March 17, 2026

Enrollment Periods for Medicare with Special Guest Ryan Dawson, Dawson Insurance Group

Enrollment Periods for Medicare with Special Guest Ryan Dawson, Dawson Insurance Group
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Season 1

Episode 2 of MedicareHour and More with Peter dives into the key Medicare enrollment periods every beneficiary should understand. Host Peter Joseph is joined by Ryan Dawson of Dawson Insurance Group (Idaho) to break down Initial Enrollment, Annual Enrollment, and Special Enrollment Periods. The episode also explores Medicare Part C (Medicare Advantage), how these plans work, and what beneficiaries should know. Plus, conversation on current events and sports.

MedicareHour & More With Peter! is broadcast live Tuesdays at 9AM PT on K4HD Radio - Hollywood Talk Radio (www.k4hd.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). MedicareHour & More With Peter! TV Show is viewed on Talk 4 TV (www.talk4tv.com).

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WEBVTT

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This program is designed to provide general information with regards

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to the subject matters covered. This information is given with

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the understanding that neither the hosts, guests, sponsors, or station

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are engaged in rendering any specific and personal medical, financial, legal, counseling,

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professional service, or any advice.

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You should seek the services.

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Of competent professionals before applying or trying any suggested ideas.

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Attention to individuals, families and caregivers. It's Medicare Hour and

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More with Peter right here on k FORHD Radio. This

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is the podcast for all types of insurance solutions while

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specializing in Medicare because we Medicare.

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Here's your host, Peter R.

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Joseph Hey, Southern California and West Coast. Good morning, Good morning,

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good morning, and glad to see you guys here. This

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is our second show. Excited to be here with you guys.

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I want to stay happy Saint Patrick's Day as well

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as you could see. I am wearing green for the festivities.

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So hey, glad you could join us. Obviously, we are

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live on a couple of places, our Facebook business page

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Joseph Insurance Broker, LLC. You can always drop comments and

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we will comment back as soon as we can. We

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are also on our YouTube channel, medicare Minute with Peter,

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so look for that channel. We will be broadcasting live

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on there as well. So before we get into our

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topic for this morning, we are going to kind of

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just summarize what's going on out in the world of sports.

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I'm a big sports fan, if you guys don't know,

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a huge Lakers fan, huge Dodgers fan, and huge Rams fan.

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Live an hour south of Los Angeles. That's where our

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brokerage is situated, and so hopefully you guys are catching

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that World Baseball Classic. It's been pretty exciting stuff, very

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controversial play this last Sunday night. The US did win,

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but that last strike looked like a ball to me, unfortunately,

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but hey, we will take the win. And now it

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looks like it's going between US, the US and Venezuela

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tonight at five o'clock PM Pacific time, So hopefully you

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guys can catch that exciting stuff. And Lakers are on

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a great wedding streak, so I'm excited about that as well.

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They are in third place in the West, so hopefully

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they can continue that trend as well. All right, and

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I just want to just send a little prayer to

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all our troops that are being sent out for this

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conflict in the Mid East. Hopefully we'll be coming to

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an end soon, I hope and pray and then for

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the safety of our soldiers. So our thoughts and prayers

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are with you guys, all right. So today we are

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going to have another special guest, one of my agents,

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Ryan Dawson, who's one of my agents for probably the

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past i'd say about maybe seven eight months. He came

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on board, lives out in Texas, just moved out to Idaho.

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He's on the border of Idaho in the state of Washington,

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and he will be our special guest today. His insurance

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group is called Dawson Insurance Group. He's been doing this

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for quite a while. He's been the insurance pace for

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quite a while, but now he's devoting his time and

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specializing in medicare and health insurance as well as small

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business group benefits. We'll be talking to him getting to

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know a little bit more about who he is as

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a person and why he has entered into this industry.

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So I'm excited to bring him on in about ten minutes.

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So the topic for today though is we you know,

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last week we talked about Medicare one on one. We

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broke down the different letters ab, C and D, and

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we dove really into A B and D. We're gonna

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talk about see a little bit more today. We also though,

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we'll be talking today about Medicare enrollment periods. That's really important,

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especially we're going to look at common scenario guides for

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you guys to just be well aware of, especially if

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you're turning sixty five, or you are collecting Social Security,

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or you're leaving your employer and you're retiring at a

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later age. So we were going to look at all

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those different scenarios. We don't want to confuse you, guys.

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We want to make sure that everything is clear cut.

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So let's kind of dive into the different periods for

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you guys. Again, if you have any questions, comments, please

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drop them down in the chat. If you're on our

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YouTube channel, please subscribe, but we'd love to have you

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subscribe to our channel for the latest information in the

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insurance space. All right, So, so our first period is

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called the initial enrollment period, and so who applies to

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is individuals turning sixty five and becoming eligible for Medicare.

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Now there's a seventh month window. When you do come

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into turning sixty five, you can apply for Medicare three

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months prior to your sixty fifth birthday, and then your

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birthday month, and then three months after your sixty fifth birthday.

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So that's that seven month window. There's no penalty when

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you sign up within those seven months. I always tell

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my clients are prospects to sign up as soon as

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that window opened. So the reason being is Social Security,

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if you don't know, is so understaffed right now. They

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don't have a lot of folks they're helping, and so

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it takes a while for the enrollment process to happen.

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It takes a longer time to get your red, blue

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and white Medicare card mailed out to you could take

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six to eight weeks, and so we want to make

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sure that you guys are ready to rock and roll

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when it's your sixty fifth birthday, you have your Medicare

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ID in hand and we can get you started on

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your Medicare journey. So that is the seven month window. Again,

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it's called the initial enrollment period. Our second enrollment period

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is the general enrollment period. So who that applies to.

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It applies to individuals who miss their initial enrollment period

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and don't qualify for a special enrollment period. A lot

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of times, you know, we have clients who just they

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don't know about these enrollment windows. A lot of them

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are so arbitrary, right, I mean, it's it just doesn't

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make sense sometimes, and it's like, you know, why can't

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we just sign up for Medicare when we want to?

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Unfortunately that's the way the government has things set up.

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So we want to be careful and not pass those

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deadlines because you will get a penalty for life. For

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Part B it's ten percent per year, and for Part

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D it's about thirty two cents per month, but you

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pay that penalty for the lifetime until you pass away.

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So you want to avoid those penalties at all costs,

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all right, So for general ROMAN period, the timing is

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January first through March thirty first each year. Coverage starts

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the first day of the month after enrollment. So here's

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the scenario examples that would happen with that case. For

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person forgot to enroll in Part B at age sixty five,

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that happens a lot person had no qualifying coverage and

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must enroll late. So we're going to talk about that

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scenario that tends to confuse folks quite a bit. And

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then the possible late enrollment penalties for Part B and party.

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So let's say you missed the window. Now you're paying

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a penalty. Well, now you're allowed to enroll into Medicare.

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Even though you have that penalty, it gives you that

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special time to actually enroll into Medicare at that point.

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So the scenario where you have no qualifying coverage, it

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mustn't relate. A lot of folks don't realize. And we

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talked about this a little bit last week. If you

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are retiring a lot of times your employer is going

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to offer you what's called cobra coverage. Well, unfortunately, cobra

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coverage is not credible coverage with Medicare or CMS or

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centers for Medicare and Medicaid, And so folks think it's

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credible coverage and then they find out the hard way

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it's not, and then when they sign up for Medicare

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they're hit by that penalty. They're upset they didn't realize.

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And so I'm glad if you are a current client

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and you're listening in that you hear this, and you

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hear this, well, Cobra coverage is not credible coverage. So

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if you're offered Cobra coverage, yeah, you can stay on

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it for a few months, but you have eight months

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after you retire to get onto Medicare without a penalty. So,

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like I said, you can stay on cover for a

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few months, but after that, I would highly recommend you

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jump on and enroll into Medicare Part B, so you

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don't get that enrollment all right, I'm sorry that penalty charge,

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all right. And then here's the big enrollment period that

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everyone hears about in commercials. It's the annual Enrollment period

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called AEP. That's how all my agents refer to it.

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AP is October fifteenth through December seventh, and this is

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a big period where you can actually enroll into Medicare

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Part B. You can actually change no, no, no, sorry, you

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can't enroll into Medica PARBENT. You're already on Medicare for

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this period of time, and for that you're going to

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actually be able to switch Medicare advantage plans. A lot

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of times, benefits change every year, and so you want

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to make sure that you're on the best plan for you.

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You always want to be with an agent like myself

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or my colleague Ryan to review your plan and make

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sure that your benefits are still the same or have

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gone up. If they've gone down or your costs have

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gone up, that's the time to review and maybe, you know,

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possibly move over to a different carrier for your Medicare

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advantage plan. So that's the time to do that is

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the October fifteenth through December seventh is switching Medicare advantage plans.

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There is you can move from original Medicare to a

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Medicare advantage So if you're just on original Medicare, which

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is Part A, B and then Part D for your prescriptions,

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you can move to a Part C plan, which is

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Medicare advantage. You can also drop your Medicare advantage and

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return to original Medicare. So that's a way that you

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can do that as well. And then you can also

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change your Part D prescription drug plans during this time.

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So especially with your Part D, if you're on just

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a Part D plan, those premiums fluctuate pretty crazy every year.

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This last year are the premiums for a lot of

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the carriers shot up dramatically, and the reason being is,

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you know, we'll talk about this later, but they went

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into this area where they decreased the cost of all prescriptions. Well,

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that was going to affect the premiums in one way

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or another, and that's what happened, and the premium started

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shooting that on the party plans. So let's stop there

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with the special enrollment periods. I want to welcome Ryan Dawson.

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Like I said earlier, Ryan Dawson is one of my agents,

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just moved from Texas. He's out on the border of

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Idaho and the state of Washington, and he has such

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a heart for seniors. He's been in the insurance space

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for quite a long time. We're going to get to

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know him a little bit of why he's doing what

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he's doing, and hopefully maybe a little bit more about

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his personal life as well. Ryan, Hey, buddy, we're excited

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to have you on. Can you hear me?

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Yeah? Yeah, I can hear you? Can hear me? Yep? Yep?

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Awesome. Well, we're excited to have you on our show.

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So we're going to ask you quite a few questions

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just to get to know you and have our audience

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get to know you.

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Right, Okay, great, Yeah, thanks for having me on.

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Yeah, Well, welcome to our show. So just, you know,

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before we get into the nitty gritty of any medicare questions,

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we ask you just tell the listeners a little bit

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about yourself, where you're from, how you got into this industry.

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Yeah, yeah, absolutely, So again, my name is Ryan Dawson

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with Dawson Insurance Group. I've been in the insurance industry

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since twenty eighteen, so it's been.

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Been a little while. Definitely came a long way.

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I started in Los Angeles actually working for a call center.

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It was actually really good experience for me. I actually

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believe all agents, if you're just getting into the industry,

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I think everybody should work for under like an agency

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model and work there. Like started out as a fronter.

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The only thing I knew about insurance was that I

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was on my mom's plan. You know, let's see here.

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So yeah, I quickly moved up the ranks, went from

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fronter to a licensed agent to a sales manager. At

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the height of it, I think I was managing about

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twenty agents on the sales floor. And then that also

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we also had a customer service department and then a

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verification department, so I helped manage all three departments. Then

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that brought me to Texas. So I was moved to

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00:13:40.039 --> 00:13:43.399
Texas to help open up another office down there and

224
00:13:43.440 --> 00:13:45.559
did a lot more operational stuff. So that's when I

225
00:13:45.639 --> 00:13:48.919
kind of started learning more about like carrier contracting. I

226
00:13:48.960 --> 00:13:56.799
had no idea what that process entailed. It's actually quite

227
00:13:57.639 --> 00:14:02.320
confusing and tedious, and you you get into a lot

228
00:14:02.320 --> 00:14:05.000
of that when you jump into medicare as well. So

229
00:14:05.279 --> 00:14:08.879
luckily I had a little bit of experience, uh, dealing

230
00:14:08.919 --> 00:14:10.360
with like the carriers and all.

231
00:14:10.200 --> 00:14:15.399
Of that, so that during my like.

232
00:14:17.759 --> 00:14:22.559
My timeline or like my experience as an agent, I

233
00:14:22.600 --> 00:14:27.360
was actually researching medicare quite a bit. I'm actually very

234
00:14:27.360 --> 00:14:31.279
bullish on medicare. I know that, you know, the overall

235
00:14:31.320 --> 00:14:35.240
outlook is a little negative right now, but there's going

236
00:14:35.320 --> 00:14:38.759
to be so many people to help, and uh, you know,

237
00:14:38.919 --> 00:14:42.919
the boomers are are retiring, and you know, they have

238
00:14:44.080 --> 00:14:46.440
no idea what's going on, of course, because it's it's

239
00:14:46.480 --> 00:14:51.679
extremely confusing. But yeah, that that that's a little just

240
00:14:51.720 --> 00:14:55.240
a little bit of my story. I'm really excited to

241
00:14:55.360 --> 00:14:56.279
jump into medicare.

242
00:14:56.879 --> 00:15:00.879
Awesome, awesome, Well, what made you decide to special just

243
00:15:01.039 --> 00:15:03.639
in medicare. I know you were in all fields of

244
00:15:03.679 --> 00:15:07.799
insurance but obviously you've kind of, you know, transitioned and

245
00:15:08.320 --> 00:15:11.320
decided to really focus in on this. What made you

246
00:15:11.360 --> 00:15:11.600
do that?

247
00:15:13.480 --> 00:15:13.840
Well?

248
00:15:13.919 --> 00:15:17.200
It's actually kind of funny because when I was an agent,

249
00:15:18.480 --> 00:15:20.919
one of my managers was like, you do really good

250
00:15:21.000 --> 00:15:24.360
with seniors. Like I seem to like actually get along

251
00:15:24.399 --> 00:15:27.080
really well, and I'm able to build rapport really well

252
00:15:27.080 --> 00:15:27.759
with seniors.

253
00:15:27.840 --> 00:15:28.559
I don't know why.

254
00:15:28.679 --> 00:15:31.399
I mean, everybody kind of like some people do really

255
00:15:31.440 --> 00:15:33.960
good with like men, or some people do really good

256
00:15:33.960 --> 00:15:34.840
with women or.

257
00:15:34.960 --> 00:15:35.679
Whatever the case.

258
00:15:35.720 --> 00:15:39.759
So I always just been able to get along with seniors,

259
00:15:39.799 --> 00:15:44.279
I guess, so I get a lot more And that's

260
00:15:44.320 --> 00:15:46.000
like one thing I noticed right away is like I

261
00:15:46.039 --> 00:15:49.279
get a lot more fulfillment when I help somebody with

262
00:15:49.320 --> 00:15:52.799
their Medicare plan than the other products that we offered,

263
00:15:53.039 --> 00:15:58.120
like ACA. I feel like it's a lot more relationship based.

264
00:16:00.600 --> 00:16:02.840
And then just getting into the community too. I mean

265
00:16:02.879 --> 00:16:06.399
that that's something that I think is like huge, is

266
00:16:06.720 --> 00:16:08.879
being able to get like actually in front of people

267
00:16:09.799 --> 00:16:11.840
so you can be you know, I want to be

268
00:16:11.919 --> 00:16:14.519
known as like the local insurance guy pretty much.

269
00:16:14.919 --> 00:16:17.679
Yeah, for sure for sure. And then where you stationed

270
00:16:17.679 --> 00:16:18.639
that right now? Currently?

271
00:16:19.600 --> 00:16:24.120
So I moved to like Pacific Northwest. So I'm gonna

272
00:16:24.120 --> 00:16:27.000
be doing the majority of my business in Spokane, Washington,

273
00:16:27.320 --> 00:16:32.320
but I live in in Post Falls, Idaho, Idaho. Like

274
00:16:32.399 --> 00:16:36.559
Coutney County is uh, there's actually no Medicare advantage plans

275
00:16:36.600 --> 00:16:40.440
available out here. There's there's dual plans, so there's a

276
00:16:40.480 --> 00:16:45.480
lot of d snips available. United's big Molina, of course,

277
00:16:45.600 --> 00:16:50.159
is really big, so that you know this market. I

278
00:16:50.200 --> 00:16:52.120
was just in a meeting with United. They said, there's

279
00:16:52.720 --> 00:16:56.120
Coutney County is one of the one of the one

280
00:16:56.159 --> 00:17:00.159
of their bullish markets that they have for for United specifically,

281
00:17:00.279 --> 00:17:04.160
So I'm gonna be you know, targeting that market a lot.

282
00:17:05.000 --> 00:17:09.160
Awesome awesome, Yeah, all right, Well what do you do

283
00:17:09.720 --> 00:17:12.359
outside of work? What do you enjoy doing when you're

284
00:17:12.359 --> 00:17:13.200
not doing medicare?

285
00:17:14.440 --> 00:17:14.640
Yeah?

286
00:17:14.759 --> 00:17:18.119
Yeah, So you know, twenty twenty five was a really

287
00:17:18.160 --> 00:17:22.759
big year for me. I got married, had a baby.

288
00:17:23.079 --> 00:17:27.359
Yeah yeah, got married to my high school sweetheart. We've

289
00:17:28.000 --> 00:17:31.160
you know, she followed me down to California and then

290
00:17:31.200 --> 00:17:36.240
to Texas and h yeah, we we had our son

291
00:17:36.319 --> 00:17:41.119
in July. He came a month early. You know, it's

292
00:17:41.160 --> 00:17:45.119
been it's been very, very very rewarding. You know seeing

293
00:17:45.200 --> 00:17:50.559
him grow up. It's our first kid together. Other than that,

294
00:17:50.680 --> 00:17:54.839
you know, I'm really into sports. I played sports growing up,

295
00:17:56.920 --> 00:18:00.240
and we enjoy eating out. I'm the I'm the big

296
00:18:00.279 --> 00:18:03.440
sucker for a nice steak dinner.

297
00:18:04.839 --> 00:18:06.839
What sport do you follow closely?

298
00:18:08.079 --> 00:18:11.039
Mostly just football, I used to you know, I know

299
00:18:11.119 --> 00:18:13.920
that you like the Lakers in baseball.

300
00:18:14.000 --> 00:18:15.039
I'm a big.

301
00:18:15.000 --> 00:18:18.279
Rams fan though, too, are you NFL or college?

302
00:18:18.599 --> 00:18:19.440
Yeah? NFL?

303
00:18:19.680 --> 00:18:23.960
I mean I really like playing fantasy football, so I

304
00:18:24.480 --> 00:18:28.000
mostly just just play fantasy football and watch.

305
00:18:27.839 --> 00:18:33.039
That awesome awesome. Well, what's what's been the most rewarding

306
00:18:33.160 --> 00:18:36.480
thing for you helping people on medicare? Obviously you said

307
00:18:36.599 --> 00:18:39.920
you've got a knack for talking with seniors, which is awesome.

308
00:18:40.839 --> 00:18:42.559
We definitely need a lot more people like you in

309
00:18:42.599 --> 00:18:46.000
the industry. So what's what's the most rewarding thing? And

310
00:18:46.039 --> 00:18:47.920
do you have any stories or do you have any

311
00:18:47.960 --> 00:18:51.359
specifics of anything that's happened lately with your clients?

312
00:18:54.240 --> 00:18:54.440
Yeah?

313
00:18:54.640 --> 00:18:59.799
Sure, Yeah, there's actually a guy that I helped out recently.

314
00:19:00.799 --> 00:19:05.559
I talked to him a few months ago. Because right

315
00:19:05.559 --> 00:19:09.400
now I'm doing the majority of my business, or the

316
00:19:09.440 --> 00:19:11.759
majority of my business is done through Facebook, right now,

317
00:19:12.759 --> 00:19:17.960
and I'm targeting the turning sixty five market. So I

318
00:19:18.000 --> 00:19:19.799
talked to a guy, you know, a couple of months

319
00:19:19.839 --> 00:19:24.960
ago doesn't turn sixty five until June. So he had

320
00:19:25.039 --> 00:19:28.519
remembered me because in our first conversation, you know, when

321
00:19:28.839 --> 00:19:30.640
I first talked to somebody, I want to kind of

322
00:19:30.799 --> 00:19:33.240
even though they're not I can't help them right away.

323
00:19:34.039 --> 00:19:39.119
I try to have a long and memorable conversation. So

324
00:19:39.200 --> 00:19:40.720
what I'll do is I'll kind of just you know,

325
00:19:40.799 --> 00:19:44.720
introduce myself, learn a little bit more about their situation,

326
00:19:45.400 --> 00:19:47.319
and so I kind of stay in that part of

327
00:19:47.359 --> 00:19:50.279
this of the conversation for a very long for as

328
00:19:50.319 --> 00:19:53.960
long as possible, so I'll get like their doctors, all

329
00:19:54.000 --> 00:19:59.160
their doctors information, their prescriptions, ask them what else is

330
00:19:59.200 --> 00:20:02.880
important to them. So while we were discussing the prescriptions,

331
00:20:02.880 --> 00:20:06.599
he had mentioned he's been dealing with a condition that's

332
00:20:06.720 --> 00:20:10.279
really affected his quality of life. And I got the

333
00:20:10.319 --> 00:20:13.640
name of the medication. It's a brand new medication. The

334
00:20:13.160 --> 00:20:16.039
full price of the medication is like thirty thousand dollars

335
00:20:16.079 --> 00:20:20.559
a year, and he yeah, yeah, so it's just outrageous

336
00:20:20.599 --> 00:20:23.839
and he was able to like get on it initially.

337
00:20:24.400 --> 00:20:25.920
I think they or maybe had him on like a

338
00:20:25.960 --> 00:20:28.680
trial period, or maybe they gave him some samples or something.

339
00:20:29.400 --> 00:20:33.720
And then Medicaid. He's in California, so medical like wouldn't

340
00:20:33.759 --> 00:20:38.000
cover it. There was just something weird. So then I

341
00:20:38.039 --> 00:20:41.599
helped him apply for like a manufacturer's So we went

342
00:20:41.640 --> 00:20:44.319
on the manufacturer's website and this was all done on

343
00:20:44.359 --> 00:20:46.880
the first call. He was of course, the person has

344
00:20:46.880 --> 00:20:51.960
to be willing to be helped as well, and so

345
00:20:52.000 --> 00:20:54.039
he went on the manufacturer's website. We filled out the

346
00:20:54.079 --> 00:20:57.960
application right there, and then I never heard from him

347
00:20:58.000 --> 00:21:01.680
after that, and then randomly he just called me and

348
00:21:01.759 --> 00:21:04.119
as we were talking, he was like super excited because

349
00:21:04.200 --> 00:21:07.559
he got that medication for free. They paid for his

350
00:21:07.640 --> 00:21:11.559
medication for I think like eighteen months worth of that

351
00:21:11.599 --> 00:21:13.119
medication they gave to him for free.

352
00:21:13.799 --> 00:21:17.599
Wow, So you really pulled through for this guy. That's awesome.

353
00:21:18.079 --> 00:21:20.079
Yeah, yeah, yeah, absolutely.

354
00:21:20.160 --> 00:21:22.119
And and you know, I've helped quite a few people,

355
00:21:22.279 --> 00:21:27.160
like you know, I'm running into scenarios where like people

356
00:21:27.200 --> 00:21:31.039
don't have enough work credits for free part A. So

357
00:21:31.160 --> 00:21:33.480
you know, you and I talked about that scenario a

358
00:21:33.480 --> 00:21:35.920
few times, so you know, I've ran into that quite

359
00:21:35.920 --> 00:21:39.200
a bit. I've gotten a few people, you know, QMB

360
00:21:39.359 --> 00:21:42.640
status so that they can get that free party because

361
00:21:43.240 --> 00:21:45.440
a lot of people don't know this that you know,

362
00:21:45.519 --> 00:21:48.240
you know, you need to work for at least ten

363
00:21:48.319 --> 00:21:50.720
years of your life to qualify for free Part A.

364
00:21:51.039 --> 00:21:53.200
If you don't have that, then that premium is going

365
00:21:53.240 --> 00:21:57.400
to be like north of six hundred dollars I've seen, yeah.

366
00:21:57.160 --> 00:21:59.920
For sure, And we talked about that our first episode

367
00:22:00.000 --> 00:22:03.119
and so you know, you guys definitely pay attention to that.

368
00:22:04.559 --> 00:22:07.559
But yeah, we do have scenarios where people don't have

369
00:22:07.640 --> 00:22:11.680
their part as. It is a lot of work on

370
00:22:11.759 --> 00:22:14.519
our part to get that thing going, but obviously there

371
00:22:14.559 --> 00:22:19.519
are ways around it. And so don't don't fret if

372
00:22:19.599 --> 00:22:21.359
you're in that situation where you don't have Part A

373
00:22:21.720 --> 00:22:25.119
or Part B that you're on like Medicaid, you know

374
00:22:25.200 --> 00:22:29.680
there are ways that that will pay for it. So yeah, no,

375
00:22:29.759 --> 00:22:32.599
I appreciate you bringing up that scenario. That's really important.

376
00:22:33.160 --> 00:22:34.400
Yeah, yeah, absolutely.

377
00:22:35.440 --> 00:22:38.119
So let me ask you this, what do you think

378
00:22:38.200 --> 00:22:42.279
is the biggest misunderstanding that people hear about medicare when

379
00:22:42.319 --> 00:22:43.279
they turn sixty five?

380
00:22:46.200 --> 00:22:50.200
The biggest misunderstanding is that it's completely free.

381
00:22:50.920 --> 00:22:53.440
Yep, you know, you.

382
00:22:54.200 --> 00:23:00.480
Yeah, had many conversations where you know, the beneficiaries ranting

383
00:23:00.519 --> 00:23:02.960
about you know, and I get it. You know that

384
00:23:03.119 --> 00:23:05.400
you you see that getting taken out of your taxes

385
00:23:05.440 --> 00:23:11.640
every year. I think it's called FIKA FICA taxes. You know,

386
00:23:11.680 --> 00:23:13.799
so you pay into your whole entire life and then

387
00:23:13.920 --> 00:23:16.559
you all of a sudden you find out that you know,

388
00:23:16.599 --> 00:23:21.559
you have a part B premium. So yeah, unfortunately, that's

389
00:23:21.680 --> 00:23:25.400
just the way that the industry is set up, and

390
00:23:25.440 --> 00:23:30.839
it's way out of my pay grade, you know.

391
00:23:31.039 --> 00:23:34.400
But yeah, yeah, well, I mean and the other well,

392
00:23:34.440 --> 00:23:35.720
the other thing I was going to say too, is

393
00:23:36.839 --> 00:23:40.839
you know, just jumping on that bandwagon. There is even

394
00:23:41.440 --> 00:23:44.599
different pro rated fees, like if you're making more than

395
00:23:44.640 --> 00:23:47.759
a certain amount of money gross, or if you're married

396
00:23:47.759 --> 00:23:50.240
and you're making them out over I think it's like

397
00:23:50.359 --> 00:23:53.480
one ninety is it one ninety right now?

398
00:23:54.759 --> 00:23:59.440
I think it's like, yeah, one eighty nine or one somewhere.

399
00:24:00.079 --> 00:24:02.359
People. I mean, I deal with clients all the time

400
00:24:02.400 --> 00:24:04.559
who get frustrated, like what I thought it was only

401
00:24:04.559 --> 00:24:06.880
like two hundred dollars a month. You know, I'm now

402
00:24:06.880 --> 00:24:08.839
I'm paying like four hundred dollars a month. What's going

403
00:24:08.880 --> 00:24:11.680
on there, and unfortunately that's just the way things are

404
00:24:11.720 --> 00:24:15.799
set up. So it's called IERMA. So we do walk

405
00:24:15.839 --> 00:24:17.920
you through all that. There is a chart that we

406
00:24:18.160 --> 00:24:20.880
give you, guys, so that you can see where exactly

407
00:24:21.519 --> 00:24:25.359
you've landed how much you be paying per month. But yeah,

408
00:24:25.440 --> 00:24:28.920
now I appreciate your Ryan bringing that up. What so,

409
00:24:29.400 --> 00:24:32.319
tell folks what happens when people miss their enrollment window

410
00:24:32.319 --> 00:24:35.279
because that's what we're talking about today. So if they

411
00:24:35.319 --> 00:24:38.519
miss their enrollment window with medicare what happens.

412
00:24:39.839 --> 00:24:42.400
So they're going to be essentially penalized for the rest

413
00:24:42.440 --> 00:24:45.400
of their life. You know, you're going to have a

414
00:24:45.440 --> 00:24:49.279
Part D penal one percent for every month that you

415
00:24:49.279 --> 00:24:52.559
could have had it, and then you have a Part

416
00:24:52.599 --> 00:24:58.640
B penalty as well. I've I haven't really encountered that scenario,

417
00:24:59.720 --> 00:25:01.519
and I I know it does come up, like in

418
00:25:01.640 --> 00:25:04.200
some of the forms that I'm in, I see agents

419
00:25:04.279 --> 00:25:09.240
posting that and it it does surprise me that some

420
00:25:09.319 --> 00:25:12.799
people do get penalized because there's just so much information

421
00:25:12.880 --> 00:25:16.119
out there, there's so many agents reaching out to people.

422
00:25:18.440 --> 00:25:19.720
But yeah, I guess it could.

423
00:25:19.759 --> 00:25:21.920
I guess the main scenario that it could happen with

424
00:25:22.039 --> 00:25:24.640
is if you're on an employer plan and you push

425
00:25:24.680 --> 00:25:28.319
out your Medicare enrollment, you just need to make sure

426
00:25:28.319 --> 00:25:31.359
that your employer has twenty or more employees for that

427
00:25:31.440 --> 00:25:35.839
to be considered qualifying coverage. But I don't know what's

428
00:25:35.880 --> 00:25:38.759
like a scenario that you encounter a lot with with that.

429
00:25:40.319 --> 00:25:44.119
Uh, usually the biggest, the biggest one lately has been Cobra.

430
00:25:44.599 --> 00:25:47.440
So yeah, we talked about that a little bit today

431
00:25:47.480 --> 00:25:51.000
and last week. But and I'm dealing with some clients

432
00:25:51.000 --> 00:25:54.279
who miss their window because they thought Cobra was credible

433
00:25:54.319 --> 00:25:56.880
coverage and then they find out it's not, and then

434
00:25:56.920 --> 00:26:00.759
they end up paying that penalty. So, you know, we

435
00:26:00.799 --> 00:26:02.720
want to make sure you guys are well aware that

436
00:26:02.839 --> 00:26:05.240
if you retire, you know a lot of times the

437
00:26:05.240 --> 00:26:09.160
insurance that you continue on is not really the same insurance.

438
00:26:09.160 --> 00:26:13.000
It's called Cobra. You want to make sure that any

439
00:26:13.039 --> 00:26:15.079
of the paperwork that you sign and you get in

440
00:26:15.079 --> 00:26:17.559
the mail, if it says Cobra anywhere on your health

441
00:26:17.599 --> 00:26:21.480
card are on your paperwork, then it is indeed Cobra,

442
00:26:21.599 --> 00:26:25.000
and that is not credible coverage. You do have eight

443
00:26:25.039 --> 00:26:28.880
months after you retire to get onto a medicure plan.

444
00:26:29.279 --> 00:26:31.240
But if you're on COBRA longer than eight months, you're

445
00:26:31.279 --> 00:26:36.319
going to hit that unfortunately penalty. So I've had some

446
00:26:36.400 --> 00:26:41.000
clients really frustrated they're fighting back and forth, especially like

447
00:26:41.079 --> 00:26:43.359
if you're in a situation where you retire and then

448
00:26:43.400 --> 00:26:46.039
you go back to work. We've had that situation happen,

449
00:26:46.559 --> 00:26:49.519
So they're on COBRA for you know, several months, and

450
00:26:49.559 --> 00:26:55.480
then they're back on their employer health insurance plan. Social Security, unfortunately,

451
00:26:55.960 --> 00:27:00.200
is a confusing place in terms of people try to

452
00:27:00.240 --> 00:27:02.839
help you sort through all that, and so sometimes it's

453
00:27:02.880 --> 00:27:05.200
good to have an agent like myself or Ryan to

454
00:27:05.759 --> 00:27:08.039
advocate for you and try to walk you through all that.

455
00:27:09.400 --> 00:27:12.079
But yeah, those are the scenarios I always run into, unfortunately.

456
00:27:12.079 --> 00:27:15.480
I mean it's it's happened probably, i'd say a number

457
00:27:15.519 --> 00:27:19.039
of times in the last six months, so I don't

458
00:27:19.160 --> 00:27:20.400
you haven't run into that yet.

459
00:27:21.559 --> 00:27:25.799
I ran into a couple who were and it just

460
00:27:25.880 --> 00:27:29.359
doesn't seem believable to me, but they are on an

461
00:27:29.519 --> 00:27:32.920
ACA plan and they were both over the age of

462
00:27:33.000 --> 00:27:37.960
sixty five. But I wasn't able to do too much

463
00:27:37.960 --> 00:27:41.920
of a deep dive on it. But that I haven't

464
00:27:41.920 --> 00:27:45.599
really ran into that scenario yet. But yeah, that's why

465
00:27:45.680 --> 00:27:49.039
it's obviously important to you know, get on it early,

466
00:27:49.680 --> 00:27:54.400
get with an agent early on, and do that analysis.

467
00:27:54.880 --> 00:27:58.039
Yeah, I mean, and I even saw a situation where

468
00:27:58.279 --> 00:28:00.720
because I do you know, we do, both of us

469
00:28:00.759 --> 00:28:03.680
do ACA, and so I've had clients where they're about

470
00:28:03.720 --> 00:28:07.720
to turn sixty five. Cover California is normally supposed to

471
00:28:07.839 --> 00:28:10.440
kick you off when he's turned sixty five. We've had

472
00:28:10.480 --> 00:28:13.680
situations where they haven't, which is just weird. I don't

473
00:28:13.720 --> 00:28:15.599
know if there's a glitch in the system or what's

474
00:28:15.599 --> 00:28:18.640
going on, and so they miss their win and they

475
00:28:18.720 --> 00:28:21.240
end up double paying. They're paying for their ACA plans

476
00:28:21.240 --> 00:28:24.319
still while they're on Medicare. So we've had that situation

477
00:28:24.440 --> 00:28:30.440
happen to Yeah. So so a couple other things, Ryan,

478
00:28:31.039 --> 00:28:35.119
What what do you hope to achieve in the next

479
00:28:35.160 --> 00:28:37.960
year for your business? What do you have some goals

480
00:28:38.000 --> 00:28:38.440
in mind?

481
00:28:40.799 --> 00:28:43.480
Yeah, yeah, I mean, I think the main goal right

482
00:28:43.519 --> 00:28:49.839
now is to obviously acquire as many members as possible.

483
00:28:51.240 --> 00:28:54.599
So right now, like since I moved back, I haven't

484
00:28:54.640 --> 00:29:00.319
really had a chance to go into the community yet,

485
00:28:59.799 --> 00:29:05.960
but right now I'm focusing on getting that going. So

486
00:29:06.039 --> 00:29:10.200
I have a seminar. I'm doing a seminar April ninth. Nice,

487
00:29:11.000 --> 00:29:13.880
So yeah, that's that's going to be because the whole

488
00:29:13.920 --> 00:29:16.200
reason why, the main reason why I got in the

489
00:29:16.200 --> 00:29:18.799
business is because I want to do like in person sales.

490
00:29:20.880 --> 00:29:23.559
So that's that's kind of that's like my main goal

491
00:29:23.640 --> 00:29:27.240
right now. I want to achieve that and then just

492
00:29:27.319 --> 00:29:28.920
go from there.

493
00:29:28.599 --> 00:29:30.759
Where is that going to be taking place? Have you

494
00:29:31.079 --> 00:29:32.319
had a location set yet?

495
00:29:32.599 --> 00:29:32.839
Yeah?

496
00:29:32.920 --> 00:29:36.359
So it's going to be the Golden Corral on Division

497
00:29:36.400 --> 00:29:39.480
Street and Spokane on April ninth at six pm.

498
00:29:40.039 --> 00:29:43.640
Awesome. Awesome. Well, and if you guys are watching, all

499
00:29:43.680 --> 00:29:46.559
of Ryan's information is on the banner scrolling across the

500
00:29:46.599 --> 00:29:51.160
screen on the bottom that's his direct number and his

501
00:29:51.200 --> 00:29:53.920
insurance group. So I encourage you guys if you're out

502
00:29:53.920 --> 00:29:58.240
in that area, definitely reach out to Ryan. He's the command.

503
00:29:58.359 --> 00:30:00.720
He will definitely help you out. He has a heart

504
00:30:00.799 --> 00:30:05.400
for it and he will set you on the right path. So, Ran,

505
00:30:05.599 --> 00:30:09.000
thank you so much for coming on our show. Is

506
00:30:09.039 --> 00:30:12.480
there anything else that you'd want to tell in terms

507
00:30:12.519 --> 00:30:16.880
of messaging to agents that are listening in if they're struggling,

508
00:30:17.160 --> 00:30:20.200
Is there any key things that they should know about.

509
00:30:21.960 --> 00:30:25.480
Yeah, yeah, definitely. I mean I see I see it

510
00:30:25.519 --> 00:30:30.160
all the time online. That just the overall frustration with

511
00:30:30.279 --> 00:30:36.960
a you know, agents, they're they're feeling very frustrated. This business,

512
00:30:37.920 --> 00:30:41.359
especially if you're going independent, is you have to look

513
00:30:41.400 --> 00:30:45.200
at it as a business and it's.

514
00:30:45.039 --> 00:30:46.200
All going to fall on you.

515
00:30:47.240 --> 00:30:51.000
So you need to be very very proactive when it

516
00:30:51.039 --> 00:30:54.599
comes to like learning the products. Learning you know, you know,

517
00:30:54.920 --> 00:30:57.279
learning the products is one thing, but I think the

518
00:30:58.480 --> 00:31:02.039
main factor is like how are you going to obtain members?

519
00:31:03.759 --> 00:31:07.799
So you need to have a you need to become

520
00:31:07.799 --> 00:31:11.160
an expert at that. I think before you go independent,

521
00:31:12.240 --> 00:31:14.799
don't go independent and then just and then say you're

522
00:31:14.839 --> 00:31:16.519
going to figure it out from there, because you're going

523
00:31:16.599 --> 00:31:22.400
to fail very quickly. And it's extremely expensive too to

524
00:31:22.599 --> 00:31:25.960
acquire a member and then to keep the member. So

525
00:31:27.400 --> 00:31:30.440
the main thing I'd say is is finding a mentor

526
00:31:32.720 --> 00:31:36.480
and hopefully you could work for like an agency where

527
00:31:36.519 --> 00:31:40.880
you have like a salary and you're just learning the products.

528
00:31:41.400 --> 00:31:43.880
I think that's what helped me out a lot, and

529
00:31:44.160 --> 00:31:47.880
I just I became I became very proactive on you know,

530
00:31:47.960 --> 00:31:51.759
learning the industry before I went independent, so you know,

531
00:31:51.799 --> 00:31:58.079
I actually bought a Christian Brindle's book before I knew it, knew.

532
00:31:57.839 --> 00:31:58.559
About you guys.

533
00:31:58.680 --> 00:32:01.960
Yeah, yeah, So actually read his book before I even

534
00:32:02.119 --> 00:32:05.839
met you or Christian or anybody. So you know, that

535
00:32:05.920 --> 00:32:08.519
was just one of many books that I read before

536
00:32:08.559 --> 00:32:10.079
getting into the industry.

537
00:32:10.799 --> 00:32:14.119
Awesome, Awesome, I'll probably send a couple other books your way,

538
00:32:14.200 --> 00:32:17.000
by the way, I bet he's written another one about

539
00:32:17.640 --> 00:32:21.559
setting up a successful agency. Are you ever thinking about

540
00:32:21.720 --> 00:32:24.839
like bringing on I mean, you have alsosly obviously learned

541
00:32:24.960 --> 00:32:28.880
quite a bit in this industry. Ryan's very plugged in

542
00:32:29.039 --> 00:32:32.039
with a lot of peers and colleagues that are high up,

543
00:32:32.119 --> 00:32:35.160
and so have you thought about Ryan, like bringing on

544
00:32:35.279 --> 00:32:37.000
some people that you can mensor yourself.

545
00:32:38.160 --> 00:32:40.480
Yeah, I mean, if anyone wants to provide the funding

546
00:32:40.519 --> 00:32:43.240
for it. I mean I've done it before. You know,

547
00:32:43.279 --> 00:32:46.480
I've ran a sales office with with you know, I

548
00:32:46.480 --> 00:32:48.839
think we at the height again I mentioned it earlier.

549
00:32:48.920 --> 00:32:51.240
I think we had like twenty agents at one time,

550
00:32:52.680 --> 00:32:58.640
so I you know, I instituted some brand new retention techniques,

551
00:32:59.160 --> 00:33:06.160
like on our retention side, uh, increase the the I

552
00:33:06.200 --> 00:33:09.759
fix the processes in our verification department. So I know,

553
00:33:09.839 --> 00:33:12.480
like all the different departments and what it takes to

554
00:33:12.480 --> 00:33:15.839
build a successful sales floor with the recruiting and things

555
00:33:15.920 --> 00:33:19.720
like that and training new agents. But the main I

556
00:33:19.720 --> 00:33:22.519
think the main factor is just when you bring on

557
00:33:22.559 --> 00:33:25.200
a new agent, you know it's going to take them

558
00:33:25.200 --> 00:33:27.799
at like at least six months to fully grasp everything.

559
00:33:29.319 --> 00:33:32.559
But yeah, that's that's definitely something I would be open to.

560
00:33:32.839 --> 00:33:36.039
Just right now, I feel like I'm not ready, but

561
00:33:36.759 --> 00:33:41.319
unless just financially, but yeah, if somebody ever wanted to

562
00:33:41.400 --> 00:33:44.759
open an office in a Pacific Northwest.

563
00:33:45.079 --> 00:33:46.799
I'm also hopefully.

564
00:33:46.480 --> 00:33:49.240
You guys are are listening in and hearing that. So

565
00:33:50.839 --> 00:33:54.079
one of our sponsors is Christian Brindle and Everything Senior Insurance,

566
00:33:54.079 --> 00:33:57.799
so I'm sure he's listening in as well. But Ryan,

567
00:33:58.119 --> 00:34:00.559
thank you so much for your time. Is there a

568
00:34:00.599 --> 00:34:03.400
website that people can look up your information as well?

569
00:34:04.160 --> 00:34:09.639
Yeah, yeah, Dawson Insurancegroup dot com perfect Perfect And then yeah,

570
00:34:09.679 --> 00:34:12.960
my phone number is five zero nine two zero nine

571
00:34:13.239 --> 00:34:15.559
nine one eight one and you can reach me by

572
00:34:15.559 --> 00:34:19.320
a call, text, you can message through my website.

573
00:34:19.840 --> 00:34:22.440
Awesome. Well, Ryan, thank you so much for being on

574
00:34:22.480 --> 00:34:27.400
our show. We appreciate your time and I hope that

575
00:34:27.480 --> 00:34:30.840
the first seminar goes really well for you. April ninth,

576
00:34:30.880 --> 00:34:32.079
Is that the date?

577
00:34:32.679 --> 00:34:34.039
Yep, yep, April ninth.

578
00:34:34.559 --> 00:34:37.440
Awesome? All right, Well you guys, if you're out in

579
00:34:37.480 --> 00:34:41.800
Idaho or state of Washington, please look Ryan up. Thanks again, Ryan,

580
00:34:41.880 --> 00:34:42.840
We appreciate your time.

581
00:34:42.920 --> 00:34:44.920
Take care of Thank you, Thank you, Peter, welcome.

582
00:34:48.679 --> 00:34:52.679
All right, that was a great interview. I love Ryan

583
00:34:52.719 --> 00:34:55.719
to death. He's he's been a great agent of ours

584
00:34:55.719 --> 00:34:59.159
for the last seven eight months and he's done some

585
00:34:59.280 --> 00:35:01.960
great work. And as you can see, he's got a

586
00:35:01.960 --> 00:35:06.320
great heart for seniors, has a great skill set in

587
00:35:06.360 --> 00:35:09.440
that department. So I love the fact that he's on

588
00:35:09.480 --> 00:35:14.760
our team and doing great things. All right. So we

589
00:35:15.039 --> 00:35:17.559
do quite a bit of things in our community, and

590
00:35:17.719 --> 00:35:21.239
we want to show you just this little commercial break

591
00:35:21.239 --> 00:35:28.840
about what we do. I think it's important for our

592
00:35:28.880 --> 00:35:33.239
business to be seen as a business that impacts the

593
00:35:33.239 --> 00:35:37.079
community in positive ways. You know, business sales and all

594
00:35:37.079 --> 00:35:39.960
that secondary to us, because we did so well in

595
00:35:40.000 --> 00:35:43.039
these last year and a half. My kids are part

596
00:35:43.039 --> 00:35:46.719
of a local elementary school here in Chino Hills, and

597
00:35:46.760 --> 00:35:50.199
so I wanted to partner up with them and be

598
00:35:50.320 --> 00:35:52.559
more involved with my kids' lives and make an impact

599
00:35:52.599 --> 00:35:54.239
on their school, and I felt like this was a

600
00:35:54.239 --> 00:35:57.519
good way of doing that. So we specialize in Medicare

601
00:35:57.679 --> 00:36:00.440
and health insurance, and then the big one lately has

602
00:36:00.480 --> 00:36:03.960
been small business group benefits. So a lot of small businesses.

603
00:36:03.519 --> 00:36:06.559
Are looking to retain their employees and the best way

604
00:36:06.599 --> 00:36:09.360
to do that is to offer health benefits to their employees,

605
00:36:09.360 --> 00:36:11.719
and so we do that. So I was actually in

606
00:36:11.800 --> 00:36:15.960
a nonprofit sector for about twenty two years and we

607
00:36:16.079 --> 00:36:19.800
just decided to transition out just because of politics and

608
00:36:19.840 --> 00:36:21.840
moving around a lot, and so I wanted a little

609
00:36:21.840 --> 00:36:25.320
bit more stable position, and so went into the insurance

610
00:36:25.320 --> 00:36:27.679
business for a little bit and was a captive agent

611
00:36:27.679 --> 00:36:30.800
with New York Life, and then decided to create my

612
00:36:30.840 --> 00:36:33.400
own business because I saw a need for seniors needing

613
00:36:33.440 --> 00:36:36.639
help with the Medicare process because it's so confusing, and

614
00:36:36.679 --> 00:36:39.679
so I felt like my skill set really transferred well

615
00:36:39.719 --> 00:36:42.199
because I've got such a servant's heart, I've got a

616
00:36:42.239 --> 00:36:44.760
calling to really help people, and so it was a

617
00:36:44.840 --> 00:36:45.760
natural fit for.

618
00:36:45.800 --> 00:37:00.239
Me, all right. So thinking local as a local support

619
00:37:00.000 --> 00:37:04.559
system that helps with schools and small businesses, we have

620
00:37:04.639 --> 00:37:07.719
been involved with them in the past years. We also

621
00:37:07.920 --> 00:37:10.119
like to give back to our small businesses. I'm part

622
00:37:10.159 --> 00:37:13.880
of the Chino Valley Chamber of Commerce here locally, and

623
00:37:14.000 --> 00:37:17.400
we're an ambassador. We also, you know, give back to

624
00:37:17.440 --> 00:37:19.519
our schools as much as we can. Like I said

625
00:37:19.559 --> 00:37:22.719
in our first show, I've got two kids, eleven year

626
00:37:22.760 --> 00:37:25.639
old that goes to elementary school out here as well

627
00:37:25.639 --> 00:37:29.519
as my daughter who's fifteen and goes to local high school.

628
00:37:29.599 --> 00:37:32.079
So we want to make sure that we support the

629
00:37:32.119 --> 00:37:35.159
community as well, that we are involved, and that we're

630
00:37:35.159 --> 00:37:38.400
not just doing business, but we're actually giving back as well.

631
00:37:38.440 --> 00:37:42.760
So that's what that little commercial is all about. All right.

632
00:37:42.880 --> 00:37:45.119
So you know, we don't have a lot of time,

633
00:37:45.199 --> 00:37:47.639
but we do have about ten minutes, and so I

634
00:37:47.679 --> 00:37:50.199
do want to continue on with our enrollment periods that

635
00:37:50.239 --> 00:37:54.360
we were talking about. So we did cover a couple

636
00:37:54.400 --> 00:37:57.440
of enrollment periods. We covered the initial enrollment period. We

637
00:37:57.559 --> 00:38:00.679
covered AEP which is annual in rolla period where you

638
00:38:00.679 --> 00:38:03.280
could switch your Medicare advantage plan or drop it and

639
00:38:03.320 --> 00:38:06.719
go to original Medicare. And then our general enrollment period

640
00:38:06.719 --> 00:38:10.159
where if you've missed that window, you're able to sign

641
00:38:11.000 --> 00:38:15.360
back from that January through March thirty. First date. So

642
00:38:15.440 --> 00:38:19.519
let's talk about a few other scenarios or special enrollment

643
00:38:19.559 --> 00:38:24.760
periods that happen. So one is called SEP Special Enrollment period.

644
00:38:25.239 --> 00:38:28.199
There's a lot of different scenarios that can happen in

645
00:38:28.199 --> 00:38:33.639
that regard. If you lose your employer group coverage after retirement,

646
00:38:34.239 --> 00:38:38.119
that opens up a door for you to sign onto

647
00:38:38.239 --> 00:38:41.760
Medicare if you're moving out of the Medicare Advantage service area,

648
00:38:41.880 --> 00:38:45.039
so if you're moving not zip codes, but you have

649
00:38:45.079 --> 00:38:48.079
to move counties. So if you're moving counties or states,

650
00:38:48.519 --> 00:38:52.159
then that also opens you up for a open enrollment

651
00:38:52.199 --> 00:38:56.239
period to get onto a Medicare plan if you're gaining

652
00:38:56.400 --> 00:38:59.920
or losing Medicaid, So for lower income folks, if you're

653
00:39:00.079 --> 00:39:03.559
using in if you end up getting onto Medicaid or

654
00:39:03.599 --> 00:39:07.679
you lose that benefit, that also opens up the door

655
00:39:07.719 --> 00:39:12.559
for Medicare. If you qualify for Extra help or low

656
00:39:12.599 --> 00:39:16.400
income Subsidy. That is something we'll talk about in the

657
00:39:16.480 --> 00:39:20.360
coming weeks, but that actually allows you to reduce your

658
00:39:20.400 --> 00:39:22.719
costs on your prescription drug plan. So even if you

659
00:39:22.719 --> 00:39:26.599
don't qualify for medical or Medicaid, you can actually get

660
00:39:26.599 --> 00:39:30.679
on a low income subsidy plan to reduce those prescription costs.

661
00:39:30.679 --> 00:39:34.320
So you know, again we'll talk about that in the

662
00:39:34.360 --> 00:39:36.920
next few weeks. And then if you're leaving or entering

663
00:39:37.000 --> 00:39:40.639
a skilled nursing facility, that also opens the door for

664
00:39:41.000 --> 00:39:44.440
a open enrollment for Medicare. So those are the special

665
00:39:44.599 --> 00:39:49.679
enrollment period scenarios. The next thing is employer coverage after

666
00:39:49.800 --> 00:39:52.519
sixty five scenario, and we talked about this with Ryan

667
00:39:52.559 --> 00:39:55.719
a little bit where we've run into situations where clients

668
00:39:56.719 --> 00:39:59.760
are confused or don't know when to actually get onto Medicare,

669
00:40:00.559 --> 00:40:03.960
your employer has to have more than twenty full time employees.

670
00:40:04.000 --> 00:40:07.119
If you're a smaller business with less than that, then

671
00:40:07.360 --> 00:40:09.239
you have no choice. When you turn sixty five, you

672
00:40:09.239 --> 00:40:12.079
have to get onto Medicare. But if you're with an

673
00:40:12.119 --> 00:40:15.480
employer that has more than twenty full time employees, then

674
00:40:15.559 --> 00:40:19.199
you actually are able to stay on the employer plan.

675
00:40:19.719 --> 00:40:23.400
And it's important to come alongside an agent like myself

676
00:40:23.440 --> 00:40:26.320
to look at your numbers and see if it makes

677
00:40:26.360 --> 00:40:29.280
sense for you to stay on that employer health plan.

678
00:40:29.800 --> 00:40:32.760
Some companies, you know, I run into clients who say, well,

679
00:40:32.760 --> 00:40:35.400
my company pays for everything, I don't pay for any

680
00:40:35.440 --> 00:40:39.639
of the premium for my health benefits. That's not necessarily true,

681
00:40:39.639 --> 00:40:41.199
and so we want to look at your paycheck and

682
00:40:41.239 --> 00:40:45.119
see if there's actually money coming out for health premiums,

683
00:40:45.760 --> 00:40:48.239
and we'll see how much you're actually paying out per

684
00:40:48.280 --> 00:40:50.199
month and see if it makes sense to switch over

685
00:40:50.239 --> 00:40:55.119
to Medicare to cut down those costs. So you may

686
00:40:55.159 --> 00:40:58.519
delay Part B without penalty. Remember, you have an eight

687
00:40:58.599 --> 00:41:02.840
month window after retire to get onto Medicare safely without

688
00:41:02.840 --> 00:41:06.760
any penalties. If you're on Cobra. Again, I will continue

689
00:41:07.239 --> 00:41:12.239
repeating this. Cobra is not eligible coverage with Medicare, so

690
00:41:13.159 --> 00:41:16.159
you want to make sure that you're on a plan

691
00:41:16.800 --> 00:41:20.079
before that eight month window ends. Now here's the other

692
00:41:20.159 --> 00:41:23.760
confusing part. You have eight months to get onto Medicare

693
00:41:23.840 --> 00:41:28.480
Parts A and B, but for Part D prescription drug

694
00:41:28.519 --> 00:41:32.599
plans that is sixty three days without a penalty. So

695
00:41:32.639 --> 00:41:34.599
you can see how confusing it can get because you

696
00:41:34.679 --> 00:41:39.400
got two different enrollment periods and it doesn't line It

697
00:41:39.440 --> 00:41:42.239
should line up in my opinion, but it doesn't, and

698
00:41:42.320 --> 00:41:45.559
so people will wait towards the end of that eight

699
00:41:45.559 --> 00:41:48.360
month window, they'll sign up and then they're like, wait

700
00:41:48.400 --> 00:41:50.639
a minute, I just got hit with a Part D penalty.

701
00:41:50.880 --> 00:41:53.559
What's that about. Well, it's because you missed that sixty

702
00:41:53.679 --> 00:41:57.360
three day window, and the Part D penalty is not

703
00:41:57.559 --> 00:41:59.800
as steep as the Part B penalty. Like I said,

704
00:41:59.800 --> 00:42:03.000
it's it's a few cents maybe thirty cents a month.

705
00:42:03.719 --> 00:42:05.199
But you don't want to pay a penalty if you

706
00:42:05.239 --> 00:42:08.400
don't have to. So what I usually do with clients

707
00:42:08.519 --> 00:42:10.760
that are retiring is I at least get them right

708
00:42:10.800 --> 00:42:13.239
away on a Part D plan so they are within

709
00:42:13.280 --> 00:42:15.760
that sixty three day window and are able to get

710
00:42:15.760 --> 00:42:18.840
on safely, and then we'll look at different Medicare advantage

711
00:42:18.880 --> 00:42:21.519
plans down the road. But you want to get on

712
00:42:21.559 --> 00:42:24.880
a Part D plan right away. Again, that's a sixty

713
00:42:24.920 --> 00:42:30.639
three day window. Now, some employer retiring plans require enrolling

714
00:42:30.679 --> 00:42:34.199
in Medicare Part A and B. That's another place where

715
00:42:34.239 --> 00:42:37.679
you come alongside an agent to see if your employer

716
00:42:38.119 --> 00:42:40.400
actually requires you to be in Part A and B.

717
00:42:40.840 --> 00:42:44.519
We've had situations where the employer didn't know that and

718
00:42:46.320 --> 00:42:49.400
they end up going to a hospital for something serious

719
00:42:50.440 --> 00:42:54.039
while their insurance that they have where their employer doesn't

720
00:42:54.039 --> 00:42:57.239
want to pay and ends up Medicare being the primary

721
00:42:57.519 --> 00:42:59.440
and they say, well, you're on Medicare. Are you're supposed

722
00:42:59.440 --> 00:43:01.400
to be on Medicare, and that Medicare is supposed to

723
00:43:01.440 --> 00:43:05.000
be paying for this, not our insurance plan. So you

724
00:43:05.039 --> 00:43:07.679
want to make sure you know what's going on with

725
00:43:08.079 --> 00:43:11.440
your employer and the rules that coincide with that employer.

726
00:43:13.199 --> 00:43:16.760
Retireing plan does become secondary payer to Medicare, so keep

727
00:43:16.800 --> 00:43:20.199
that in mind. And then failure to enroll in Medicare

728
00:43:20.239 --> 00:43:23.559
could result in loss of retire coverage. So we don't

729
00:43:23.599 --> 00:43:26.679
want that scenario to happen to you. Let's make sure

730
00:43:26.719 --> 00:43:29.280
we get ahead of the game before you're actually retiring,

731
00:43:29.360 --> 00:43:32.440
to see all the ins and outs in that we

732
00:43:32.639 --> 00:43:36.320
dot our eyes across our t's all right, and then

733
00:43:36.400 --> 00:43:40.039
moving scenarios. You know, someone moves again. We talked about

734
00:43:40.039 --> 00:43:42.360
this as a special Roman period. But if you move

735
00:43:42.360 --> 00:43:45.599
out of the Medicare or advantage plan service area, if

736
00:43:45.639 --> 00:43:47.639
you move to a new state with different plan option,

737
00:43:47.920 --> 00:43:51.679
this trip typically triggers a special rollment period. You know.

738
00:43:51.800 --> 00:43:55.320
The other thing that happens too, is that plans will

739
00:43:55.440 --> 00:43:58.280
leave the market, and if that happens, that opens a

740
00:43:58.320 --> 00:44:02.000
special roment period for you as well. Medical networks change

741
00:44:02.079 --> 00:44:06.400
that opens a door as well. But if you find

742
00:44:06.440 --> 00:44:09.480
out that your plan is ending or terminating, you know,

743
00:44:09.599 --> 00:44:11.440
reach out to an agent so we can get you

744
00:44:11.480 --> 00:44:15.800
on the right path for that, okay, and then you know,

745
00:44:16.000 --> 00:44:23.119
Ryan basically did mention this briefly, the dual eligible DECENTI

746
00:44:23.440 --> 00:44:26.360
for sure, that's what decent means. It's dual eligible. What

747
00:44:26.400 --> 00:44:29.559
that means is that you're both on Medicare and Medicaid,

748
00:44:30.079 --> 00:44:32.840
all right. And then in California it's called medical so

749
00:44:33.000 --> 00:44:38.119
individual with both Medicare and Medicaid, they can actually change plans,

750
00:44:38.960 --> 00:44:43.360
especially if you're on full Medicaid. You can change plans

751
00:44:43.639 --> 00:44:47.440
once every month, that is the new rule. But you

752
00:44:47.559 --> 00:44:53.639
have to change onto what's called a fully integrated dual plan.

753
00:44:53.800 --> 00:44:57.400
So not all carriers have that. And again it's it's

754
00:44:57.440 --> 00:44:59.800
good to get with an agent to help you decipher

755
00:45:00.159 --> 00:45:04.920
plans out there on the market are actually fully integrated plans,

756
00:45:05.519 --> 00:45:10.519
all right. So when you are on full Medicare and Medicaid,

757
00:45:11.159 --> 00:45:13.800
again that allows you to change. Now, you don't want

758
00:45:13.800 --> 00:45:16.039
to have to change every month, obviously, you want to

759
00:45:16.079 --> 00:45:20.039
be with a plan that works for you, and it

760
00:45:20.079 --> 00:45:21.760
would just be a nightmare if you have to change

761
00:45:21.760 --> 00:45:24.960
your plans every month. So there is you know, that

762
00:45:25.159 --> 00:45:27.960
opportunity for you. But you know, if you're on the

763
00:45:28.039 --> 00:45:31.000
right plan, there's no reason for you to change every month.

764
00:45:33.280 --> 00:45:37.320
And then there's institutional special needs scenarios. So if you

765
00:45:37.519 --> 00:45:42.880
are in a nursing home, assisted living facility, long term

766
00:45:42.920 --> 00:45:48.719
care facilities, they may switch Medicare advantage or part plans monthly.

767
00:45:48.920 --> 00:45:53.199
So if you're in any of those institutional special needs scenarios,

768
00:45:53.280 --> 00:45:56.039
just know that you're able to change your plan monthly.

769
00:45:57.079 --> 00:45:59.800
The next one is what's called a five star special

770
00:46:00.079 --> 00:46:03.920
rollment period that allows you to go onto a plan

771
00:46:04.119 --> 00:46:07.400
if you're on a Medicare advantage plan per SE that's

772
00:46:07.679 --> 00:46:10.880
got four stars. So all these plans that you're on,

773
00:46:11.719 --> 00:46:16.239
they're actually rated by a CMS from one star, which

774
00:46:16.280 --> 00:46:18.719
is the worst, to five stars, which is the best.

775
00:46:19.079 --> 00:46:21.440
And if there is a five star plan in your

776
00:46:21.519 --> 00:46:25.360
area or county, you're actually allowed to get onto that

777
00:46:25.440 --> 00:46:30.199
five star plan automatically if your star if your plan

778
00:46:30.360 --> 00:46:34.639
is less than five stars, so just keep that in mind. Again,

779
00:46:34.679 --> 00:46:36.880
an agent is the best person to talk to to

780
00:46:36.920 --> 00:46:40.280
see if those plans exist in your area, so you're

781
00:46:40.320 --> 00:46:46.159
able to switch around for that. The last you know,

782
00:46:46.239 --> 00:46:50.400
we'll talk about more of this next week since we're

783
00:46:50.440 --> 00:46:52.639
starting to run out of time here, but The last

784
00:46:52.679 --> 00:46:56.400
scenario is the late enrollment penalty scenario. There's a ten

785
00:46:56.440 --> 00:47:00.320
percent increase again for each twelve month period that someone

786
00:47:00.360 --> 00:47:05.119
delays without credible coverage. You're allowed to sign onto Medicare

787
00:47:05.159 --> 00:47:07.880
if you hit that penalty, and then party penalty is

788
00:47:07.960 --> 00:47:11.639
one percent of national based beneficiary premium for each month

789
00:47:11.960 --> 00:47:15.159
without credible drug coverage. So, as you see, Part D

790
00:47:15.360 --> 00:47:17.840
is not as steep as we said. Part B is

791
00:47:17.840 --> 00:47:20.519
the one that's steep. That's ten percent per year for

792
00:47:20.599 --> 00:47:26.440
the life time. So you want to make sure if

793
00:47:26.480 --> 00:47:29.679
you're getting penalized, get onto medicare as quickly as possible.

794
00:47:30.119 --> 00:47:32.599
Talk to an agency or an agent that can get

795
00:47:32.639 --> 00:47:35.360
you on the right foot in for that. So we

796
00:47:35.480 --> 00:47:38.519
cover quite a bit of information. I know, I hope

797
00:47:38.519 --> 00:47:41.400
I didn't bore you guys. That's why we bring on guests.

798
00:47:41.599 --> 00:47:44.039
We want to in commercials to make this a little

799
00:47:44.079 --> 00:47:47.199
bit more livelier. Medicare can be tedious and there's just

800
00:47:47.239 --> 00:47:50.800
a lot of information to decipher and process. But we

801
00:47:50.840 --> 00:47:53.360
want to make this as easy as possible for you guys,

802
00:47:54.039 --> 00:47:56.519
and that's why we've created this show. We'll be talking

803
00:47:56.519 --> 00:47:59.000
about other things in Medicare obviously in the coming weeks.

804
00:48:00.400 --> 00:48:03.440
But again, if you have any questions, drop some comments

805
00:48:03.559 --> 00:48:06.239
on our Facebook page or on our YouTube page. We

806
00:48:06.320 --> 00:48:08.880
will respond back to those. You can also call us

807
00:48:08.920 --> 00:48:11.440
at nine O nine two one seven two six three zero.

808
00:48:12.119 --> 00:48:15.800
We are on live at nine am Pacific time every Tuesday,

809
00:48:15.920 --> 00:48:19.159
so please watch us on the different channels. You can

810
00:48:19.239 --> 00:48:24.000
also see us on kfour HD Radio KFOURHD dot com.

811
00:48:24.239 --> 00:48:26.920
You can also download an app to your smartphone that

812
00:48:27.079 --> 00:48:29.400
is free for you and listen to us on there

813
00:48:29.480 --> 00:48:33.800
as well. So to our listeners, just remember Medicare decisions

814
00:48:33.800 --> 00:48:37.039
are important and the right guidance can make a big difference.

815
00:48:37.440 --> 00:48:41.519
You're listening to Medicare Hour and More with Peter, where

816
00:48:41.559 --> 00:48:45.079
we want to make an impact in our community and

817
00:48:45.239 --> 00:48:46.800
we medicare.

818
00:48:48.440 --> 00:48:52.280
Thanks for listening. Tune into Medicare Hour and More with

819
00:48:52.440 --> 00:48:56.440
Peter every Tuesday at nine am Pacific time right here

820
00:48:56.480 --> 00:49:01.880
on KFOHD Radio at KFOREHD dot for more real life

821
00:49:02.000 --> 00:49:07.039
stories from experts who medicare about you and protecting your health,

822
00:49:07.199 --> 00:49:10.960
your finances, and your future. See you next week.