Matt Feret:

Alright, Olivia, welcome to the show.

 

Olivia Richardson:

Yeah, good morning. Thank you for having me. I'm really excited. I actually was looking at some of your other series and other of the shows that you've had. You have a lot of really intelligent people on here. So I'm really excited to be asked on today and really honored for sure.

 

Matt Feret:

Well, thanks. It's really nice of you. Let me just clarify. I have a lot of intelligent guests. I think that's what you meant to say.

 

Olivia Richardson:

No, you and I have gotten to work with each other in the past and I'm really excited today to kind of roll up our sleeves and talk shop. I know you are incredibly knowledgeable in a lot of this stuff as well. So it's not really often you get to talk to people who are excited about Medicare and excited about insurance. I'm really excited today to be able to do that.

 

Matt Feret:

Well, that's awesome. And yeah, so this is going to be a special kind of 2023 2024 Medicare edition, you know, released separately. And so let's let me start with my normal question. Tell everybody what you do, how long you've been doing it and how you help people.

 

Olivia Richardson:

Sure. So my name's Olivia Richardson. I'm currently serving as the Vice President of Corporate Alliances at Senior Marketing Specialist. We're an insurance brokerage. We have about 10,000 agents across the entire United States. And I've personally gotten to work with almost all of them. I measure my time here by AEPs, which we're currently going through right now. And so this will be my 11th AEP in the industry. So I've kind of seen. We've been going through a huge, we'll get into it, lots of changes and so I've kind of see the evolution of what's been going on throughout the last 11 years with Medicare. My primary focus and what I've done to kind of get excited and passionate about this topic, because again, you don't talk to a lot of people who enjoy the research, but my primary job here at Senior Marketing Specialist has been to train advisors. My role, and what I wanna do is I always wanna make sure that mom, dad, brother, sister, grandma, grandpa, that everybody's able to get access to healthcare. And the way that I found I've been able to accomplish that on the mass scale has been to train the advisors and make sure advisors really know how to best serve beneficiaries and how to best serve their clients. So that's where I've been able to focus the majority of my time is by training better advisors. And like I said, it's my 11th AEP doing so, and I've really enjoyed it.

 

Matt Feret:

Nice. Um, so this is the annual election period or the AEP. And even sometimes Medicare messes up and calls it the OEP, the open enrollment period, it's not,

 

Olivia Richardson:

Yes.

 

Matt Feret:

but basically it's the time period between October 1st and then October 15th to December 7th, where people can make changes to their Medicare coverage. Not

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

all of it necessarily, but a lot of it. And in my books. I have this little section, actually it's a chapter in the end called annual housekeeping and that's my way of saying, okay, not only do you have to make your decision first, but you know, what you may have picked at age 65 or 67 or whenever you went on Medicare may not be what you need at age 72 or 75. So talk to me about what that time period, what people should be doing during this time period.

 

Olivia Richardson:

Well, it's interesting that you say, and I agree with you, it's, you know, what you picked at 65 may not be what you need at 72. This year, what you picked at 75 or 65 may not be the same plane you needed at 66. This time of year, obviously, because with Medicare Advantage plans and prescription drug plans, you have to have special circumstances to switch during the year, and there are not a ton of these circumstances available to majority of people out there. So this time of the year is really your only chance, without talking into OEP, is really your only chance to review your plans, review your medications, review your lifestyle changes, and to make sure that plan's still gonna work for you the following year because you're gonna be stuck with it for the next 365 days. And you have about an eight week period, not including the kind of the looking period, the first two weeks, October 1st through the 14th. you don't really have a lot of time. There's Christmas, there's Thanksgiving, there's a ton of other holidays in there, then that timeframe is really busy for everybody. You got a lot going on. So it goes way more quickly than what a lot of people anticipate. So it's really important that you get in there early, talk to experts early, do your research early so that you're not left December 6th saying, oh man, I haven't even started looking at this stuff yet because it can get overwhelming pretty quick.

 

Matt Feret:

Yeah, and that's a good distinction you made too. So when I said it a little earlier before, I kind of flew right by it, but you pulled it back. So October 1st is when insurance companies and really insurance agents are allowed to talk about the benefits and what they may be and the types

 

Olivia Richardson:

sure.

 

Matt Feret:

of plans for the next year. This is called between the 1st and the 14th is Basically the time you can market it, advertise it, talk

 

Olivia Richardson:

Love

 

Matt Feret:

about

 

Olivia Richardson:

you,

 

Matt Feret:

it,

 

Olivia Richardson:

bye

 

Matt Feret:

but you can't

 

Olivia Richardson:

bye.

 

Matt Feret:

buy anything. You can't actually enroll in anything as a consumer. Starting October 15th, that's the first day that you can actually begin to enroll in something effective January 1st, and that ends at midnight on the 7th of December. So

 

Olivia Richardson:

Sure.

 

Matt Feret:

there's time and planning to your point. There is the... There is a little small window and it's not even doesn't even start on October 1st because you can't buy anything till the 15th Something happens before then though. That's really important right for consumers and that's at the end of September. What is that?

 

Olivia Richardson:

So at the end of September, consumers will start to get letters called ANOX. They're called annual notices of change. So in the industry, we try not to use jargon, but everything is hyphenated and abbreviated. So they're known as ANOX. But what these annual change letter reviews are is basically a letter explaining to the client, hey, these are the changes coming to your plan this year. And it's several pages long. There's a lot of verbiage to it. It's a lot of numbers. It kind of looks like trash, kind of looks like junk mail, so a lot of people will throw it away or just breeze over it and really don't pay attention to it. But it's a really important notification to let you know what you should be expecting from your plan come January 1st.

 

Matt Feret:

So if I get this big thing in the mail, does it come in email?

 

Olivia Richardson:

Some carriers you can elect to get your stuff via email. That option is not really heavily utilized, so majority of the time, and honestly all the time, it is gonna come in a mail format.

 

Matt Feret:

Okay, so I get this big stack of paper that I don't want to read. What should I read if I don't want to read the whole thing? Or what should I breeze through? What should I be looking for?

 

Olivia Richardson:

Yeah, if you're going to rely, and this is if, you have a couple options when you do receive this letter, if you are wanting to be self-sufficient and you're strong, independent, beneficiary, you do have the option to kind of review the information on yourself. And if you do wanna go that route, then there are portions of the ANOC letter that'll basically look like a summary of benefits. We'll say, here's what your hospital co-pay is gonna be this year. Here's what your premiums are gonna be this year. but it does exclude a lot of the information like formularies and things like that, provider directories. There are things that are not gonna be included in that letter that you really do need to make sure you know to make an educated choice come AEP. The other route is honestly one that I typically recommend, and that is to be paired up or to work with an advisor who is able to look at that plan, explain to you, and by an advisor I mean an insurance agent, but somebody who is able to look at those changes, they're able to look at your prescriptions, they're able to look at formularies, your providers, and make sure that everything that's included on that piece of paper, but then everything that's not to make sure all of that is considered when shopping for a new plan. So I'm pro agent, obviously with my job, my lifestyle, but I've seen what happens when people don't involve an agent. You don't know what you don't know. I mean, Medicare can be incredibly confusing when you start adding these letters, when you start adding. carrier advertisements, it's not an easy maze to navigate. And so to have somebody there who's experienced, who is unbiased and can give you real advice about what you should look at, at least going into the next plan year, it's worth having that guide.

 

Matt Feret:

And I say this in my book and elsewhere,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

if you're on a Medicare Advantage plan or you have a standalone Medicare Part D prescription drug plan, your plan will change every year.

 

Olivia Richardson:

Yes.

 

Matt Feret:

Something will change. I've never seen an example of any insurance product in those two lines that doesn't change. Premium, benefits, formulary, provider networks, dental. I mean, the list goes on and on and on, right? For everybody out there listening, you're gonna get something in the mail, you're not gonna wanna read it, you're gonna put it on your counter next to your fridge and stare at it for a while, and you're gonna put other mail on top of it. That's the one you gotta read and you gotta open it up.

 

Olivia Richardson:

Yes.

 

Matt Feret:

But Olivia, to your point, it's not all that's in there. So if I'm DIY-ing this myself, what else do I need to do? Do I need to go on my carrier's website and check the provider directory, see if my docs are still on?

 

Olivia Richardson:

Sure.

 

Matt Feret:

Do I go on Medicare.gov and type in my new prescriptions if I've had them? What do I do if I'm trying to DIY this thing?

 

Olivia Richardson:

If you're trying to DIY it, the first thing I would do is say a prayer, honestly,

 

Matt Feret:

Hahahaha

 

Olivia Richardson:

to the Medicare gods. And to your point, things do change. Sometimes the changes are for the better. Sometimes the benefits are better. They get richer, but a lot of times they're not. So there are tools and resources out there. If you are somebody that's wanting to, again, DIY it, to be able to do this on their own. Again, Medicare.gov is a consumer facing tool that does have some excellent resources. You can put in your list of medications, you can put in sometimes the providers in there. The problem with Medicare.gov is that unfortunately, even though it is a government associated website, it's not always the most accurate and there's not a whole lot of accountability to ensure that it's accurate. If you make an enrollment on there and the information either is inaccurate or changes and you weren't notified of those changes, then there's really all you have to do at that point. I mean, you call 1-800-MEDICARE, which is a call center located in Louisiana because the cost of living is lower there, so they can pay their people lower there. So you're calling that call center, and somebody's following a script to try to help you and navigate you through what mistakes were made or not made. So again, there are tools out there. Medicare.gov is one of them. If you care your websites, they are incredibly helpful. If you're wanting to go ahead and see, is my hospital still a network? Is my specialist still a network? You absolutely should be using those tools. But if you're doing that, then you're still kind of focusing in on what you currently have. If you were to do this on your own, then you might want to be able to use resources. Like you'd have to use multiple websites to really compare plans to make sure that you're on the one that fits your lifestyle and fits your budget.

 

Matt Feret:

Yep. You're right. And the and the do it yourself, the DIY piece, it's possible. It just,

 

Olivia Richardson:

Sure.

 

Matt Feret:

it's, it's tough. It's

 

Olivia Richardson:

it is.

 

Matt Feret:

not continually going back to my book, but I will hear it's

 

Olivia Richardson:

Well, it's a

 

Matt Feret:

you

 

Olivia Richardson:

good

 

Matt Feret:

can

 

Olivia Richardson:

book,

 

Matt Feret:

do it.

 

Olivia Richardson:

so you should.

 

Matt Feret:

Well, thanks. I mean, you can do it. It's just, you know, when you, you know, you open up, if you live in a city, and you go, what Medicare Advantage options do I have, you're going to pull up 60?

 

Olivia Richardson:

Yeah, yes.

 

Matt Feret:

Okay, which How do I start? When you, you know, I get even in rural areas, you pull up a Medicare Part D plan, you're going to have 30.

 

Olivia Richardson:

Uh huh.

 

Matt Feret:

Okay, which one do I do?

 

Olivia Richardson:

Thank you.

 

Matt Feret:

And so, all right, let me move into the next piece, right? So there are there are three ways to consume your Medicare insurance, right? The first

 

Olivia Richardson:

Uh-huh.

 

Matt Feret:

way is I call bear with Medicare. You keep on you stay on original Medicare Parts A and B, the red, white and blue card, and you have to buy a standalone Medicare Part D prescription drug plan. Okay. You have to buy that from an insurance company because there isn't a federal default option that's always sold by an insurance company. And the

 

Olivia Richardson:

Right.

 

Matt Feret:

next

 

Olivia Richardson:

I always

 

Matt Feret:

way

 

Olivia Richardson:

call

 

Matt Feret:

to do

 

Olivia Richardson:

that

 

Matt Feret:

1. Ha

 

Olivia Richardson:

Medicare Part U. I heard that

 

Matt Feret:

ha.

 

Olivia Richardson:

it was actually Dan Mangus, who is really well known in the industry, says it's A, B, D, and U, because you're paying the rest of it,

 

Matt Feret:

That's

 

Olivia Richardson:

which

 

Matt Feret:

funny.

 

Olivia Richardson:

is a really clever way to remember that.

 

Matt Feret:

Yep, yep, I like that one. So bear with Medicare or Medicare plus you. That's funny.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Either which way, right? You've got original Medicare plus a D. And the second way is the same version except you add a Medicare supplement plan on that. And I'm gonna save Medicare supplements to the end of our conversation for a couple of reasons which will become apparent. And then the third way is to buy kind of that all in one combo plan, i.e. Medicare Advantage where you've got... Your A and B benefits rolled into D benefits all in this thing called Medicare Part C. All right. Now, Medicare Part C, the Medicare Advantage, those are the ones that I say change every year without fail. Their 12-month calendar period, right? They start, your benefits start on 1-1, they end on 12-31. If you do nothing, it just rolls over into the next plan of the year, right? If it changes, if it goes up, if it goes down, if it gets better, if it gets worse, whatever, if you don't do anything during the AEP, you just keep getting what you're getting. Same with part D, right? One, one to 1231. If you do nothing, whatever they tell you, if the benefits go up, they go down, right? The ear drug is on the formulary, not on the formulary, your premium goes up, your premium goes down, whatever. If you do nothing, it will just roll over. So there is a do nothing option here. However. There are changes that are made, as I said, to both of those programs every year, but there are also changes to the way Medicare themselves make companies change their benefits. And those are changing every year. So let me start with Medicare Advantage first, since I think right now half the Medicare population is on a Medicare Advantage. Let's go there. What big changes are being made either by the carrier or enforced or being told to the carriers? from Medicare are happening that aren't getting much press and may be surprising to people.

 

Olivia Richardson:

Right, right. So I'd start off with saying, in the past three to maybe even five years, we've seen Medicare Advantage plans remain actually really stable. And so people who are having these conversations about like, you know, do I need to shop? They may not be used to actually having to do a lot of research, may not have to been previously used to doing a whole lot of shopping. That's gonna be pretty different this year. This year, we're expecting a ton. of market shakeup, a ton of benefits going up and benefits going down for people. So this year, why is there so much shakeup? There's several different reasons for that. Number one, Medicare Advantage plans and prescription drug plans. A lot of the funding for those plans come from CMS, Centers of Medicare and Medicaid Services. This year going into 2024, previous years we saw the funding just increase and increase. This year we saw it actually take a significant step back. They didn't get near the funding that they had previously and near the funding that they had expected. So we're seeing where that, you know, we have to remember these companies, these insurance companies, they are for profit. Their number one concern is to make money at the end of the day. So they're not gonna eat those costs. They're gonna make sure they're adjusting those benefits to where they're still able to hopefully remain profitable at the end of the day. And those benefits are gonna be consumed by. the consumer, the beneficiary. So some of the things that we're seeing, some major changes, I'll start with Medicare Advantage Plans. Number one, you're going to see some investments in the shiny, I know that's kind of what you and I referred to it as earlier. We're gonna see some investment in the shiny stuff and maybe some detrimental stuff happening to the actual health and benefits. And we call them the secondary benefits. By secondary benefits, I'm talking about those benefits that don't show up on your Medicare card or don't show up on your insurance card. You'll have your copay for your doctor, ER copay, things like that. What I'm talking about, things that you might see take some significant increases are gonna be things like your specialist copays, ambulance rides, skilled nursing care, some of those things that are true and things that can cost more money, you're

 

Matt Feret:

But they

 

Olivia Richardson:

going,

 

Matt Feret:

don't jump

 

Olivia Richardson:

you really

 

Matt Feret:

out at

 

Olivia Richardson:

need

 

Matt Feret:

you.

 

Olivia Richardson:

exact.

 

Matt Feret:

Yeah, they don't jump out at you, yeah.

 

Olivia Richardson:

Exactly. They're the ones that are going to be seeing some of these increases. So you really need to pay closer attention. Now, things that we're starting to see this year continue to raise up are going to be those new and Chinese. And so we're seeing huge investments being made into dental benefits. We're seeing huge investments being made into flex cards, which are like grocery benefits, over-the-counter drugs. And I'll say that when we look at the utilization of those benefits, is actually really low utilization. Some of these plans are offering thousands of dollars a year in groceries and healthier groceries. And it gets your attention, you can get really excited about it, it's easy to sell that. But when you see people actually utilize those benefits, the utilization is quite low. So it grabs your attention, but it's not what you should be purchasing your plan off of. You really need to remember, this is a health insurance. Buying this insurance is the difference between you recovering in a hospital or you recovering in a home or in a less than great situation. So you really need to remind yourself or be remembering that you need to pick a plan based on those benefits. A big example of that is going to be these Part B give backs. People know like this is big commercials

 

Matt Feret:

Yeah,

 

Olivia Richardson:

that

 

Matt Feret:

what?

 

Olivia Richardson:

everyone wants to talk about.

 

Matt Feret:

Yeah, yeah, you used and I know you did because we're both in the industry,

 

Olivia Richardson:

Yes.

 

Matt Feret:

but you used a phrase that not everybody's gonna know. So what is a part B give back plan?

 

Olivia Richardson:

Yes, a Part B give back is one of, I'm sure you're hearing about it, it's everybody wants to talk about it, the Joe Namath and the JJ Walker advertisements. What it is that the carriers are essentially saying, hey, if you enroll into this plan, then we will make sure that if you're getting your Part B, if you're paying for your Part B out of your Social Security, we'll just take less out of your Social Security. You'll see less of that being deducted from your Social Security account each month. Or if you're paying for your Part B via a check. quarterly, they'll say, we're just going to bill you less. It's called a Part B give back. You're not actually receiving that money in your hand. They're just taking that money and deducting it from your Part B premium each month or each quarter. And so the interesting thing about those is that they are, again, when Deft Research has a lot of really valuable information, they survey the beneficiaries to try to figure out, how are we thinking? What does the United States have to say about their insurance? One of the top reasons why people are interested in shopping plans is for these Part B givebacks because they're new and shiny and they sound great. But keep in mind, again, insurance carriers are for-profit organizations. When they're using these new and shiny things, dental, travel, those flex cards we talked about, they're anticipating a lot of low utilization on those because that's what history has shown us. People don't use rebates. are 100% utilization. They are by far the most expensive bell and whistle that a carrier can offer, because it's 100% utilization. We can imagine if Medicare continues to see a decrease in these plans and the price of everything continues to go up, it's very likely that carriers are going to quit offering these bells and whistles, especially that part B rebate, part B give back. So if you're buying a plan and that's the reason why you're buying it, you're making, you know, if you're going from a Medicare supplement to a Medicare advantage, especially you're making a pretty permanent decision on something that could potentially be very temporary. So it's just extra things to consider when you're looking at buying health insurance. You're not buying a gym membership. You're buying health insurance.

 

Matt Feret:

Yeah, I always come back to a couple of things and you and I have both been doing this for a long time of you want stability, right? You want stability in your premium, you want stability in your network, you want you, you don't want to have to mess with it. I mean,

 

Olivia Richardson:

I'm

 

Matt Feret:

nobody

 

Olivia Richardson:

sorry.

 

Matt Feret:

wants to nobody wants to mess with it every year. I get it.

 

Olivia Richardson:

Sure.

 

Matt Feret:

Yet sometimes you're forced into messing with it. And I think what you're saying is, and tell me if I'm hearing this incorrectly is that when you make an initial purchase of, in this case, a Medicare Advantage plan, really gives some thought to how long that plan has been there,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

what that star rating looks like. Do the benefits look the same a year ago as they do next year or very similar? Because you're right, there are many examples around the country of insurance companies opening up new plans. with, I think I call them in the book, you know, shiny objects. Don't get

 

Olivia Richardson:

Excellent.

 

Matt Feret:

blinded by shiny objects. You know, they'll offer $5,000 worth of dental.

 

Olivia Richardson:

Right?

 

Matt Feret:

OK, that's great.

 

Olivia Richardson:

Sure.

 

Matt Feret:

But what are the medical benefits look like? What do the prescription drug benefits look like? You mentioned Part B givebacks. Well, I just use the industry phrase. Basically, it gives you a credit on your right. It gives you a little credit. It's actually not zero dollar premium. It is zero dollar premium. And they don't take as much out of your Social Security check.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

or if you have to pay it quarterly, then

 

Olivia Richardson:

Sure.

 

Matt Feret:

you have to pay less. My impression is those benefits don't always last.

 

Olivia Richardson:

Sure.

 

Matt Feret:

And that's what I think you're saying too, is

 

Olivia Richardson:

Yeah.

 

Matt Feret:

that I've seen Medicare Advantage plans that started in 2007 and they're still here today.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

And I've seen Medicare Advantage plans that get introduced and two years later, they're deleted. they're gone. And when that happens, there's a scramble. So they can't cancel you, but they can cancel the plan you're on. And when that happens, you'll get a notice in the mail that says, hey, we're no longer offering that plan. In other words, if you do nothing, you're going to go right back to original Medicare, and then you're forced to take action. So that's my extended way of, I think, spitting back to you what I heard, which is be really intentional. on the plan choice you're making on Medicare Advantage. Don't just pay attention to the bright shiny objects. Pay attention to its stability, its longevity,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

and yes, its benefits. And if you've got a good reason or a healthcare reason or need some dental work done or are really attracted by some of these new things plans are offering, I think what you're saying is, yeah, consider it, but make sure it's ranked in your brain the appropriate.

 

Olivia Richardson:

And what I'm not saying is I don't want to demonize Medicare Advantage plans. Medicare Advantage plans can be fantastic options. Several of my friends, some of my people that I advise, they have Medicare Advantage plans because they looked at the benefits, they looked at the health care, they weighed their priorities. Where did they want to save money? Do they want to save money upfront and willing to pay for it later and copay in other situations? or were they wanting to work at the budget and spend a lot more upfront with the Medicare supplement? So I don't want to come across saying like Medicare Advantage plans are bad. They are not. They are fantastic options for a lot of individuals out there, but you just have to know how to shop for them. And to the other point with medic, you know, talking about wanting stability, Medicare Advantage plans are not the only people or not the only companies or plans. that have come in with that mindset. We're gonna come in shiny and awesome and then get what we can for a couple of years and then we're gonna get out of there. We've made our money, now we're gonna get out of there. Other plans, including Medicare supplements, have done really similar things. They can come in with incredibly low premiums and look at how cheap we are. We're 50 bucks a month cheaper than our competition. Come buy us wherever. Our Plan G looks just like their Plan G. But then... a year, two years down the line, they start hacking up those premiums as well. So across when you're shopping for any insurance, regardless of if it's a Medicare supplement or a Medicare Advantage plan, you need to make sure you're looking at more than just new and shiny. You need to make sure you're looking at more than just premium. And again, that's why it's really nice to have a true advisor that help guide you through that. Because you as a beneficiary, how are you supposed to know that? How are you supposed to know how to shop for that? That's why. It's best to work with an expert when it comes to those questions.

 

Matt Feret:

What other changes in the Medicare Advantage space are you seeing that, um, aren't well publicized or well known yet that people need to be looking for when they're opening their mail or considering their current or a different plan.

 

Olivia Richardson:

Yeah, the biggest thing that can come to mind is with Medicare Advantage, but more so focuses on the prescription drug sides of things. And that's gonna be check your formulary. There are some significant shakeup that on paper looks pretty cool and really awesome, but when you dig into what it actually means can be a little concerning. So prescription drug plans, we're looking at, again, when we're looking at prescription drug plans, we know those are carrier. own. There's not just like a Medicare drug coverage. You have to go through particular carriers for that. In the past, you know, we can expect to see some significant increases and just general cost for prescription drugs this year, either by the premium of the plan or by the formulary. And I'll expand on that just a little bit. Let's start with premium. So we're seeing a huge increase across the board for drug plan premiums. And for example, last year, when we look at the national average of drug plan premium, the national average premium was about $33, give or take 50 cents. Going into 2024, that national average has almost doubled. We're seeing $64 as the national average premium. So a lot of people are going to look at that and be like, well, you know, I have a Medicare supplement. This affects my Medicare supplement people. Medicare Advantage clients, of course, that's built into that plan. might be a little anxious about, well, how do I pay for the Part B premium? How do I pay for my MedSupp premium? Now I have this drug premium. So those same people are gonna be really attracted to what we're seeing kind of at the exact opposite of this. You're gonna look at these options, be like, well, this Olivia person told me everything's so expensive, but I'm seeing a drug plan here for a standalone drug plan that's 50 cents, that's completely zero dollar. And so that's gonna be really attractive to people. It's so imperative this year, regardless of what plans you've been on the past, please, please run your drug list. And when I say run your drug list, what I mean is look at your prescriptions you're taking that are long term prescriptions for your chronic conditions and make sure that drug plan is going to continue to cover them at the costs that you are comfortable with and familiar with. When we're seeing these plans take their premiums next to nothing, then they're making up for that cost somewhere. And oftentimes that means a lackluster formulary or maybe having to taking advantage of the entire deductible when maybe they haven't in years past. I can get into the science as to why this is happening. Nobody cares, but long story

 

Matt Feret:

Thank

 

Olivia Richardson:

short,

 

Matt Feret:

you.

 

Olivia Richardson:

what it comes down to is that the government is putting, thanks to the Inflation Reduction Act put into place a couple of years ago, the government's putting a lot of pressure on making prescriptions. affordable and making drugs more affordable and they're putting that pressure on insurance companies and so huge and so Carriers are trying to find out again. These are for-profit companies. How do we help facilitate that cost? You're they're gonna see it in the premium this year or you're gonna see it and just formulary is just dying off

 

Matt Feret:

Hmm. And that approach is really a market approach that you described. So

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

if the, if the insurance companies are being asked to cover more or more comprehensively drugs, prescription drugs, then one company might say like, okay, well we'll cover the same or similar, but our premiums are going to go up by 50% and another company might go, well, we think there's a market opportunity here to build more customers. We're going to actually cut our monthly premiums. but our formularies and what recover is gonna be cut as well. Is that what you're saying?

 

Olivia Richardson:

That's exactly, I mean, if you look at it from what makes sense business wise, they really don't have an option. They have to make a profit on this. And so, it's going to, one or the other is going to be affected. Exactly what you said.

 

Matt Feret:

So if there's this, you were talking about standalone Medicare Part D plans, which are either, is what you use if you're either option one, bear with Medicare, or option two, bear with Medicare plus a Part D plus a Medicare supplement. But also, number three is impacted here too, which is Medicare Advantage, because as you know, Medicare Advantage takes medical benefits of A and B

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

and D and rolls them all into Part C, which is Medicare Advantage. So...

 

Olivia Richardson:

Yeah.

 

Matt Feret:

Part D within Medicare Advantage is probably impacted as well. If I have a Medicare Advantage plan, what should I be paying attention to specifically around my drug benefits embedded within it?

 

Olivia Richardson:

Sure. So Medicare Advantage plans are actually getting hit twice as hard as your standalone prescription drug plans because there's something happening as well on the health side of things. So your Medicare supplement, they only have to worry about the health stuff. There's part B claims are going up due to the effects. We're still seeing the effects of COVID, people delaying care, people delaying. So you're getting more serious diagnoses because people are just now making those claims. And so with Medicare Advantage plans, not only do they have to handle the rising costs of healthcare and the rising costs of claims, especially for the turning 65 year olds, they're also having to figure out how are they gonna pay for these drugs, these drug benefits and handle the premium. And again, people know that what makes Medicare Advantage plans so attractive are gonna be those really low, if not $0 premiums. So a lot of the times they don't have the opportunity or the option. to raise up that drug cost, because it's really difficult to go from a zero dollar premium to a 64 dollar premium. So you're gonna see them

 

Matt Feret:

Yeah,

 

Olivia Richardson:

not

 

Matt Feret:

you're

 

Olivia Richardson:

so

 

Matt Feret:

going to

 

Olivia Richardson:

much.

 

Matt Feret:

lose a lot of customers that way.

 

Olivia Richardson:

Exactly,

 

Matt Feret:

Yeah.

 

Olivia Richardson:

it's a lot harder to go from zero to 64 than it is to go from even like 30 to 90, that's the psychology behind it. So you're seeing these Medicare Advantage companies really have to cut elsewhere, because a lot of them are gonna be unwilling to get rid of. the things that gain the market's attention, including the low premiums and the new and shiny, but they still have to have a cost for these drug plans. So I think a lot of that what you're gonna see is, again, a lot of these companies are really focusing on the dual special needs. What I mean by dual special needs are gonna be people who have access to both Medicare and Medicaid, because Medicaid will help with low income subsidy, will help kind of pick up that Part D bill, will kind of help pay for those prescriptions and the drugs. So you're seeing a lot of Medicare Advantage companies shift their focus into some of those more specialized markets and you're seeing some of the plans that are, again, designed for the average 65 year old, 65 and up, you're seeing some of those plans maybe take some of those hits on what you mentioned earlier, those secondary benefits, those ones, the benefits that don't show up on the insurance card.

 

Matt Feret:

Okay. So pay attention to your, what your Medicare Advantage plan is doing.

 

Olivia Richardson:

Yes.

 

Matt Feret:

Because if your premium is staying the same, that probably warrants more inspection. Because the market has changed, the costs that the insurance company have to bear are greater than they were in prior years.

 

Olivia Richardson:

Exactly. It's not going to be, and again, it's, um, it's, they're not going to affect the sexy benefits. They're not going to affect what people talk about, what Joe name is, and, and these advertisers are not going to affect what they're talking about. They're affecting your actual healthcare benefits. So it's really important. Again, there are still some wonderful plans out there, some amazing plans with really rich benefits. You just got to do a little bit more research than what you're probably used to doing.

 

Matt Feret:

Yep. Makes sense. Okay. I'm going to pivot to Medicare supplements because Medicare Part D and Medicare Part C, Medicare Advantage, really run by very similar rules, right? In the annual election period, you can change your Medicare Advantage plan regardless of your health status during this time. You can change your Part D plan regardless of your health status at this time. There's no underwriting. There are no medical questions. You just go. If you're in Plan A and want to move to Plan B between October 15th and December 7th, work with your agent, do it yourself, you can do it. No questions asked. This is your time to make your annual change. Medicare supplements don't play by those rules because Medicare supplements are state regulated. Yes, they're federally regulated, but they're state regulated at the state level and they don't play by the same rules because A, they're older, they've been around for a very long time. So they're kind of entrenched, but B, they have different schedules. They don't have the same schedule. They don't have the same schedule of when you get your renewal letter and know what your rate is going to be for the next year, whether or not the company is going to stay in business. I mean, it's a whole kind of other thing, even though it's part of the Medicare insurance ecosystem. Let's talk specifically about what you're seeing in the Medicare supplement space.

 

Olivia Richardson:

Yeah. And I'll just want to remind everybody too, if you're listening to this podcast and you're like, well, they've not talked about me or hit me at all. I'm a med set person. I will let you know that the number one time of year where people change Medicare supplement plans is in the fourth quarter is during an EP because you're reviewing your drug plans and trying to find extra dollars. So this does absolutely this time of year absolutely still affects you, just not in the same way. The Medicare supplement market right now, for lack of a better term, they're a little nervous because of the popularity that Medicare Advantage plans have offered and the option of I can get great benefits and even more benefits and pay much less. The Medicare supplement, what we're seeing right now, because of, again, a couple factors that come into it. I know we're all sick and tired of talking about COVID, but COVID is a lot of, it's affecting Medicare supplements right now. as well as again the growing popularity of Medicare Advantage. And finally, our turning 65ers, our baby boomers who are finally reaching Medicare age. To go into that a little bit more, what we're seeing for trends, let's just focus on the turning 65ers. What we're seeing as a pretty significant trend is that what used to be the most popular, the most profitable book of business for insurance companies are actually causing the biggest losses. These, the turning 65ers, on average are actually costing these insurance companies a lot of money. And that is because the claims that they are submitting are by far outweighing the premium that they're paying in. So they're costing these insurance companies dollars, not making them dollars. And it's completely understandable why. We're finding that many people turning 65 are delaying significant surgeries, either because they wanna wait until they're on their Medicare benefits. or because they want to wait until they retire and actually have time to recover from that. So that's something that the insurance companies are having to adjust to. What used to be most profitable is now starting to see, like, hey, this is actually, you know, they're changing their marketing strategy. They're saying, we maybe don't want those 65 year olds. We may not have the nicest premiums for the 65 year olds. We'll be more attractive to people who've been on Medicare for a while. And so

 

Matt Feret:

Ugh.

 

Olivia Richardson:

what a lot of people are seeing with that is, higher entry cost, higher cost to a Medicare supplement than what they may have been led to believe was gonna actually happen to them. And then you're also seeing maybe some more premium increases down the road because they have to make up for that loss, the 65ers have to make up for that somewhere. So you're seeing, again, we kind of hit on this earlier, but companies that are coming out saying, we're gonna come out really competitive, really affordable, really cheap. You're starting to see a year or two in. they have to accommodate and you start seeing some rate increases. So if you're in a state that offers these guarantee issue rules, we're talking about these anniversary rules, we haven't really hit on that yet, but a lot of these states are seeing that, that seeing our people are getting enrolled into these plans and then having some significant rate increases that they just can't afford. So states are trying to, again, these are state ran, they're trying to cut a lot of these beneficiaries a break by saying, okay, so for example, I'm from Missouri. So we have, and this is not a new rule for us, but we have what's called the Missouri Anniversary Rule. That means at my policy anniversary, I can switch to any plan that I, or any carrier that I want, but I have to stay with my same plan. So if I'm on a Plan G with Mutual of Omaha during my anniversary, I can switch to a Plan G with UnitedHealthcare and not have to go through any medical underwriting. That sounds amazing. That sounds really awesome. It sounds like you're giving seniors, or excuse me, beneficiaries an opportunity to... you know, shop and remain on low cost plans. But if you look at Missouri's premiums compared to somebody like Kansas, where they don't have those rules, Kansas premiums as a whole are a lot lower than ours because they don't have to accommodate for those loss ratios, because there's not a bunch of people, sick people switching plans. And so if you are in a state that's recently reviewing what those rules are, I'm looking at Illinois, Missouri, Louisiana, Nevada, there's so many of them that are coming out. Oklahoma just launched one. Just be prepared that sounds great on paper, but you might be expecting to see some rate increases that you may have not been familiar with in years past.

 

Matt Feret:

A very good point and you're right. The states are making those rules for the benefit of the beneficiary, right?

 

Olivia Richardson:

Really?

 

Matt Feret:

Because if you don't have those anniversary date or there's birthday date rules in there that you can do in your particular state what you just described, which is,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

all right, I turned 65, I bought product A, a plan G, that's up plan G. Turn 70, I don't like this company anymore or my

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

rates are going up. What else is out there? in non-birthday rule or non-anniversary States, you're kind of stuck.

 

Olivia Richardson:

If you can't answer health questions,

 

Matt Feret:

Right.

 

Olivia Richardson:

if you're 72 years old and still running marathons, you're fine. But

 

Matt Feret:

Yeah,

 

Olivia Richardson:

if

 

Matt Feret:

you

 

Olivia Richardson:

maybe

 

Matt Feret:

can go

 

Olivia Richardson:

you

 

Matt Feret:

through

 

Olivia Richardson:

have...

 

Matt Feret:

medical underwriting with another carrier and get it. But if you're not running marathons

 

Olivia Richardson:

Right.

 

Matt Feret:

and you're getting over cancer or had a heart attack or had a stroke, you're going to be in that med sub program unless you drop it and go back to original Medicare.

 

Olivia Richardson:

Absolutely.

 

Matt Feret:

And so what I think states are doing and what you're saying is I don't like that. And they want to give people the option to switch plans and save money, which is great from the consumer

 

Olivia Richardson:

on paper.

 

Matt Feret:

standpoint,

 

Olivia Richardson:

Absolutely.

 

Matt Feret:

right? The problem with that is, you're right, the insurance companies know that and see that and are going to price accordingly.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Because here's another way I'll explain it, and this kind of goes back to Medicare Advantage and D, and you touched on it. When you're on a Medicare Advantage or a Medicare Part D plan, the federal government is sending a certain amount of money and I'll say subsidizing that care by sending some money to the insurance carrier.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

right, in addition to whatever premium you're paying to pay for your care. The Medicare supplement plan isn't getting any of that. So if you have a $200 monthly premium, right, that's going to be $2,400 a year for the insurance company. And you go, Oh, that's a lot of money to the insurance company. It is. Unless you go into the hospital in that year and charge $500,000. Those numbers don't work for anyone. I mean, if you're running a small business and you have $2,400 of income, yet

 

Olivia Richardson:

I'm not

 

Matt Feret:

you have

 

Olivia Richardson:

great

 

Matt Feret:

$500,000

 

Olivia Richardson:

at math, but I

 

Matt Feret:

worth

 

Olivia Richardson:

know that

 

Matt Feret:

of expenses.

 

Olivia Richardson:

doesn't math. Doesn't math.

 

Matt Feret:

That doesn't matter. Yeah, I'm not a math whiz either, but you get the point, right? So there is no subsidy. There is no additional funding. So basically it's old school insurance, right? You have a pool of people, you know, the healthy ones have to pay the $2,400 a month or a year, right, and not use it to help the other people who are also paying $2,400 a month, but charging 500,000. That's kind of the whole like people in the pool. And the more people in the pool you have, the fuller it becomes. The more one or two people in the pool get sick. Well, they're fine. Cause everybody else is paying for them. That's and, and when that breaks down or people leave the pool in these state based rules, carriers are left with some options,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

take losses, right? Active losses, real money or raise rates. And that's what you're saying. That's what, that's what it's looking like they're doing.

 

Olivia Richardson:

And it's magnified because unless you're in a community-aged or community-rated state, the people who are paying the lowest premium are people with the highest costs or the people who are experiencing the most claims. So your 65-year-olds, because they're aged younger, it's assumed that they're healthier and that's how they actuary and that's how they bill these rates. But when we're seeing that people are waiting until they get onto their Medicare and Medicare money being spent is coming from the people who are paying the least amount in. So it just kind of magnifies that effect. Hahaha

 

Matt Feret:

Yeah, that's not a great scenario you just painted.

 

Olivia Richardson:

I don't want to bring it down and be sad. It's just incredible research and just trends to keep in mind.

 

Matt Feret:

Yeah, no, that's really good. So if someone is thinking this time of year, I get this question all the time.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

It's kind of a cost benefit analysis, but it's also like it's a hard question to answer. If someone is thinking of moving off a Medicare supplement because they've been on it for whatever, two, three, five, six years, and the rates have gone up, And they'll get another renewal notice and say, oh, surprise, it's another 14%. And they go, gosh darn it. My neighbors are on these programs, but I'm a little suspicious of it. It's unfamiliar. Medicare supplements, easy. No provider networks. On a Plan G, all you have to do is satisfy your Part D deductible, and then you don't pay any more in medical. They're sweet. I mean, we call them in the industry Cadillac plans, because that's what they are.

 

Olivia Richardson:

It's

 

Matt Feret:

They're

 

Olivia Richardson:

as easy

 

Matt Feret:

very

 

Olivia Richardson:

as it gets.

 

Matt Feret:

little. Yep, easy as it gets. provides the most, I'll say comprehensive financial protection

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

that you can. But those premiums are real, and especially if it's mom and dad,

 

Olivia Richardson:

Right?

 

Matt Feret:

and you're saying, you know, that's two premiums a month you're paying, and part D is going up potentially. That's a lot of money coming out of your pocket now. That you know, regardless if you get a social security check increase this year or not, it's a lot of that's going to be eaten up by the increases to your premiums. So Someone's in this scenario and they're going, I'm on a MedSupp, I love it, but man, I don't love the prices.

 

Olivia Richardson:

Yeah.

 

Matt Feret:

If they're thinking of moving to a Medicare Advantage, what thought process should they take? What thought process could they embark upon?

 

Olivia Richardson:

I love that question because I think something that we find really interesting is that deaf research has actually looked at this demographic of people saying like if you know people who they call them the switchers from Medicare supplement to Medicare Advantage and they're finding that over half of the individuals ended up regretting it not because the plan was a bad plan but because they were under educated about what that move actually meant. So I do, I work with a lot of people who have moved from that Medicare supplement and made the jump into Medicare Advantage plan and have been incredibly happy doing so. Unfortunately, there isn't a blanket answer for this because every situation is different based on again, lifestyle and budget. And honestly, what you have as a priority. The one thing I would mention if people were asking me this question, because I do get this question, and it's simply taking a look and saying, when do you wanna pay? When do you want to pay this money? Are you okay? And how do you want to budget your healthcare fund? Do you want to pay for it in the beginning, knowing that the rest of it is taken care of? Or do you want to say, let's go ahead and save this money away and instead of putting this premium here, let me save it for a rainy day and make sure that if I do go in the hospital for an extended stay, if I do have to see somebody out of my network, I feel comfortable being able to cover that after the fact. Am I disciplining myself well enough to know that I'm not paying it here, but I may have to pay it back there. Either answer is a good answer. It just has to be what's right for your priorities. Other thing I would mention is that if you are wanting to say like, I'm hearing a lot about this, this seems pretty, I need a significant amount of dental work done, or I need, you know, I really am interested in paying, you know, a zero dollar premium on this. What I would say to them is, is this your first time ever? going on a Medicare Advantage plan and really look at the history of their coverage because you may not know, you may not know what you've had in the past. But what CMS has done is allowed people kind of, they call it a trial right period. That if you've been on a Medicare supplement, I don't care if you've been on a Medicare supplement for one years or 15 years, if you've only been on a Medicare supplement plan, they give you 12 months to kind of look at what it's like to have a Medicare Advantage plan. If within that next 12 months you say, you know what, I don't like it, it's not what I thought it was gonna be, my doctor just left the network, because that can happen in the middle of the year, then you have a 12 month window to go back to that same Medicare supplement company and that same Medicare supplement plan and basically act like nothing ever happened. You can then enroll in a standalone drug plan and it's kind of all is forgiven. You kind of pretend like the last five, six months, whatever, however long you're on there, pretend like that didn't happen. The exception to that is if you're on a really old Medicare supplement and they no longer offer that company or that plan anymore, then you do get what they call a guarantee issue right to try another Medicare supplement company or plan. But we do, again, that does happen. So if you want to try a Medicare Advantage plan for the first time, just be conscious. You do have an opportunity, but it's only 12 months. So get the most out of it, see if you actually like it, and then we can put you back on MedSupp.

 

Matt Feret:

Makes a lot of sense.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Let's flip it. Let's flip it. Let's say I'm on a Medicare Advantage and I'm past my guarantee issue rate, right? I'm 70, 72. And I've been on a Medicare Advantage for a year or two or three or four. And I don't like it. And I do want to change my coverage to a Medicare Supplement. What's that process look like?

 

Olivia Richardson:

Yeah, absolutely. So what's funny about that process is that timing is everything. So know that if you are, you've been on the Medicare Advantage plan, you no longer qualify for a trial, right? Then what you will have to do is you will have to answer medical questions, which means that you have to qualify for that Medicare supplement. The last thing you want to happen is to enroll into a Medicare supplement and enroll into a standalone drug plan. And then come January 1st, You find out that, well, this condition, we don't cover that, or you were denied coverage due to your health or something that you may not be familiar with, and come January 1, you now have original Medicare. You're in that first option we talked about, the Medicare and you. You have A and B, and you're covering everything else outside of the drug stuff. So timing is everything when it comes to this. If you are wanting to make that route, you have two options. If it's early. In AEP, I'm talking October 15th through like November 10th would probably be where I would feel safe doing this. If you're in that first few weeks of AEP, go ahead and submit a Medicare supplement applications. Go ahead and qualify underwriting, work with an agent to find out which company is right for you. Once you get told, yes, we accept you, you're healthy enough, here's the premiums that we're gonna have for you and you're happy with that, then go ahead and enroll in a standalone drug plan. What a lot of people don't know is that when you enroll in a standalone drug plan, CMS will say, well, you can't do that. You can't have a Medicare Advantage plan and a drug plan. You submitted this drug plan. We're gonna go ahead and kick you off this Advantage plan effective January 1st. So if everything goes to plan, January 1st, you have A and B of Medicare, your Medicare supplement and your drug plan. If you miss that window, and the reason why I give that window is because sometimes when you have to answer medical questions, Medicare supplement companies can take a long time to actually go through and underwrite you. They can take a long time to make a decision because they're really busy. So if you miss that window, then we have something called the open enrollment period, not to be confused with the annual enrollment period, which again,

 

Matt Feret:

Yeah,

 

Olivia Richardson:

carriers

 

Matt Feret:

but as I

 

Olivia Richardson:

can't

 

Matt Feret:

said,

 

Olivia Richardson:

really figure it out.

 

Matt Feret:

they

 

Olivia Richardson:

They

 

Matt Feret:

are two different things that drives me

 

Olivia Richardson:

are.

 

Matt Feret:

nuts that people use them as synonyms. They're not the same

 

Olivia Richardson:

They are not interchangeable.

 

Matt Feret:

thing.

 

Olivia Richardson:

They have

 

Matt Feret:

Memo

 

Olivia Richardson:

very distinct

 

Matt Feret:

to Medicare

 

Olivia Richardson:

differences.

 

Matt Feret:

marketing people in Baltimore, stop calling it the OEP in

 

Olivia Richardson:

Someone

 

Matt Feret:

December

 

Olivia Richardson:

fix this.

 

Matt Feret:

and November and October. It's not.

 

Olivia Richardson:

Someone fix it. But

 

Matt Feret:

Use

 

Olivia Richardson:

during

 

Matt Feret:

your

 

Olivia Richardson:

the...

 

Matt Feret:

own acronym. It's the

 

Olivia Richardson:

Exactly.

 

Matt Feret:

annual election period, the AEP. All right, go

 

Olivia Richardson:

So

 

Matt Feret:

ahead.

 

Olivia Richardson:

let's

 

Matt Feret:

I'll

 

Olivia Richardson:

not

 

Matt Feret:

get

 

Olivia Richardson:

be

 

Matt Feret:

off

 

Olivia Richardson:

confused.

 

Matt Feret:

my high horse.

 

Olivia Richardson:

No, no, but to your point, there, did you know, again, I'm sure you know this, but to our listeners, there are three different types of OEP. None of them, including the AEP, which people use interchangeably. There is three types of OEP. This is maddening and of course so confusing. But the OEP that I'm referring to, which is referring to Medicare Advantage OEP, goes from January 1st to March 31st. And I call this kind of the mistake fixing one. Now this will only affect people who are in a Medicare Advantage plan going on January 1st. If you are in a standalone drug plan, this doesn't affect you whatsoever. So those people who are on a Medicare Advantage plan starting January 1st, they get a one more chance. They get a one more chance to be like, are you sure? Are you sure you wanna be on this particular plan? And during that time, a beneficiary can then underwrite through a Medicare supplement plan, then they have a little bit more time. You have three months at this point. You can enroll into a Medicare supplement, then once your plan, and only once you have confirmed that your plan has been approved and you have coverage, go ahead and enroll in that drug plan. It'll kick you off the Medicare Advantage plan and you can go throughout the year. on your Medicare supplement. And if you are somebody who's worried about the premiums of your MedSupp, worried about the premiums of your prescription drug plan, there's a lot of money saving things that you can do. One of my favorite check, or one of my favorite websites is actually benefitscheckup.org. It is a website that you can go to. As an organization, I am not, you know, I'm promoting it because I've used it with our own clients. But you're able to go on there and try to find different ways to pay for different services. It's not Medicare related, but they can help you find ways to pay for things like maintenance that you need in your home. They can help you find ways to pay for those really high cost drugs that maybe is a tier four, tier five, maybe it's too expensive with your drug plan. So finding alternative ways to help pay for those plans. So it's a really awesome way to kind of find extra money to where you don't have to be so concerned with your rising cost of healthcare. Because at the end of the day, if we don't have access to healthcare, That's pretty scary, we don't have access to a lot. So a lot needs to be considered when you're making those choices.

 

Matt Feret:

That's a great call out. There are lots of state-based, federal-based,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

local community-based resources that can help out in a lot of ways. Premiums, drugs, benefits, assisted living, caregiver help, it's all, and you're right, benefitscheckup.org is a great place. There are others, but that's a great place and I know a lot of insurance agents use them.

 

Olivia Richardson:

Sure.

 

Matt Feret:

Before I move off MedSupps real fast.

 

Olivia Richardson:

Yeah.

 

Matt Feret:

buying a Medicare supplement. And I do find myself in a situation where I'm going to need to be underwritten. Are there rules of thumb that apply? In other words, I already mentioned a couple of them. If you've had a heart attack, you're probably not gonna be accepted. If you've

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

had a stroke, if you've had cancer, you're probably not gonna be accepted. Are there broad and general rules like that? You're like, you're not gonna be accepted, so you probably should stay on original Medicare or get a Medicare advantage.

 

Olivia Richardson:

Yeah, a couple of them that are going to be obviously your significant intense diseases or illnesses. End stage renal disease, you're going to have a hard time. A lot of mental illnesses, diagnosable again, intense mental illnesses might be something that you need to double check. What's really interesting is that a lot of carriers have really loosened up. I think what meds up carriers are doing to try to recover from losing a lot of the market share to Medicare Advantage plans, is that they're coming out with these niche products. For example, diabetes. If somebody was insulin dependent diabetic five, 10 years ago, they were pretty much on like a non insurable list. However, right now, if you're taking less than 100 units of insulin, there's several plans out there that are happy to accept you and have that calculated into their premium. So they're not worried about your insulin dependency. So my recommendation is never hurts to double check. Again, if you have had been diagnosed or receiving, another one is like, are you currently receiving treatment for something? So if you are, let's say you're getting, or not insulin shots in your knee, that would be weird. If you're getting,

 

Matt Feret:

Yeah.

 

Olivia Richardson:

what is that gel? Cortisone shots for your knees or joint, things like that. A lot of companies will consider that ongoing treatments. So if you're receiving, or if you're currently in physical therapy, if you're currently receiving cancer treatments or having the last two to five years, A lot of carriers will say, well, that's an ongoing thing, that's a pre-existing thing, we don't wanna start taking over that cost. But if you've had a break in treatments or you haven't received treatments in the last two years for a lot of carriers, then they oftentimes are completely fine with that previous diagnosis. So as always, it never hurts to double check, it never hurts. If you, again, in some significant chronic illnesses, you may have a harder time, but it never hurts to double check.

 

Matt Feret:

Yeah. And, um, each company has its own rules and Medicare supplements. So company A may say no, but company B maybe may say yes. Company

 

Olivia Richardson:

Absolutely.

 

Matt Feret:

C may say yes, but your premium is going up, or we're not going to cover this for a period of time or whatever,

 

Olivia Richardson:

Exactly.

 

Matt Feret:

right?

 

Olivia Richardson:

Yeah, exactly.

 

Matt Feret:

Well, then I'll just say it because this is, you know, I think this is, I mean, this is what I would recommend to my family members. If that's your case, use an agent. Your agent is going to know this stuff. Your agent's going to walk you through this instead of going to 85 carrier websites and trying to figure that making 85 applications, I got you. That's

 

Olivia Richardson:

Yeah.

 

Matt Feret:

that's a real benefit of using an agent that knows what he or she is doing.

 

Olivia Richardson:

Oh my gosh, I can't say it loud enough. Agents, they're in it, they eat it, they breathe it. Most of the time, you're working with somebody who's independent, then they're able to look across many different carriers and they're not, they're working for you and you the beneficiary, you're not paying them. The carriers pay the agents because they wanna make sure that the agent is taking care of you. It's really important to work with an agent because then there are issues. When this claim doesn't get filed right, or when you have questions about your medications, you're not calling 1-800-MEDICARE, you're not calling an 800 number, you're calling the person who helped you with that plan. So I am a huge advocate, I'm passionate, I guess I didn't realize how passionate I was until this exact moment, but I'm really passionate about making sure people are using insurance agents because it is in your benefit, for sure.

 

Matt Feret:

Um, I didn't ask this earlier and I had it in my notes, but I'm going to ask it now, cause I already know the answer to it, but I want you to say it. Um, if you're on a Medicare advantage plan, we already talked about what costs are now being born out by Medicare insurance companies, all types of Medicare insurance companies. Um, there's something that I write about in the book a lot and probably not only because it's really important and people miss it, but also because it's really fun to say, and that's the moop.

 

Olivia Richardson:

Don't move.

 

Matt Feret:

The MOOP.

 

Olivia Richardson:

Yes.

 

Matt Feret:

The MOOP. The MOOP stands for Maximum Out of Pocket. MOOP. I'm going to say it again. MOOP.

 

Olivia Richardson:

Mop.

 

Matt Feret:

A MOOP has to be on every Medicare Advantage plan.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Which means it's kind of like when you're... you know, if you're on your employer's insurance, right? At some point in there, there's a little line that says... you know, they call it... stop loss or maximum out well, we have a maximum annual year maximum. Basically, like if you have a really bad health year and you pay 10,000 bucks after you're out of pocket is $10,000. We cover a hundred percent. Like we're not going to make you pay $150,000. At some point, the insurance companies go, okay, you've had enough. This is your maximum financial exposure. You've paid it.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

We're going to take it from here. Right. Okay. Same thing, same concept in Medicare advantage. Every plan has to have a moop. And if you have a plan like a PPO, that moop can be in network, lower than out of network.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

So if you're going out of network, the costs are higher. The maximum amount of pocket is greater. If you stay in network costs are typically lower and the maximum amount of pockets typically lower a couple of years ago. Very quietly, the Medicare CMS allowed insurance companies to raise that moop.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

and they're doing it again in 2024, right?

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Have you seen, looking into your crystal ball, in all the plans and all the states and all the people you talk to, have you seen carriers going up to that MOOP limit and increasing that as part of what they're trying to do to tackle the healthcare costs?

 

Olivia Richardson:

It's what we have gotten used to in years past is saying the moops up here, but we're gonna keep it right here, right? And just a reminder, Medicare Advantage plans have these moops. Original Medicare does not. So on paper, like having a max amount of pocket is absolutely better than not having a max amount of pocket.

 

Matt Feret:

Correct.

 

Olivia Richardson:

But the idea is that we're used to people saying, yes, there's a ceiling over here, but for the majority of our plans, we're gonna keep that ceiling down here. We can choose. to say, yes, we're gonna go all the way up or we're just gonna keep it at this lower level.

 

Matt Feret:

So what you're saying is, and I say this actually everywhere. I'm like,

 

Olivia Richardson:

Yeah.

 

Matt Feret:

look at your moop. And if it goes above $4,000, you just need to shop. But that moop maximum that can be there is getting higher and higher. Sorry, go

 

Olivia Richardson:

Yes.

 

Matt Feret:

ahead.

 

Olivia Richardson:

No, no. What I'm saying is that you're exactly right. Is that people, the plans this year are starting to actually utilize that ceiling. You're starting to see that people are taking the maximum allowed, maximum out of pocket and applying that to their own plans. And again, being really quiet about that, not necessarily wanting to advertise at their maximum out of pocket. What we have been seeing are the plans with the part B givebacks, these rebates we talked about earlier, these plans with the $5,000 dentals, we're seeing those plans take the cost out on that maximum out of pocket. Not all of them, but a lot of them are. So making sure that when you are shopping for your plans, look at those maximum out of pockets. And you know what, you may decide that like, hey, this maximum out of pocket, same thing with Medicare supplement premiums. Your Medicare supplement premium annually may be less than that max amount of pocket. So you wanna look at that when you're comparing your meds up to Medicare Advantage plan. But for the Medicare Advantage plan, again, those can change year to year. They are changing this year. They are going up in some cases pretty dramatically. So definitely something to pay attention to that you may not have had to in years past.

 

Matt Feret:

I can talk to you for obviously another hour, but let me ask just a couple of other questions that I think are germane. We didn't really touch on provider networks much. What you said was true, which is provider networks aren't set annually. If a doctor moves, leaves, decides they don't want to be a part of the network, they can quit mid-year. And so you can be stuck. Stuck is the wrong word. You can have your Medicare Advantage plan, for example,

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

that uses a network and you're going to your doctor and you can walk in June and the doctor goes, yep, we don't take that anymore. Oh, you can't change. You are going to have that plan until you decide to change it and

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

find one that's in the doctor or in the network or find another doctor. And that's just the way it is. It's not a nice, that's one of I think the downfalls or the annoyances of Medicare Advantage. So they do come with HMO and PPO networks.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Medicare supplements don't. All they have to do is accept Medicare assignment and that's 99% ish of all doctors and hospital

 

Olivia Richardson:

for sure.

 

Matt Feret:

systems out there. So that can be a big difference.

 

Olivia Richardson:

It can absolutely be a big difference for sure. That's one of the top reasons why we see people go the med sub route isn't financial at all. It's freedom to know that I don't care if I have a grand kid in New York and a grand kid in California and I'm taking my RV back and forth, I wanna make sure if I need help, I need medical care, I can see it without having to work with paperwork. That's what we're seeing, a trend that we're seeing is that finances actually are not. a lot of the reason why people are shopping MedSupps versus Advantages. It is that choice and that freedom.

 

Matt Feret:

So if you're in a Medicare, and I agree with you 100%, that comes back to your lifestyle, right? You keep saying, what's your lifestyle? It's not just how sick or unsick, or how well or unwell are you? How many prescriptions do you have? What are they? Yes, and what's your life like?

 

Olivia Richardson:

Yes.

 

Matt Feret:

Do you run? Do you travel? Do you visit? Do you go overseas? I mean, this is all the mental math you have to put yourself through, not just dollars and cents. Anyway, I digress.

 

Olivia Richardson:

I'm sorry.

 

Matt Feret:

What have you been seeing trend-wise around Medicare Advantage networks? Have you seen them getting bigger? Have you seen them getting smaller? Have you seen them becoming more in line with certain hospital systems versus others? Are they getting bigger? Are they getting smaller? Does company A have a completely different one? You're in Missouri. I'll say St. Louis.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Does company A have their own set in their networks and company B has a completely different set and they don't share? Like what does the network thing look like over the years?

 

Olivia Richardson:

I love that question because it's actually you're seeing completely different things happening at the exact same time, but they are still trends. And so when we're talking about these, I call them the big boys, we're talking about your UHCs, Aetna's, Humana's, your big guys in the field, we're seeing their provider networks actually expand. They're introducing something, people, it depends on the carrier, but called national networks. that are saying that it doesn't matter if you're in Missouri, Florida, or California, if you find somebody that accepts our company, they don't have to accept your certain plan. They just have to accept our company. And so this is really opening up for my travelers out there. It's really opening up Medicare Advantage as a good, appeasing option for them because that network has tremendously expanded. On the other side of that, whenever we're seeing new carriers enter the industry, new Medicare Advantage plans, we're actually seeing really reduced networks and they're calling them these value-based providers. That's what

 

Matt Feret:

Okay.

 

Olivia Richardson:

I'm trying to say. You're really starting to see these smaller Medicare Advantage companies, these more, and I say smaller. When I say smaller, I mean regional. These more regional Medicare Advantage plans, we're starting to see them form really tight-knit relationships with the provider. So they're not accepting as many But we're saying the ones that we do work with, we work with incredibly closely. So that eliminates things like the waiting periods or when people have to go through some of the step therapies. And when you work with somebody who is one of those, again, those value-based providers, those ones that are working really with a limited network, you're actually seeing better client care because the provider and the carrier, it's a slower waiting period for a carrier to actually approve a procedure. And oftentimes the carrier doesn't need prior authorization. Oh my gosh, it was so hard to think of. They don't require prior authorization in a lot of these smaller networks. So you are seeing again, to answer the question, you're seeing the trend on either side. It just depends on what's important and the lifestyle of that consumer. If they want immediate care, really focused care, but a Medicare Advantage plan is appealing to them. then the smaller regional carriers with the narrow networks are really solid options, they're amazing. But if you have somebody that's again, a Medicare Advantage plan is appealing to them, but they want more of that freedom, then some of those larger carriers offering the national networks might be a good option for them.

 

Matt Feret:

What a wonderful answer and very insightful. Thank you very much. So

 

Olivia Richardson:

Of course.

 

Matt Feret:

even within Medicare Advantage plans and Medicare

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Advantage companies, the way they, the way you're able to consume your healthcare benefits can be very different based upon the network you have access to and the type of providers that are in that network.

 

Olivia Richardson:

It's a rabbit hole. Let me tell you, if we have seven or eight more hours, I could be happy to educate

 

Matt Feret:

Yeah.

 

Olivia Richardson:

you. No, and I know you know all of this, but it's just, again, points to why it's so important to work with somebody who does keep up to date with this. Because how on earth are you a beneficiary supposed to know this stuff?

 

Matt Feret:

Yeah, I made this up. So I'm a little proud of it. But I say from GED to PhD, this stuff is confusing for everybody.

 

Olivia Richardson:

Yes, absolutely. I love that. I'm going to steal that for sure.

 

Matt Feret:

Please, please take it. Listen, Olivia, this has been really comprehensive. That's so much information. And you know what? I don't know it all. I learned stuff every day. I learned stuff from this conversation because even though we both have done this for well over a decade, it's changing all the time. And it's our

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

jobs to keep up with it. And, you know. It's a lot to keep up with. So this has been really clarifying, I hope for a lot of people listening and watching, but also for me. So really thank you very much. What question about Medicare did I not ask that I should have?

 

Olivia Richardson:

Yeah, you know, the only thing that I think I would want to talk about, maybe for another episode, I'd love to come back, but it's gonna be all the things that Medicare doesn't cover, which I think is actually more important than a lot of the conversations we have about Medicare supplements, advantage plans, and drug plans, is making sure that you are, as a beneficiary, protecting yourself against things like the costs of cancer. things like medical, things associated with your teeth, gums, knowing that hearing loss is actually one of the number one causes of depression in people over the age of 65. And these are things that you could help finance and help protect yourself against, but they're not the questions that people are asking. It's how do I protect myself against the non-medical costs of cancers and things like that. So there's so much more to discuss. And I just think that if to everybody listening here today, I encourage you to ask your agent, what does Medicare, where is Medicare leading me? A little high and dry because there's a lot out there that's not being discussed.

 

Matt Feret:

I agree with you. Long-term care is the biggie.

 

Olivia Richardson:

It is.

 

Matt Feret:

Medicare doesn't cover long-term care.

 

Olivia Richardson:

No, and

 

Matt Feret:

The transition,

 

Olivia Richardson:

it's so confusing.

 

Matt Feret:

yeah, the transition like short-term care. Everybody knows long-term care, right? We all know how expensive it is and how hard it is to get underwritten and how many companies don't offer it anymore.

 

Olivia Richardson:

Mm-hmm.

 

Matt Feret:

Short-term care coming out of the hospital and skilled nursing and transitioning back into the home. There are gaps there.

 

Olivia Richardson:

Absolutely.

 

Matt Feret:

some of those gaps. I list all of the gaps in my books, and so I can't remember them all, but they're all there, and they're,

 

Olivia Richardson:

lot!

 

Matt Feret:

I can't remember them all, because there's a lot. But there's a lot of areas and a lot of ways to at least partially financially protect you or prepare for them, that you're right. We didn't discuss the gaps of original Medicare, some of which are covered in Medicare Advantage plans or attempt to be covered, but some not. I would love to have you on to talk about those again, but... Also, I want to do this again next year. This is a fantastic,

 

Olivia Richardson:

sure.

 

Matt Feret:

fantastic refresher for everybody. And I'm gonna guess there are quite a number of Medicare insurance agents listening as well. So hello to

 

Olivia Richardson:

Sure.

 

Matt Feret:

you, you do great work, thank you.

 

Olivia Richardson:

Thank

 

Matt Feret:

But

 

Olivia Richardson:

you.

 

Matt Feret:

from a consumer standpoint, this has been really, really helpful. And I wanna thank you very much for the time.

 

Olivia Richardson:

Well, I can't say again, the amount of respect that I have for you, that the industry has for you, your published authors, congratulations, and getting out there and actually helping the beneficiaries and answering the questions that people are asking or asking. So huge honor to be on. I can't wait to do it again. And I can't say thank you enough. It's been

 

Matt Feret:

Aw

 

Olivia Richardson:

wonderful.

 

Matt Feret:

shucks, you're too kind. You're gonna make me blush. All right, enough of that, enough of those compliments.

 

Olivia Richardson:

I'm sorry.

 

Matt Feret:

Olivia, thank you very much. This was great and thanks so much for being on.

 

Olivia Richardson:

Of course, thank you.