Welcome to Wisdom Wednesday on Real Easy Medicare with Al Kushner! Drawing on four decades of experience, Al reveals elite-level strategies to optimize your Medicare coverage and reduce costs.

1. Hidden 90-Day Benefit Period
   • A single benefit period spans multiple hospital or SNF stays within 60 days, avoiding repeated $1,632 Part A deductibles; track your 60 lifetime reserve days carefully
2. Medicare Secondary Payer Techniques
   • Strategically choose when employer or indemnity insurance pays first to minimize out-of-pocket; stack accident, critical illness, or hospital indemnity policies
3. Medigap Birthday Rule Exploits
   • In states like California and Oregon, switch Medigap plans annually during your birth month without underwriting; intra-company switches may apply elsewhere
4. Network Quality over Quantity
   • Evaluate local specialist depth rather than total network size; identify responsive providers by calling offices about appointment availability
5. True Out-of-Pocket Cap Insight
   • The $2,000 Part D true out-of-pocket cap replaces the donut hole; timing high-cost drug purchases no longer accelerates a gap
6. Appeal Success Path
   • Appeals win rates climb from 20% at level 1 to 60% at ALJ level; persistence and thorough documentation are critical
7. Social Security–Medicare Synergy
   • Coordinate premium deductions, assistance programs (QMB, SLMB, QI), and optimal enrollment timing for tax and cost advantages
8. HSA Continuation Strategy
   • Delay Part A enrollment under HSA-qualified employer coverage to maintain tax-free HSA contributions post-65; requires pre-65 planning
9. Geographic Cost Planning
   • Compare Medicare Advantage and Medigap rates across ZIP codes before relocating; retirement location can double or halve premiums
10. Critical Enrollment Timing
    • Medigap’s six-month guaranteed issue window versus MA’s annual OEP and SEPs; missing these windows locks in coverage

Next Episode Preview: Tips & Tricks Thursday—actionable hacks and shortcuts you can implement immediately to streamline your Medicare journey.

Welcome to True Story Tuesday on Real Easy Medicare with Al Kushner! In this episode, Al shares seven authentic beneficiary stories that illustrate how seemingly small decisions can lead to lasting consequences—and how to avoid them.

1. Margaret’s Late Enrollment Disaster
   • Missed Part B IEP, went uninsured for four months after a broken hip, incurred $80,000 out-of-pocket costs and a permanent 10% penalty
2. Robert’s Zero-Premium Trap
   • Chose MA for zero premium, faced network limitations, high copays, and a $7,800 out-of-pocket maximum during heart care
3. James’s Medigap Timing Error
   • Delayed Medigap beyond his six-month window, was medically underwritten and denied coverage after a cancer diagnosis
4. Susan’s Network Nightmare
   • Lost in-network doctor mid-year and surgeon out of network, resulting in $15,000 surprise bills
5. Paul’s SEP Confusion
   • Worked past 65, missed the 8-month SEP after retirement, incurred permanent Part B and Part D penalties, and limited Medigap options
6. Dorothy’s Dual Coverage Mistake
   • Enrolled in Part B unnecessarily while on employer insurance, paid duplicate premiums for eight months
7. William’s Benefit Illusion
   • MA dental and vision benefits fell short of actual needs, and high medical copays led to higher total costs than a Medigap plan

Key Takeaways:

• Enroll within IEP and SEP windows to avoid penalties
• Evaluate total plan costs, networks, and benefits beyond premiums
• Understand guaranteed issue periods for supplemental coverage
• Recognize that MA networks and benefits can change unpredictably

Next Episode Preview: Wisdom Wednesday—uncover advanced strategies and insider insights from Al’s four decades of Medicare expertise.

In this Mistake Monday episode, Al Kushner exposes the most devastating Medicare error: failing to protect against unlimited out-of-pocket costs. Learn why Original Medicare alone leaves you financially vulnerable and how to secure comprehensive coverage.

1. The 80/20 Catastrophe
   • Medicare pays 80%; you’re responsible for the remaining 20% with no annual cap
   • Robert’s $180,000 claim left him $36,000 short
2. Hidden Deductibles & Daily Charges
   • Part A deductible $1,676 per benefit period; $419/day after 60 days; $838/day after 90 days
   • Part B deductible $257, then 20% coinsurance on every service
3. Real-World Impact
   • Sarah’s $300,000 cancer treatment resulted in $60,000 owed
   • Thousands sell assets or face bankruptcy due to unexpected medical bills
4. Two Protective Solutions
   • Medigap Supplement: predictable premiums (~$150/mo.) and near-zero coinsurance (Plan G covers all but the Part B deductible)
   • Medicare Advantage: low premiums, annual out-of-pocket caps ($3,000–$8,000) for total cost control
5. Enrollment Urgency
   • Six-month Medigap open enrollment window guarantees acceptance; missing it risks denial or high rates.
   • Medicare Advantage requires enrollment during designated periods
6. Cost vs. Risk Analysis
   • Compare annual premiums (Medigap $1,800 vs. MA $3,000, including max exposure) against potential unlimited Original Medicare liability.
   • Recognize insurance’s purpose: protection from rare but catastrophic events.s
7. Action Steps
   • Calculate your financial exposure under Original Medicare alone
   • Compare supplemental policy and MA plan costs and out-of-pocket limits
   • Enroll promptly in the option that aligns with your risk tolerance

Next Episode Preview: True Story Tuesday—real beneficiary experiences showing how informed choices avert costly Medicare mistakes.