Ep. 228 – Mastering Medicare Planning in Retirement

In this Episode of the Secure Your Retirement Podcast, Radon and Murs discuss Medicare planning for those coming up on Medicare and those already in Medicare. This is a checklist of three main topics to help you understand what you should be thinking about when it comes to Medicare.

Listen in to learn how to evaluate your prescription drug needs and choose the right Medicare plan that caters to those needs. You will also learn about Medicare supplements and Medicare Advantage plans, plus how to join our Free Webinar to learn more about Medicare planning from experts.

In this episode, find out:

  • Prescription drug plan – understand your prescription needs, if the plan covers your needs and the cadence of your refills.
  • Comparing different part D plans that would cover your specific prescription drugs at the lowest cost.
  • Evaluate your pharmacy network – ensure it’s cost-effective and convenient for you.
  • Cost analysis – Look at your prescription drug cost to determine the type of plan to pick.
  • The importance of taking the time to review your plan annually and make changes if needed.
  • Dental, vision, and hearing – Think about the dental, vision, and hearing coverages you need.
  • Integrative plans – Do an educated analysis between Medicare Advantage plans and Medicare gap policies.
  • Doing an individual needs assessment – understand your needs and get an individualized cover.
  • Medicare supplements and Medicare Advantage plans – an outline of what we’ll cover on our free webinar.

Tweetable Quotes:

  • “There’s one part of Medicare that covers hospitals, one part that covers doctor’s visits, and then there’s a part D which is all about prescriptions.”– Radon Stancil 
  • “Just because your neighbor, parents, or a family has a certain type of plan doesn’t mean that that’s going to apply to you; Medicare and healthcare in general is very individualized for a reason.”– Murs Tariq

Register For Our Free Medicare Webinar:


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To access the course, simply visit POMWealth.net/podcast.

Here’s the full transcript:

Radon Stancil:Welcome everyone to Secure Your Retirement podcast, where our goal is to make sure that we share with you something of benefit each and every week. I’ll tell you right up front, I think we have a topic right now that I know is timely because we are very close to what is called Open Enrollment for Medicare. Now, I know there’s two different sides of Medicare. There’s the planning for it that, I’ve never had it. And then there’s, I’ve already had Medicare and I want to make sure that I am in the right plan. And so that’s why we are labeling this really as a, topics I need to think about for Medicare before and after age 65.  
 Also, we’re going to cover a lot of different little things. Think of this as a checklist. A checklist of things that you just want to get in your head and think about. And again, this applies whether I’m coming up on Medicare or I’m already in Medicare. And so what we’re going to do though to go into a lot more detail, and we’ll give you information on this if you want it, we have a webinar that’s coming up. And we’re going to give you all the details at the end so that you can know exactly how to join that webinar where we’re going to go into detail about these Medicare supplements, how they work, what is the difference between them and all those kind of good things.  
 So really, what we’re going to do is cover three main topics. And again, think of this as a checklist of items. Remember that we have a blog written on this on our website, pomwealth.net. And we’re really going to just work through these topics and say, okay, these are things I need to think about.  
 Let’s look at our main point number one and this is around prescription drug plans. Lots to think about here. So Murs, can you give us our first little checkpoint here?  
Murs Tariq:Yeah. Under prescription drug plans, our first point is going to be, you got to understand the prescriptions that you are taking. What are your needs as far as prescriptions go? Because drug plans have different coverage on different types of drugs and so you want to make sure that we are selecting the right plan that is going to be catered to what you need for your health in the best manner. So that’s looking over your individual medication needs. And then you want to look at, on the plan side, they typically have a list of prescription drugs that they are going to cover. So you want to make sure that what you need is going to be covered by the plan that you are look to … that you’re currently in or that you’re looking to switch to.  
 And then one thing that is also very important is the cadence at which you need to get those drugs or refills done. So am I getting refills on a monthly basis? Am I getting refills on a longer term basis? So just three quick points there when we’re looking at understanding our prescription needs.  
Radon Stancil:And that segues real good into this next checkpoint, and that is comparing different, what are called, Part D plans. The reason we are talking about Part D is because Part D is the prescription part of Medicare. So there’s one part of Medicare that covers hospitals. There’s one part of Medicare that covers doctor’s visits and those kinds of things. And then there’s a Part D and that is all about prescriptions.  
 So now if you do what Murs said in the first point, now we go and we start looking and comparing the different types of plans under Part D that would cover my specific drugs at the lowest cost. So imagine, let’s say I’ve got one person who maybe has got cholesterol, high blood pressure, those kinds of things. Well, that’s one type of medication. But what if I am dealing with other things? Maybe I’ve got rheumatoid arthritis and I’m taking something for that. Or maybe I’ve got blood thinner or I’ve got other things that I’m taking. Now I’ve got my first part done, the part that Murs just talked about, and so now I can start comparing those Part D plans. Because what you’re trying to do is, again, compare in order to find what fits your specific needs the best because different ones might … What if you’re taking no medications and you just want to say, “Well, I just need something in case it comes about. What are my highest risk that I might have?” So think about it that way.  
Murs Tariq:All right. The next point is evaluating your pharmacy network. So if you’re taking prescriptions and you typically, you just go to your local CVS or wherever you get your prescriptions filled, well, that changes based off of the drug plan that you are in. I look at it from a cost perspective and a convenience perspective. Is the plan that you’re going to be in or change to, does it have a pharmacy within their network that is convenient to your location? You don’t want to get a prescription filled and then go have to drive 30 minutes to pick it up every single time, especially if you’re doing this on a monthly basis. So convenience is going to be very important. A store that you’re comfortable with and have gotten used to how they operate.  
 And then there’s also the idea of mail-in prescription online type of pharmacies. There’s pros and cons of those. They may be lower cost, but you lose the convenience. You’re subject to getting things done online. You’re subject to processing paperwork online and then also waiting for it to be mailed to you. So I would evaluate what you’re more comfortable with in that case. And ultimately, is it convenient enough for you?  
Radon Stancil:All right. Our next one here is our cost analysis. What we’re really looking at here is, I got to think about plans and how much they cover, that’s called premium cost, versus my out-of-pocket cost. Sometimes people have the mindset that they want 100% of everything covered. Well, if you do that, you’re going to have the higher premiums. So what you look at is to say, well, how much are my drugs? How much are my cost under the prescription drug plans? I might have a very simple scenario where my prescription drug cost is very low, I take a medication that’s inexpensive, I can buy it with very little cost, would I need to go then buy the most expensive drug plan out there?  
 Again, this is all things that I’m just sitting down and I’m trying to consider it because what we’re looking at is what we call the coverage gap, or if you go into more research, they call it the donut hole. What that is saying, I’m trying to do an analysis and in order to do analysis, I got to know what those things are. So this is just going to take a little bit of data for you to gather and then we can actually start working those figures out. Also, there’s considerations on my income. If my income is low, and sometimes in retirement I have clients that because of their structure, although they might have very good assets, they don’t have a lot of taxable income. Well, that could be to a benefit and that’s going to help us to determine what type of plan that we pick.  
Murs Tariq:The last point under prescription drug plans is going to be annual reviews and making sure you take the time to review your plans. We’ve heard countless stories with some of our Medicare partners as far as, I have a family that they’ve been on the same plan for years and years and years. And we had a conversation and they made a change and it saved them $2,000 a year going forward just because they took the time to sit down and take a look at it. So just like you would with anything else, with your car insurance, with your homeowner’s insurance, with your retirement plan, with your life insurance, you want to be taking a look at those every year. Medicare and the plans around that, I think, is equally as important. So don’t let those slide. And the other importance of it is you can make changes during the Open Enrollment period which is coming up here in October. I believe It’s October 15th through December 7th, is the period. So a limited window for you to make that change if you want to make that change. So stay on top of that.  
Radon Stancil:All right. Main point number two. Dental, vision, and hearing. Big topic. Murs, get us started.  
Murs Tariq:All right. So dental, vision, and hearing. Especially if you’re not on Medicare yet and you’re working for an employer, you pick the healthcare plan that you want and then dental, vision just comes with it and you coast. Well, that’s not going to be the case in Medicare. You’re going to have to think about what type of dental coverage you need and find the appropriate plan for it. It’s not an all-inclusive type of deal. And there’s a lot of importance in dental coverage. A lot of times your dental health can extrapolate into your overall health. So we don’t want to ignore our teeth or our eyes or how we hear because as we age, those elements can start to deteriorate at a rate that we don’t want. So the importance, I believe, is having that coverage and taking care of that.  
Radon Stancil:All right. Vision coverage, which is our next subtopic here. Basically, we got to look at things and say, do I want my eye exams covered? Do I want the coverage of my glasses or contact lens covered? And then, what are my costs there, potential costs? And again, we’re trying to compare this with, do I want to buy a vision plan? Or do I want to just say, no, I’m going to cover my vision? I don’t need to insure that because, again, anytime I try to insure something, it might be that it costs more for the insurance than it does, or is the same, for me just to have my coverage for vision.  
Murs Tariq:All right. The next point is under hearing coverage. The biggest item here, I think, is if you think there’s a chance for hearing aids in your future and being able to have access to those hearing screenings. Those are not cheap things. Hearing aids are expensive, the screenings for those are expensive. And so if that is a risk that you feel that you want to get covered and it’s a common thing that you may want to consider looking into that, having enough coverage for that as well, rather than paying it all a la carte and then realizing that it was way more expensive and it was a much better option to have the insurance, if We’re going to go down that path.  
Radon Stancil:All right. This leads us to our next topic which is integrative plans. And this is where when you’re looking at all these items, there are plans called Medicare Advantage plans that give you all those things as a part of their coverage. I want to give a big asterisk here and that is, you also then have other things that you need to consider if you are looking at Medicare Advantage. So we are not promoting Medicare Advantage plans. What we’re saying is, depending upon all of your analysis, then you can make an educated decision, do I want to do a true Medicare gap policy, or do I want to do a Medicare Advantage? And we’re not going to go into all the details on this today. We will talk a lot more about Medicare Advantage and Medicare gap policies in our webinar. So you’ll want to tune into that, like I said. And we’ll give you more information on that as we get closer to the end.  
Murs Tariq:All right. The final point here is doing an individual needs assessment. So just because your neighbor or your parents or a family member has a certain type of plan, doesn’t mean that that’s going to apply to you. Medicare and healthcare in general is very individualized for a reason. And so doing that needs assessment is going to help you, just like we said earlier, understand your prescriptions before you choose that drug plan, understand your needs when it comes to dental vision and hearing, and how much coverage you actually need versus, well, you may not need as much as your parents do. So understand that, and you got to be forward-looking as well so that you are covered in case something does happen that you think is a possibility of happening.  
Radon Stancil:All right. This brings us to main point number three which we’re going to call Medicare Supplement and Medicare Advantage plans. That’s what I was just telling you about before. So what we’re about to do right now is almost a little part of an outline of what we’re going to cover in the webinar. We’re not going to go into these details. We’re almost just going to list for you these bullet points just so we can say, here’s what we’re going to consider. So don’t think about us answering anything right now. Just say, hey, this is the outline just so you can build anticipation.  
Murs Tariq:The point number one here is understanding the basics. Medicare, there’s a lot that goes into Medicare, but then there’s also Supplements and Advantage plans and what is the difference between those? What they cover, what they don’t cover. They’re state specific, so you got to understand that too, if you’re living in a different state or you just move to a new state. So there’s a bunch of nuances that we’ll cover here in this upcoming webinar to help you get educated on the difference between the two to help you decide what’s going to work best for you.  
Radon Stancil:That leads us to point number two here, cost considerations. You’re going to have different types of premium cost and plan benefits between the two. So we’re going to look at what a premium cost is, what is that? What does it look like between the two types of plans? What are my out-of-pocket costs between the two different types of plans? And then understanding the value of what I get from one to the other and then my restrictions from one to the other.  
Murs Tariq:Which leads me into point number three, is going to be the network restrictions. In network, out of network, maybe you’ve had a family physician for the longest time and you don’t want to leave them. You’re going to want to understand what the plan covers, what it considers in-network so that you can have the flexibility that you want from a choice of doctors, to hospitals, understanding referrals to specialists. Those are big things when it comes to getting your annual visits taken care of. And if you need extra care, how that’s all going to be handled.  
Radon Stancil:And point number four here is, additional benefits. Now this is something that Medicare Advantage plans talk about all the time. Extra benefits like fitness programs, wellness services, assessing even additional benefits. Are they really valuable to you? And what do I give up from the Medicare Supplement plan to be a part of the Medicare advantage for these benefits that can look flashy and good on one side, but is it the most benefit from my healthcare plan?  
Murs Tariq:And the final point here is getting access to personalized advice. Just like you work with an advisor for your investments or retirement planner to help you think of retirement and how that’s all going to play out for you, there are Medicare specialists in this arena that we have access to. And having someone that’s able to take your list of prescription drugs, take your list of your health concerns and everything like that and have someone in your corner to be a sounding board I think is going to be the best way to help you make the best decision for you going forward. And then also, we can’t forget that we have to reevaluate it at least annually. And being able to leverage the resources that you have in front of you I think is going to be great. Unless you just have that desire to become the expert that knows every little thing about every single Medicare policy, you’re really going to want to partner up with someone.  
Radon Stancil:All right, so that leads us down now. We’ve given you all these points to really want to tell you about this webinar we have coming up because we think it’s going to be extremely valuable. We’re going to have a Medicare expert on that’s going to walk us through all these plans. Murs and I are going to really interview them and try to say, “Hey, tell us about this, answer this question.” We’ve gotten a lot of questions submitted and you can do the same thing.  
 So a couple things. If you would like to register for that, if you have specific questions that you would like for us to answer, then simply send an email to info@pomwealth.net. And in your subject line say, Medicare Webinar. If you do that, list out any questions you want to make sure that we cover. Anything at all you want to know about Medicare, list it, we’ll try to make sure that we address it in the webinar. And then also, they’ll reply back to you with a link for you to be able to register for the webinar.  
 So again, that’s info@pomwealth.net and we’ll be glad to get you on that. Absolutely no cost. You’ll be very, very educated. You might want to tell your friends that have been asking about Medicare as well. This is going to be a free open webinar just to give information out there about Medicare.  
 We know we went through a lot. We know that we’ve covered a lot of different material. You can always go to our log page and look back over these points. Feel free to also come to the webinar. We hope you have a great week. We’ll talk to you again next Monday.