Aug. 25, 2026

Medicare 2027 Uncovered: Jerrie Taylor on Protecting Beneficiaries & Staying Diligent

Show Notes
Transcript

Season 2, Episode 4 of MedicareHour & More with Peter welcomes Jerrie Taylor, Owner of Lion Heart Medicare in Pennsylvania. Jerrie and Peter discuss Medicare, 2027 changes, beneficiary concerns, and how agents can stay educated and diligent. A powerful conversation about putting clients first—across every state and market. We Medi CARE!

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).

MedicareHour & More With Peter! Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.

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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 host, 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 of.

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Competent professionals before applying or trying any suggested ideas.

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

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with Peter right here on K4HD Radio. This is the

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podcast for all types of insurance solutions while specializing in

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Medicare because we Medicare. Here's your host, Peter R.

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Joseph.

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Good morning, good morning, good morning.

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Great to see you all this lovely morning. I can't

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believe it is the end of August. One week left

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and then we are into fall. It just definitely does

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not feel like it. It's been over 105 degrees all

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week here in California. It's been insane, and I know

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all over the U.S. it's getting pretty bad too. So

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global warming, yeah, well, I don't know. Anyways, just want

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to let everyone know we are live on quite a

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few places, K4HD Radio, K4HD. com. You can also download that

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app to your phone. We are also on Facebook Live.

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We are on our Joseph Insurance Broker LLC website. And

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we're on our YouTube channel at Medicare Minute with Peter.

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So hopefully you can catch us any of those places.

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You can also text us any questions live, 909-217-2630, and

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we will answer you in real time. We are so

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excited about our show this morning. We've got a guest,

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Jerry Taylor. I've known her for quite a while. We

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actually ran into each other at the Medicareians conference a

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couple years back. connected over social media. She has got

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quite the story, has been in this industry for quite

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a long time. She's the owner of Lionheart Insurance Group.

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So we'll hear from her in a little bit. We

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also are going to talk about hospital indemnity plans and

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what that means for you. If you haven't noticed here

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in the ACA market, which is Affordable Care Act or Obamacare,

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as you know it, That's health insurance for those under 65.

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It is getting ridiculously priced. Premiums are shooting up every year,

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it seems like. And the deductible and out-of-pocket costs are

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just increasing every year. Just for example, I just did

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a family of three yesterday, and their out-of-pocket for a

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family of three was going to be $ 19, 600. $ 19, 600. I mean,

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that is crazy. So these hospital indemnity plans kind of

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get layered on top of a health insurance plan. It

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helps you mitigate those costs and close the gap of

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that $ 19, 000. So if anything tragic happens like cancer, an accident,

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let's say you're in the hospital for a What hospital

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indemnity plans do, they pay you directly a check, and

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you can use that money towards anything. It could be

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towards that hospital expense. Sometimes it covers more than that,

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and you can pocket the rest. So it's amazing what

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this product can do for you. It's only a couple

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hundred dollars a month. And it helps getting onto a

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lower tier health insurance plan and then layering that hospital

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indemnity plan on top. And that way you're not paying

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so much out of pocket each month. And then you're

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covered for that gap. So we're going to show a

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quick commercial on Manhattan Life.

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That's the product that we go to. So take a look.

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Hey guys, Ted here again with another Monday Minute. Even

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though technically it is Tuesday, I apologize. Just was traveling

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yesterday for medical reasons. But today I wanted to go

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ahead and take a look at Manhattan Life's Affordable Choice Plan.

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Like I mentioned, it does work a little bit different

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than a traditional health plan. Again, just like the one

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we went over last week, it could be compared to AFLAC,

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not because of the benefits it offers, but just the

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way that it pays. It pays set amounts based off

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of certain circumstances, certain benefits. services that you have that

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come up, it will pay a cash benefit that can

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either be paid to a provider if you do an

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assignment of benefits, or they can be paid directly to you.

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So let's go ahead and get started here. I'm gonna

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just use kind of a generic information to quote again.

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So just using a family in their 30s that has

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two kids. So give me just a second to enter

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that information here. Let's see. I'm gonna check out affordable

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choice plans. As you can see, there's going to be

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four different options. You've got your Classic, Classic Plus, Elite,

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and Elite Plus. For a family of four, you can

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get coverage as cheap as $ 272 a month. And if

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you want the maximum amount of coverage, of course, that

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would be closer to $ 662 a month. Now, as always,

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I like to stress that, of course, these numbers could

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still be pretty costly. But if you're comparing these to,

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let's just say, an ACA plan on healthcare.gov, let's just

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say you don't qualify for a subsidy or at least

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not a large subsidy. And you're looking at a plan that, Hey,

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it might cost, you know, $ 1, 500, $ 1, 800 a month. This

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is definitely a good option that you can definitely take

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into account. So what I'm going to go ahead and

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do first is kind of give you a little bit

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more of a real life example of how it works.

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The example one here, it's just based off of the

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elite level of benefits. As you can see, again, these

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are just estimates based off of healthcare data that's pulled

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from Manhattan Life. A hospital stay that's for about a

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duration of seven days could cost as much as $ 41, 660

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and change. There is a network that they work off of,

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so if you use one of their network providers, they

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can get that discount that's available. Again, just using that

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as an example, leaving a balance of just under.

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$ 23, 000.

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You can see here the Elite Plan will have an

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admission benefit of $ 2, 000. Then the hospital benefits stay at $ 4, 000

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per day. Again, for seven days, it comes out to $ 28, 000,

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leaving a total paid of $ 30, 000. So on this example,

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the amount that would be paid to you directly, $ 30, 000,

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that difference of your balance money being right under $ 23, 000,

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you would actually be able to keep that difference in

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the money that's received And that can be used to

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help cover missed pay. Sometimes you may have family members

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that have lodging expenses, food expenses, for example. So that

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money could definitely come in handy to cover those types

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of things. I'll give you another example here that's provided

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is using their classic level of coverage. Just an example

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of a preventative care office visit with some labs, $ 95

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for the visit, $ 90 for the labs, but $ 185 total.

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The plan would pay $ 125, which does still leave a

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pretty good gap. But as you can see here, another

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example of network discounts using a network provider could be

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knocked down from 185 to 130 minus your 125 in

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benefits would leave you with just a $ 5 balance left

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over that you would owe to that provider. So definitely

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is something that can be good for a lot of people. Now,

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just for time's sake, of course, I can't go over

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every single one of these. And I know that this

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is just a ton of information right here. So definitely,

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if you have questions, just let me know. You can comment.

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You can give me a call, 325-261-7211. I just wanted

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to kind of give a high-level overview of some of

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the benefits. As you can see here, on the right

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hand starts their lower amount of coverage, which is the classic,

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all the way to the left, which is their highest,

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the elite plus. So you've got an inpatient hospital confinement,

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which is based off of per inpatient day. So $ 2, 000

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from the classic up to 3,000, 4,000, and then 6,000

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all the way on the elite plus. You do also

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get a hospital admission benefit for the first inpatient day

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for every calendar year. And so that's basically an additional

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amount of money that's paid on top of this benefit

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right here. And as you can see, it ranges anywhere

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from 1,000 to $ 3, 000. You have your emergency room benefit,

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which I can definitely tell you from experience, emergency room

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definitely does cost more. that was provided here. But do

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keep in mind, you definitely do want to only go

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to an emergency room if it is absolutely necessary. And

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I recommend that no matter what plan you have, or

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even if you're self-pay, emergency is something, you know, life-threatening,

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something that cannot wait. But if you have just like

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a common code, for example, and you can go to

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an urgent care, then you're definitely going to get more

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bang for your buck, if you will, Urgent care, let's

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just say even if it costs $ 200, $ 250, $ 300, you

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can see right here you have that benefit there for

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that urgent care. It does offer surgery benefits, surgical center

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benefits as well, anesthesia, assistant surgeon. One other benefit that

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I will highlight here right now in front of the

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screen is a doctor's office visit. As you can see,

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it does provide it based off a number of days.

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So from the classic plan, you got six days per

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calendar year. all the way up to 10 days for

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that year, it will basically pay you anywhere from $ 75

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per office visit up to $ 200 per office visit. And

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if you're thinking, you know, well, hey, what if I

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go over six days, eight days, or even ten days

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per year and I go to the doctor a whole

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lot more well if you have a good year you

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can roll over up to five visits per policy year

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and that can definitely come in handy to kind of

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rack those up prescription benefits as you can see here

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you got some prescription benefits and just a whole lot

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of other things you know allergy shots that was very

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common here in Abilene I myself am on those got

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some cancer benefits and just a bunch of different things. Again,

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just for time's sake, I definitely don't want to bore

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you with every single thing, but hopefully, you know, if

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you can pause the video, take a look and see

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if there's something that interests you are again, if you

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have a question, definitely let me know. We can definitely

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go over that with us. We can go over that together,

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excuse me, um, in the phone call or in the

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comments or just wherever, whatever you're most comfortable with. But

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in the meantime, if you have any other questions, um,

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I'm available pretty much any time. If you can just

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give me a call at 325-261-7211 and I'll be glad

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to help you out. So just remember, let TED coverage

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get you covered.

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All right.

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So there's a lot of information there. Manhattan Life is

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one of the products we are, it's our go-to, especially

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out here in California. As you can see, you know,

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that was an affordable choice plan, which is a little

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bit different. It can take your place of your typical

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health insurance plan. And as you can see, it covers

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you for hospital stay, ambulance, urgent care visits, doctor visits, labs,

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all that stuff. And so if you can't afford, you know,

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an ACA plan, that might be an option for you

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to do. And they do offer other plans. Like I

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was saying, you could layer like a cancer plan, which

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is basically geared towards if you come down with cancer,

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it will pay you out a cash settlement on a

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That diagnosis. So, you know, let's say you're paying out

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of pocket or through your insurance chemotherapy bills and they're

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pretty high. That hospital indemnity plan or that cancer plan

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will come in and kick in and give you that

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check to cover some.

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Of those costs.

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So It definitely helps mitigate those costs for ACA plans.

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For example, the premiums on some of these plans are.

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Like $ 2, 500 to $ 3, 000.

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A month premium for a family of three. And that's

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without any subsidy.

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So that is pretty high. And so what I do

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have some clients do is go on what's called a

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bronze plan, which is the lowest tier plan on an ACA.

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where they're only paying maybe about $ 1, 700 to $ 1, 800 a month,

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and then they'll layer one of these Manhattan plans on top.

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And so they're paying less for better coverage than if

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they paid like $ 2, 500 on the silver plan.

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So we do the math for you. We see if

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it works or not.

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If you have any questions about any of that, you

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can always reach out to us. You can text me

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909-217-2630 or go to our website, josephinsurancebroker.com, and put in

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your information, and we will contact you if you have

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questions specifically on the Manhattan products. So before we continue

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on our show, I'm waiting to see if Jerry comes on.

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I don't think he's in the room. Is Jerry here?

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Not yet?

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Okay.

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So we'll wait until she comes on.

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Again, Jerry is the owner of Lionheart Insurance Group. She

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is a rock star in her industry. She's been doing

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this for quite a while. She's got a heart of gold.

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She definitely has a calling for this kind of work

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that she does with our seniors.

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And so it'll be interesting to see.

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Kind of her viewpoint on what's going on with Medicare

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in 2027. And I'm going to reach out to her

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real quick because she is a little late.

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So I'm going to see what's going on. OK. All right.

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So while we await for Jerry, I'm going to share

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my screen here and show you something.

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So you probably.

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Have heard about.

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Articles in the paper lately about different Part D plans

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possibly going up for prescription drugs for next year for Medicare.

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The government is not doing subsidies anymore for Part D.

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And so people are panicking because they're thinking their premiums

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are going to shoot up for next year.

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They are going to be impacted. I will tell you that.

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You know, the good thing is.

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With what has been in place recently, the government is

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negotiating prices with some of our drugs for next year.

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This has been happening over the past few years. So

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for next year, let me show you real quick.

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You could see.

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Because of the Inflation Reduction Act for the prescription the

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last few years, we had a cap, thankfully, on insulin,

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$ 35 per month.

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Zero on those vaccines.

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And then in 2024, you know, the catastrophic coverage went away.

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So basically, you know, there was a cap now on the.

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Deductible, which is great.

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So in 2025, that cap was $ 2, 000, which made prescriptions

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a little bit more affordable. But what happened with that

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is that premiums for Part D plans.

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Did go up because of that.

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So in 2026, you can see it's a $ 2, 100 cap.

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That's this year.

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And then these are the prescription drugs that have been negotiated.

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For lower prices. You've got Eloquist, Xarelto. You know, Eloquist

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is used for heart conditions. It's used for guardians, for enslavers.

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And Diabetics, and Trusto, and then you go on and on.

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And then you go to next year, that cap is

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now $ 2, 400, which is still pretty low. And you could

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see OZENFIC is the big one that's being negotiated next year.

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There is a GLP-1 program now through Medicare where you

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can get that for $ 50 a month. So that's mitigated

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costs on the OZENFIC side of things. I know a

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lot of my clients are on that.

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So that's good to hear. And then you could see

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Trilogy is one for next year.

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And then you can see all these name brand medications

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that are being negotiated and lowered in price.

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So that's the good news.

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And so hopefully that will continue to help us out

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with prices.

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There are options out there. We do send our clients

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to the Canadian pharmacy, actually, which is very legal.

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And the other thing that happens is that we do....

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Send Clients to GetRx.

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And that's a free app that you can download that

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reduces our prices on our prescription drugs. And usually I

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tell my clients, you can just use that instead of

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going through your insurance company because it could probably save

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you a.

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Lot more money than going through your insurance.

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So you basically type in the prescription you're looking for

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on GoodRx, and then you select that one. You select

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the pharmacy you're going to, and then a code will

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appear on your phone.

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We can do it on our desktop, too.

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You can send it to an email on your phone,

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and then you show the pharmacist that code, and they

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apply the discount right then and there to your prescription.

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So those are just some tips for our clients about

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prescription drugs.

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I see Jerry has entered our room. Hey, Jerry.

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Oh, you can see me.

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There we go. Awesome.

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How are you?

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I'm good.

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I'm good.

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How are you, my friend?

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Fantastic.

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Fantastic.

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I think the last time I saw you was like

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two years ago, right?

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I know.

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Yes. Medicare is that? Yeah.

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00:18:25.190 --> 00:18:29.380
Yeah. Yeah. In Vegas. Yeah. You're coming back next year, right?

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I am.

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Yes.

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I am coming back next year.

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Yes.

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And I just put myself, let me put myself on

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do not disturb.

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Okay.

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00:18:38.190 --> 00:18:40.400
And then give me a phone number for you so

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we can scroll back.

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It's 443-467-2262.

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All right.

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Awesome.

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All right.

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00:18:51.980 --> 00:18:54.690
So for our audience who doesn't know you, obviously I

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00:18:54.710 --> 00:18:56.869
know who you are, but do you want to give

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a little bit of background of how you started in

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this industry back to the beginning?

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What made you start? Just where you're from? anything like that.

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Absolutely. Yes.

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Okay.

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So I'm Jerry Taylor. I am, um, I started in

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the Medicare space, um, by default, I started with, um,

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final expense and my clients were asking me about Medicare.

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And honestly, Peter, I knew nothing about Medicare. I I

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didn't even know there was an 80-20. All I knew

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is they took money out my check, you know, when

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I was an employee and that was Medicare. And that's

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how I started really just by accident. And I started

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doing some research. There was a huge need in my

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community and I just, you know, got certified, took the ball,

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and just ran with it.

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That's awesome. That's awesome. And where are you located at, Geri?

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I'm in Maryland. I'm on the eastern shore of Maryland.

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Yes.

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00:20:01.789 --> 00:20:01.990
Okay.

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00:20:02.029 --> 00:20:05.529
Very cool. Yes. Did you grow up in Maryland?

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So I'm originally from Philly.

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OK.

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Yes. Originally from Philadelphia. And then I lived in the Washington, D.C.

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area for for a while. I was there for like

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almost like like 20 plus years when my baby girl

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graduated from high school and went off to college in 2013.

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My husband and I decided to move to the Eastern Shore,

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which is more rural Maryland. We were in the DMV,

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which is the D.C. metropolitan area. But we moved to

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the Eastern Shore, Maryland. And I love it here. Like,

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I really love it here. And I've been here, although

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Philly is my home town. Cambridge, Maryland is where I

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had moved to. I consider Cambridge being my second home

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here on the Eastern Shore. But I lived in a

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DMV for like 20 something years, but I was in

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a Cambridge area for like 10 plus years. And that's

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where I've actually grown my business. It's my second home.

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Okay.

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00:21:00.990 --> 00:21:02.150
Very cool. Very cool.

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00:21:03.410 --> 00:21:06.230
So what, what made you decide, you know, obviously it

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00:21:06.250 --> 00:21:08.329
sounds like you were doing final.

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00:21:08.109 --> 00:21:10.529
Expense for a little bit and then you went to Medicare.

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00:21:10.589 --> 00:21:15.299
So what made you transition from that to Medicare? Yeah.

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00:21:15.380 --> 00:21:21.000
So again, you know, my clients were asking me about Medicare.

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00:21:21.319 --> 00:21:24.490
And when I found that there was a need here, I,

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you know, I just went on ahead and, and Jump

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both feet. And of course, final expense is a byproduct, right?

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00:21:32.829 --> 00:21:37.329
So I still do life insurance, final expense products. But honestly,

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the Medicare, there is a greater need and it's a

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lot easier. A whole lot easier.

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Yes, it is.

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I agree.

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I agree.

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Yes, because, I mean, you need health insurance. Of course, everyone,

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Medicare 2027 Uncovered: Jerrie Taylor on Protecting Beneficiaries & Staying Diligent

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