BRIDGING the GAP to Medicare

by | Mar 12, 2021 | Healthcare for Businesses, Medicare, Savvy Health Shopper, Uncategorized | 0 comments

Retired before age 65 and want to BRIDGE the GAP to Medicare?

Lately, we have been getting more referrals from financial advisors looking to help save their clients money from expensive individual health care plans because they simply can’t afford them and it destroys retirement income distribution later on.  Most of these men and women age from 53-64 and are not inclined to give over cash savings for some “security”.  Let us take a look.

 

To begin is to GIVE.

We empower YOU, the consumer, with the information and knowledge you need to know about the health care system, (if you care enough learn).

It’s a SYSTEM.

It’s a system that cares more about your money than your well being.  Sorry, but that is the truth.

It is PEOPLE that CARE, not corporations.  We teach you how to SHOP the SYSTEM.  And God Bless all the care givers, practitioners, nurses and more that offer kindness, gentleness, patience and love that heal others.  Thank you!

Below are two scenarios that came in this week that we want to share with you because maybe you or someone you know is experiencing the same pain.  We are going to compare two health benefit plans for both cases; insurance (contract for payment)  versus medical cost sharing (membership guidelines).

But first, let us address the top areas of health related concerns (or fear) we hear the most.

  1. Pre-existing conditions
  2. Expensive medicines
  3. Emergency medical help
  4. Doctors, network

Easily addressed with some QUESTIONS for you.  (From these answers we can create a strategy that matches your concerns and lifestyle, we want to see you happy.)

  1. Pre-existing conditions
    1. when did this condition start
    2. how do you manage this condition
    3. have you ever been hospitalized for this condition
    4. do you take meds, if so, what is the cost
    5. does having this condition cause you fear and insecurity
    6. who is your doctor and how often do you meet with your doctor
  2. Expensive medicines
    1. pharma details: name, dosage, frequency, cost
    2. when did you start these meds
    3. when will the meds end
  3. Emergency medical help
    1. where is your local urgent care? avoid hospitals (cost doubles)
    2. research the cost for a visit
  4. Doctors, network
    1. who is your doctor, specialist, clinic, address
    2. how often do you go to the doctor
    3. do you travel
    4. would you like access to alternative treatments for illness and disease
    5. What is the cost (look up pricing on clinic website)

 

FIRST CASE:  Larry is 63 and his job has been eliminated causing him to retire earlier than expected.  The company has given him a small severance but it does not include any health care benefits.  Larry and his wife age 62 can either go on company COBRA, self insure or find an individual plan to share their health risks.

From the questions above and answers given; Larry is healthy but is having some blurred vision lately.  He had some diagnostic testing performed to no avail and he was offered steroids to which he declined.

Larry and his wife take no medicines and are otherwise healthy with no other pre-existing conditions in the past two plus years.  Larry and his wife are planning to move to Florida.

Low maintenance couple;

RECOMMEND Larry and his wife cover their risk of a major medical event; illness, injury, accident, diagnosis.  (Incorrectly referred to as Hospitalization, and only because it causes one to think EXPENSIVE medical bills.)   And for the day-to-day stuff, pay as you go and use Teladoc.

The cost for this strategy starts from $350 a month for both husband and wife.

Plan includes teladoc for virtual care any where in the USA 24/7/365 and ONE office visit within the PHCS network nationwide, this is often used for the PREVENTATIVE well person check up.  All other in-person doctoring is the discretion of the consumer.  We will show you how to SHOP healthcare!

REASON for this recommendation: this couple has little to no medical conditions besides the eye problem Larry is currently experiencing, and it is not life threatening.  We shopped the cost for eye procedures on the medicare.gov website as a baseline for the self pay cost, and the most we found was $1300.   (we are using this treatment $ in the example below to illustrate the potential cost either way).

We compared traditional insurance to medical cost sharing membership for both Larry and Mary.

Here are the numbers.

**Larry’s Eye problem EXAMPLE $ 1,300 medical bill.

 

Carrier:
Cost:
Deductible:
Max-out-of-pocket:
Co-insurance:		 UCARE
from $1017.94/month
$6950
$13,900
$ 0 after deductible		 MCS
from $350/month
IUA $5000
$5,000 per NEED (x3)
N/A
ANNUAL Plan Cost $ 12,215.28 $ 4,200
Treatment for Larry’s eye** $ 1,300 (toward deductible) $ 1,300
Total for the year $ 13,515.28 $ 5,500

FYI: Larry will have to change the UCARE insurance plan once they move to Florida, but the MCS plan is good worldwide, so no change required.

 

SECOND CASE:  Joe Man will be turning 65 in July and his wife is 7 years his junior plus they have two sons.  Joe would like to retire but he believes he should continue working until age 72 when his wife becomes eligible for Medicare because he knows medical insurance is expensive.

Joe Man and his family are European and have a mainly Mediterranean diet (healthy).  They do not take any medications except for Joe has been recommended to take a cholesterol medicine because of a family history. (hmmm, how does taking a medicine for a condition you don’t have improve the condition you don’t have doctor? …. maybe that will be another article.)

RECOMMENDATIONS: based on the answers given.

Joe should request a letter from the employer stating any changes to his health benefits once he turns 65 and what the health benefits will cost for his family.  The table below will illustrate health benefits without the company group plan. Once Joe receives the benefits letter we can compare that cost to the sample below;

Joe retiring earlier than age 72 and protecting his family.

Joe’s monthly Medicare expenses 2021:

Part B                  $148.50

MA Plan              $0                       $3000 is added to a NEW MSA

Part D*               $16                      *optional

TOTAL                 $1,974/year

 

Spouse (age 57) and sons (17 & 21)

Carrier:
Cost:
Deductible:
Max-out-of-pocket:
Co-insurance:		 Preferred One
from $ 872.17/month
$3000/6000
$6900/13,800
20% after deductible		 MCS
from $433/month
IUA $2500
$2,500 per NEED (x3)
N/A
ANNUAL Plan Cost $ 10,466.04 $ 5,196
Accident EXAMPLE $25,000 in bills $ 7,400 $ 2,500
Total for the year $ 17,866.04 $ 7,696
Joe’s Medicare $ 1,974 $ 1,974
TOTAL for the year $ 19,840.04 $ 9,670 (PLUS $3000 MSA) = $6,670 indirectly

 

This is a SAMPLE of the calculations we go through to determine the true cost or at least as close to understanding what the budget will be with the known costs.  We want you to understand what you are paying for!!

We hold workshops on this topic to educate men and women about how health care works and what Medicare is all about.

Want to retire early, we can help.