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Matt Feret (00:04):

Hello everyone. This is Matt Feret, author of the Prepare for Medicare book series, and welcome to another episode of The Matt Feret Show, where I interview insiders and experts to help light a path to a successful retirement. Come say hello at https://themattferetshow.comYou can also check out https://prepareformedicare.com, and my new site, https://prepareforsocialsecurity.com Both support the books, Prepare for Medicare: The Insider's Guide, and my forthcoming book, Prepare for Social Security: The Insider's Guide. Make sure to sign up for my newsletter, you can do so on all three sites.

(00:45):

When I was a kid, I loved the radio, I listened to it constantly. I was fascinated by the DJs, the timing, the production, and of course the music. Around age 12, I launched my first radio show using walkie talkies in the basement of my friend's house down the street, mainly because his mom's record collection was better than the meager offerings at my house, and she was willing to listen while cooking dinner and my mom wasn't. I was that teenager who stayed up late into the night, under the covers with my headphones on, moving my manual radio dial millimeter by millimeter with my fingernail, trying to tune in faraway AM radio stations from across the country. One of those stations I can remember being delighted I was able to tune in was WGN AM in Chicago. It's no small feat tuning in a signal from Chicago all the way from southwestern Virginia. Some of you know I followed my childhood broadcasting passion from walkie-talkie radio shows to college DJing, and a brief stint as a local live TV news reporter before pivoting into healthcare.

(01:56):

So imagine the thrill I got when I was invited to talk about healthcare, Medicare, and my book, not once, but twice this fall on the John Williams Show on WGN AM. Clearly, I still get a thrill out of broadcasting, and sometimes wonder if I missed my calling. That's one of the reasons I launched The Matt Feret Show in 2022. And as we wrap the year, I'd like to sincerely thank you for listening. We're just getting started. Enjoy.

WGN (02:24):

This is WGN at AM 720, and on Smart Devices Worldwide.

WGN (02:33):

(Singing).

John Williams WGN-AM (02:36):

It's Wednesday, October 26th, and it also means that it's time to start thinking, if you're one of those people, about Medicare, and how do you sign up, and what do you sign up for? Terry Savage, on the Wintrust Business Lunch, many times has said that people make mistakes and sometimes it costs them money, thousands of dollars for years. And as a person who is getting closer and closer to becoming Medicare eligible, I'm getting more and more interested in this. Maybe you are too. This is Matt Feret. He is the Medicare expert and the author of a book called Prepare for Medicare: The Insider's Guide to Buying Medicare Insurance. He's a Chicago guy, insurance industry for 20 years. Matt, you're on WGN, how are you?

Matt Feret (03:25):

Morning, John. I'm well, thanks for having me.

John Williams WGN-AM (03:28):

What's the signup period? What's the window for everybody on this?

Matt Feret (03:32):

Sure. So the big period right now for people currently on Medicare is... It's going on right now, it's called the annual election period, or the AEP, and it ends on the 7th of December, so we've got a couple weeks to review your plans for the next year. Even if you're happy with your plan, you really should review this stuff every year, because things change every year. You got to look to see whether or not your doctors are still in the network, whether your prescriptions are still on the formulary for 2023, review your annual maximum out-of-pockets, they may be going up. And then of course, monthly premiums change and benefits change. So this is really a good time to review and make sure you're in the right plan for next year.

John Williams WGN-AM (04:10):

What about people that are signing up for the first time? What should they be thinking about?

Matt Feret (04:16):

Sure. So there are a couple of key dates and timeframes, and first of all, the nice thing is when you turn 65, or you retire and take full Medicare, you've got a seven-month window. It's the month of your birthday, three months prior, and three months after. Of course, with anything having to do with the federal government, you want to get that done early, you don't want to wait till the last minute. There are a couple of key things though when you're working. So let's say you've put off Medicare Part B for a few years while you've worked past age 65, there are some pretty tight deadlines specifically around your prescription drug coverage, and so that you only really have a 63 day window after you decide to retire to get your drug coverage, and you have a little bit longer to fix your medical around Medicare Supplement or Medicare Advantage.

(05:02):

So again, the message here is, if you're turning 65 or you're retiring after working past 65, work with your HR representative, but be very mindful of those key dates. You can't wait six months and then decide to do it, or you'll face those dreaded Part D and Part D penalties for life.

John Williams WGN-AM (05:19):

Well, if you're working past 65, should you stay on your employer's plan or should you use Medicare?

Matt Feret (05:25):

You can. And it really comes down to the individual. If you've got full employer's coverage and you like it, and you're working, you can keep it in most cases. Also, really depends on whether or not you've got a partner or a spouse that's not yet 65 and eligible for Medicare, and whether or not they're on your insurance. So it's not a cut and dried answer, and it's a really good time to sit down... You can read it all in my book, where you can sit down with a retirement advisor or an expert Medicare insurance agent, and really walk through the steps. And not to reiterate it, but the key here is planning and getting out in front of it, and really understanding the deadlines and timelines, and having those all sync up with your employer-based health insurance.

John Williams WGN-AM (06:04):

Well, is the Medicare plan administered by the federal government? Are they the insurance company, if you will, or do they just administer it in private companies actually provide the coverage?

Matt Feret (06:16):

So it's a bit of both really. So original Medicare, which started in the 1960s, you've got original Medicare Part A, which covers hospitals and some more things, and then original Medicare Part B, which covers outpatient and your doctor's visits. And then there are a couple of other letters after that, the ABCDs of Medicare. I'm going to go to Part D first, that's Medicare Part D, and that's your prescription drug plan, and you can add a PDP, or prescription drug plan, onto original Medicare parts A and B, got comprehensive healthcare and prescription drug coverage. And there's an option number two, which is to add a Medicare Supplement or Medigap plan on top of that, which, as the name suggests, fills in the gaps that original Medicare has. Original Medicare doesn't cover a number of healthcare related items, dental, vision and hearing being one of them. And there's 20% co-insurance on the original Medicare. Then if you move back from Part D, which is standalone prescription drugs, you get this thing called Medicare Part C, commonly known as Medicare Advantage. And those are basically combo plans.

(07:23):

They take Medicare A and B and D typically, and combine them all into one health insurance plan. And those come with networks that you're used to if you're on employer-based coverage or you're on an ACA plan, HMOs and PPOs. And so the federal government does... Is, I guess, the insurance company for original Medicare, and then you've got private insurance companies that administer the Part D benefits, the prescription drug, and the Part C benefits are Medicare Advantage.

John Williams WGN-AM (07:51):

You mentioned that gap coverage for dental, vision and hearing. Is there anything... This is a tangent, but since you brought it up, is there anything on the horizon to provide for hearing for seniors? I mean, everybody loses their hearing, some more profoundly than others. It's terribly expensive. There's a range of options, and I'm amazed that for all we're going to do for everybody these days, that we don't do something as basic as underwrite the cost of hearing aids.

Matt Feret (08:27):

Yeah, I agree. And if you throw dental health on top of this, there's a ton of evidence out there that keeping your teeth and your mouth healthy really affects your overall health, and so I agree with you. There was an effort earlier this year in Congress to pass some hearing benefits that eventually got carved out, but there's also a private industry and a private insurance company solution to this. You can buy dental, vision, and hearing plans on the open market at a reasonable rate, and then those Medicare Advantage plans also are allowed to include additional benefits not covered by original Medicare. Dental, vision, hearing benefits are among those. And so if you do a little searching, and there are a lot of options out there, but if you do a little digging, there are Medicare Advantage plans out there that cover those additional things that aren't covered by original Medicare.

John Williams WGN-AM (09:18):

Well, for most retirees, is Medicare at no cost or is that based on their previous earnings? How is the cost for an individual determined?

Matt Feret (09:28):

Sure. So if you meet the minimum qualifications, and they are pretty minimum, for working, Medicare Part A typically doesn't come with any premium, so you just get that. Medicare Part B does come with a monthly premium, and for most people in 2023, that's $164.90 cents a month, it's actually slight decrease for the first time in 11 years this has happened from the prior year. So great, we get one more cup of coffee with that slight premium decrease. However, there's something called IRMAA and nobody likes her, because that's basically a way of means testing your Medicare Part D and your Medicare Part D premium. So IRMAA stands for income related Medicare adjustment amount, and if you in retirement, as an individual, make more than $97,000 on your tax return, your premium goes up next year to $230.80 cents a month, which is a big difference from $164. And so there are different levels, I guess, and when I say means testing, I mean that. So if you make more as an individual filer or a couple, you could end up paying more for your Medicare Part B and your Medicare Part D premiums.

John Williams WGN-AM (10:42):

Trying to get ahead, or a handle, on how onerous that is for retired people, $164 or $230 a month is not a small amount, but it strikes me as a manageable amount. Would you agree with that? Can you give me some perspective?

Matt Feret (10:59):

I would agree with that. If you think about the benefits you're receiving, again, you're only paying, in that Medicare Part B premium, a very small percentage of the overall cost of care if you think about your employer premiums and what those totals are. At the end of the day, you've paid in over your lifetime of working and you are getting that back, it just isn't enough to cover 100% of the premium costs. And so no, I would... I mean, if you're looking at health insurance coming out of one's check, that's a pretty low amount, even in retirement, for what you're getting.

John Williams WGN-AM (11:28):

But if you're the healthcare provider, you're a doctor or dentist, whatever, Medicare doesn't pay 100% of what you would typically charge either, right?

Matt Feret (11:37):

Well, Medicare is on a fee schedule with the federal government, and so every doctor, every hospital out there gets paid a certain amount from Medicare, they know what that is, and Medicare changes those every year, based upon some medical inflation. And then if you're on a Medicare Advantage plan, where private insurance companies administering those benefits as part of that Medicare Advantage combo plan, those individual health insurance companies also have their own schedules with those doctors in network.

John Williams WGN-AM (12:06):

So here's a question then... We're visiting with Matt Feret, and his book is Prepare for Medicare. Prepare for Medicare, it's an insider's guide to buying Medicare insurance. Should I do that on my own? Should I go through a federal website? Should I call an insurance agent? So what's the best way to sign up or change this stuff? Answer that for us and I'll bet you've got a question too. I'm asking him to describe it. If you've already been on the program, you probably have more specific questions. My number's 312-981-7200, you can call right now.

(12:44):

Well, all our phone lines are ringing and I can't say I'm surprised. Anything you want to mention to me, Pete? Okay, we'll start with Diane. Matt Feret's got a book out called Prepare for Medicare, and he's just talking to us about the various plans. I haven't even asked him which Medicare Advantage plans are the best. I'll ask him to define that and then answer that. Matt, we've got lots of questions from our listeners too. We're going to start with... Pete, you said... Diane, you're on WGN Radio. What can we do for you, Diane? You're on the air.

Listener Call-in (13:15):

Well, hi. Thank you, so good to be on.

John Williams WGN-AM (13:18):

Good. What's your problem?

Listener Call-in (13:19):

Yeah, well, I'm in my 70s, so I was my husband, we've been on Medicare for over 10 years, but we've had a few denials this last year from our insurance policy and we've had quite a few medical conditions to deal with. So we're debating should we change? Will we lose because now we're changing after 10 years with the company? How do I go about that?

Matt Feret (13:44):

Hi Diane, it's Matt. What kind of insurance do you have? Do you have a Medicare Advantage plan or a Medicare Supplement plan?

Listener Call-in (13:50):

Well, here's the thing. It doesn't say Medicare Advantage, but they told us that their insurance policy is first, Medicare has been second, but it's not called in a, it's... Do you want me to say the name of the company?

Matt Feret (14:04):

Yeah.

Listener Call-in (14:05):

Aetna Medicare is what it's called.

Matt Feret (14:09):

Okay. So does that particular plan combine your medical and your drug together? Do you use one card for your doctors and at your pharmacy?

Listener Call-in (14:18):

Yes.

Matt Feret (14:20):

Okay. It sounds like what you have is a Medicare Advantage plan, and those come in several different flavors. You have an HMO, which you have a group of doctors, and a PPO. Do you know which one you have?

Listener Call-in (14:30):

PPO.

Matt Feret (14:31):

Okay, PPO, great. So you've got an group of doctors that are considered in-network and contracted with that company, and then some out-of-network doctors. Medicare Advantage comes with great work benefits, but it sounds like what you might be running into are something called prior authorizations or pre-authorizations. And those happen because Medicare Advantage plans are also called managed care. And so a simple explanation of managed care is, let's say you hurt your toe, and you go into the doctor and the doctor orders an MRI. Well, the insurance company is first going to say, "Well, hold on doctor, how about x-ray first before we go to the MRI?" And so it's an overly simplistic way of explaining managed care, of taking the right steps, but there are steps to take, especially for very complex and expensive procedures around that, that you may be running into. And the second place is there's something also called care management.

(15:30):

Now, original Medicare, and even a Medicare Supplement plan, doesn't do care management, but part of the care management is making sure you, as the whole person, get the care that you need and you may be running into some of those things. So let me stop there, and I'll move to the second part of your question is, if you switched as I'll just start over. And I would say if you move from one Medicare Advantage plan of company to another, nothing starts over so to speak, but it could take a little bit of coordinating from one company to the other, or with your doctors and hospitals, to make sure that they understand you're on the new plan. And yes, you may have to go through some of those prior authorizations or some of that medical management again, so it's not to dissuade you at all. I would really look at your experience, and whether or not your doctors and hospitals are in network, and your out-of-pocket expenses every year, and look to see which plan fits you best.

Listener Call-in (16:23):

Okay.

John Williams WGN-AM (16:23):

But isn't your concern, Diane, that you're afraid now if you switch to a new company and they're going to say, "Wait, you've had these previous medical issues," it's going to be a lot more expensive. You're already in the door with the one company at one price, but if the new guy finds out, it's going to be a lot more, is that going to happen to her, Matt?

Matt Feret (16:40):

No, that will not happen, because those plans... You can sign up for a Medicare Advantage plan whether or not you're a 70-year-old marathon runner in perfect health, or whether or not you're 105 years old and have two seconds left. So there is no medical underwriting on Medicare Advantage, they're not even allowed to ask you health-related questions, and so you won't get into a situation where they will either A, deny you, or B, it will be more expensive. The only way it would be more expensive is if you buy a plan that's more expensive and has fewer benefits. If you buy a plan that's less expensive and has better benefits, then those are the benefits you're going to get, it doesn't matter about your health.

John Williams WGN-AM (17:17):

Okay. Yeah, there's always that balancing act between premiums and deductibles. Do you have any suggestions for us on that, Matt?

Matt Feret (17:26):

Yeah, there's a couple things to pay attention to. Obviously, monthly premium is a big thing, but also you got to really look at something I call... It's called the maximum out-of-pocket, which is... In a world full of acronyms, this is the most fun one at healthcare, it's called the MOOP. You say that three times, you can't help but smile. That's the maximum out-of-pocket on plans, like Diane just talked about, which are Medicare Advantage plans. And so a maximum out-of-pocket very simply is, if you use your medical benefits so much in one given year, at some point the insurance company will take over 100% of the costs for after that year. Now, some plans come with a low MOOP of three or $4,000, which means if you go through a bunch of medical conditions in a given year, once you reach $3,000, for example, of out-of-pocket, you're done for the year and the insurance company will take up all the medical costs after that. Some plans come with a maximum out-of-pocket as high as $8,300 a year.

(18:24):

And so while it may be tempting to look at whether or not your doctor copay is $5 or $10, or your specialist copay is 20 or 25, what I always recommend is to look at first premium, and then second on these Medicare Advantage plans, your maximum out-of-pocket. Because really what you're trying to ensure against is somewhat of a catastrophic situation. You have a health, bad health here, or you have a lot of conditions, you want to make sure to limit that maximum out-of-pocket or that MOOP as much as you can.

John Williams WGN-AM (18:51):

Right. Even if your incidentals are more expensive than you want, it's not going to bankrupt you?

Matt Feret (19:00):

Don't pay attention to the difference between a five or a $10 copay I'd say. I'd say pay attention to the big stuff. You definitely don't want to look at a Medicare Advantage plan with an $8,300 maximum out-of-pocket when something may exist for half of that.

John Williams WGN-AM (19:19):

Okay, I'm out of time and I know our phone lines are busy and we don't have time for more calls here, but we'll invite you back. And in the meantime, prepareformedicare.com, prepareformedicare.com is the website associated with the book, which you can also get, and it's got the same title, Prepare for Medicare. It's very helpful, it's got a lot of the questions in there that you might be asking. It's by Matt Feret, F-E-R-E-T, F-E-R-E-T. Matt, nice to talk to you. Thanks for helping us out a little today.

Matt Feret (19:51):

John, thanks so much.

Speaker 2 (19:53):

When news breaks in Chicago or the world, you'll hear it here and we'll talk about it here. This is Chicago's very own 720 WGN.

John Williams WGN-AM (20:03):

Okay, so the Medicare deadline is right around the corner. I think it's the 6th or is it the 7th? Matt Feret is the Medicare expert and author, Prepare for Medicare: The Insider's Guide to Buying Medicare Insurance. He joined us a couple of weeks ago, here he is again. Welcome back, Matt.

Matt Feret (20:20):

Thanks for having me, John.

John Williams WGN-AM (20:22):

What's the deadline? Is it the 6th or the 7th? When do we have to have this done by?

Matt Feret (20:26):

Oh, you got it the last time. If December 7th, that's the last day you can make changes to your Medicare coverage for 2023.

John Williams WGN-AM (20:34):

If I already have Medicare and I'm satisfied, do I have to do anything or should I do something?

Matt Feret (20:41):

Well, if you're satisfied with your plan or the satisfied with the company you're with, that's one thing, but I always urge everybody to still take a peek of what the benefits are going to be like in 2023, because while you might like your premium, those things can change. You might like the way your prescription drugs are covered. Well, those formularies can change, sometimes your drug can fall off the formulary in the next year, sometimes it can move up in tiers and cost you more. So even though you might say, "Well, I'm satisfied and I like it," you still want to go through your plan documentation that you got in the beginning of October to make sure those changes aren't really going to affect your day-to-day use of your Medicare coverage.

John Williams WGN-AM (21:20):

Does that happen often where the prices change or the plan changes?

Matt Feret (21:25):

It does, it happens every year. These Medicare Advantage plans and the Medicare Part D prescription drug plans are on an annual contract basis. The insurance companies file these plans for one year, which means they can change every year, and so they do. They change all the time. The premiums go up, the premiums go down, the copays go up, they go down, the drugs go in, they go out. It really does change every year, sometimes even in the middle of the year. So unfortunately, also what can happen is doctors' offices and hospitals can go in and out-of-network even in the middle of the year. So you definitely want to check that.

John Williams WGN-AM (22:03):

What about the people that are just getting Medicare for the first time? What's your advice for them?

Matt Feret (22:09):

Well, it's really... And I outline this in my book, there's three different ways you can consume Medicare if you're just now... Or going to be aging into Medicare as we say, or turning 65, or working past 65 and coming off your employer's plan, there's three ways to consume it. One is to use your original Medicare, red, white, and blue card for Medicare Part A and Part B for your medical, and then you buy a prescription drug plan or a PDP on top. The next way of doing... Version two is doing the exact same thing, but then buying a Medigap or Medicare Supplement to cover those gaps and things that original Medicare doesn't cover in original Medicare Part A and B. And then the last version is this all-in-one plan combo. It's Medicare Part C, which is also more commonly known as Medicare Advantage. So the pros and cons are... There are a lot of them. I mean, it really depends on how you want to consume your Medicare.

(23:02):

Do you like to pay more upfront for the safety of knowing most of it's paid for if you use it? Or would you rather have a concept of self-insure and have a lower premium but pay more out-of-pocket when you actually use it? So I take you through that all in my book, it really comes down to the personal choice of how you like to consume your healthcare.

John Williams WGN-AM (23:21):

And that may depend on how healthy you are or think you're going to be. If I sign up for one program, which maybe has a higher upfront cost because I think I'm not going to use it that much, but then later on my health starts to deteriorate, can I switch from one kind of coverage to another?

Matt Feret (23:39):

Not all the time. No, you can't. And some of these rules are state-based, and so if you have... I always recommend when people say like, "Hey, I've had cancer," or, "I had cancer in my 50s and it may reoccur," or, "I've got a family history that people get sick of congestive heart failure." I would say, if you're thinking about this, you should probably look at a pretty comprehensive plan. I know Medicare Supplements, or Plan Gs, are the most comprehensive medical ones you can buy. They come with a hefty premium, and normally when you buy a Medigap policy or Medicare Supplement, there are only certain other times of your life where you can get it without that medical underwriting. On the Medicare Advantage plan, you can actually switch every year. And so if you're 67 and you have a Medicare Advantage plan that isn't meeting your needs, and you want to switch it for the next year, you can do that during this timeframe we're in right now, the AEP, which ends on the 7th.

John Williams WGN-AM (24:35):

Janet, you're on WGN. What's your question? Hi. Hi, Janet, you're on the air. What was your question? Yeah, hold on. Let's try it one more time. Hey, Janet.

Listener Call-in (24:50):

... Price should just pay out-of-network, how does that work?

John Williams WGN-AM (24:54):

Start again, Janet, we missed the first part of your question. What did you want to say?

Listener Call-in (24:57):

Okay. Okay, I'm helping my sister navigate. She chose a Medicare Advantage plan and now she found out her doctors are not part of it, and they told her, "Well, that's okay. We can still service you, you'll just pay out-of-network." So is she going to pay that doctor's full price or is there still somewhat of a savings?

John Williams WGN-AM (25:19):

Okay, let me put you on hold and we'll them give us a starter answer to that. Matt, go ahead.

Matt Feret (25:24):

Sure. Hi Janet, thanks for the question. So it really depends on what type of Medicare Advantage plan your sister has. So if she has a Medicare Advantage plan that's an HMO, and the doctor is out-of-network, then you should really anticipate paying that full doctor's charges. If your sister's on a Medicare Advantage PPO, those come with out-of-network benefits, they're just not as good as in-network benefits. So that's one of those advantages of the PPOs that there is some coverage out-of-network, but not as much as if your sister had stayed in-network. So on the other hand, this is the time to look for a Medicare Advantage plan for next year, 2023, where her doctors are in the network so you don't have that exposure out-of-pocket and out-of-network.

John Williams WGN-AM (26:10):

Thanks Janet, that's a good start. Questions like this are answered in Matt Feret's book. You can find The Insider's Guide to Buying Medicare Insurance bookstores online. You can click on prepareformedicare.com, prepareformedicare.com. All right, Matt, nice to talk to you. Thanks for the help today.

Matt Feret (26:30):

Thank you.

(26:33):

Thanks again to John Williams and my publicist, Virginia Mann, for scoring those interviews. Until next time, to your wealth, wisdom, and wellness, I'm Matt Feret, and thanks for tuning in.

(26:51):

The Matt Feret Show, related content, publications, and MF Media LLC is in no way associated, endorsed, or authorized by any governmental agency, including the Social Security Administration, the Department of Health and Human Services, or the Centers for Medicare and Medicaid Services. The Matt Feret Show is in no way associated with authorized, approved, endorsed, nor in any way affiliated with any company, trademark names, or other marks mentioned or referenced in or on The Matt Feret Show. Any such mention is for purpose of reference only. Any advice, generalized statistics, or opinions expressed are strictly those of the host and guests of The Matt Feret Show. Although every effort has been made to ensure the contents of The Matt Feret Show, and related content, are correct and complete, laws and regulations change quickly and often. The ideas and opinions expressed on The Matt Feret Show aren't meant to replace the sage advice of healthcare, insurance, financial planning, accounting, or legal professionals.

(27:50):

You are responsible for your financial decisions. It is your sole responsibility to independently evaluate the accuracy, correctness, or completeness of the content, services, and products of and associated with The Matt Feret Show, MF Media LLC, and any related content or publications. The thoughts and opinions expressed on The Matt Feret Show are those of the host and The Matt Feret Show guests only, and are not the thoughts and opinions of any current or former employer of the host or guests of The Matt Feret Show. Nor is The Matt Feret Show made by, on behalf of, or endorsed, or approved by any current or former employer of the host or guests of The Matt Feret Show.