Welcome to Retire Smart Austin. My name is Cynthia De Fazio. I’m joined today by Phil Capriatti Sr, he is president and CEO of Empower Wealth and Tax to our viewers at home. We are talking about a very important subject today. We’re talking about Medicare. We know there’s a lot of questions when it comes to Medicare. And today’s show is devoted just to that. Phil, how are you today?
I am wonderful. It’s good to be with you again, Cynthia,
it’s so good to see you. And I am so glad that we are uncovering this mystery of Medicare because I know you have a lot of questions from people that are coming in. They want to talk to you about things that they should know before they enroll in Medicare. So, thank you for devoting today’s show to Medicare.
Yeah, I thought it was really appropriate. It’s one of the few topics that we don’t really cover in detail really cover it all during our TV and radio. And one of the things I don’t really talk much about is we have our own Medicare department within our company. Nice. Yeah, we actually have a, we have a whole team in our home office that looks at all of the Medicare supplement plans. We’re going to talk about that and all of the Medicare Advantage plans. It’s really confusing. Many folks think when they go on Medicare, they get bombarded. Number one when you’re an open enrollment, and you turn 65, about 90 days or 120 days before you turn 65, which is when you become Medicare eligible for Medicare. They get bombarded with salespeople. They’re basically licensed agents. And, and it’s, have you ever been at the beach? And when you’re eating or watching somebody eat french fries, and you wonder the kids throws a french fry up in the air? And all the seagulls converge on it? Yeah, that’s what it’s like to go open a robot. Okay, honestly and true, it truly is. And so, we have our own department. And so again, I’ve told folks, you know, we do property casualty, but the Medicare is really important because, folks, when you come on to Medicare, it’s like hitting your RMD age, you’re not expecting it. Well, when you come on to Medicare, your whole health insurance plan changes. So, let’s talk about approaching Medicare. Okay, first of all, your original Medicare is Medicare A and B. Medicare A is responsible for covering hospital care. And it has deductibles and CO payments. Medicare B covers your medical rehabilitation. And it also has deductibles and CO payments. So, with Original Medicare, this is where you have the opportunity to choose your own hospital, your own doctors, your own surgeons, you’re not in a network, you’re not in a PPO plan, or an HMO plan. And we’ll get into that, who should have what we’re going to also dive into that. Remember one thing when you first started becoming eligible for Medicare, you have what’s called an enrollment period, it’s your initial enrollment period, i e, p, this is the seven-month period that begins three months before you turn 65 and four months or three months after you turn 65. Okay, three months before and then that month that you, you turn 65 And then three months after, okay? It includes your birthday month, and then it continues for three days after what are three months afterwards. So, three months before, then your birth month, then three months afterwards. That’s the seven-month Initial Enrollment Period. Okay. During that period, you can enroll in any type of plan, Medicare Advantage or Medicare Supplement. So, let’s go ahead and talk about it. That’s number one. The next thing that we want to be mindful of is our G P our general enrollment period. And so, if you miss, miss your initial enrollment period, you can enroll during the general enrollment period, and this runs from January 1 to March 31 of each year. Okay, okay. And these are all recent changes during this period So just in case you missed it, okay, you have the first three months of the next new year, okay, where they give you a kitchen pass. I’ve had folks that decided not to, to sign up for Medicare Part B. And if you don’t sign up for Medicare Part D, there are huge penalties you have to pay when you eventually do so make sure you don’t miss that. Second thing is your special enrollment period or your SEP, SEP, you may qualify for a SEP, if you have certain life events, such as you move to a different state. Okay, okay. You lost your other health care coverage. For instance, you have a Medicare Advantage plan, who then they are no longer providing services in your area, this does happen. So, remember the three different enrollment periods. And when you come into the office, our licensed Medicare supplement agents, they know this stuff inside and outside, I just wanted to bring it up today. Because you know, we’re always talking about tax efficient planning and estate planning. This is really extremely important. Now, that’s Medicare A and B. The next thing that you have is called Medicare. See now this was initiated by President Bush back in 2008. Okay, Medicare A and B is the original, it allows us to go out of state, we can go to any hospital that accepts Medicare, we don’t have to worry about a network. Now with the Medicare See, that’s known as a Medicare Advantage plan. These plans are offered by private insurance companies. And they’re approved by Medicare. So, Medicare approves them, these private insurance companies awful, also give you additional benefits. So, they’ll give you a routine exam, they might give you eye vision, they may give you some hearing, what happens is Medicare pays a premium to the insurance company. So, then I’ll have to mess with it. Ah, Medicare pays your premium. And that premium range is now over $600 a month. Okay, so your Medicare, Original Medicare says yeah, get the Medicare Advantage and we don’t have to mess with it. All right. However, with a Medicare Advantage, what you have to consider is these coverages also include Part D, or your Medicare drug plan, we’ll get into that. And second, but it also makes sure that you are resolute, and you have to understand you are stuck in your own healthcare provider network. Okay. So, you’re in one of these little cubbies. You’re not allowed to go out of network? Well, now let me rephrase, you’re allowed to go out of network, but the full expenses are not paid. Many times, only 50% of the total cost is, is paid when you go out of network. So, give you an example. God forbid, let’s assume you had cancer or something of that nature. You may not go to MD Anderson may not be able to if you have a health care plan here in Austin, because why it’s out of the network. They want to keep it in a local network. Okay. What happens is the private, private insurance companies work out deals with the hospitals, medical personnel, private networks, so that they pay a certain amount. And this is the insurance company remember, what are they in business to do? provide service and make money? Absolutely. They’re not in it for free. Okay. So, I tell folks, look, it depends on your feeling. If you can afford to have a Medicare Supplement, which will we’re going to get into they’re called Medigap plans. Me, I have Original Medicare, and I have a Medicare Medigap Plan, why, if I’m traveling anywhere, including out of the country, I want to make sure that I’m covered. Sure. And I want to choose my own doctor, surgeon specialists or what have you. I don’t want to have to go for a referral. I don’t want to have to stay in in any particular network. And I also don’t want to have to worry about my plan being cancelled because the Medicare Advantage company spent too much in one area and they lost money. So many times, what we’ll see is they may have a, they may have a plan this year for the next five years and all of a sudden, that plan is no longer available in your area meaning in the zip code that you live. Okay, that’s what they look at. They look at the zip code that you where you live, okay, so Medigap, Medigap, and then we’re going to jump into a break Medicare supplement plan. They go along with Medicare originally Medicare to pay the deductibles and CO payments that are not covered under Original Medicare. I personally have a plan CI; I have a doctor’s deductible of about $240 a year. And then everything else is covered as long as it’s approved by Medicare. So along with that, you must have a plan D. I know have to run for a break. Don’t wait,
We definitely do. Would that be all right, I don’t want to stop you. But I definitely want to give some people some,
Plan D when you have a regular Original Medicare, you have to have a Medicare supplement and then purchase your plan D and that covers your prescription drugs.
Phil, thank you so much to our viewers at home, we have to take a very short commercial break here and Retire Smart Austin but what Phil is offering you today to the first five callers would be a complimentary consultation. Before you start deciding which Medicare supplement that you need and how to choose those things. Why not give the office a call and book a complimentary consultation to find out where exactly you should land that number again is 888-818-6557. Or if you have your smartphone handy, go ahead grab it click on the QR code. It’ll take you right to Empower Wealth and Tax landing page. There’s only five complimentary Medicare consultations available this week. We’ll be right back momentarily.
I watched my parents work, work themselves really to the bone. I saw my father retire at 63 and pass away. Six months later, once he had stopped working. My mom looked at me and she said, you better be an accountant. You better learn the tax law. I went to a private school, got a great education, lived in the library and graduated without any debt. I realized the benefit of being debt free at a very young age. I also realized the benefit of educating and speaking to people and I liked working with folks who actually needed help. I started my company 17 years ago and now we employ two CPAs and two licensed tax professionals. We have a legal arm that helps folks design trusts as well as wills. We have an insurance and that offers property casualty insurance, we sell health insurance, Medicare Supplements, long term care life insurance annuities, and we have wealth management that I started to work with Ed slot looking at tax efficient ways to have retirees or soon to be retirees retired tax free. If your accountant or CPA is not also your financial advisor. You really have a conflict of interest.
Welcome back to Retire Smart Austin. My name is Cynthia De Fazio. I’m joined today by Phil Capriatti Sr, he is president and CEO of Empower Wealth and tax and we’re talking about all things Medicare, and I want to jump back into Medigap for just a moment. Phil, I’ve not heard of Medigap before. So can we spend some time just really talking about what that is and why it’s a benefit. Okay.
And you know, first of all Medigap plans are really they have initials, they range from Medigap plan a plan B, all the way up through high deductible plan n. Okay, all right. Now back in the day, when we first started it was Plan A, B, C, D, E, F, G, okay, they were just four and then they came in with these high deductibles. So, for some folks with higher net worth, they want to pay reduce premium. Now your Medigap Plan, you do pay an extra premium for this. All right, now you are paying for your Medicare Plan B, whether you’re in Medicare Advantage, or Original Medicare, so that’s all the same. The two different changes is with a Medigap plan, you’re paying for that supplement. It’s also offered by a private insurance company. Again, I told you, I like the Plan G very simply because it covers all my deductibles and CO payments and the premiums only 120 bucks a month. Okay, so that may sound like a lot to some folks. But for me, I take a look at it. We’re talking about 14 $1,500 a year. And it gives me the opportunity to choose my own doctor, my own specialist. Hopefully I never need it. But if I do, you’re not going to be able to change from a Medicare Advantage to Original Medicare. Okay, as soon as you have to go out of network for care is the time you realize maybe you should have been in Original Medicare and not the Medicare Advantage. These The reason I make the analogy with the seagulls into french fry, okay, is because they pay these licensed insurance agents, a very sizeable commission to sell these Medicare Advantage plans and those Commission’s range about $600 a year every single year you have, have them. And it changes, it varies depending on the zip code that you’re in. The fact of the matter is, again, you only have 20 nickels in the dollar, right? But I like to be in control of everything. I like to be in control of my retirement plan, my tax plan, my Medicare plan, no, no difference to me. Now with that, also, you’re going to have to have a Part D drug plan. This and basically you use a formulary. So, all we do is we look up each year, I look up, okay, what drugs are you on? Well, if you’re not on any drugs, you’re going to have the basic plan. Maybe it’s about nine bucks a month, okay? Something like that. Okay, if you have an extended plan, maybe it’s $30 a month. It’s not that much more expensive, right. So basically, you will, and then our folks will check your formulary to see which Part D plan best fits you lowest deductibles, lowest co pays. But again, you’re putting things in your own hands, you have control of it. Okay, so coverage needs and health status. during this open enrollment, regardless of your health, you can choose a Medicare Advantage or Medicare Supplement. There are no waiting periods for preexisting conditions. So, you need to know that. And okay. I personally like the fact that I can pick my own network. Absolutely. What we’re also going to talk about, and I know we’re coming up on a hard break, Medicare does not Medicare Advantage plans have very limited coverage when it comes to long term care, nursing home care, and home health care.
Interesting. I’m so glad that you’re bringing that up, Phil, because so often we hear people say, Well, I don’t need long term care planning, because I have Medicare, it’s going to cover everything. But that’s not true.
No, it’s not true. And with the Medicare Advantage plans, you have to see you still have to pay a copayment. So, what I’ve noticed as that with Original Medicare, Original Medicare without a supplement is going to cover 100% of the first 20 days in a skilled nursing facility. And in many cases, whether you need skilled care, Intermediate Care, irrelevant, then there’s a deductible for the next 8080 days. So Original Medicare is going to cover you up to the first 100 days. And then your supplement will cover the CO payments from day 21 to 100. So, between your Medicare and your Medicare supplement, even have that covered. It also has significant home health care benefits, if you need help, dressing, eating, rehabilitation, all of that. And again, I don’t have to worry about being in a specific network. For don’t like my care provider, I can choose another one. So, I like choice. We’re going to talk about the differences when we come back between Medicare and Medicaid. And I’ll tell you why. I have had folks come in and oh, I don’t need to worry about long term care, home health care, I had Medicaid. Now the funny thing is, Medicaid folks is not Medicare. No. Medicaid is a welfare program for end of indigent individuals. It’s also a plan that you’ve may become qualified for once you spend out all of your assets in a long-term care facility or home health care. So, when we come back, we’ll talk more talk about that in more depth. But understand something Medicaid and Medicare are two separate health plans. One does not now you can also be dual eligible. You can have Medicare and Medicaid. Okay, okay. So with Medicare and Medicaid, you don’t have to have a Medicare supplement or a plan D, because Medicare gives you your original Medicare A and B but dual eligible means you can also have Medicaid, which means the Medicare health plans or Advantage Plans love that because now they get paid for Medicare and Medicaid. Wow. So, they offer Medicaid or folks that are in extremely low income. They’re getting paid twice, one for Medicare one for Medicaid. The Medicaid is a welfare program. We’ll get into that we come back to the break.
Well, Phil, we offered five spots, but do you think you need more because I think your phones are going to be ringing,
Give us a call if this whether you’re an existing client, even if you are on Medicare, Medicaid or Medicare Advantage, give us a call because what we can do is we can look in your zip code to see all the plans that are available because you will have an open enrollment that happens at the end of each year. And if you’re doing Will eligible qualify for Medicare and Medicaid? You don’t have to wait for an open enrollment. You’re allowed to change plans anytime you want once every calendar year, okay, okay, so give us a call. And by the way, if you want us to review your portfolio and do a Morningstar report and portfolio analysis while you’re in talking about Medicare with Gregory or one of other licensed agents, feel free to tell the tell the, the young individual that you want to do both talk about Medicare and you want to talk about your portfolio.
Phil, thank you so much to our viewers at home that number to call is on your screen 888-818-6557 If you don’t have a pen that’s okay. Grab your smartphone click on that QR code at the bottom corner of your screen that will take you right to M power wealth and tax landing page. We’re gonna take a very short commercial break here and retire smart Austin don’t go anywhere. We’re discussing Medicare and Medicaid in great detail this week. Stay tuned.
We know the market is going to get worse from here. This is the biggest monthly decline in 10 years, people’s 401 K’s took a major hit.
My investments are tanking retirement isn’t going as planned. I can’t believe I let my kid talk me into buying crypto. I mean, what is that anyway?
This was the fourth worst contraction in history.
So how are you two doing?
Your financial future doesn’t have to be uncertain. I’m Philip Capriatti, CEO of Empower Wealth and Tax if you amass the nest egg, it’s time for a financial advisor to help you reach your retirement goals. This is one of the greatest tax windows in history. And now is the time to take advantage of this tax discount while we can we specialize in retirement income planning, tax mitigation, estate planning, and so much more. So, plan your retirement right Call now for your own complimentary portfolio review and tax analysis.
Welcome back to Retire Smart Austin. My name is Cynthia De Fazio joined today by Phil Capriatti Sr, he is president and CEO of Empower Wealth and Tax flow, I want to ask you a very important question. We have a viewer that would like to have some clarification on something. His name is Teddy. says Phil, I heard you mentioned that Medicare actually can help with international travel if I get sick, right? Is that true?
Yeah, it is. So again, if you like to travel a lot, and we’re going to recommend you do Original Medicare. And because you don’t have to worry about the referral because it’s going to cover, I believe it’s up to $100,000 in any type of care out of the country. So, care out of the country is extremely important care in the country, but in different states is also important. Now many times your Medicare Advantage plan will cover it. But they will have restrictions. Again, with Original Medicare and your Medicare supplement or Medigap plan and plan the, you’re really pretty much independent when it comes to that. So, travel is also one of the prerequisites that we’ll ask you about when we help you determine what’s the best plan for you getting into the differences between Medicare, excuse me and Medicaid. Let’s talk about that. So, Medicare and I’m going to give you the formal direction generally available for individuals who are aged 65. and older. Individuals who also have disabilities can qualify for Medicare. It’s not based on income, but Medicare is part of the Social Security benefit or Social Security Administration. Many folks don’t realize that Medicare A which covers your hospital is part of your Social Security benefit. You get Medicare A without any additional premium. Now Medicaid, for instance, that’s primarily designed for low-income individuals and families. So, for many of the folks who are indigent or even individuals who are come to our country recently, guess what they’re eligible for Medicaid and Medicare? Yes, exactly. So, when you look at women who come over, so if you’re pregnant, or you have children, or any of that low income or no income, we have the Medicaid, it’s no wonder everybody wants to come to our country. And again, there’s nothing wrong with that, but understand there are two separate programs when we look at the coverage. Medicare consists, as we said before, of part A, which is hospital, Part B, which, which is medical part C, which is privatized Medicare. That’s the Medicare Advantage plan, and Part D which is prescription drugs. So, it provides coverage for a broad range of situations and medical conditions. Medicaid on the other Hand offers more comprehensive set of benefits. You pay absolutely zero when you’re on Medicaid, you need home health care, zero, you need long term care zero. So, when an individual says to me, Phil, I have Medicare Medicaid, I don’t need home health care long term care, I immediately asked them about their income. Yeah. Because if they aren’t low income or no income, yes, they would qualify for Medicare and Medicaid. But if they are, if they’ve worked their lives, pay taxes and have any significant assets, including owning a home and have more than $3,000 in the bank, they’re not going to qualify for Medicaid.
That’s what I was going to ask you. Because I’ve always heard that to qualify for Medicaid, you really have to liquidate all of your assets. And so that is true.
And not necessarily the home you live in. However, they will put a lien against that home, and that home will be sucked up as a reimbursement. Okay, so it is what it is. And this is why it’s important to do retirement income planning, because we fit all of that in there. We structured all in there. Now the funding, let’s talk about that funding, the funding for Medicare, it’s funded through payroll taxes, general revenues and the premiums that are paid in by the beneficiaries. Okay. That’s how it’s funded. So, if you’re still working and paying into Social Security, and you’re paying payroll taxes, like the gentleman I spoke about, who’s 72 years old, and he filed for Social Security, he’s still paying into Social Security. It goes towards the Medicare, Medicaid, however, it’s funded by the federal and state government. The federal government sets up guidelines. The state government has the flexibility to design and administer, administer their own Medicaid program, but it’s basically federal and state funded welfare. Okay. Okay. Medicare and the Medicare administration is, is administered by the federal government through the centers of Medicare and Medicaid Services. Medicaid, on the other hand, is administered by both the federal government and the individual states. They, they basically co-sponsor, okay, so it costs the states it costs the federal government it costs the taxpayer. Make sure you have the right Medicare plan and Medigap plan or Medicare Advantage plan. And if you are eligible for Medicaid because you are low income, we’re more than happy to help you get enrolled by medical with Medicare Advantage and be dual eligible.
Phil, thank you so much for another amazing and informative episode to the viewers at home. Thank you for spending time with us on Retire Smart Austin. Be safe, be happy, be blessed. We’ll see you back here one week from today. Take care now.
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