Sept. 1, 2026

Medicare AEP & Life Insurance Solutions: Elena Schofield & Lisa Rehburg Return

Show Notes
Transcript

Season 2, Episode 5 of MedicareHour & More with Peter welcomes back Medicare expert Elena Schofield and Life Settlements Broker Lisa Rehburg. Elena helps agents and beneficiaries prepare for AEP and October’s Medicare enrollment season, while Lisa makes her final appearance with important life insurance settlement options to consider before letting a policy lapse. Two experts, two critical topics, one mission: 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).

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We'll be right back. Attention individuals, families, and caregivers. It's

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Medicare Hour and more with Peter right here on K4HD Radio.

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This is the podcast for all types of insurance solutions

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while specializing in Medicare because we Medicare. Here's your host,

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Peter R.

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Joseph.

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Good morning, good morning, good morning. I'm so glad to

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see you guys all bright and early this morning. We've

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got a great show for you, like always, right? So

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we've got a returning guest, Elena Schofield. She'll be joining

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us a little bit later on in our show. She

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has 26 years experience in the Medicare field. A good

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friend of mine. She's been on the show a couple times.

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This will be her third and final appearance for this year.

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So we're excited to have her. Just to give you

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a heads up, we've got a few places where we

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show ourselves live. K4HD Radio, K4HD. com. You can also see

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us on Facebook Live. I've got my phone number now up.

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So if you're watching and you see that number, you

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can text me any question and we'll answer it in

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real time. That's what we're here for. And then the

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other place you can watch us is on YouTube at

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Medicare Minute with Peter. That's our channel at Medicare Minute

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with Peter. And then you can find all our resources

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at josephinsurancebroker.com. That is our website. So we've got a

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lot to talk about. We've got open enrollment coming up

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in about six weeks, guys. It's crazy for us agents,

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but also for our clients, because they're going to start

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ramping up with phone calls. Unfortunately, people get like 50

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calls a day. There's going to be mailers. There's going

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to be commercials. It's just a crazy time. And we

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are probably going to have another disruptive open enrollment for

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Medicare because, unfortunately, a lot of plans are leaving the market,

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which is going to affect some of our current clients

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and some of you prospects out there listening in for

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the first time about Medicare. So that's what we're here for.

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We're here to help you through and navigate all that

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chaos and It's going to be kind of a bumpy road.

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We did talk about briefly too last week how Part

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D is going to be affecting all our plans for

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next year. That's our prescription drug plans. The government has

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stopped their subsidies with Part D, which means we'll probably

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see an increase in premiums.

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I know.

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It's just bad news. But we do have some great

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news to share with you guys, too. It's not all

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doom and gloom. But I want to show you this video.

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It's great. It's really spot on. The commercials are out

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there that are really misleading you guys. there's a difference

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between what open enrollment really is about and what it's

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not about. So watch this clip and then we'll come back.

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In today's video, we will discuss the only three plans

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that Medicare's open enrollment applies to.

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Which ads are misleading you and why?

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And also stay tuned to the end where we will

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discuss which plan absolutely does not apply to Medicare's open

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enrollment and is never addressed in any of these ads.

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Let's first talk about how you are bombarded with all

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the phone calls and mailers filling up your mailbox daily

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from insurance companies and insurance agents. You are overwhelmed with

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information telling you, now is the time to switch plans

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and choose a coverage that better suits your needs, which

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then causes FOMO.

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Yes, the fear of missing out.

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Why do we say it's misleading? Because only three of

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the four primary Medicare plans does the Medicare annual enrollment

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apply to? And we have not seen really any of

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the ads where they make that so clear. So let's

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first discuss the only three plans that Medicare's open enrollment

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does apply to. Original Medicare, Parts A and B, Medicare

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Advantage or Part C, and Medicare Prescription Drug Plan, also

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called Part D. Now listen very carefully. To feel confident

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with open enrollment each year, you must clearly understand the

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differences between Original Medicare with a Medigap, also called a

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Supplemental Plan, and a Medicare Advantage Plan.

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If you aren't sure, check out our channel and look

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for our other videos where we will discuss the difference

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in detail. The critical point for this video is, if

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you have a Medicare Advantage Plan, called Part C, you

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do not have Original Medicare as your primary.

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Here's another key takeaway.

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If you have a Medicare Advantage plan, you must still

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be enrolled and pay for Original Medicare Parts A and B.

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Why?

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Medicare subsidizes Medicare Advantage plans by funding them around $ 12, 000

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per year.

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That's a lot of money. Why so much money?

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Simply put, Medicare does not want the responsibility to pay

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any of your claims if you are sick.

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Not one penny.

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The Medicare Advantage plans are entirely responsible and override or

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replace your original Medicare plan.

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So are we saying to stay away from these plans?

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No.

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Now, other YouTubers will clearly say why they would never

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buy a Medicare Advantage plan. Well, watch out for our

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other videos where we will discuss why they are excellent

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for some, like my mom.

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And why others should stay clear from them, like my mom.

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Knowing that you either have original Medicare or Medicare Advantage

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plan and cannot have both at the same time, here

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are the changes you can make. you can change from

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Original Medicare to a Medicare Advantage plan. If you don't

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like your Medicare Advantage and want to return to Original Medicare,

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you can drop your Medicare Advantage plan and go back

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to Original Medicare. If you don't like your current Medicare

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Advantage Part C plan, you can switch to a different

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Medicare Advantage Part C plan. You can also switch, add,

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or drop your Part D drug plan each year during

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this open enrollment period.

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Confused?

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Just pause this.

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Video, rewind, and rewatch.

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What should you do if you have one of these plans?

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We'll give you a three-point checklist here in a bit.

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But first, did you notice which plan Anne did not

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mention this period applies to? Yes, Medigap plans. They're also

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called Medicare supplement plans. Medigap or supplemental plans are the

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traditional secondary plans to original Medicare. These plans are where

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Medicare is the primary, and Medicare is paying the 80%,

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and the Medigap is paying the 20%. That's why they

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call it Medigap. You also know that you have a

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Medigap if your plan has a letter. For example, Plan N,

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Plan G, Plan F. So what's so misleading about these ads? Well,

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we have not seen one ad, one mailer, or even

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a TV commercial from the insurance companies, agents, or I

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hate to say it, even Medicare make this clear in writing.

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Please note this 30-second commercial from the Centers of Medicare

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and Medicaid Services and the U.S. Department of Health and

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Human Services.

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An official message from Medicare.

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Mary and I just compared Medicare plans.

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Found one that's going to save us money all next year.

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Dang, I told you it was open enrollment. Yes, you did.

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But we used the plan finder at Medicare.gov. Oh, I

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see what you mean.

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Makes it easier to compare health and prescription plans.

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They sure can change year to year.

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Compare plans now at Medicare.gov.

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Open enrollment ends December 7th.

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Hey honey, let's take a look.

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Paid for by the U.S. Department of Health and Human Services.

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Now, did you notice any disclosures saying this does not

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apply to Medigap or Medicare supplement plans?

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Where's that guy with the deep voice in those commercials

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like the drug commercials? Medicare open enrollment does not apply

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to Medigaps. Think about it. The definition of open enrollment

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means that you can switch or join a plan with

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no health questions and no need for a special event. However,

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to join a Medigap, you must answer health questions. And

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if you cannot pass health questions, you must have an

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IEP or an SEP. Your IEP is your initial enrollment period,

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which lasts for only six months from the time that

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you turn 65 or are new to Part B. A

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special enrollment period or SEP is, for example, you move

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outside the coverage area.

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Alright, so, you know, it goes on and on and

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I don't want to bore you guys but it was

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a very helpful video of colleagues of ours and you

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know It shows that everyone freaks out because if you

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have a Medicare supplement people think oh wait I got

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to change my plan because they hear all these ads No,

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your Medicare supplement is totally different from Medicare Advantage so

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if you're on a Medicare supplement and you actually don't

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change unless you're in what's called a birthday rule state,

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which is California. So on your birthday month, you can

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change your Medicare supplement without any underwriting if you change

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to a different carrier with the same plan letter. So

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you go from G to G, from like UnitedHealthcare to

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Anthem Blue Cross. You would do that without any underwriting.

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But It does not apply to you for open enrollment.

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The only time open enrollment applies to you is if

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you have a Medicare Advantage plan or part d plan

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and you can change that yearly okay so i know

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it gets confusing but that's again that's why we're here

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that's why they pay us the big bucks right to

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help you um get educated on the different medicare journeys

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make sure that you're going on the right path so

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um I encourage you guys to keep watching that video.

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You know, you can pause it and rewind it and

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watch it again. You know, obviously we're on Apple podcasts,

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so it clearly lays out what open enrollment looks like

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and who it applies to. So I encourage you guys

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to do that. All right. So we've got Elena Schofield.

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She is here.

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Hi there, Peter.

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Thanks for having me. Hey, how are you?

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I am great. I just got back from Boston, actually

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Sonoma first, then Napa, then to Boston to speak at

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a ladies conference. So I'm doing great.

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That's awesome. What kind of ladies conference was it?

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Insurance. Awesome. So yeah, I was on stage talking about

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Medicare tips to thrive. and survive.

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Oh, I love it.

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I love that title. Very cool. Well, hey, you've been

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on several times. Thank you so much for making the

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time again for us this morning.

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Thanks for having me.

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Yeah. So for those who don't know who you are,

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do you want to just give a background of where

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you're from and what you do?

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Okay. So I'm currently in Connecticut and I've been a

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Medicare for specialist or expert for the last 26 years

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in and out of the business, but primarily in the business.

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I worked for many big carriers such as Aetna, worked

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at WellCare, worked at for Connecticut for a short time,

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and Kaiser back in my early days. So now I'm independent.

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I have a pretty, well, I'm in 14 states, so

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it's not a big brokerage, but I do it boutique

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style where I really personalize my service to my clients,

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and they like that. So it's completely referral-based. I don't

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buy leads. Yeah. So I have great relationships within the community,

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and so I get referrals mainly from my clients and

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other agents, PNC financial advisors, And my ladies groups that

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I've collaborated with.

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Awesome. That is very cool. Well, that's a way to

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have a thriving business, right? Is based on referral. Yeah,

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that's very cool. Well, you know, obviously, you know, let's

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not talk about the doom and gloom of Medicare. It's,

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you know, it's everywhere right now. It's the headlines. But

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is there anything about Medicare that surprises you in the

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26 years you've been doing this?

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Not at all.

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Not at all.

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Change is inevitable. It's going to happen, right? So we're

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going to see highs and lows. And, you know, 2027,

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we're going to see a lot of changes, a lot

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of disruption, especially in Connecticut and northeastern states. I think

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mainly due to the cost of care in Connecticut, New York,

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and Massachusetts. So a lot of the carriers have scaled back.

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on benefits because they have to. I'm no longer seeing

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the OTCs, the dental's been cut back, the vision and

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co-pays go up. And I'm not sure if they're still

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going to have lots of zero premium plans, a lot

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of HMOs, but not too many PPOs.

236
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Yeah, we're even seeing that in California this next year.

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I think there's, I mean, we're notorious for having zero

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premium and zero everything and we're starting to see premiums

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on some of these plans. So it's unfortunate, but you know,

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that's what we're here for, Elena and I, and we're

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here to guide you to the best options for you guys.

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So obviously, you know, me and you, we met online,

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we've built a relationship that way. What kind of things

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have you learned about the Medicare community through relationships you've

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built through people online or through conferences? What's one of

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00:14:37.610 --> 00:14:38.889
the key things that you've learned?

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00:14:40.149 --> 00:14:43.529
What I find is that the people like you and

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I that like to collaborate rather than compete with each other,

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we win because we can refer to each other, right?

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And we steer clients in the right direction. Maybe you

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know a friend here in Connecticut or New York or Mass,

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and you could pick up the phone and say, Elena,

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can you help my friend out? This is the beauty

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of collaborating. I don't like it when we get too

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competitive because nobody wins. Clients need more of us, not

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less of us.

257
00:15:21.639 --> 00:15:25.500
Yeah, no, for sure. I mean, there's already a shortage

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of doctors out there that our clients have to deal with.

259
00:15:29.210 --> 00:15:32.629
Why are we going to start having a shortage of brokers, right?

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Why not all of us work together for the good

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of our clients, right? And I love that. That's awesome.

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Yeah. There is trying to steer people to their website.

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So why don't we do a better job and steer

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clients to each other?

265
00:15:51.590 --> 00:15:55.860
Yeah, I agree. I agree. Well, you kind of alluded

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to what 2027 might look like for our clients. Are

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there any Any words that, like, let's say you had

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to pick three words to describe what 2027 is going

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00:16:07.750 --> 00:16:09.809
to look like. What three words would you use?

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Disruption, disruption, disruption. However, disruption equals opportunity.

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Amen. Amen.

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Yeah.

273
00:16:20.960 --> 00:16:24.799
I agree. No, that's right on. And, you know, there

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are some agents who are new out there who freak

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out and think, you know, oh my gosh, what am

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I going to do? I'm going to lose all these clients. Well,

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you got to stay on top of it, right? And

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we do the research. We know, you know, ahead of

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time what plans are leaving the market. And that's where

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we step in, right?

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Yeah.

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00:16:42.769 --> 00:16:45.889
We have to be on top of everything because the

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Medicare rules keep changing. The carriers keep changing. In Connecticut,

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carriers are dropping out. So we're seeing less and less PPOs.

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So we need to be the best we can be,

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the most knowledgeable for our clients and prospects.

287
00:17:04.930 --> 00:17:05.750
Yeah, for sure.

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The senior centers, they don't know. They rely upon us.

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Yeah, I agree.

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I agree.

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00:17:15.299 --> 00:17:17.980
So we know the biggest thing going on in the

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news right now is the government letting go of the

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subsidies for Part D. So, obviously, we don't know everything

294
00:17:26.759 --> 00:17:29.759
going into next year. I mean, we're hearing snippets here

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and there. We're seeing the first looks. You know, the

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insurance companies are rolling out what plans are coming out.

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But what do you think our beneficiaries should be aware

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of or should start preparing for for next year?

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00:17:44.190 --> 00:17:49.049
Well, you know, I put out my letter. Actually, it's

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an email. stating that this year is critical, you must

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do a plan review. Don't assume that your plan is

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staying the same because the Part D is going to change.

303
00:18:03.450 --> 00:18:09.549
I think significantly the carriers may be dropping some drugs

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that are too expensive or placing them on Tiers 4.

305
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Who knows? We don't know everything, but The writing is

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on the wall. We see it coming because these drugs

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are so expensive. The carriers cannot afford to keep all

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of them in their formulary. So that's the first thing.

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I'm telling my clients, check your formulary. I can help

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you do that, but that's very important.

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What if you have an appointment with one of your

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clients or a prospect and they say, you know, Lena,

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I want the plan with the lowest premium. I mean,

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how would you respond to that? Like, is that necessarily

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the best option for them? It depends, right? Absolutely not. Yeah.

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00:19:05.430 --> 00:19:09.170
I mean, I would never, ever tell my client, let's

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shop by price only because The networks changed. Doctors have

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00:19:14.549 --> 00:19:15.130
dropped out.

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Hospitals.

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00:19:16.730 --> 00:19:21.150
We're seeing a lot of hospital disruption in Connecticut. And

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that's very important. So first check our doctors. Check your medications.

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So we'll check the formulary. We'll check the hospitals. If

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everything checks off and we still have a zero premium plan,

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00:19:37.299 --> 00:19:42.109
PPO preferably in place, then let's do it. If not,

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00:19:42.890 --> 00:19:47.220
If let's say one of the carriers like Aetna perhaps

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00:19:47.759 --> 00:19:52.349
is no longer zero because of all these changes, then

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00:19:52.849 --> 00:19:56.420
perhaps that might be the best option if it's $ 15, $ 20.

328
00:19:56.329 --> 00:20:01.240
I don't know. I'm going to just throw that out there,

329
00:20:01.319 --> 00:20:04.740
but I would never shop by just premiums.

330
00:20:06.079 --> 00:20:09.329
That's why you're a quality broker, right? Because you know

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00:20:09.440 --> 00:20:13.150
what's what and you do what's best for your client.

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00:20:13.789 --> 00:20:14.150
I do.

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00:20:15.670 --> 00:20:18.589
Elena is one of the best out there, folks. Keep

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00:20:18.609 --> 00:20:21.470
that in mind whenever you need some help out there

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on the East Coast. She's the perfect person to reach

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00:20:24.230 --> 00:20:27.819
out to. The other thing that's changing for next year,

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00:20:29.420 --> 00:20:31.880
we know CMS is putting a lot of emphasis on

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00:20:31.980 --> 00:20:37.609
star ratings and making it about clinical quality, health outcomes.

339
00:20:38.670 --> 00:20:42.329
Do we think our clients really know what star ratings

340
00:20:42.369 --> 00:20:42.789
are about?

341
00:20:43.329 --> 00:20:44.130
No. No.

342
00:20:44.609 --> 00:20:49.089
They have no clue. So when I do my educational events,

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I have a slide and it shows the star ratings,

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00:20:53.450 --> 00:20:58.589
one through five. In Connecticut, it's mostly four stars or

345
00:20:58.690 --> 00:21:02.109
some are four and a half star rating. A lot

346
00:21:02.130 --> 00:21:04.690
of the parties are three stars or three and a

347
00:21:04.690 --> 00:21:08.930
half stars So they'll ask me, oh, what's that mean?

348
00:21:09.309 --> 00:21:14.309
And then the slide shows whether it's provider experience or

349
00:21:14.509 --> 00:21:19.009
quality or, I don't know, I think there's one about

350
00:21:19.470 --> 00:21:25.529
customer complaints. So these, it may or may not mean

351
00:21:25.569 --> 00:21:28.490
a lot, but I always say if it's three and

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00:21:28.519 --> 00:21:31.119
a half stars or less, you kind of want to

353
00:21:31.180 --> 00:21:35.549
steer away from that plan. That's or three stars or less.

354
00:21:36.069 --> 00:21:36.390
Yeah.

355
00:21:36.569 --> 00:21:36.829
Yeah.

356
00:21:37.410 --> 00:21:42.029
I agree. One year, a PDP plan had two and

357
00:21:42.049 --> 00:21:43.670
a half stars. I'm not going to mention.

358
00:21:44.190 --> 00:21:44.509
Right.

359
00:21:44.809 --> 00:21:45.730
But you know who they are.

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Yeah.

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So I'm like, well, I don't think you want to

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00:21:50.289 --> 00:21:54.789
go at that plan just based upon the star ratings.

363
00:21:55.470 --> 00:21:55.869
Yeah.

364
00:21:55.950 --> 00:21:56.109
No.

365
00:21:56.130 --> 00:21:59.890
I want to have a good customer experience because if

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00:21:59.990 --> 00:22:02.970
I'm going to advise you properly, I don't want you

367
00:22:02.990 --> 00:22:05.619
to come back to me and say, this was horrible.

368
00:22:06.180 --> 00:22:09.849
I hated it. It reflects upon me.

369
00:22:10.329 --> 00:22:13.970
It does. It does. Yeah, for sure. So that, I mean,

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00:22:13.990 --> 00:22:16.430
that's why we care so much about, you know, what

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00:22:16.490 --> 00:22:19.150
plans you're on because it's our reputation on the line

372
00:22:19.190 --> 00:22:21.309
as well. Right. You know, we want to make sure

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00:22:21.329 --> 00:22:24.049
that you've got the great customer service on your side.

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00:22:24.150 --> 00:22:27.809
So we do all that research, you know, obviously we've

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00:22:27.829 --> 00:22:31.150
been around the block, so we know what's what. But

376
00:22:31.170 --> 00:22:35.609
I think, thanks Selena for mentioning it. That's really important. Um, what's,

377
00:22:36.069 --> 00:22:39.809
what's a mistake that you've seen beneficiaries make every AP

378
00:22:40.049 --> 00:22:40.910
or open air moment?

379
00:22:41.490 --> 00:22:41.809
Okay.

380
00:22:41.950 --> 00:22:47.970
So I am, I cannot stand the fact that the

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00:22:48.019 --> 00:22:54.059
call centers continue to call, you know, this started back

382
00:22:54.099 --> 00:22:59.119
when the, um, Joe Namath, right. That was like six

383
00:22:59.180 --> 00:23:03.160
years ago. And so you know, they dangle the carrot

384
00:23:03.460 --> 00:23:07.440
and those calls keep coming. My clients get them and

385
00:23:07.480 --> 00:23:10.740
they'll call me and they'll say, Lena, I was offered

386
00:23:10.940 --> 00:23:16.079
all these free food benefits and OTC benefits over the counter,

387
00:23:16.200 --> 00:23:20.809
et cetera. And I said, you have to qualify for that.

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You do not qualify for that. So do not assume.

389
00:23:25.789 --> 00:23:29.829
I recommend do not take those calls. And I ask

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00:23:30.329 --> 00:23:34.759
my clients, to just, you know, go to the do

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not call registry, even though that doesn't work.

392
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Right.

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I mean, they have to not answer those phone calls

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because I've had bad experience where a lot of clients

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have picked up the phone, 94 year old lady crying,

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Medicare AEP & Life Insurance Solutions: Elena Schofield & Lisa Rehburg Return

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