Community Partnerships & Business Growth: Local Leaders, Real Connections, Real Impact

0:00 This program is designed to provide general information with regards to the subject matters covered. This information is given with the understanding that neither the hosts, guests, sponsors, or station are engaged in rendering any specific and personal medical, financial, legal, counseling, professional service, or any advice. You should seek the services. Of competent professionals before applying or trying any suggested ideas. Attention to individuals, families and caregivers. It's Medicare Hour and More with Peter right here on KOHD Radio. This is the podcast for all types of insurance solutions while specializing in Medicare because we Medicare. Here's your host, Peter R.

0:49 Joseph. Hey, good morning, good morning, Good morning man. We made it to episode six. Can't believe it. We are rolling along here. Appreciate you guys listening. We are on Facebook Live and we also are on YouTube Live. If you have the app, you can download k four HD Radio to your smartphones and listen to me live there. We're also on Apple Podcasts several days after we air, so you can listen to us in so many different ways. Appreciate you supporters. We just looked on and our first episode has over twenty two hundred views, so obviously we are being listened to. So I appreciate all you guys listening in, our clients, our prospects, our colleagues in the industry, and anyone else who's listening in and wants more information about insurance. So, hey, we've got a different kind of show today. We've got some special guests. But you know, unfortunately some of our guests can't come on live because we are on Pacific time and some of our guests are in different time zones, so we end up recording the session with them and then putting it out there on our live show. So today we actually have two guests that we're going to be talking with. One her name is Prush Cox. The other one name is Ryan Miller.

2:17 They are partners in crime. They are also owners of what's called Gray's Craze, a secuitary catering company out here in both Ontario, California as well as Corona, California. Again, we want to give special voices to our small businesses that we do business with, that we have relationships with, because we want to give those resources to our clients and prospects and our colleagues here in the industry, and that's why we bring them on to our show. So we are going to show that first clip of Prush Cox and Ryan Miller. Here we go. Oh okay, So, by the way, before we shout that clip, I do want to share that, you know, I'm a big basketball guru.

3:05 My Lakers are unfortunately falling apart. If you haven't heard, Luca is hurt, Austin Reeves is hurt. So I'm not sure how far they're going to get in this series. But I'm excited about the playoffs. I think I honestly think this is one base year. I think the Spurs are going to take it all. I know Boston's probably going to get to the finals on the East Coast. I like Detroit. I just don't think they have a lot of experience. So but I'm excited to see how it plays out. Obviously, I think the Lakers might win that first round. I don't know if they're going to get any further than that, unfortunately. So all right, here we go. Here's our video with Presh Cox and Ryan Miller.

3:46 All right, good morning everyone. We want to welcome Presh and Ryan. Welcome you guys to the show. We want to start with some introduction. So, Presh, since you're on here first, why don't you tell us a little bit about yourself and how Gray's praise came to Ontario. Oh, we actually Corona and Ontario. So awesome. Yeah, awesome. So Preshbox owner co owner of Grace Price for An on Ontario. We've been in the restaurant business between my business partner and I over sixty years and he started looking for something just kind of a little side hustle, and I asked him, are you taking me along for the ride? So we flew out to Washington, tried the food and fell in love with it and that's it.

4:35 That's where we got here. Awesome, awesome. Well, Rian, I know Presh sent me some information on you. You've got thirty years experience in the restaurant industry, You've seen a lot, so tell us about your journey. What brought you into this partnership with Presh. Well, first off, you're making me, you're making me feel old. But yeah, thirty years. My journey started at a red lobster and riverside way back in the day as a busboy, and over those thirty years, I've done a tremendous amount of interesting and cool things. I worked for Disney for a while out Back Steakhouse, back Running, Grow Buffalo, Wow, Wings and and such. And now you know, we've got this journey with Grace. Grace which we've been on now for about two years, give or take, was when we really started walking down the path, and it's been fun and exciting. Prussia and I have worked together in the past on a couple of different occasions and just decided that this was the right time to maybe venture in and see if we could do something on our own, create our own business and with our own philosophy and our own way of taking care of our guests.

5:37 So we're excited to share that with you all today. That's awesome. Thanks Ryan. And then how did you guys connect? What makes his partnership work? Anyone can answer? He let him? Okay, okay, Well, you know, I did get the Entrepreneurial book right right around COVID time, and I think COVID had I had an opportunity, did really kind of. I guess, you know, simmer on it a bit. So when I did. Start poking around, we'd looked at a couple of different opportunities, and I decided not to venture far from where we what we knew, which was food and grace. Grace was just this opportunity that we felt was right there for the taking. Really not a not a market for charcuterie boards and boxes at this point in time. So we're the largest and the most nationally known version of charcuterie.

6:29 And you know, we. We walked down this path in twenty twenty four and opened up our first location in Corona in September of twenty five, and I'm sorry in September of twenty four, and then in September of twenty five we opened up Ontario, which is our second location, and just excited to continue to grow this in any way we can. All right, We actually met thirteen years ago. I walked into a Buffalo Wild Wings for an interview and that yeah, and then I continue to say yes in any venture that we do together. So it the relationship works. We pick up with the other lacks. So it's kind of why we chose to go on this venture together because we work very well together.

7:20 I guess remember our parents our parent company is twice on Sunday, And it's because I've always told Fresh that I would pick her every day of the week to work with and twice on Sunday. Nice. Nice. So what sets your charcruiery offerings apart from traditional catering our food options. We put ourselves in the back. Yeah, we do. This is the relationship. So we pride ourselves in the fact that all of our boards are made to order, so there's nothing pre made. We deli slice all of our meats in house. We bake our own bread, We bake our own fennel spiced ham. All of our dips, chances and hummuses are made from scratch. The jams have fresh fruit in them, the roasted beat hummics, klipinia hummus, they're all baked in house. So that kind of what sets us apart from your traditional place. It's not drag cured meat, but sitting in some warehouse for god knows how long and you know you got to open it up and see it there We've done a sliced fresh that morning.

8:19 Very cool. Well, what type of events or customers do you guys? Serve? Mainly anyone and every anyone. Okay, anyone and everyone. We've got anything from you know, you're just having you know, some friends over for football or if you're having girls' night. We've done baby showers, we've done weddings, we've done funerals. I mean, there's no stopping us for yeah, all of them. Okay, okay, very cool. Well, so we're all about you know, Joseph insurance broker. We're about spotlighting small businesses and we want to give you guys a voice. And obviously you know, I know Crush, I think I've known you for quite a while now, and I know we've had a connection through the chamber and so and then Brush actually helps me facilitate a community Facebook forum. So I appreciate your health in that you know, Gino Hills. So just telling all the businesses that are listening in right now, from an operator's perspective, what are some keys to building a successful business? Right and you can answer.

9:28 First off, I'd like to apologize that you're that connected with Presh. I know sometimes that could be very difficult. But the Women's Chamber and then I'm going to lead to the Women's Chamber, so that's a great relationship you. I would I would say, you know, for anybody starting their own business, you know, it's uh, it's obviously has to be a labor of love. I mean the hours that are put in and the amount of work versus initially anyway, the amount of money coming back into the bank account is not is not. Conducive to health a living. So yeah, I mean, I you know, find something obviously that you're very passionate about because you're gonna be spending a ton of hours in it, you know.

10:12 And for us, I think it was really important. That we, uh, we looked at our business as we wanted to elevate the customer experience. And part of that. Is is, you know, we we call it a plus one where let's just say, for instance, someone who get invites us and has us bring some circuitary boards for a baby shower. We will we will ask about, you know, is it a boy or a girl, what are some of the interests of the mom and dad, and try to kind of step that board up a bit from just a traditional board that we would give them. And again that plus one we think is really really important.

10:53 For ourselves more importantly than anything. But also you know, I think our guest notice, we get a lot of thank you cards and a lot of just a lot of covedots in terms of hey, we appreciate you going above and beyond what a traditional you know, business would just do. And it's important to us that that we have that standing within with our customers, but also within the community. We try to do as much as we can to give back and be a part of that, uh, you know, being a part of the chamber and and doing a lot of the events that that they're involved with. I think is is very very important to us. And and it's the difference between owning your own business and working for someone who's maybe values and ethos don't line up with with what yours are, you know traditionally, whereas when when you own and start and create your own business, you can basically just design it anyway you'd like and do it the way exactly.

11:43 The way you want to. That's awesome. Now, do you guys actually have storefronts in Ontario and growna Yes, you do? Oh awesome, Okay, okay, very cool. So how would people actually order from you guys? Is there a website people can go to? We're going to actually have your information scrolling across while this interview is happening. So a website, phone number? What's the best way? Is there a social site that you guys. Have all of the above, so graceprase dot Com is the easiest one. And then they could choose any of the locations, so either the Corona or the Ontario, whichever is closest to them. The phone, any either of the phones both bring through to me, so even if no one's in the store, we'll still get the call. Okay, And we are on Instagram and Facebook as well.

12:32 As TikTok oh awesome. Is it under grays Craze or is there. Grace Craze dot Com on our Grace Phrase Corona and then Grace Space Ontario. Okay, okay? And then how do you guys maintain quality and consistency as you guys grow, because obviously you've been around for a little bit. Are there any values that you guys inherently you know follow. I can answer that, okay, Sara, I'm pretty passionate about it. First and foremost, A majority of the gals that and gentlemen that have worked for us our family. So that's really a cool thing that that we can really kind of protect our investment and protect you know what, what we we feel is important by just having you know, having precious daughter works for us. My stepdaughter works for us, my son worked for us for a while. I've had a niece that worked for us. So I think it starts with just.

13:31 Hiring the right people that you know that are going. To feel the same way about you know, how you want to take care of the guests and how you want to take care of each other. I think that's really vital. And then once you kind of create that DNA woven in and then you start to add other people and blend them in, I think they kind of they kind of kind of just kind of fold into the mix, you know. I always like to say when I when I talk to people, it's like the in and out approach or the Chick fil A approach, and that is it does it just seems like they always hire the best people. And I don't necessarily think that's the case, But what they do is they create a culture that of expectation of guest service, and and that's just that's what it's demanded.

14:12 You don't have an option to opt out of. That, for sure. I think also where all, I'll pick here with your food than we are with ours, so there won't be a strawberry a great or something that would end up on your board. It might end up in our mouth board because we truly take pride in what we're serving. That's awesome. Well, I appreciate both of you sharing your viewpoints on that because that's really important as our small businesses are listening in. You might have touched on this a little bit. But for anyone who's listening who's starting a business, especially in food our hospitality, what advice would you give them. Today from I would say, I think it's kidding.

14:56 No, Ryan, Bryan, where'd you go? I know he's driving, Say madam, Yeah, Brian, you're still there. And that goes into start we lost started lately. Yeah, I have to start over and we lost him again. Okay can you hear me now? We can't? Yeah, okay, So yeah, I think that it's important to understand that, you know, at the beginning, the money will not fall from the sky. It is not going to be a uh a windfall, and and there's a tremendous amount of work that has to be done creating your customer base and and and making your presence known within the community.

15:45 And uh I. Always I always tell Presh, you know, year three is the year that we really need to look at in terms of are we is this a viable business and are we going to make it? So give yourself three years, three solid years of work, uh, to see how it plays out. And we're you know, we're real confident that that's that's gonna be a good thing for us. We're trending in that direction. We've had several significant increases year over year in sales over the last several months, and we hope that that continues. That's awesome. I think that's true across the board with any business. I mean, I can speak from our experience. We started right before COVID hit. We went through uh, trial and error, and we were actually in debt for the first couple of years, and then our business just took off probably the last two years. So you definitely have to give yourself years. I agree with that. And uh, you're gonna You're gonna have some really rough moments too.

16:44 I mean, they're there. We've had some pretty you know, heavy conversations and stuff. But I think it's healthy to have those, right. We need to be able to express how the others feeling and hear each other out. But you got to give it your all. You definitely do and you got to persevere. I mean, you're gonna hit those pitfalls and you can't. You can't relent. You got to have faith, and you got to surround yourself also with great business minds, right, I mean, you can't just do this alone. So obviously being involved with the chamber. That's awesome that you guys are doing that. All right, So we're gonna ask you guys just some personal things and then we're going to do a rapid fire to have some fun to end our segment. All right, yeah, all right? So so first of all, fresh outside of running your business, what do you enjoy doing.

17:31 Nothing, no time for no no spending time with my my kids, my husband, but things that take me away. My daughter and I make bracelets together, so awesome, awesome. Yeah, and what about you, Ryan, I'm an avid baseball fan sports, oh yeah, but mostly baseball. And to take it a step further, I'm an avid fantasy baseball fan. So I'm in my element right now. And uh so I'm I'm unfortunately an Angel fan and a world of Dodger fans. It actually is really sad right now, but uh it is what it is. You know. Every year, we hope springs eternal, and you know, we we got.

18:17 A chance again until about three weeks into it and then well, no we don't. But oh I love baseball, I love sports. I love spending time at home. I I do a lot around the house, gardening. I've got a. Beautiful family, and I've got a you know. A four year old yellow lab that won't leave me alone. So I spent a lot of time here at the house. Also, that's awesome. That's awesome, all right. So both of you can go back and forth rapid fire. So you don't have to say why, you just answer the question, all right, So presh, First of all, favorite go to snack are guilty pleasure. Food, andy twizzler, like the little bell bites for sure, Ryan.

18:59 Oh Man, anything pastry, donut wise, just keep it away, all right. Crush early mornings or late nights, late night? Oh no, But you ask my husband and he tells me. He tell you that I sleep all the time, but I nap all the time. But I'd say late nights because of the industry. Okay, okay, Ryan. It's why it's why we work. I'm I am, I am early, I am get up and get after it. And when the sun sets is when I'm going to bed. No, but fairly shortly after that. Nice, nice, all right, it's coming up in nap times, so.

19:40 All right. A favorite local restaurant crush? Oh hm, anything Mexican, honestly, okay, yeah, anything Mexican. I love it. Ryan. I live in Yorba, Linda, and we've got a couple. We've got reunion kitchen and the stand that are our really cool cool out here. So I love the stand. We've got to stand out here too. Yeah, yeah, you got that, all right. Last question, one word that describes your work ethic rush one word go first? All right, you could go first run. This is easy. This is easy, delegate. That is so true.

20:32 They called me so just so you know, they call me the Tom Sawyer. I don't know if you're familiar with Tom Sawyer. And he had to paint, he had to paint the fence, and he ends up getting all of his friends to do it for him. That's man, I don't know, brying you do you answer for me? No way, I am not answering the trap for sure, No way. No, I'm relightless. Those two words. I mean, that's good. All right. Last question for both of you. Why should Gray's Craze be on their list?

21:15 Right? You know, we we have we have a saying that says, we celebrate you, and I think it's important as we, you know, in life, that we celebrate the things in life that make us happy and we want to be there to help you with that and make it easy and more enjoyable and just stepping up a bit. So for us, it's just you know, celebrating whatever you're celebrating. Awesome, Awesome, They're wonderful stories through food. Sorry, that's mine, great stories through food. We're the new water cooler, right, everyone used to way back in the day. We're aging ourselves facing that we all used to gather around water coolers and talk. And that's what food's about. Food brings people together. Awesome, awesome. Well, thank you both for being on our show, for sharing your stories and for building here in our community of Ontario and Corona. To our listeners, Supporting local businesses isn't just about buying a product, it's about investing in your community. So this is Medicare Hour and More with Peter, where we bring you more than just Medicare.

22:13 We bring you to people and businesses shaping our community. Thank you both, Thank you Ryan, thank you Prey. Thank you, thank you for having us. Thanks Peter. All right, I hope you guys enjoyed that interview. I really love both of those guys. You know, it's good to hear how businesses have struggled. It's not just any business, it's across the industry, especially COVID hit really throw people for a loop that you know, business is hard and it takes uh an army, it takes a village. You know, you don't want to do this on your own. You want to connect with colleagues that have gone through these trials and struggles. We all go through debt. I mean, that's a necessity, it seems like in business before you come out on the other side. So you know, don't fret.

23:08 If you are starting a small business like myself or like Prussian Ryan, you'll get through. You can always reach out to me for advice. I've been through hell and back, so you know, obviously I'm still here survived. Our business is thriving now, so we will help you through that. And again you can find their information. Grayscraze dot com is where you will find all their information. You know, even if you're doing, like let's say you're a colleague of mine, you're in the medicare space and you're doing a a seminar for those turning sixty five, or you're doing a conference for your agents and a training. That's a great place to have food for you know, you can cater your event with Secuitary. They've got all kinds of things you can look on their website and it's it's very affordable. So I would highly recommend them for your future events. All right, so before we go on to our next interview, we're going to show you how.

24:17 You know, we've been talking about how to enroll into Medicare and it seems complicated, but it really isn't. We We try to dumb it down as much as we can. We make it simple for you guys. We walk you through the steps. Check out this commercial. That's it. I mean, you can enroll simply from home, believe it or not. COVID actually trained all of us to do zoom meetings and own appointments and that still works till this day, and so a lot of my clients, I mean, we do still meet in person. I love meeting people in person.

25:09 They come over to our place of business, or I go to their homes to conduct appointments. But obviously you can do this over the phone. We do this compliantly by recordings, and we just collect your information. We submit the application for you, guys. You get a confirmation email and then we send you stuff in the mail, and then the carrier that you sign up with will send you your insurance card. It's that simple, so don't fret. We will do whatever it takes to help you get onto medicare, whether it's at home, through zoom in person, We're right there for you guys. All right, So this next video, we were interviewed by Christine Chang, a local realtor here. We actually were a part of what's called B and I at a networking group for small businesses.

26:00 I'm no longer a part of that group, but she is and she's knocking it out of the park. So she wanted to interview our business and what we're all about. So please watch this video. We showed some of it last week, but we're going to show the rest of it today. Hi Peter, Hey Christine, how are you. I'm good? How are you? I'm good? I'm it's going well, it's my birthday today, so I'm kind of celebrating a couple of things. But I've had some great conversations with some clients this morning, so it's been a good day. Sounds good. Happy birthday. And I see that your kids made you breakfast this morning.

26:40 They did, they did. That was an exciting surprise this morning. That's that's so cool. Well, thank you for joining me today in this interview, because I've had so many people reaching out to me about medicare and what to expect and their loss and I perfect because I know you and I know that you'd be the perfect person to talk to. So so I just want to thank you. For joining me today. Of course, let me share a little bit about Peter to the group. Peter is an Egyptian American and has been married for seventeen years to his beautiful wife, Bonnie. She is a supervisory social worker for the State of California.

27:22 They have two amazing kids, Noah Liam aged five and Julia Grace, aged ten. He was in the nonprofit sector and a pastor for twenty two years. He then transitioned into the insurance industry for three years. Peter's family was featured in a local magazine in February of twenty twenty neighbors of West Chino Hills for the business they work and the impact in their community. He was also featured on Biz TV Los Angeles for an interview about Medicare. He is also an ambassador for Chino Valley Chamber of Commerce since February of twenty nineteen and a member of the B and I Chino Valley Strategic Alliance Group. Peter is looking out for the best interest of seniors. He has no bias toward any carriers. Peter works with all the top star rated plans. He's contracted with scan, United Healthcare, Anthem, Humana, health Net, Blue Shield, Etna, Silver Scripts, and Molina. Peter can help with Medicare medical plans, Medicare supplement plans, Part D plans, as well as low income help for Part D.

28:35 So I do have some questions for you, Peter. Let's jump right into it. Why did you decide to go into Medicare? So, for those who don't know me, I was in the nonprofit sector for about twenty two years and just have a servant's heart. I love helping people out and so I felt like after I left the nonprofit sector, I felt like this was a great place to go for my skill set in helping people kind of navigate the Medicare journey. And like I said, I love helping people. I'm all about educating and giving free consultations. Awesome. Now, how old do I have to be to start thinking about Medicare and why?

29:20 Well, honestly, you know, people say you should wait until you turn sixty five, but I do have some prospects that I work with who are sixty three. So I would say, if you're turning sixty three, you need to start thinking about it because there's so much out there, There's so much terminology, and it gets kind of confusing. So it's important to start planning ahead and so I can work with you and then when we turn sixty five, we can get you on the right plan. Good to know. Now, how does one enroll or start the process of Medicare. So it's recommended that ninety days before you turn sixty five, if you're not collecting Social Secure that you contact Social Security Office to start the enrollment process. With Medicare Part B, you're automatically enrolled in Part A, but you do have to start payperwork to get into Part B, so ninety days before your sixty fifth birthday.

30:16 Ninety days So this is very confused. But what's the difference between Medicare, medical Medicare Supplement, and Medicare Part D. So I will try to break this down as simplistic as possible. So, Medicare is the federal government healthcare. That's what we pay our taxes into. If you're a W two employee or even if you're self employed, you're paying into both Social Security and Medicare. That's taken out of your paycheck. And so that is something that we all are entitled to when we turn sixty five. Medicaid is actually a state subsidized health program for those who qualify.

31:00 It's usually for those who are low income. We're talking about for singles nineteen thousand dollars married would be about twenty four thousand dollars gross for the year. And then Medicare Supplement are for those who travel a lot when they're retired. It's for those who want to see any doctor that they want and be one hundred percent covered. And so I usually saw these kind of plans to folks who are traveling to other states visiting family, and God forbid anything happens to them. If they have a supplement plan, they are one hundred percent covered. And then Part D is your prescription plan, and that's something that you have to have if you don't have a Medicare advantage.

31:41 So let me break this down even even into smaller bits. Medicare advantage is called Part C that encompasses A, B and D. If you don't have Part C, then you have to get Part D. That's kind of just the way things are set up. So I hope that that it helps make a little bit of sense of all that terminology out there. That definitely does. Next question is what makes one insurance company better than another one. So the federal government actually rates all our plans that are out there from one star, which is the worst, to five stars, which is the best. And so there are some plans that people are in that are even not rated at all, which means that's not a good thing.

32:27 That means the federal government has passed on rating them because they're so bad. So ratings are based on both customer service and healthcare needs. And so I always try to get my clients on plans that are four and a half stars are above. Okay, got it? Now, can you help me if I'm on both Medicare and medical and if so, how does that work? Yes, people don't realize that there are plans out there with insurance companies. If you're both on Medicare and Meta cal there are extra benefits out there at no extra charge that you can get on and it's easy. It's an easy enrollment process. It takes about five minutes, and you get extra benefits like chiropractor, acupuncture, in home support services, emergency response system. All those benefits are at your disposal.

33:20 All you have to do is get with a trusted agent. Got it? And you are a broker, So do you offer any help or any other products? I do. I'm actually just contracted with Cover California, and the reason being is I do have some clients have spouses that are under sixty five and need to find some kind of healthcare, need options to fill the gap until they turn sixty five. So I do offer health insurance. I also offer life insurance on the side, but ninety percent of my business is Medicare, and like I said earlier, I do offer also Medicare supplement plans. Got it? Now? Last question? What is annual enrollment period? And I keep getting inundated with mail every October about Medicare.

34:07 Why is that? Well, unfortunately, annual enrollment period is your opportunity to review your plan and switch plans. And so, just like with an employer, every fall, you get a change your health plan if needed, same thing with Medicare. You're able to change your plan at any point in October through December seventh, and that's what's called the annual enrollment period. Got it? Thank you so much, Peter. This helped me a lot, and I'm sure it's going to help all my contacts on my Facebook, we Chat and Instagram. Thank you so much. If when and if they want to get into contact with you, I would be giving your information to them.

34:51 Is that okay? Yes, please do. And it was a privilege and honor to be interviewed by you, Christine. Thank you, Peter. All right? But bang, all right. You know obviously that interview was done I believe five years ago, so I've actually been married now for twenty two years. And you know some of those numbers have changed too. For Medicare with IRMA, you know obviously that changes every year. So your premium is based on how much your gross income is again. We'll go over that in the future episodes, but already seen some people are watching our show live, so I commented back, thank you, Andrew Soaksa. He was one of our first guests on our inaugural show six weeks ago, so I appreciate him watching today and commenting on our show.

35:47 We love our podcast too, so thank you for supporting us. Andrew. Yeah, so you know, obviously we offer more than just Medicare. Our show is medicare our and more so we talk about small businesses, We talk about all things insurance, so you know, yeah, about seventy percent now of our business is Medicare, but we do property and casualty, We do small business group benefits, we do health insurance for under sixty five, We do commercial insurance, we do liability insurance, we do earthquake insurance, home insurance, so you name it. We're kind of your one stop shop. And if you see our Google reviews, we are top rated here in southern California, so you can't go wrong working with us.

36:30 So I appreciate that last interview with Christine, but we do offer more than just Medicare. Just to keep you guys a praise to that all right, So we've got probably about ten minutes left of our show, so I wanted to finish out. We were talking about Part C for quite a while, for about two weeks, and so this is our last week talking about Part C and what that means for you folks, what the differences is between them parts and supplement. You know, in a couple of weeks we are going to talk about a supplement plan and what the difference is there. I will be actually attending a Medicareans twenty twenty six conference in Las Vegas next week, So next week's show is going to be a little bit of difference. It's not gonna be live, It's going to have some recordings and that it will have new pertinent information. I encourage you to continue to listen in our show and glean some information from that podcast next week. But yes, I will be in Vegas next week. I'm excited. CMSA is usually out there centers for Medicare and Medicaid. We learn about our new regulations for this next year. We learn how to pivot and do our best for the plans coming out for next year for our clients, and we learned some from new roles, new regulations, all that stuff. That's why we go every year so that you know we're not left in the dust.

38:01 We definitely want to continue to grow as a business and continue to grow in knowledge every year as regulations always change in Medicare every year, So that's why we go to those conferences. So anyways, let's focus in on Part C. Here we talked about, you know, the differences of being like a network plan. Most of the Medicare Advantage plans are HMOs if you remember us talking about that last week. Their PPO plans are not as prevalent. There are though PPO plans outside of California, They're just not as prevalent here in southern California. PPOs allow you to see doctors in or out of network. Out of network at a higher cost, So Medicare advantage usually it has a low or zero dollar premium flexibility. It's limited networks. Again, you're in a network. If you're in HMO, you have to get an authorization through your primary care doctor to see a specialist. With original Medicare or Meta gap or Medicare supplement, you have nationwide access. Out of pocket. Yes, there's a maximum out of pocket costs on Medicare advantage plans anywhere from two hundred dollars all the way up to eight thousand dollars, just depending on the region of where you're at. In the United States, for original Medicare or Medicare supplement, there is minimal out of pocket if you're just on original Medicare. Remember there is no ceiling, so your max out of pocket can go up and

39:33 up and up and continue going up. You're only yeah, you're responsible for twenty percent of the cost. So if you have one hundred thousand dollars bill from the hospital, you're gonna have to pay twenty thousand dollars. That's why people get on the supplement or an advantage plan to mitigate those costs. Referrals. Remember Medicare advantage, it's often required original or Medicare supplement. There is no referrals needed unless it's physical therapy. On supplements, I think that's holds travel limited. You can go to any urgent care emergency room facility across the United States if you're on a Medicare advantage plan. If you're on a Medicare supplement, though, you could see whatever doctor you want wherever in the United States, so it's excellent in terms of travel underwriting. Later Medicare advantage it could be risky. Again, it just depends on the area you're in and the plan you're on. We've had some clients, you know, go through disapprovals or not get authorizations fast enough to go through, or not approved for certain lab work. It doesn't happen often, but it does happen with Medicare supplement. Remember, you are guaranteed in when you're algible for Medicare. If you try to get onto Medicare supplement later on, then you have to go through underwriting.

40:55 They're going to pull your medical records and you're not guaranteed in. So just keep that in mind, all right. So who's Medicare advantage best for. It's best for budget conscious clients, healthy individuals, people who stay local are okay being in a network, and veterans. You compare this with a VA plan. You can also be on a Medicare advantage plan without the party for if you're on Trycare for Life. I know some folks are hesitant to do that. Trycare does take care of your drug prescription costs. What I would recommend is if you go on a Medicare advantage.

41:38 You choose a PPO plan and you can use the extra benefits on that Medicare advantage plan, like your vision, hearing, dental. That's the advantage of having trycare and then being also on a Medicare advantage plan. So just talk to us about that if you're in that scenario, so we can walk you through that. Now, it's not ideal for frequent travel uh snowbirds, clients with complex conditions cancer treatment. Again, with cancer treatment, your max out of pocket. A lot of times you're paying twenty percent of the chemotherapy drugs. Some plans will max out and some don't. So you got you gotta talk to a specialist and walk through that to see if that applies to you or not.

42:22 And then specialist dependency. Clients with specialist dependency, I highly recommend going the supplement route. All right, So Medicare advantage works great until you actually need it, right, So a lot of people who out here in California, I would say it's pretty competitive and people have not run into as many issues. If you're in other states, though, if you're constantly sick chronic conditions, sometimes it's better to be on a supplement. It's not about what you pay when you're healthy, it's what happens when you're sick. Your doctor matters more than your premiums. So obviously you know, if you want to have a certain doctor, then a supplement won't bar you from that. An HMO plan might. So that's a big difference as well. Now, the enrollment periods for PARTZ, We've talked about this, but I'm going to quickly go over it. Initial enrollment period it's going to be when you're turning sixty five. That's IEP annual rollment period.

43:25 As you saw in that interview with Christine, you guys who are turning sixty five get inundated with mailers, with calls, all that stuff, unfortunately. And so annual rollment period is October fifteenth through December seventh every year. That's where you can switch your Medicare advantage plan or you know, you can drop your Medicare advantage plan and go onto original Medicare with a part Z for your prescription drugs. Open Enrollment period that's OEP that's January first to March thirty first. You have another period there to actually switch your Medicare advantage plan only one time. So with AP it's Basically, the last plan in is the one that takes precedent with OEP. Once you change it during that period, that's the plan that's going to stick with you until the next following year. And then there are special Roman periods life events. If you move out of a not a zip code, but a county, then you obviously can change your plan if you move out of state. If there are what's called FEMA Special Roman periods where it's weather related, whether out here in California it's wildfires or earthquakes, other places it's going to be winter storms or hurricanes. Any of that, CMS will put out a special enrollment period which allows the client to change their Medicare advantage plan.

44:49 So again you want to get with a client to know if those are in place in your area. Now, the biggest mistakes clients make is that they choose based only on zero dollar premium. You want to choose what's best for you in terms of the benefits that are provided, not checking your doctor or hospital networks. That hits us hard down the road is that you find out you thought your doctor was in a medical network and then also in the midyear, they drop out of that medical network and then you're stuck with not being able to see that doctor anymore. So again, you want to make sure that your doctors are in network with your plan. Ignoring drug formularies. Every carrier is going to have a different drug formulary, so it's important to give a list of your prescription drugs to your trusted advisors so they can run through the costs of that and then not understanding your maximum out of pocket exposure. That's really important because sometimes not everything applies to the maximum out of pocket.

45:51 Never reviewing your plan annually. If you just decide, you know, I'm going to sign up and just leave it, let a roll, I'll just stay on its plan rolette and you're throwing your coin onto black I don't know, seventeen or something like that, and then you just let it stick. Obviously, you don't want to do that every single time that you're playing, right. You want to diversify and make sure that their best odds are to change that up. Same with your Medicare advantage plans. Benefits change every year, and so you want to make sure that you're reviewing that plan every year with your insurance advisor. You will get basically a letter in the mail from your insurance carrier showing you what benefits are changing, if they're increasing or decreasing, you want to make sure that you pay attention to that.

46:46 It's called an anoc annual notice of change, and a lot of times it gets lost in the shuffle of all the mail that you get about Medicare and you don't realize your benefits are getting cut. So again, talk with advisor every year. And assuming that the Medicare advantage is the same as Medicare, it's not. It's completely different. Yes, it covers your basic Medicare needs. But again that primary insurance carrier is taking the primary in terms of their Medicare. So if you're like, let's say you sign up with the healthcare and I Healthcare is going to take precedent not original Medicare, all right, so you want to keep that in mind. Again, dress of insurance broker, We're a plan reviewer, not a planed seller. That's you know, our motto is that we Medicare. We we highly want to, you know, gain your trust. We want to build that relationship with you. We're not about you know, being transactional, making the dollar and then moving on. We continue that relationship with you.

47:55 Every year. We review plans with our clients constantly. We're in touch. You get a newsletter from us, you get birthday cards, you get emails constantly telling you different changes in regulations with Medicare. So and your reviews are our recurring client trench points. We educate on exit risk to go into a Medicare supplement, and we build trust by explaining downsides up front. We are very transparent and we want to make sure that you guys understand everything that's going on. So again, Medicare advantage isn't good or bad, it's just specific, all right. The real question is does it match your lifestyle, your doctors and your long term health needs? All right, that's what you want to keep in mind, all right.

48:42 So we are going down to our end of our show. We thank you so much for listening to Presh Cocks, to Ryan Miller, to Christine Chang, and we hope that you continue to listen, ask questions. And again we're live on YouTube Medicare Minute with Peter. We're live on Facebook both on Joseph Insurance Broker, LLC and my personal email, our personal Facebook Peter Joseph. So please ask us questions. Chime in. If you have any feedback, we'd love to chat with you while we're doing our show. So I will not be live again next week. I will be in Vegas with my colleagues at a Medicare conference, but we will have our show in a different format, so please listen in. Thank you so much for your support and you trust us. Why do you trust us because we Medicare.

49:40 Thanks for listening. Tune into Medicare Hour and More with Peter every Tuesday at nine am Pacific time right here on KFOHD Radio at kfohd dot com for more real life stories from experts who medicare about you and protecting your health, your finances, and your future. See you next week. H