Welcome back to another episode of the Sandwich Bread podcast. Today we're talking about a topic that affects so many families in the sandwich generation, whether you're raising young kids or supporting aging parents or navigating your own personal retirement timeline. Diving into Medicare is a necessary evil for all individuals. Open enrollment ends December 7th. So we're pushing out this episode with a couple of days to spare before open enrollment ends. So it's not too late for you to revisit your own Medicare enrollments or those of your loved ones or aging parents. We have a little bit of time left, so we want to push this one out quickly. We have been delivering a little bit more content than expected in these first few weeks. We will settle into a cadence of one to two per month when the time is right, but we just had some time-sensitive deadlines we wanted to hit this fall. So joining us today is Grant George, Medicare done professionally, a Medicare advisor that we happen to use for client reviews when appropriate. He brings in education first path and guidance with his clients that aligns well with how we serve our clients. So with that, let's get into it for today's episode.

Welcome everybody to another episode of the Sandwich Bread podcast. This is a very special episode and timely and time sensitive. We've got a Medicare expert on for this episode, ⁓ Grant George, and why it's timely and why it's time sensitive is because the deadline for open enrollment Medicare is December 7th. So with that, Grant, welcome.

Thank you. Thanks for having me. I'm excited. Excited to talk Medicare. It's a very sexy industry to be in. yeah. Yeah.

You bet. Yeah, you bet.

Yeah

Only the hottest content on the Sandwich Bread podcast.

Let's get into the good stuff. So Grant, high level first and foremost. Tell us about your background. What got you into this dazzling field? and what you like about it.


Yeah, yeah, absolutely. My dad had always been in the health insurance industry. For 40 years, he had done ⁓ what's called employer group benefits. So he implemented health insurance for big, big employers and their employees.

One of his biggest challenges was helping them understand Medicare and really understanding it himself. And he knew that people needed help understanding it and they needed to turn to a person they could trust. So in 2014, my dad actually left corporate America and started MDP, which is Medicare Done Professionally.
I've been doing this about six years now my dad founded the company a little over 10 years ago I tell you what I really enjoy doing it every day. and it's amazing how just a little proper education on Medicare people can be so relieved and understanding that it's really not as complicated as as it seems.

Tom Kaminski (02:38)
Yeah. And so for the sake of this audience, know, we're aiming at that sandwich generation where you've got aging parents or elders you're caring for. then in some cases, young families and dependents you're caring for, some cases, Medicare is sort of the concept is thrust on them with almost no advance notice. all of a sudden you have a parent with a health event. and you have to learn about Medicare for the first time. So for the sake of this episode, I was hoping you could kind of help educate our audience. just offer the fundamentals of the program, how it works what it is intended to do. and then just give us that primer.

Grant George (03:14)
Yeah, so Medicare, of course, it's for generally the American citizen that's 65 and older. Now, some individuals can qualify for Medicare under the age of 65 if they're disabled and they've been disabled for two years or they have a terminal illness like end-stage renal disease or kidney failure can also qualify you under the age of 65. But generally, it's for those people that are 65 and older.
in most situations, you don't have to go on to Medicare at 65 if you're still working and you're covered by the employer plan. Medicare looks at the employer and they determine if that's credible health insurance or if it's not. If you work for a company that has more than 20 employees, then you have credible insurance and if you're gonna work beyond the age of 65, you can stay right there on the health plan. You don't have to go on to Medicare. But I always advise everybody, right? Whether it's the person themselves or maybe you're looking at mom and dad's plan, they're turning 65, I always advise you just, you do A cost comparison of what the employer plan costs versus what Medicare costs. generally what I'd say is
that I've yet to find an employer plan that is better than Medicare.

But then it's the idea in the question of, OK, when do we go on to Medicare? Do we go on at 65 because we don't have credible insurance in place? Or maybe we work beyond the age of 65 and we're going to hold off. The first step in the whole process is you have to apply for Medicare. there's four major parts to Medicare, but the first two parts are part A and part B. have those two pieces in place before you can do anything further with Medicare. So part A, that is your hospital insurance. It's really just that. It's inpatient hospital care. And part B is called medical insurance. I like to call it doctor's coverage. Part B is everything outside of the hospital setting, so outpatient services. So think about when you go to the primary care doctor Think about specialists, so cardiologists, dermatologist, dermatology, Any type of doctor outside your primary care is a specialist. Urgent care in emergency room, a lot of surgeries outpatient today. They have you in the morning and you're back home in the afternoon. And then imaging, x-rays, MRIs, CT scans are all going to be covered outpatient under Part B. Those two pieces are what is known as original Medicare and that was what was signed into law this year 60 years ago. People think Medicare has been around for hundreds of years and it really hasn't. it's still a young program. very quickly there it was realized that there was one big

Tom Kaminski (05:36)
Yeah.

Grant George (05:41)
flaw in the Medicare program and that was that part A and part B while yes it's very comprehensive coverage it only covers 80 percent of the bill. In the Medicare beneficiary the person receiving the Medicare benefits they would be left on the hook for the other 20 percent and that 20 percent is unlimited and uncapped. Well 60 years ago that wasn't terrible but all things relative it was still a big expense right?

Tom Kaminski (06:05)
Yeah, 50 bucks here, 60 bucks there. It's like not a big deal.

Grant George (06:08)
Yeah, yeah, you fast forward today

in 2026 and that's a major exposure. So when you, yeah, when you go start your Medicare journey, as I like to call it, you go get part A and part B first.

Tom Kaminski (06:14)
Yeah, it's a big problem.

Grant George (06:22)
Then you have to decide, okay, how are we going to get coverage for that other 20 %? one of the options is you can add an additional piece of insurance or a secondary policy called a Medicare supplement. Or sometimes you'll see it be referred to as a Medigap policy. This is a very powerful piece of insurance. it's a secondary policy to Medicare Part A and Part B at the hospital and doctor. And it essentially follows that person, that individual to any hospital in the country under Part A because any hospital accepts part A and just about any doctor, it's like 98.2 % of all physicians in America accept part B. And when they have that Medicare supplement with them, more specifically a Plan G, the Plan G Medicare supplement, instead of that person owing 20 % unlimited uncapped, now they just have to meet their calendar year one-time single-year deductible of in 2026, $282.

Once that deductible is met, they're covered at 100 % the rest of the calendar year. So, for example, you had a knee replacement, was $100,000 knee surgery, you'd be on the hook for $282, you had physical therapy three times a week, after that knee surgery you wouldn't pay a dime for any of the physical therapy.

Tom Kaminski (07:36)
So quick tangent, my genuine curiosity, how do those companies make money when the deductible is so low, the costs are so low, and healthcare expenses are so dramatically high as you age? How does that work out? that government subsidy or how does that work?

Grant George (07:51)
Yeah.

But it's truly, it's not subsidized. It's truly the insurance law of averages, They're really hoping that more people are gonna be healthy than sick. My grandmother had a Medicare supplement for the 25 years she was on Medicare, and she probably cost Medicare and her supplement north of five, $6 million total. That supplement never made their money back on her.

Tom Kaminski (08:17)
Yeah.

Grant George (08:18)
Every company that offers a supplement is going to, in each specific state that they offer the supplement, they're going to take that group of people and rate it accordingly. They're also going to rate that accordingly to health care costs. in Kansas City, you're going to find a supplement's 150 bucks if you're 65. If you go down to Florida, it'll be like 250 to $300 for a 65 year old.

Tom Kaminski (08:40)
Got it. That makes sense. But all right, so let's a couple more things. Very complicated program, but I think you did a good job breaking it down in simple language that folks can understand. A couple other things. When you run into private insurance for retirees, where somebody after the Medicare age actually does have a really good legacy employer plan. how do you compare the two?

Grant George (09:00)
Yeah, I mean, it's really a case by case basis. It just really starts with, hey, bring any and all information on that plan to me, let's sit down and look at it and let's just crunch the numbers. Let's see what it costs you. Let's more importantly see what type of plan it is. I see retiree plans from big large companies where they offer two options. They offer the supplement and then they offer the Part C Advantage plan. Sometimes it's only one option and it's a Part C Advantage plan. The whole general concept of an advantage plan to the general public that doesn't have access to a legacy plan is that the advantage plan doesn't cost you any premium. It's zero.
Where I'm seeing these legacy or retiree plans charging 80, 90, 100, sometimes $150 a month for an advantage type plan They can change the benefits. They can change the cost every single year with most of these plans.

Tom Kaminski (09:52)
Got it. Got it.

Grant George (09:59)
haven't checked your retiree plan in years just because why would we? know, it's obviously got to be good because the employer is offering it. Not all the time. So it really comes down to cost and really evaluating the plan and seeing, you know, if it is an advantage plan, what does the max out of pocket look like? compared to what does a max out of pocket look like to the general marketplace What do some of the co-pays look like? Is there certain added benefits like dental? Is there vision and hearing? A lot of Advantage plans has a gym membership, really nice, and an over-the-counter allowance. So does this retiree plan have those extra benefits? And so we evaluate all

Tom Kaminski (10:32)
it.

Grant George (10:34)
that. Like I said, I've seen really, really wonderful retiree plans and I've seen plans that I think people are taking back like, whoa, you know, we had no idea because we just never thought of checking.

Tom Kaminski (10:43)
So the big takeaway is if somebody is looking at their parents health insurance for the first time, for example, and you see a private plan, it's worth setting up a meeting with a specialist or an expert or just you yourself going online and researching the options and comparing. That would be kind of the big takeaway.

Grant George (11:01)
Absolutely. 100 percent. Most advisors that do Medicare, like myself, don't charge any fees, right, to do ⁓ a consultation, right, and just check your plans. And so I think it is so valuable to work with, you know, a Medicare advisor and just get their opinion. Is this plan worthwhile or not? Definitely find somebody you can trust, but absolutely. I think it's absolutely important to check that plan.

Tom Kaminski (11:25)
You bring up an interesting point there. Maybe you could shed some light on, know, if somebody is engaging with a Medicare specialist, how are you compensated and what are some things to look out for that may not align perfectly with the consumer's best interest?

Grant George (11:40)
Absolutely. yeah, like said, most Medicare advisors are not going to charge you any fees. We don't, and most of the advisors that I have relationships with in the area and in the industry don't charge any fees to be a client, to just give you their opinion. And so I would tell you if you get charged a fee, you know, look out for that But we make money when you decide to let us help you and assist you in enrolling or maybe even changing your current plan structure. So anytime we actually interact with the application and picking up a policy, that's how we get paid. And there's no built in fees to that to the consumer. Right? It is a standardized commission built by Medicare and CMS. So you don't you don't pay any fees to me and you don't pay any built in hidden fees either. So it's truly no cost to the consumer, which is wonderful. It's kind of a no brainer. Well, why wouldn't we go get a second opinion?

Tom Kaminski (12:29)
Got it.

Grant George (12:34)
definitely make sure when you're working with a Medicare advisor, make sure they give you the whole landscape. Make sure they're going to tell you and educate you on what a Medicare supplement is with a drug plan. and a Medicare Advantage plan. There's two options. I hear it time and time again where, you know, Grant, we were never told about a Medicare supplement. We were only told about the Advantage plan or We were never told about an Advantage plan. ⁓ And that's not as frequent, but it's happened, right? So make sure you have an advisor that you can trust, right? And that's gonna give you the whole landscape of options, not just one option out there.

Tom Kaminski (13:10)
Yeah. Yeah. And I can tell you from my perspective, it's, you know, who's leading with education, who's really transparent about the different ways they get paid. And transparent about the conflicts that may arise and helps the consumer navigate a complicated system to get to the right place. But that's good. I appreciate your transparency and openness on that question.

Grant George (13:30)
Absolutely.

Tom Kaminski (13:32)
Best practices, let's kind of wrap with that. Could you share some best practices, things to do each year, things to look for, and things you're noticing, maybe even trends you're seeing with Medicare that people need to be out in front of?

Grant George (13:43)
Absolutely, best practices, whether it's you yourself reviewing your Medicare plan or a spouse's plan or maybe you're helping mom or dad or both. Best practices is be aware. Be aware of what, if you're helping your parents, be aware of what they have. There's a vast difference between having a Medicare supplement and having an Advantage plan. And sometimes that takes an education to learn what that is, but being aware and understanding what your parents have.

Another best practice is never assume that what you've got is the best and most cost effective plan that you have. Never assume that. It's always good to check your plan every year. If the plan's been working well, fantastic. Make sure your doctors are going to continue to be covered. Make sure your medications are going to continue to be covered.

I can't tell you how many times I've met with people that the medication, they've been notified that it's not going to be covered. And if they didn't make a change, would cost them literally thousands of dollars. So never assuming that the plan you have right now, even though it's been working well, is going to continue to be the best plan.

You might find it's a really easy conversation and yep it is and you're on your way and you don't have to do anything. But you also might be surprised to find that holy cow I'm really glad I had that that conversation and checked the plan and was aware of the changes. ⁓

Tom Kaminski (14:59)
Is it fair to say, you know, this is a fall, like a fall exercise each year during the open enrollment period, basically at kind of at minimum, but in the fall, don't gloss over it and just auto renew, review everything.

Grant George (15:12)
every year, right? So again, whether it's you checking your own Medicare plans or maybe you're helping mom and dad, I tell everybody I work with. October 15th through December 7th. That is the annual enrollment for Medicare. It hasn't changed those dates in forever. That's always been the dates. October 15th through December 7th. It's important. You got to remember it So so yes fall is is end of the year quarter four means we got to check our health plans. you know, make it make it a calendar reminder,

Yeah, and one more thing I think as a best practice is, you know, legally, The insurance companies have to send you what's called an ANOC, which is an acronym, Annual Notice of Change, to the beneficiary every year. And they generally try and get these out ahead of open enrollment, late September, early October. And it's a nice little booklet that literally tells you, here's your plan this year, and here's exactly what it's doing next year, side by side. So you have that at your fingertips. It comes in the mail. So be prepared to get that. Look it over.

Tom Kaminski (16:13)
And so we're probably going to air this a few days before December 7th. And if you've made your enrollment decisions, can you go back like, or you're set to basically auto renew, can you go back and edit them, revise them before the seventh? Or is it one of those things where you submitted it's done?

Grant George (16:28)
You can make as many plan switches from October 15th through December 7th as you want. At the moment, the clock strikes midnight December 8th, what you've got is

Tom Kaminski (16:33)
Cool. Okay.

Grant George (16:37)
what you've got.

Tom Kaminski (16:38)
All right, good. So we'll definitely get this aired before December 7th so people can panic and check it out. 

Then another question. So somebody's 64 and they're turning 65 in six months, or maybe they turned 65 tomorrow. You know, when, how far in advance of age 65 should you be getting enrolled with Medicare for the first time?

Grant George (17:03)
Yeah, yeah, well, you know, with that answer, if you're coming up on turning 65, I generally say, I think it's really important to start the education process four to five months in advance of your 65th birthday, but you can't actually enroll in Medicare until three months in advance of your birthday, right? So you turn 65 in January, you can't actually go online and apply for Medicare until October.

Now Medicare will begin on the first day of the birthday month. So even if somebody is born on January 25th, Medicare will still start January 1st for them. But they can't actually start the process any sooner than three months in advance.

The beauty of that too is if that person has worked with their financial planner and they've decided that they're going to take Social Security at maybe 63 or 64, And that's just what they found best fits them. They're retired and they can do it. Then they actually don't have to do anything upon their 65th birthday. They're automatically going to get a Medicare card sent to them in the mail. And so if that's the case for anybody, they just wait for that Medicare card. It'll be in their mailbox. typically three to four months in advance and then they're ready to make that next decision of going with a supplement or an advantage plan.

Tom Kaminski (18:12)
for this episode I'll add to this the normal disclaimer of no this is not medical advice so we'll just throw that one in there. Legal, tax and medical.

Grant George (18:17)
Please, I generally tell people I'm no medic, I'm not a doctor, you know, but if it was my advice, yeah, working on it.

Tom Kaminski (18:26)
I'm not yet a doctor, yet. I love it. All right, last thing, resources for folks that are maybe looking to learn for the first time about their parents' or elders' plan or for individuals who might be approaching Medicare ages themselves, resources.

Grant George (18:45)
Absolutely. So a few resources. to the general websites, Medicare.gov is a good one. www.Medicare.gov, very generalized information there, but nonetheless, it'll hit all the key talking points. When somebody's turning 65, they're going to get a nice little 280 page booklet called Medicare and You. ⁓ So they'll get that. And then of course,

Tom Kaminski (19:02)
A love story. ⁓

Grant George (19:07)
Yeah, exactly. It'll put you to bed late at night, but if you can't sleep, but but yeah, then of course, you know, find a local agent, We're more than happy to help. And so our website's just www.mdp.gov MDP, Medicare Done Professionally, so mdprs.com. Mdprs.com and you'll see kind of our backstory, you'll see pictures of all of our advisors, so you can kind of see who we are. ⁓ But then you'll see our phone number. Feel free to give us a call, shoot us an email. ⁓ We'd be more than happy to help.

Tom Kaminski (19:40)
Cool, great. Awesome, Grant. Well, and I thought of a joke mid-call that I'm gonna just throw at you right now. What comes before Medicare Part B? Part A.

Grant George (19:47)
Yeah my gosh. Yeah, hey, you're, you are one step above me ⁓ on the dad jokes. I, as a new, as a, as a new dad here, I'm still, I'm still ironing out my dad jokes, but nonetheless, I need to, I need to get them going.

Tom Kaminski (20:05)
There we go. Yeah, yeah. For the listeners at home, was raising the roof while I did that. All right. Grant, thanks so much. Really appreciate the time, the expertise. And maybe we'll have you back on earlier next fall, earlier in open enrollment season next fall. All right, man.

Grant George (20:14)
No, that's a good one. I like it.

You bet. Would love to do it. Absolutely. Would love to do it. Well, I appreciate you having me and have a great rest of your year Tom, so I appreciate it. have a good day.

Tom Kaminski (20:35)
Awesome. Thanks, Grant.