk about all the different Social Security scenarios. What I would offer is,

[00:07:03] Medicare is available and it's independent of Social Security. Some people don't take their Social Security right away. In other words, independent of Social Security, three months before you turn 65 is when you can first get Medicare. Some people turn them on concurrently, but I think you can do Social Security perhaps, even though, I'm not saying, I don't know all the, the times and I don't want to go down a rabbit hole

[00:07:19] not as, uh, uh, expertise on, but my point is you, if someone wanted to, you can log in to ssa.gov, which is Social Security website and or Medicare because they are highly coupled. I think the same login might even work in both websites, but you can go and you can, someone can say, I'd like to turn both those on as long as they're eligible.

[00:07:36] That's saying it gets a lot more complicated perhaps on Social Security, but if you want, you can say, Give me my Medicare cause they're one of the things they're gonna ask you if you turn on part B, how would you like to pay for your Part B, Sir, Madam? And you can say, if you said, Well, I'm turning on Social Security, they will automatically withdraw that from it.

[00:07:51] So with, I, I'll stop there, but my message is, you can get, you can, when you turn on, when you turn, three months before you turn 65, I'm a proponent of getting Medicare, you can get it. You are gonna have to pay, for people in 2022, most people pay, uh, a hundred dollars, $170, that's kind of the standard rate. We can talk more about how that, if you, if you have high income you can pay more than that.

[00:08:12] But as a general, many people, 80 plus percent of people pay $170 bucks a month for Part B. Now you said Medigap, the thing is, I am not a proponent of rolling with just Medicare. That is conceptually an option, you could say, You know what, I'm just gonna go with Medicare part A and part B from the government.

[00:08:26] There's some real shortcomings with doing just that. That's where a licensed professional like me comes in to talk to you about, for example, Medicare doesn't cover drugs, so you'd have no drug coverage if you did that. And then the day you got, uh, prescribed, and medication's expensive, if you said, Oh, I'm gonna get on a drug plan now, there's a penalty.

[00:08:41] [easy-tweet tweet="So I also recommend getting some kind of Part D, that is a drug plan solution as well, cause Medicare part A and B from the government doesn't cover it." user="freecircle3" hashtags="#Podcast,#Insurance,#Medicare" template="light"] The government doesn't offer drug coverage. So you have to get that from one of these insurance carriers. Let me stop there.

[00:08:53] Ed Watters: That's interesting. And, and actually that's why it's so complex and there's so many arms to this octopus. So reaching out to somebody that knows how to navigate, it's really important. Um, now with the different plans, uh, there's always this tit and tat about staying on just the Medicare and using a Medigap plan versus Medicare with a supplemental plan. What's the difference between those?

[00:09:34] Tom Basey: And so that's a great question. So I don't think you're 65 yet, I can't tell, right? We, we don't have a high quality thing. But I think you're asking a great question,

[00:09:41] Ed Watters: Not quite.

[00:09:42] [easy-tweet tweet="Tom Basey: Yeah. But it's good to know, right? It's good to know in advance. Um, but so the thing, and one thing I said, Medicare detective, often I'm helping people, sometimes your grandmother or your parents don't know what they have. So it's good to understand all this so you can help provide, or guide, or help them administer their care." user="freecircle3" hashtags="#Podcast,#Insurance,#Medicare" template="qlite"]

[00:09:57] So the biggest, what you just asked is the most important question. [00:10:00] Once you get Medicare, you really should do one of two different things. You should either do the traditional approach, which is a Medicare, a Medicare supplement, also called the Medicare Medigap policy, and a drug plan. You can certainly consider that, or you should do the new thing that's only been around, say, 20 years, which is the Advantage plan.

[00:10:16] Which one should you do or your parents do? Well, it depends, that's why you have to understand the difference between both of them. So the traditional approach, it, all these plans vary zip code to zip code to cost. But typically a Medicare supplement's gonna cost you, I'll use the number $100. If you're turning 65,

[00:10:31] it'll cost you a hundred, $120 a month above and beyond your, your Medicare. Like I said, for most people it's $170. So a hundred bucks for the Medi, Medigap policy, and then another, say $20 bucks, but that also can vary for a drug plan. But when you do that, in other words you do the traditional approach, you have very little out of pocket cost. Because the Medigap plans, as the name implies, or supplement, they're designed to pay for these things that Medicare doesn't.

[00:10:55] For example, if you go into the hospital on Medicare alone, there's almost, there's around a $1,500 deductible. And then if you stay in there x number of days, there's like a $370, $380 per day that you pay for some days there. And so a Medigap will cover that and so that's what most people do traditionally. Uh, you buy Medicare, Medigap policy and then you need to add their drug plan

[00:11:16] cause even Medicare supplements, they do not have, as the name implies, they don't have pharmaceutical, they don't have drug coverage. You need to get a drug plan as well and that way then whether your doctor prescribes you an antibiotic, or you're taking something for cholesterol, high blood pressure, you have a drug plan that they'll, they will share the cost with you.

[00:11:30] Otherwise, some drugs can be very expensive. So that's a traditional way to do it. Now, that's one option, another option that many people consider is the Advantage plan and they advertise those all over TV and it's highly regulated. And what I'm telling you is everything they see on TV about them, I think so, is largely true because they have to get approval to do it,

[00:11:48] there's just things they don't mention. That is an Advantage plan. And let me clarify, I'm appointed with a lot of different carriers. A lot of the major, some of the biggest companies in the Fortune 10 even, offer Medicare policies and they can do a Medicare supplement for you, or a drug plan, or the Medicare Advantage plan. And what you hear about the Advantage plans, often they're available

[00:12:07] for $0 a month. You can get one for $0 a month and not only will it have, not only will it help you with medical costs, like it'll have a $0 copay for your primary care physician. There'll potentially be $0 preventative dental services, $0 vision, uh, checkup, and maybe some allowance for frames, $0 for ears. Uh, there may be some transportation benefits,

[00:12:27] at least they'll, they'll know, 24 one-way rides to medically necessary activities. There may be post operation meals, sometimes there's a $0 gym membership, all kinds of bells and whistles at $0 a month. That's what all these celebrities are telling me, and that is true, doesn't that sound good?

[00:12:42] Ed Watters: Yeah. Yeah, actually that's very impressive because for $0 you get quite good value. The, the downside to that,

[00:12:53] Tom Basey: Yeah, that's, they don't like to mention that, they don't, that doesn't ever come up on those commercials. The downside is, the cost of care will be more. So, in other words, the traditional one I talked about, you'll have very little out of cost care. If you go to the hospital, you may pay, I'm gonna say $300, $400, depends on the state and the zip code.

[00:13:10] You may pay $304 a day for the first five or six days, then it'll go to zero. If you have an MRI or some kind of diagnostic, well, that may cost you $200, $300. And so my point is that they don't, they don't mention that in the commercials, but that's the thing. So that's why if I'm talking to you and I wanna help you decide, or help your parents decide, I have to make you understand both.

[00:13:29] So $0 and all those benefits sound great, but the cost of care will be more. Now there are two words that I'm not allowed to use in the Medicare world. There are two four-letter words there, and that's B, E, S, T and F, R, E, E. I can't tell you which one your, or your parents or grandparents, would be B, E, S, T for them, because I don't have a crystal ball.

[00:13:48] If I knew what was gonna happen, then I could tell them which one of those scenarios would be better. Since I don't know, I have to, I have to explain it to them, let them understand, and they decide. I wanna pay more per month, if you pay more per month, there's a couple other things, Medicare supplements are accepted

[00:14:02] anywhere that is networked, is, I'm sorry, that Medicare is, is accepted. So there's no networking implication, if, if that doctor takes Medicare, you go there. If you go to the Advantage Plan, they're typically network based, so they're typically an HMO, so you need to stay in care and they'll, they will refer you in there.

[00:14:18] Now there are some, and some still are available at $0 that you, that are PPO, which means you can go outta network if you want, but it'll cost more. But my point is, so some people, some people poo poo the Advantage plans, number one, because they don't like dealing with networks. They wanna be able to go wherever they want to go.

[00:14:32] And anywhere Medicare's accepted, you can use your Medicare, your Medigap policies. That's one thing and then, uh, the other thing is, uh, uh, the cost. I mean, well, let me, let me rephrase that. They like to know how much, know, some people control their medical costs by signing up with a Medigap policy, then you know what it is.

[00:14:48] You're just paying that monthly and you really won't have much more beyond that. If you, if you're doing that $0 one, taking advantage of what I like are, a lot of the advantages of the Advantage plan, the dental, the vision, the hearing, the transportation. But if you go to the hospital, you're, you're, what happens is they have an out of pocket maximum, which is good.

[00:15:04] In other words, there's often a $0 health deductible, but there's an out-of-pocket maximum. I'm gonna use the number $4,000 for a HMO plan. Again, it varies from zip code to zip code. But at least you know, if you have a terrible stay, car wreck, long stay in the hospital, you're gonna hit that out of pocket max, say $4,000 on an HMO plan.

[00:15:22] If you go for the PPO, which you, because you don't wanna do referrals or you wanna be able to see somebody out of network, there's still $0 to have some of the benefits, but the out-of-pocket maximum can rise up to $800, sometimes $12,000. So it costs more to have the flexibility to go out of network. But your original question, what's, what's the difference?

[00:15:38] I hope I've articulated that effectively. One, you pay more per month, but then there's very little out of pocket for care, that's the traditional Medigap policy. Or you can do the Advantage plan, which is beautiful, and that it costs $0 and you get a lot of bells and whistles. But if you go to the hospital, you're gonna pay more.

[00:15:54] Ed Watters: Yeah, and also another thing to add there is, the traditional Medicare, they do not pay for your dental, your vision, or your hearing.

[00:16:07] Tom Basey: Right.

[00:16:07] Ed Watters: So that's another great thing.

[00:16:08] Tom Basey: Even if you get Medicare, you can get a Medigap policy, well, you can add one on, in other words, I offer those products as well. So actually, if I were to enroll you, if you'd said, Tom, I wanna pay more per month and I just don't want to have any out of pocket costs, we'll do the Medigap. You do that, well, then we can add on a dental and a vision plan as well, it just cost you some more. But those are available.

[00:16:24] Ed Watters: Wow! I did not know that and that's for the Medigap side of this. That's very interesting, that's helpful to know. Uh, because another big issue that a lot of people talk about is when they go to the doctor, and they are very budget oriented, many senior citizens and people of disability are, they want to know up front,

[00:16:53] what is my cost going to be for these procedures? Because a lot of them have the procedure done and then, here, there's a bill that they're expecting not to be there. How can you avoid that and know what your cost is up front when you go to that doctor?

[00:17:15] Tom Basey: Uh, you know, you, I think avoid is a great word.

[00:17:17] I dunno if you can always know a hundred percent, but both versions kind of give you, methodologists know that, for example, on the Medigap side, there's a list of Medicare, this is what we pay, and where, these are the deductibles. And then there's a list from the Medigap policy that shows we cover those. So often,

[00:17:31] for many times it's gonna be zero. Like for example, when I, when the numbers I was throwing out there, I was really talking about the G plan. There really is an alphabet suit, but G Plan is the most thorough Medigap policy you can get. Basically there's a chart that shows how a G plan is designed to cover the copays and the thing, and the deductibles that Medicare doesn't cover except for a part B

[00:17:50] $230, uh, deductible. And so you don't know exactly what it's, but it's very close. But on my, but, so that's one way on that. So the Medigap side, the way you know is cause there's very little, it's mostly covered. On the Advantage side, even though there will be copays, actually, they're supposed to give you what they call an exclamation, an E O B, an exclamation, an Explanation Of Benefits

[00:18:10] or an Explanation Of Coverage. And so you can look and see, so you can see how much an outpatient surgery, or how much a colonoscopy, they've literally got a book of stuff so you can kind of see that. You never know for sure. I'm a proponent of checking with the care provider for them. But the good news is I don't find that to be that much of a problem these days. The carriers,

[00:18:28] and so I'm gonna go ahead and throw some of these carriers out because they are all good. Cause another, another remark I would make when you were asking about the, the, the dental and vision. So I could enroll you in a Medigap policy from Aetna, and then I could enroll you in a drug plan from United Healthcare, and then I can enroll you in a, a Humana Dental and Vision plan.

[00:18:47] So my point is you can mix and match those if you want. If you go to the Advantage, it's all from one, you pick one of those carriers. But my point is, all the major healthcare carriers, they really do have those plans. Now, I guess another point I should, I should, here's, here's two things since we're talking about this.

[00:19:00] Let's pretend it's Ed and he's turned 65. I will ask you for two lists perhaps. Please give me a list of any medications that you're on and please let me, give me a list of doctors that it's important to send, for you to see. If, on the medication, I'll use that, either I can, I have tools that I can plug in and I will show you both by retailer,

[00:19:18] whether you're going to a Walmart, or a CVS, or your local pharmacy, I can show you a matrix and show you, and if you use Humana, or Aetna, or uh, United Healthcare, I can show you and you can kinda optimize. So I can show you through your list of medications in your zip code, so that's good. I, So my point is, I use the pricing notes because I'm an independent broker,

[00:19:35] I don't care which carrier you go with. Carriers, your captive obviously, they want you to use their carriers. So that's what I do, I like to show you that so you can pick maybe based on medications. Sometimes if you've got four medications and all generic that, there won't be a difference. But if you've got one of the ones that they advertise on tv, those ad dollars are expensive and there's a big budget spent on developing that drug.

[00:19:53] There can be, uh, uh, there, I, there was my, my poster child for this, is a lady who lived one city over for me. She had [00:20:00] 23 different medications she was taking. So depending on which carrier she went with, it was gonna be $500 a month difference on her medication. So clearly she used that to decide what drug plan she would pick.

[00:20:10] Ed Watters: Wow.

[00:20:11] Tom Basey: On the Advantage Plan side, I've got a tool that will show me, which, Like if you gimme seven doctors, I'll type them all in and it'll, I can say, Show me only Advantage plans that, that all, that all these doctors take. And then sometimes, inevitably, there'll be one doctor, two years that they don't take Medicare or Advantage plans.

[00:20:27] Well, I can say show me all but one doctor, all but two doctors. But it'll actually show me because they have checks and minuses by their name, so that's good to know. Cause my point is, if you're like, You know what? I, I wanna pay the $0. I don't, I feel healthy, I don't think I'm gonna go to hospital service. I want the $0 plan and I want all the bells and whistles.

[00:20:42] Okay, but let's check and make sure that most of your doctors go there and we need to sign a primary care. So going back to talking to some Medicare professional, we can do things like that, we can do those analysis for you to help you, I call it tailor, tailored solution. So you can pick either the one care on the Advantage side or two or three different carriers to optimize, to minimize your drug cost to, that kind of thing.

[00:21:02] And to make sure if there's a dentist you like, if you're doing the standalone dentist plan, we make sure the dental, the dentist is covered as well on either side.

[00:21:09] Ed Watters: So, So how do people approach this journey up front? Do they come to an insurance carrier or do they hit Medicare up first? Which is the best approach to establish your care?

[00:21:27] Tom Basey: Don't say that one. Well, actually, actually, maybe you can there. I can't say which plan is best.

[00:21:31] Ed Watters: Oh, that's right.

[00:21:32] Tom Basey: But that's, well, but I do think,

[00:21:34] Ed Watters: Sorry, Tom.

[00:21:35] Tom Basey: That's okay, no big deal. The government, they only administer part A and part B. In other words, The drug plan, and the Medigap, and the Advantage plans are all administered by third party care. So I would contend they're ill prepared or they won't be

[00:21:47] best to consider that. No, they could, They, they're the authorities and the owners of the part A and part B. So if you have questions about Medicare, I think that's a great place to go. So you can dial 1-800-MEDICARE, you can do that. But I recommend that you get with a professional and you can use social media or uh, search things.

[00:22:04] Actually, I think most people that turn 65 will tell you, Yeah, there, my phone's ringing off the wall and I'm getting my mailboxes flooded. Actually, believe it or not, it's illegal for them to cold call someone who's 65. So they're not supposed to do that, but they do. But we are allowed to approach them by mail.

[00:22:18] So here's me sending out, uh, here's pictures, here's me with one carrier, uh, sending something out by mail. Here's me with a different carrier, sending something out by mail. And so I send these things out. So if someone wants to talk, they can reach out to me. But I'm available on all social media platforms, Tom Basey, Basey Insurance.

[00:22:35] They just look me up, connect to me, and schedule a time. We'll just visit. And that's the thing, I, I claim to be the educator and, uh, and a detective. I get on the phone all the time and I'll just help people find it. In other words, I don't like to sell people things, so I'll help someone figure out with their mom,

[00:22:49] like many people, my mom's in the hospital and she doesn't even know, right? So I'll help you figure out, we'll determine, does she have a Medicare supplement or Medicare Advantage plan? And I'll help them along the way. Cause I find if I help people then they'll refer me, that kind of thing. But, so find somebody, whatever methodology you have to seek out help, uh, do it.

[00:23:06] But I, I'm a proponent of finding independent brokers.

[00:23:10] Ed Watters: Yeah. Yeah, I agree. Because you're gonna get, like you just stated, a tailored fit for your needs and not a rushed, here, this is gonna work for you.

[00:23:23] Tom Basey: Yeah.

[00:23:23] Ed Watters: There's a big difference.

[00:23:23] Tom Basey: If this is the only plan I have with, if I'm, If I'm, here's the one plan I have here, yeah, sign up for that. Well, okay. Can we look around?

[00:23:31] Ed Watters: Tom?

[00:23:32] Tom Basey: Yes.

[00:23:33] Ed Watters: Now, Now, how, if you're not satisfied with the plan that you have, they have this waiting period thing. Could you talk to them about the, how you have to change if you want to change your plans

[00:23:53] Tom Basey: Okay.

[00:23:53] Ed Watters: once you establish care.

[00:23:55] Tom Basey: So I'll, I'll make some remarks about that. That's such a complicated thing that we don't have time to cover. But what I would offer there on the two different sides is two different answers. So, number one, once you get on a Medicare supplement, for one thing, it's easier to get on when you first turn 65. So if you're considering the Medicare supplement approach, I'm a proponent of doing it then. There's not gonna be a lot of underwriting questions because you've turned 65,

[00:24:14] they're not gonna ask you, have you been in the hospital? All these tons of things like they would if two or three years in. If, in other words, it's easy to go from a Medicare supplement side to the Advantage plan. It's harder to go from the Advantage plan to the Medicare supplement because you're older and they're gonna, there's gonna be more underwriting,

[00:24:27] they're gonna ask you questions. Because they have to cover, so I'm a proponent of getting in the MedSup early, if that's what you're gonna do. As a general rule, I don't recommend you change the MedSup. Now, they will go up over time, the pricing levels may go up over time. So I'm not saying don't ever change. But I, I think you'll find because a G plan is a G plan, they're the same

[00:24:45] depending on which carrier you go with. I don't know that you're gonna save much by switching. The way to save is to go ahead and decide, I'm gonna go ahead and go to the Advantage side instead. So as a general rule, when someone's on a Medicare supplement, as long as you can afford it, then I'm a pointent of staying there.

[00:24:58] What you do change is the drug plan. Every year you should review your drug, the, uh, cost. Because it may be even if your drug, if your, even if your drug, four drugs didn't change, but there may be a new plan or a different plan. The plans have something called a formulary, which is the list of drugs that they call, that they cover, and what tier it's in there.

[00:25:16] If your drug falls off the formulary, then you're gonna pay retail costs. So I think on the Medicare supplement side, ride that one as long as you can, switch on the drug plan, check it at least every year, I should say. Stay on, no need to change at all, you don't have to, on either sides, you don't have to,

[00:25:29] as long as it's working for you, you don't have to do a thing. But it's good to go ahead and at least check the pricing on the meds each year, because that's something that can change. On the Advantage side, similarly, as long as it's working for you, there's no reason to change. They talk all about it, talk all about it, but there is a couple different times when you can change on the Advantage side.

[00:25:44] So number one, every year from October 15th to December 7th, you can make a change then, you can. And, and that is the time to change if, for example, your beloved, uh, orthopedic surgeon retires, and the new guy doesn't take an Advantage. I know if there's a doctor reason to change, because if they're not networking, you can't go to it.

[00:26:00] So if there's a doctor reason to change, do it in that window. If there's a medication need, do it in that window. Uh, so you can do that and, and that's what most people do. And there's actually even, I call it a mulligan, there's actually the Q1 of the following year. Like what if you made that change? And then, which, so you, that's the thing, you're looking at it, Hey, I can save 50 bucks a month if I make this change.

[00:26:20] You make that change in the fall and it goes into effect January 1. You're on January 1, and then suddenly, Oh no, but your doctor's not in there. You have a one time mulligan you can, you could actually change again as well. So there are, there are windows they define, and yet there's even others. For example, because Advantage plans are network based,

[00:26:35] actually, if you move, that's a S E P, a Special Enrollment Period. Uh, so there's, there's a series of things, or if you qualify for, for example, Medicaid, which is another discussion we can have or not depending on your, your timeframe. But there are reasons why they'll like change. So the good news about Advantage plans, you can change them periodically if need be throughout the year, at least one time.

[00:26:54] But there's several, typically, there's several times when you could, if you need to. Ideally, if it's tailored, you won't have to change. If we've done a good job of finding one that keeps your medication costs low and your doctor network, you don't have to change. But that's easier said than done sometimes. And, or as soon as you get a new, uh, prescription, that may change the scenario.

[00:27:11] Ed Watters: Yeah. Well, well, you bring up Medicaid, now, this is something odd and unfamiliar to me, how does Medicaid fit in with Medicare?

[00:27:24] Tom Basey: So when I worked in corporate America, I didn't know what Medicare was and I didn't know what Medicaid was. Medicare is health insurance from the government part A and part B for people 65 and above.

[00:27:34] Medicaid, Although it is funded perhaps by the, by the federal government at least partially, it is typically, at least partially funded and administered at the state level. And it's for financial assistance for folks who are, and they've got, you know, varies state to state, but if you're kind of in the poverty line. And so there are people who have Medicaid,

[00:27:49] like younger people that are unemployed, they may have Medicaid for whatever reason, you can apply. And you have to reapply every year. So it's thing, so it's, it is financial aid approximately for living like foods, and health, and that kind of stuff. If you have both of those, so in other words, There, there's a subset of population that has both Medicare, either because of age or because of disability, and they're also on Medicaid.

[00:28:11] And if you have those, they call them dual, that is cause they're both. And so there's something called DSNP, Dual Special Needs Plans. And those are actually like supercharged Advantage plans. And so I like to find underserved populations and I like to know them because they're full featured and my plan is, for example,

[00:28:27] a regular Advantage plan, if you're not, if you're not dual, if you're just a regular person on the street, you may have, uh, let's say a thousand dollars worth of dental coverage that they'll pay for and it won't pay for implants and or dentures. If you're on a dual plan, potentially it'll be $5,000 and it will cover implants and or dentures.

[00:28:44] If you have, typically your, your medication costs, it'll cover all the copays. So in other words, instead of, so, so a, an Advantage plan for someone who's dual, I kind of call 'em supercharged Advantage plans. They're much more full featured. Sometimes they have like a fresh foods card involved, so maybe a hundred dollars a month or a quarter, you can get food at the store on the thing.

[00:29:02] So I, if I find an underserved community and there's somebody who has a d, dual, that is both Medicaid and Medicare, there's some really, And so it's a $0 plan, just like everybody's Medicare, uh, Advantage plan, but they're, often, the copays are zero and then the, the benefits are even bigger, more dental, more vision, that kind of stuff. So I like to enroll people in those plans when I, when I find them.

[00:29:24] Ed Watters: I, I was very unaware that you could have both at the same time. I thought you had to have one or the other, that's very interesting. Uh, well, uh, Tom, anything else you would like to add to the conversation?

[00:29:39] Tom Basey: Uh, let's see, since you asked about that,

[00:29:40] well, one other thing I would offer then. So, veterans, people who serve, there's, they have a different level of health insurance, like you hear about the VA all the time. They go there and then actually TRICARE and or TRICARE For Life, there's different kinds of scenarios they have, not everybody, uh, uh, has those.

[00:29:54] But what I would offer is, and I'm gonna go ahead and again, I, I'll, I'll say these three plans because they're examples. [00:30:00] So United Healthcare has a plan called Patriot, Humana has a plan called Honor, Aetna has a plan called Eagle. They actually also have the Advantage plans that people can get those. So it's, I'm glad they have those.

[00:30:10] So often those are $0. And so if you're a veteran, even if you have VA, VA or something, they think, I got TRICARE For Life, I don't need anything. I'm a proponent of investigating potentially getting those plans. Because then you get some of those additional services, some of those bells and whistles.

[00:30:23] [easy-tweet tweet="What if the VA's far away from you? What if there's a dentist right around the corner where if you're on an Advantage plan designed for, to pay with their TRICARE For Life, these veterans friendly plans, then you can go to the dentist close by you. You can see a, you don't have to go to the VA hospital for all your outpatient. And sometimes there's even things like, even emergency care." user="freecircle3" hashtags="#Podcast,#Insurance,#Medicare"]So there's, there's some real benefits aside from the things like a zero, a $0 gym membership that, a lot of Advantage plans have that. And then the other thing, what you hear about on tv, and there are few on this, but this is an example. There is this, the magical, the, the sought after part B giveback.

[00:30:56] As I started my conversation by saying, for most people, they pay $170 for their part B. Sometimes plans, and particularlly veterans ones, do a good job of doing this, they actually pay back something. Sometimes you can get $35, $50 bucks, something like that, back towards that. So my point is, I like the fact that they will do that for vets.

[00:31:11] That they will have these, these big carriers have these plans that are, that will pay with their Tricare and give them some good benefits. So that's another underserved community I like to mention.

[00:31:19] Ed Watters: That is awesome right there. Uh, you know, that was,

[00:31:22] Tom Basey: I'm not gonna spend all day here, but we're doing this recording, it's a good thing to mention.

[00:31:25] Ed Watters: Yes, Yes. Well, Tom, I sure do appreciate our conversation, you're very knowledgeable. How can people reach out and get ahold of you if they're in your area? And also, could you let people know the best way to get ahold of other agents in their area?

[00:31:43] Tom Basey: Okay. So first off, my name is Tom Basey. I, I connect with people, so reach out to me on social media platforms, I'm on a lot of them, connect with me directly or find the company, Basey Insurance,

[00:31:51] you can find us that way. Our website is basey-insurance.com. B, A, S, E, Y. Uh, and then, and please do find me. I'll answer the questions to your point if you wanna find someone like me, someone you can, you can use your search engines to find them. But so I'm a, I'm an indi, so you can, you can say Medicare. Well, Medicare's from the government, I'm the proponent of saying,

[00:32:11] Independent Medicare Broker. If you search that, that'll find somebody. Cause, and that's the thing, there's nothing the matter, I like Medicare overall. It's not perfect, but, so you can call the government, talk to them, and I like all these different carriers. There's nothing the matter with working with a captive

[00:32:24] guy too. But I just like the independent implications, because that's the thing, An independent guy, I don't even think he can, I don't think he can enroll you if, if he works for company X and, and your drug list costs less on company y, I don't think he can enroll you in that. So he's gonna enroll you in what he can.

[00:32:38] So I'm a proponent of using an independent. So just use social media to try to find independent Medicare Plan Broker.

[00:32:46] Ed Watters: I love the knowledge you have. Yeah. Well, Tom, I sure do thank you for the time you've spent with us and the knowledge you've shared with us. Uh, thank you for being part of the Dead America Podcast.

[00:32:59] Tom Basey: Beautiful. I've enjoyed it. Uh, I wish a, a good rest of the day to all your listeners, thank you, Ed, for hosting.

[00:33:07] Ed Watters: Thank you for joining us today. If you found this podcast enlightening, entertaining, educational in any way, please share, like, subscribe, and join us right back here next week for another great episode of Dead America Podcast. I'm Ed Watters your host, enjoy your afternoon wherever you may be.

Tom Basey