Ep # 34: Attaining Confidence In Your Medicare Elections With Anthony Minetola

Benjamin Haas |



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Benjamin Haas  00:06
So welcome, Anthony. This is A/B Conversations, a podcast where we help people get a little information on financial planning. I'll certainly introduce you because clearly A/B conversations typically are Adam and I, and you are clearly not Adam. So for our six loyal listeners or whatever it is, Adam is alive and well but we thought this was a great opportunity to invite you, Anthony, on to the podcast, to be a resource for a lot of our clients and anybody out there, around the thing that you know best: Medicare. So, again, welcome. I'll introduce you. BGA Insurance Group since 2010 and going to be a very little-known fact, we actually spent some time together at Ameriprise Financial prior to your stint there. You're a branch manager.

Anthony Minetola  01:03
We did, very brief.

Benjamin Haas  01:06
So you're a branch manager, Allentown, Pennsylvania. A proud new father and you don't even have bags underneath your eyes. I've come to know you as an expert in Medicare. So let's maybe just jump right into it. You know, we're both in the business of helping people with some really important decisions and oftentimes, information can just feel daunting, especially if they've got somebody in their ear saying, well, you should do this and you should do that. Let's maybe help people get untwisted on that and really just focus on what I think are some of those key questions that you can really help people with. So let's just start there, when people are prepping for retirement and Medicare decisions, what are the key factors that you would really want people to be thinking about or considering before making that decision? 

Anthony Minetola  01:58
You know, I always tell people, it is a big decision that you need to make and at the end of the day, you can't rely on what other people, friends, relatives, family members have done or plans that they've chosen because what's best for them might not be best for you. At the end of the day, peace of mind is what I want anybody to have that I'm meeting with. There's a lot of information out there and it can be very confusing because the way Medicare presents it on their website, on the books that they send out, very redundant. A lot of times, it almost seems like they're using words that will confuse people that aren't experienced in it so I always tell people don't even worry about the Medicare book because what we do for them is we're going to break down that whole book and help them understand how the Medicare system works in a language that they're going to be able to relate to. But I think peace of mind is really the most important thing. This is a decision to what you guys do with helping people with their retirement planning. We don't know what our life expectancy is. So, you know, for some people, they're making a decision on a plan that they don't know if they're going to have this plan for the next six months, the next year, the next 10 years, 20, and so forth. People are able to make changes but you want to make a choice that you can honestly say, if I'm turning 65 and I live to 100, is this going to be a choice that I feel comfortable with over the next 35 years?

Benjamin Haas  03:45
Yeah, well said. We often say that to when you have so many different options and your mind goes to so many different places, you have to keep the main thing, the main thing. When it comes to Medicare for people, what do you say so that they're not listening to their friends and everybody else? What is the key thing that they should be focused on about their own financial life, that might lead you to say, well, then here's what I think is best for you.

Anthony Minetola  04:11
First thing I always say is have an open mind. If their friend referred them to me, don't worry about what the friend has, don't worry about what the friend told you about their coverage because that plan for their friend or their family member was picked out and works perfectly for them. So it's just coming in with a clear mind and understanding that I am the expert here and I have all the tools. I have all the companies so you know, let's find out what's going to be the best plan for your needs, both financially based off your medical needs and then go from there.

Benjamin Haas  04:51
So is that a key? Is medical history going to weigh in in a big way here? 

Anthony Minetola  04:57
Yep, absolutely. For somebody that has medical problems and had medical problems in the past, we're going to lean more towards a certain set of products just because they're going to give them better coverage. If somebody comes in and they have a pretty clean health history and they just go for the regular checkups once or twice a year, then it opens up some other possibilities and then it really would determine what type of risk they want to take on. When I say risk, how much out of pocket exposure if something were to happen but if somebody does have the health conditions, there's plans where they don't have to take any type of risk on, paying a big bill if something does happen again.

Benjamin Haas  05:40
Okay, so then let me stay there. You said is there an opportunity to change those choices year over year? And so like, what is that process?

Anthony Minetola  05:49
Yep, so the annual enrollment period for Medicare runs October 15th through December 7th. During that time, anybody can make just about any change they would like and whatever changes they make will take place for January 1st. Now when I say that, they can pretty much make any change they want, there are certain plans that still do have medical underwriting. So during that time, even though it's the general enrollment period, some plans you still would have to go through a plan’s underwriting. That's why it's not a definite that you can do any type of change you want but it is the general time where you can evaluate your coverage, see if anything's changed with the plans, update your agent to notify me if there's any change in your health history and then also just to see what new plans are available. Insurance companies are always trying to come up with the next best plan or throw a new benefit. For example, what we're seeing now, some companies are using an insulin saber program. So insulin is a very expensive cost. There are some companies that are actually covering insulin as a generic cost, just to kind of experiment, to see how it works so anybody that in the past has been paying high cost for their insulins, one of these new plans might be something to look at because, sure, you might have to change your medical benefits a little bit to go into a new plan but if it's going to save you hundreds, if not 1,000’s of dollars on your insulin, it's probably worth it. So, just being open, like I said, to new options out there, new programs out there, that's what the enrollment periods for and that's when people can really take advantage and make sure that they're in the best position for the following year.

Benjamin Haas  07:43
Yeah, you use the word underwriting. Let's maybe just mark a client's situation here, where they go into this Medicare selection process with a pretty clean bill of health in the past but then something happens in their life and now all of a sudden, they're a little bit more concerned. They may have to go through an underwriting process and they may not be able to be approved to go into a different plan. Is that accurate?

Anthony Minetola  08:05
Yes, that's correct. So the first thing I'll say is whenever somebody gets into Medicare for the first time, whether they're turning 65 or if they go work past 65 and come off their employer coverage. They have their own special window where they can never be turned down. The government will say it's a seven-month window that starts three months prior to getting on the Medicare the month of and then three months after. It actually does extend six months past getting on to part B of Medicare or getting into Medicare so in that window, there's no plan that can turn somebody down. They're not even allowed to ask any health information on the application. Once that window passes, there's two main ways that you can obtain your medical coverage. You can choose to have Medicare as your primary and then choose a Medicare supplement or Medigap Plan, the terms are synonymous or you can choose to forego your Medicare benefits and choose a Medicare Advantage plan. Now without getting into all the details and what the differences are, as far as the health goes, the Medicare Advantage plan can never ask any health questions. So you can change into a Medicare Advantage plan, switch to a different company's Medicare Advantage plan and you'll never be turned down. Obviously, you can do that during the enrollment period. The Medicare supplement or Medigap plans, when you first get in, they can't ask any health questions outside of that first six months, then you're going to have to go through a series of underwriting questions where you can be declined. The way it works for most companies, it's either going to be a yes or no. Yes, we're going to take you and you're covered in full from day one or no, unfortunately we're not going to be able to take your application. The questions that they ask, they're looking more so for major medical questions. They understand that as we age, you know, minor things do happen, blood pressure, cholesterol but they are looking for severe conditions. They're looking for forms of cancer, a heart attack, stroke, other heart issues, congestive heart failure, more severe conditions like dementia and Alzheimer's. What they're going to do is they're going to ask a series of yes/no questions on the application. If you answer no to all of them, then you're going to get the coverage. If you do answer yes to them, some companies are going to say, you know what, that's declined, we can't take you. There are other companies out there that have a higher rating system. So they'll have like a preferred rate and a standard where if you can answer all of their health questions, they're going to take you at their preferred rate. If possibly you do have one of these health conditions, they'll say, well, we can insure you but you're going to pay a higher amount so there's a couple of companies that do allow for that. So, in an extreme case, you know, let's say somebody starts out with a Medicare Advantage plan because they are healthy and all of a sudden, now that we have all these series of health issues, they can still get a Medicare supplement plan. It's just they're going to pay a lot more for it. 

Benjamin Haas  11:20
Understood. So maybe that ties into my next question, where do you see people make mistakes? Or maybe said a little differently, is this one of those situations where people may be end up regretting a choice that they made because they didn't think far enough ahead?

Anthony Minetola  11:37
Yeah, I think the biggest mistakes that we see people make is when they try to do things on their own. Again, there's a lot of information out there. When somebody turns 65, it's public information that they're turning 65 so any insurance company out there can bombard people with literature in the mail and that's the biggest complaint I get is they had the stack of paperwork and they don't know what to do. The insurance companies aren't necessarily out there to call somebody with Do not call and privacy laws but every company knows when you're turning 65. I do find the big mistake people make is they get something in the mail, where they get a phone call and they just jump the gun and say, you know what, I'm going to go with this, I think I understand it. I'm not just going to say this next part because I am an insurance, Medicare insurance broker, I'm saying this as brokers in general, no matter what the field is, if you have the opportunity to work with a broker, work with a broker because they're going to be able to give you so much information and really help you out with making the right decision. Too many times I see somebody, they get something in the mail from a company like AARP and AARP is a great company. They're a great lobbying group for people who are 50 and older. They partner with United Healthcare, I do a lot of business with them so I'm not bad mouthing them in any way but people get something in the mail and they think, oh, it's AARP, I have to go with them. For some people, that might be the right choice, for other people, that might not be the best choice. So really, that's the biggest mistake I see people make is they try to do it on their own because they don't want to be bothered by the insurance companies and the insurance agents when in reality, we're the ones here to help them in making that informed decision.

Benjamin Haas  13:25
Yeah, so let me then pivot, just like our clients can't have a crystal ball to see the future, I'm not expecting you too either. However, you are my resident expert here so let me throw this at you. If you could shake that crystal ball right now, we get a lot of questions around the future of these government programs. Stability, solvency, Social Security. Where do you see the industry going? Where do you see maybe costs changing? Anything you can share that you would want people to be thinking about?

Anthony Minetola  13:57
Well, it's health insurance. It's never gone down in cost and it's not going to happen that way so I do foresee that the costs will continue to go up. Now, when it comes to Medicare compared to individual plans for people that are not 65 yet, the costs are very low. When I have somebody who's retired already, that when they get to 65, they're coming off an individual plan and go into Medicare, the amount of money they save is incredible but right, it's not the case for everybody. We have seen the cost go up. The standard cost for Medicare right now is $148.50 per month. Most people pay that based off of income levels. Some people do pay less, some people do pay more than that but in general, everybody's paying that. When I started in the industry, I started with BGA in 2010. I actually started in the Medicare industry back in 2008, the standard costs for Medicare was $96.40.

Benjamin Haas  14:58

Anthony Minetola  14:59
So it's gone up quite bit in the last 12-13 years. I do foresee that happening where it's going to keep going up. It's somewhat regulated, I mean if we look at the grand scheme of things, everything has gone up since, you know, in the last 12-13 years.  

Benjamin Haas  15:15

Anthony Minetola  15:15
If you're saying $96 to $148, depending on who you're talking to, that's not a terrible jump but one thing that I always do look at when we can try to figure out what's going to happen with costs of Medicare in the future. We're in a period now where we are right in the middle of the baby boomers and eventually, we're going to get out of that period. Right now, there's so many people that are getting on the Medicare every day. I think the stat is like 10,000 people per day, age into Medicare, that's not always going to be the case. So, maybe not in the next 10, 15, 20 years but when you and I are at that point where we might be getting ready for Medicare, that's where the cost could be a lot higher because there's not going to be as many people getting into the Medicare system every day.

Benjamin Haas  16:03
Yeah and maybe this is just one of those myth busting things too. But most people, I think, kind of have at least a baseline grasp of social security and know when they can actually start taking benefits or when they would get full benefits and it does get confusing because that age does move. 

Anthony Minetola  16:21

Benjamin Haas  16:21
Medicare is age 65. That's it. Doesn't matter when they start Social Security. Correct?

Anthony Minetola  16:26
Correct. Yes. The only way someone's eligible for Medicare prior to 65 is if they have a permanent disability, that once they would be collecting disability for two years, they become eligible for Medicare. 

Benjamin Haas  16:37
Yeah, I mean, again, I know you don't have a crystal ball. Do you see that age requirement ever being something on the table?

Anthony Minetola  16:44
There are talks about it now where they're trying to get it lowered to age 62, which I think would be the most logical thing. Somebody is able to retire and take their social security, I feel like they should be able to collect the Medicare as well. Too many times I run into somebody that they turn 62, they decide they're ready to retire and nobody informs them about what the cost of insurance is going to be. All of a sudden, their Social Security is pretty much being used up on their health insurance so I would love to see it go to 62. I know, like I said, there has been talks about it but nothing is set in stone. It's probably not something that's going to happen in the near future but if it's something that's going to happen, I think it would happen. Still, while we're in this baby boomer era, just because there's so many more people that want to retire earlier and if you can get more people on to Medicare. You lower the age, there's more people in it now, that could actually if not reduce costs, keep them pretty level for the foreseeable future.

Benjamin Haas  17:50
Yeah, bigger pool. So yeah, we see this a lot with people have been committed to saving, maybe have some flexibility to retire or even just phase out of retirement, that gap between workplace benefits and Medicare. We're talking and I don't want to generalize here, but we're not talking $150 a month, like you just said; we're talking hundreds of dollars a month, maybe even more than $1,000 a month, so it's significant. So let me then kind of pare back, I know it's far less common these days that someone would have worked for a company that may provide some retiree medical benefits. Can you help people like that at least compare what coverage may be offered to them versus what Medicare would look like?

Anthony Minetola  18:35
Oh, yeah, absolutely. Any company is going to be able to provide you with their Summary of Benefits. Generally, once somebody is over 65 and retires, we don't see that they're going to carry them anymore but that doesn't mean that it's not going to happen. So it's always good to compare the benefits. I actually was just talking to a gentleman today. He's in that boat where he's still working, his wife's going to be going on Medicare and he wants to see is it better for her to stay on his work coverage or go to Medicare and it's a very simple comparison. There's a lot of things to take into account. Number one, what the cost of the insurance is going to be for monthly premiums, what type of benefits you're going to get, and what type of extra programs that they're going to throw in there. There's no way to generally say it's better to do one or the other. It's just always best to sit down with someone and go over what all the costs are going to be to make an educated decision. Then there's some professions out there or some companies that people work for, where they go to retire, and everything is pretty much covered, where they don't need to take Medicare. I don't want to just throw out certain careers or start certain professions where people don't have to worry about what to do when they get to Medicare because they're going to be covered because things can change and I don't want someone to hear, oh, I did this job so I'm covered. I don't have to worry about it. You know, a lot of times to attend on how long someone's been with the company but in general, it's just one of those, you always want to compare with what's available with Medicare because when you get your employer coverage, generally, there's only a couple of options if you even have options. Where, when you get to Medicare, there's so many different options out there that you might look at the coverage you have and say, well, I think I have a decent plan but you don't know what's available under Medicare.

Benjamin Haas  20:27
Yeah, compared to what? Great point.

Anthony Minetola  20:29

Benjamin Haas  20:31
All right, well, then let me put this back on you. Sometimes we don't know what questions we should be asking. So are there questions that you would want people to be asking or things that you would want to know, that I maybe haven't brought up?

Anthony Minetola  20:48
You know, I think the biggest thing that people have to do is see what implications of making a decision when they're first getting into Medicare is going to have over the remainder of their lifetime and you've said it a couple of times, none of us have this crystal ball to know how long that lifetime is going to be. But just asking questions to whoever they're going to be meeting with, whether it's meeting with myself or another agent out there, or directly through an insurance company, just asking those questions of, how am I going to be impacted down the road? You talked about it earlier with the health conditions and some people they get into a plan and they just assume that the Annual Enrollment Period means, okay, I can make any change I want. Where I've run into people where they had health conditions but not severe enough for them to want to take the Medicare supplement, they take a Medicare Advantage plan because it's less expensive. They throw in all the bells and whistles, now all of a sudden, they realize that their costs are higher than they thought they were going to be and they can't get into the Medicare supplement. It's really just asking those questions of what's going to happen in the future and any good agents are going to be honest with somebody and let them know exactly what I'm saying here that, yeah, right now you can get in a supplement. Down the road, you might not be able to so that's one of the big ones and then there are other products out there. Everybody thinks that insurance is something that you want to have the cheapest insurance and the least amount of plans. It's not always about that. There are times where people are over insured but there's also ways that you can take multiple insurance plans that might be able to satisfy your needs better than taking one plan that has a higher cost. For example, with these Medicare Advantage plans, one of the things people don't like about them is they have an out-of-pocket maximum, generally in the area of $5,500 to $7,500. Meaning in a given year, if their bills added up, they could pay out of pocket. So a lot of times they will be afraid to go into one of these plans because that out-of-pocket exposure. Well, there really are only a couple ways that somebody can hit that out-of-pocket exposure and there are additional products that someone can take to add on to that Medicare Advantage where you can almost have the same type of coverage as a Medicare supplement that somebody else has. And why to bring that up is let's take that person that took the Medicare Advantage now their health, somebody came up with their health, they might not be able to get back into a supplemental plan. Well, there might be ways that they can get a plan to at least cover that high expense if they were to hit it. So not all is lost if you can't get back in on Medicare supplement but it's just asking the additional questions. What other insurances are available to me? Is there anything else I can add on to this to cover some of those costs?

Benjamin Haas  23:55
Okay, then let me throw you a couple softballs here as we kind of try to wrap some things up. It's not just the decision at age 65 but that open enrollment period every year. True or false? Is it a good thing to reach out to somebody like Anthony, every year and say, hey, is this still the best fit for me?

Anthony Minetola  24:13
Absolutely. Yeah, I tell anybody that I meet with and all my clients, I tell them my phone, my emails open, reach out to me at that time. They all know that I'm busy but I'm busy for reason because I am helping everybody out. You know, obviously you know, at that time trying to help out, you know, people that are looking who are not my clients that are looking to switch into something I offer, but I'm always there for my clients as well. When somebody signs up with me, you're not just signing up for that day or that year. You're signing up to work with me for the rest of your life because I want to build that relationship where people know okay, my price is starting to go up. I know I can call Anthony at the enrollment period and he'll be honest with you. He'll tell me if there's a better way to go or if anything, I keep using that word or that term peace of mind. You call me up during the enrollment period and I tell you, hey, there's nothing better you can do. Now you know for the next year, you don't have to worry about your insurance, you don't have to worry about, you know what you're getting in the mail. You don't have to worry about the commercials you see on TV. You know that you're in the best position.

Benjamin Haas  25:24
Yeah, and do you charge a consultation fee or anything on the front end to meet with somebody and go through that data?

Anthony Minetola  25:30
No, I do not charge any fee and I don't charge a fee for some of the work of me. I'm contracted directly to the insurance company. So as part of my contract with them, if somebody enrolls into a plan that I represent, then I am compensated by the insurance company. I don't charge anything to meet with them. I don't charge anything in addition for them to sign up and they can know that by signing up through me, rather than going directly through the insurance company, the price has stayed the same. So it's not like the insurance company is going to charge them more to go through me, I'm just the middleman connecting them with the insurance company.

Benjamin Haas  26:07
That's really good to know. So anything else that you want to share? Myth that you see misunderstandings, anything else for the audience today?

Anthony Minetola  26:16
I honestly think we covered it all. I was thinking about this the last couple of days as to some of the myths out there and it really is just getting all the facts, as I had said before and don't be afraid to work with an agent. From what I've seen, I know a lot of Medicare agents just you know, over the years, because we all do represent similar companies and we go to functions for the insurance companies. You get to meet people in the industry. If somebody has been in the industry for Medicare, for even a couple of years. I've been in it for 13 years but even somebody that's been in it three to five years, it's somebody you can trust and they know what they're talking about. This industry, as you know, with you're in a similar industry as well, there's a very high turnover rate with agents because people don't know what they're getting into. They just want to see how it works. So, if somebody does stick it out and is able to make this their career, they're probably good at what they do and they're going to help you out. It's just being willing to meet with somebody and in general, like I said before, find a broker. Whether it's for your Medicare, whether it's for your financial needs, whether it's for your other insurances, car insurance, homeowners, I recently just bought a home. I worked with a mortgage broker where he's able to find multiple mortgages and pick out the best one. It's just, you want to find somebody that is going to have multiple options that's going to be able to work for you and put you in the best position and not just say, here's what we have, take it or leave it.

Benjamin Haas  28:01
Yeah, I'm really glad you closed with that because I do think we often talk about the stigma in our industries and certainly there is some overlap because we're both here to advise clients. It is to make it crystal clear for people that you don't go to Anthony because you're going to be sold something and I'm glad you talked about how you're compensated. You're there to give the information and what people pay is not going to be different so take that opportunity to speak with an expert. That's certainly why we rely on you with our connections and I'm really glad you kind of put all that out there today. So again, I appreciate the time. You can find Anthony, of course at BGA Insurance Group. I'm not sure the exact website, but Google does a good job these days, right?

Anthony Minetola  28:44
The website is bgainsurance.net

Benjamin Haas  28:48
There you go. Perfect. Well, again, I really appreciate you taking some time. I'm sure this will be useful for people and of course, personally, I'll see you around.

Anthony Minetola  28:59
Sounds good. I appreciate you having me, Ben. 

Benjamin Haas  29:01
All right. Thanks.

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