Sage Insurance Advisors LLC, specializes in Medicare plans and represents insurance companies offering Medicare supplements, Medicare Advantage Plans, and Part D prescription drug plans.

Serving Northeast Indiana from 4233 East State Boulevard in Fort Wayne and online at SageInsuranceAdvisors.com.

we're glad you're with us tonight here on PBS Fort Wayne we have a very good interesting topic that will affect so many of you.

So I hope you're going to stick with us here for the next half hour.

We're going to be talking about health insurance and if you have health insurance you probably will be interested in some of the things that are going to be revealed here in the next half hour if you don't have it, probably time to get and I have an expert here who comes every year of this time to help us talk about what's new and what has changed in terms of Medicare.

By the way, if you are on Medicare you've probably gotten your booklet already.

If you haven't yet you can check on my website or give him a call and and get yours.

OK, Greg MacDonald is my special guest.

Greg, come back or thank you for coming back.

You're welcome.

We'll come back again.

Greg was here last week if you were watching and that was for us part one part one of health insurance and Greg comes every year this time to give us updates on Medicare changes in some of the changes that some of the health insurance plans have last week was very interesting and we're going to review some of that for you and then we're going to talk about some additional things and you see the phone number at the bottom of the screen down here and we put that out there because you are welcome to call us.

You love it and answering phone calls.

>> It's a lot of fun so please call.

All right.

Here's your chance to get some complementary insurance advice for you here.

Nine six to nine twenty seven twenty .

Now this is PBS so we don't have any commercials.

We just go straight through for the half hour.

But if you can't we'll talk to you on the phone or you can leave your question that you have they'll type that up and put it on the teleprompter for me to read to you Greg.

>> Very good.

OK.

All right.

Well, let's start talking about Medicare and you for 20 26 this is the time of year when people start making decisions about whether to change their policy or what.

>> Let's talk about the times so today as we taped this we do the show right now.

Yeah, this was the beginning October 15th of the beginning of the annual enrollment period and that is for Medicare Advantage and prescription drug plans.

So this is the time that you have to do that when it comes to Medicare supplements, there's no timeframe for that any time of the year and you can get on for changing.

You can do that any time.

But for Medicare Advantage and Medicare drug plans, this is time to from now until December 7th.

December 7th.

OK, OK.

You know it's really important that you pay attention to those times because a lot of people are thinking oh I want to do this, I want to do that or I'm busy right now or I've got Coleraine to take care of and Thanksgiving and I'll get to that later and then the enrollment time is over.

It goes quickly faster than one thinks and this is a time that you don't you want to take advantage of it because there are surprises that can happen that you don't realize.

For example, one of the drug plans Cigna I'll just call them out CIGNA thing which was a fairly popular plan for this year had a premium around twenty dollars a month.

>> Yeah OK with that same plan is going to have a seventy nine dollars premium that's so if you don't yeah that's a big jump so if you don't look at that and then all of a sudden in January you get this bill surprise and you can't change it.

>> Yeah it's too late it's too late if you are on like a group plan for Cigna or anything else and that doesn't yeah that has no bearing.

So if you're if it's this is a an employer group plan this has no bearing to that it's going to be the family nine .

>> No no no no no no.

If you have an employer group plan that has its own enrollment period oh every company has their own open enrollment ok.

OK so what I'm referring to does not refer to the group market.

It doesn't doesn't impact the individual market.

I'm simply talking about Medicare.

OK got it.

>> OK I understand that now.

Yeah.

You know what we want to talk about two and we focused on this last week for a little while and I had some questions about it this week Greg.

So I want to talk again about 10 drug plans and we do have a billboard to show you here what those are because some of them I don't know how to pronounce you're talking about the 10 drugs that go on through negotiation.

>> Yeah, they're already approved for a lower price right through the federal system on the screen there.

So yes, Eliquis Realto Jardins Januvia for Seega interest though in fact I can't even pronounce that Stelara and Novela those are all Imbruvica Imbruvica celeriac I think.

>> So these are all plans drugs that they've negotiated lower prices for for next year so people are going to see that that price for them is going to be dropping on their plans both the prescription drug plans and the advantage plan they'll see a price difference.

>> Well you just saw there on the screen a lot of are pretty popular.

>> I see a lot of commercials for them and that's why they were selected and they went to the most popular drug plans, the ones that Medicare was spending the most money on, OK?

And so that's what what they were going for .

They were anxious to they they're trying to decrease the cost for themselves and the consumer.

>> OK, is that in stone now or is there a chance that there might be other drugs that are discounted?

Well, they're going through another negotiation for 20 seven and those are for twenty six.

Those are for twenty six.

There's another list for twenty seven.

I don't remember them offhand but they're looking at at those drugs that are most commonly used and are the most expensive well and they've been talking for a year or more about dropping insulin to thirty five dollars thirty five dollars or twenty five percent of the cost whichever is lower.

>> Oh OK but that phase that's not going to change is going to be certified correct.

>> That's good news for a lot of people with diabetes.

That's good.

That's good.

Yeah OK I hope that if you have a drug and you're paying a lot of money for that I hope that it was on that list that we just shared with you so that you'll have hopefully an opportunity for a lower price.

>> Right.

And that's important for a particularly it is important to those on Medicare Advantage but it also is a big deal for those on Medicare just drug plans and Medicare supplements.

>> Yeah, because supplements are really going to have an eye opening premium change for a lot of people coming up this year.

>> Oh, they are.

Yeah, More than a normal year or other year I have seen price increases as high as 29 percent.

Wow.

And the thing with Medicare supplement they usually have two price hikes a year.

One is an adjustment to whatever the trend is cost and then they have whatever they're going to do age wise.

>> OK, age wise.

Age wise.

What do you mean most of the plans in our area are what they call attained age.

OK, so the older you get it just goes up a little bit every year so on your birthday you see an uptick in your cost.

All right.

But then you have the cost of of health care change and this is what I'm talking about the twenty nine percent or twenty five percent or 20 percent I have most of them at all been I haven't seen any single digits they've all been 10 12 up to 29.

>> So it's it's a big increase.

So then if you have a supplement now tell me if I'm correct here if you have if you have a Medicare supplement you should just count on there being an increase of roughly 20 percent more or less.

>> Don't be surprised and I tell my people when they buy a supplement I just expect the price increase because they're going to go up once or twice a year.

They just are.

But this is an extraordinary year and there's several things causing it.

>> Why is why is it happening?

Well, one, people like to save money, right?

And so given the high deductibles in both the group market and the individual market, if you've got five, six, seven, eight , nine thousand dollar deductibles, some plans unbelievably have and you have a procedure wouldn't if you could wait a year to get that taken care of .

A lot of people wait so they don't have to pay that high price.

I mean if they can wait they'll wait and once they get on Medicare and then they'll take care of it, OK?

And it makes sense.

Yeah, I've seen it happen in my own family where it's like OK, I need to see a doctor but I've got two months to go.

>> I'm just going to wait.

Are they blaming you or your family?

No, no, no.

So it's not so much that growing up but that happens in the other thing is so when people do come and they have their option to choose from a supplement an advantage plan and a person is healthy.

Yeah, most of them will tend to go toward Medicare Advantage because they have a very low premium and they only pay when they have services.

Well, heck, if you're only going to if you can get by for less than a thousand dollars a year which is typical, uh, people will go that way for healthy folks and an advantage plan doesn't have an increase twice a year like a supplement, is that correct?

That's correct.

If you have a premium, you know what it is and most of the plans in our area are zero premium now so people aren't going to pay for something if they don't if they're not getting a lot of services.

So what does that do to supplements?

Well, if you're unhealthy you have a tendency to go toward a supplement which makes sense, right?

Yeah, because a supplement you're going to pay a premium but you're not going to pay for services on the back side.

>> And so there's a lot of security in that and also knowing that you can go where you want to go and you don't have prior authorizations at least not right now.

Mm hmm.

So people have a tendency to go towards supplement.

Well, what does that do?

Again, it tends to put more unhealthy people on supplements versus advantage plans.

So what we see is a healthier population of people going on the rolls of Medicare supplements which is increasing premiums and we can see that they have a measurement that you can look at.

>> It's called a loss ratio.

Who have it?

Everybody does OK.

OK, these are the insurance companies.

OK, and so this is a rather technical but I could find that like on their website.

>> No no you have to have age you're going to have to have somebody who knows how to get into it but you have 80 percent of what an insurance company takes in in premium is the target for what they pay in claims.

OK, that leaves 20 percent margin for them to pay their expenses and to have for the profit.

OK, so you look at if you're able to look at the loss ratio of these companies and if you see that they're hovering around that 80 percent range, you can say OK, this company is healthy and you know they're in good shape when you start seeing that loss ratio up 90 percent 95 over one hundred percent well they're not making money or they have very tight margins and so what are they going to do?

They're going to increase premiums and so when one looks at supplements, what I would suggest to people is when you talk to your agent and you're just, you know, talking about well, you know, my mom always always had an Appalachian State supplement.

>> We love them.

OK, great.

That doesn't necessarily mean it's going to be super for you because the plans a plan B is a plan B regardless you get it from you know what you want to make sure is that that the company has a good loss loss ratio, that it's a good financial you know and best rating.

Right.

And also how many years have they been in the market?

What's their percentage increase year to year?

Those are things that are important to making a decision .

Great.

I've heard and read that because it's Spences well that they have to pay out insurance companies have increased.

I don't whether it's more people getting sick or surgeries and procedures getting more expensive but that to make up for that loss insurance companies are dropping a lot of things that they used to include in a policy like silver sneakers or gym memberships or vision or hearing.

>> That's what we're getting that on the advantage plans just advantage just advantage supplements are regulated by the government.

>> OK, so that's why I'm mean I would say that a Plan G is a plan G regardless of how you get it from.

>> OK, let's look at the screen.

We're going to show you again what advantage plans are and then supplements and we'll talk a little bit more about supplements.

So here you go.

Here's a Medicare Advantage.

Anything you want to comment specifically just keep in mind that advantage plans are plans that the insurance companies paying the claims and they will operate a lot like group plans or individual plans but they have it's the same type principle.

>> They just work a little bit differently.

Yeah, So advantage plans are being squeezed by the inflation reduction so the companies are getting less money.

They're having to pay more out on drug claims.

OK, and so in order to keep their profit margins good they are cutting some things in order to keep profitable those But that's one advantage.

It's not on supplements themselves.

>> OK.

All right.

On supplements with something really specific we should pay attention to Greg.

Well, it's that what I was just referring to just be watching the cost, see what the financial position is for what the company is and but one thing that it's up there that we haven't really talked about I need to is that Indiana has passed legislation called the birthday rule the birthday of the birthday just Indiana or have other states where the we are the ninth state in the Union to pass this.

OK, so what this birthday rule does is within 60 days following your birthday you're allowed to switch from your Medicare supplement plan to another another some supplement plan with a different company without having to answer health questions.

>> Happy birthday.

Happy birthday.

So you know, it's like OK, if you have what you say you have a plan with Company X. Yeah.

And Plan B you switch to company Y, plan G OK it has to be the same plan with a different company company Y cannot ask you medical questions so you can just simply look if you're paying three hundred dollars and X and you can pay two hundred dollars and why you make the switch the matter if you do have some serious health plans but you have to just health issues but you have to disclose them you do not have to disclose them with this.

Yeah but if you do in a situation where you do disclose them does the premiums go up?

>> No no not with this then why do we have to fear about it without this birthday rule if you take this at a different time the insurance companies can ask questions and they can say no OK or they can write you up OK OK so this legislation that's insurance go right you write you and Jack the price OK there's layman's terms Jack the price so what with this people can make that move.

Yeah.

And not have to answer health questions.

OK so what's what does this mean for the average consumer.

Well if you have a supplement that is really expensive.

Yeah.

And and people come to me I have one today they're paying four hundred dollars a month for it said OK what do I do.

Well you have two choices and now you can go to advantage because Medicare Advantage does not ask health questions OK and you have to look at work what's the most you can spend with advantage versus what you're paying in premium?

>> OK, so there's a question there or you can wait until your birthday and move to a different planet in 60 days within 60 days of your birth.

>> OK, but you ask why premiums are going up in this thing was one thing I neglected to mention insurance companies are now having to take on people that they can't underwrite.

They don't know what the health conditions of these people are going to be.

>> So how are they going to compensate for that?

Yeah, they're going to jack up the rates that rate you they're going to rates you have got to work that and that's you somebody else.

>> OK, now last week Greg made a point of talking to you all about phone calls you might be getting.

I'd like you to emphasize that again.

>> Great.

Your viewers it's very interesting if if anyone calls you other than your health insurance company so if you're I'll just pick United Health Care if you have a United Health care plan and somebody calls you from United Health Care and can you can you believe that they're United Health Care?

>> They can tell you remember you know, say something to prove that they're actually from go ahead and talk with them.

OK, If your agent calls you talk with them.

But if someone that you do not know calls you and you didn't ask for that phone call do not talk with them because they're not supposed to be calling you anyway.

>> OK, so that's like a law or rule or whatever that insurance yeah.

>> Unfortunately like the call list right.

Yeah.

You know how well that worked go over that.

>> You mean like put your numbers past you put your number down and they're not supposed solicitors are supposed to call that worked really well right if this works almost as well and I seen that very facetiously OK it means that people are disregarding the law.

Yeah.

And a legitimate broker will not do that.

>> Yeah.

I mean we we have to I mean all our certifications, everything that the company tells us to do is we cannot do that.

So if you're getting that those types of calls don't you know don't take them just hang up.

Yeah I realized today and it says a different insurance company on it or you can believe that because I got a call I remember this past year are you health OK, who are you talking to?

And it was an overseas call list but you know I get these calls that are junk calls what they look like they're coming from for you know, a lot of times you don't even have like six zero, you know, the area code and you think well then that's somebody I know it's frustrating.

>> It's frustrating.

Yeah.

but yeah, don't take them just do not do not take those calls.

>> Well I have seems lately an abundance of TV commercials about insurance like every other ones about insurance now it seems and then I get something in the mail cerebral aids a week I get some kind of Mercure card or something now that's OK.

>> Right.

That's fine.

They can mail to you.

There's no there's no problem with that and they can email you.

>> Oh really.

Well you can but they have to have an opt out there so you're supposed to be able to say not subscribe to unsubscribe or you can say do take me off your list.

>> They're supposed to do that .

>> I do block sender.

I do that too.

OK, you're getting text messages.

>> You get a lot of junk text messaging or I just block them.

It's so hard it's just so hard in the people who do that who are trying to scam you or or make it illegal or whatever calls they're getting very sophisticated and they're finding a way around what we would normally know.

For example, the area code or whatever.

But you know, they're getting very good a big percentage earnings and coming from the United States.

>> But it's very interesting.

I have to admit, Greg, a couple of times I've just played along and let them talk to just see what it's all about.

>> I mean one time I was on a cruise all kinds of good.

Oh yeah.

At the end it was all I had to pay was like five hundred and fifty dollars to cover some taxes or something and let's say I won another trip I won a vacation home Vermont there but there's always something at the end you know.

Yeah they're trying to something I will tell people talk with your own broker OK I mean if you have an agent talk with your agent if somebody else calls you and tries to get you on to do something else, keep in mind that as soon as you do something with them you've just taken your broker off OK and they're no longer your agent.

Oh really?

Oh yeah.

If you talk with somebody and they said Oh we can move you over here well great but you've just lost your agent.

Does the agent know that?

Usually not.

So you wouldn't be notified if somebody did that to you.

You know if something happens during this time I don't know what until it's till later when they asked me to do something that I'm no longer the agent on I can't.

>> Oh wow.

So be very careful about agreeing to anything and particularly over the phone.

Right.

Because I mean that kind of phone calls they might be making now would be maybe to try to talk you into a different plan or you know, make their company sound more attractive and use we talked a little bit about this last week.

They use some of the benefits that are available for those on Medicare and Medicaid because they're very rich.

You pay very little for anything but that's because these folks need financial assistance.

Yeah.

So they use the benefits of these plans to lure people in and get them excited that they can have that too.

And then you get excited and then it's like oh well we can't quite have this but we can do this and know that called bait and switch Vitruvius or write you up.

>> I got it there you rates you up well our time has gone so quickly I hope you've learned some new things about insurance and it's been something that will be valuable information for you.

Thank you.

Great welcome mixdown coming to us each year and for sharing that get over here cold.

>> You shouldn't have a cold this time of here.

Not a good time.

Andrology, thank you so much for watching us here on LIFE Ahead.

We'll see you back here next Wednesday night at seven thirty.

Thank you Sage Insurance Advisors LLC, specializes in Medicare plans and represents insurance companies offering Medicare supplements, Medicare Advantage Plans, and Part D prescription drug plans.

Serving Northeast Indiana from 4233 East State Boulevard in Fort Wayne and online at SageInsuranceAdvisors.com.