Okay, we are going to go ahead and start. I would like to welcome everybody to today's webinar. A couple questions here on the first screen. The title of our webinar, "Are you new to Medicare? Are you already enrolled?" Regardless of your answer to either of these questions, I would bet that there are questions that you have about your Medicare drug plans.

It is one of those things that once we turn 65, everybody in America becomes more familiar with, but there's still lots of questions. It is simple, but it is very confusing. Today, we have Lyndsay Stretch here with us. She's the team lead at Medvocate.

A little bit of the background of Medvocate before we get started. As most of you know, at One Brunswick Avenue in Gardner, J.M. Arbour, as well as Rune Law and Avery Insurance, are all in the building together. Myself and Nick and Todd, the other owners of the two businesses, came together and said, you know, we have a lot of demand from our current clientele to create an agency to serve specifically around Medicare, and that is who Lyndsay is, that is what she does every single day, and folks, to be honest. exactly what it takes.

Medicare, while it is simple, it can be very complicated. There's a lot to understand based on where you live, who your doctors are, who your specialists are, the drugs that you take, the time of year that it is, the county that you live in.

So, we're going to talk about all of that today, and again, that's why we titled this webinar, you know, along the lines of whether you're new or whether you're already enrolled, it's really one of those topics that behooves a person to talk about it each and every year. So, we just finished up annual enrollment period. Lyndsay, we're now in open enrollment period. I've heard great feedback from the clients of JMA, as well as Rune and Avery, in terms of how educational time with you is.

I'm going to hand it over to you. Please kick this off by sharing just a little bit more about your experience in 2025, what people were hearing, and then let's parlay that into what we're going to be looking at today for 2026.

Lyndsay Stretch, Licensed Agent

01:44

Okay, great. Thanks, Jac, for having me. Thanks, everyone, for being here.

I am Lyndsay, like Jac said, I'm a licensed insurance agent, and I happen to specialize in Medicare. I've been with Medvocate since its inception, which has been a wonderful journey, meeting clients of JMA and Rune Law and Avery. I love the family office vibe that we have working with each other, and each other's clients.

Some great feedback this past year, really with the one-on-one approach that I can give clients, where we can either meet via Zoom or in person in the office, and really talk about Medicare, because, like Jac said, it can be confusing.

Everyone has a different story on what their healthcare needs are, and looking for different types of benefits, and really looking at your lifestyle, and your budget, and how Medicare is going to work for you.

So, tailoring these meetings to you, so I can recommend the best Medicare plans for you that are on the market. It might be a different plan than your husband or neighbor has.

So, making sure that I really tailor these meetings to you is, what the best feedback I had. There's a lot to cover today. We're going to dive right in and talk about the different types of Medicare.

The different enrollment periods that you have throughout the year,

and we're going to touch base on the penalties that you can get if you delay your Medicare enrollment.

So, today, like I said, these are all the topics that we're going to cover, and now we're going to dive right in.

So, who is Medvocate? A lot of times, people ask me, Medvocate, where did this name come from? We are your Medicare Advocate. Our job is to help you learn about Medicare.

Learn about enrollment, where to enroll, how to enroll, why to enroll, and really be there for you for your lifetime that you're on your Medicare policy. Update you with any plan updates, update you on any legal Medicare updates.

Some fun facts are 1 in 3 people use a Medicare agent to enroll, and out of those 1 in 3, 85% of them are more confident and happy in their Medicare because of their agent. So, a really helpful thing.

What Medicare is and isn't. So, oftentimes, Medicare gets confused with Medicaid. Medicaid, just to put it out there, is MaineCare. We're not talking about that today. We're going to talk about Medicare. Medicare is provided by the federal government.

It also is available to you once you've turned 65 years old, or maybe you're on disability and you can have Medicare.

Medicare is also earned through work history, and we'll talk about that in the further slides.

Medicare is not free. It does have cost. And Medicare's also not automatic, so that's something we'll talk about when we talk about the different types of enrollment.

Medicare has different parts to it, which is why it can feel confusing and overwhelming.

Medicare has Part A, Part B, Part C.

and Part D.

Medicare Part A is our hospital coverage. Things like inpatient.

skilled nursing facility, or lower-level nursing care. Hospice and home health care are covered by our hospital insurance.

Medicare Part B covers our medical, so anything provided by any of our doctors, our outpatient, our preventative care, our durable medical equipment, like CPAP machines or diabetic equipment, is all is covered under Part B.

Together, Parts A and B cover a large portion of your healthcare, but not all of it.

That's why we look at a Part C policy. So those are Advantage plans, Medigap.

And then also, we need to talk about drug policies. Those are called Part D. I like how they made the D simple and used D for drugs.

So I want to get back and just really zoom in on Original Medicare, which is Part A and Part B together. So, Part A of Medicare is what we've earned through our working career.

Every time we get paid on our paycheck, we see the pay stub, and it's federal taxes, we pay into Social Security, and we pay into Medicare. That paying into Medicare is filling your Part A bucket.

Your Part A bucket is full once you've worked for 10 years or more, or for 40 quarters.

If you've filled that bucket by working that much, then you have no Part A premium once you've enrolled in Medicare. It comes to you not as free, which is confusing, but with no premium, because you've earned it.

Now, maybe you didn't work, but you were married to someone who did, then your Part A is also available to you at a premium freight.

Part B of Medicare, that's that medical coverage, that does have a monthly premium. So it's really important to understand the difference between the two.

Part B premiums based on income.

And those standard premiums come in this year at around $200 a month. You must enroll in Part A and Part B, and we'll talk about enrollment in a few slides down.

So the benefits of Original Medicare, A and B, okay. You have A and B, now what? You have nationwide coverage with Medicare A and B.

You have predictable coverage structure.

So, A and B together, there's that big number on the screen, 80% covered. A and B together will cover 80% of your Medicare coverage, which is really good coverage that you're getting with just a Part B premium. That's great.

And with Part A and Part B, Original Medicare, there's no prior authorizations. Another benefit.

Some concerns, though. Once we have A and B, we have 80% of our healthcare covered.

What about that 20%?

That's your responsibility, if you choose.

Or, you can add on an Advantage plan or a Medigap plan, and we'll talk about those.

A and B together, yes, they cover 80%, but you're still going to have co-pays and coinsurance and deductibles within that structure.

The other tricky part about A and B together is that that 20% does not have a maximum out-of-pocket. It's unlimited. So if you go to the hospital, and you have an inpatient surgery, and it's a $100,000 surgery.

20% of that bill, so $20,000, is your responsibility. That feels a little scary and unknowing. So that's why we talk about Medicare Advantage plans and Medigap policies, to help fill that coverage.

So, you have different options, and this is where really good education and really personalized planning come into play.

Option number one to fill that 20% gap is a Medigap policy with a stand-alone prescription drug plan.

Medigap policies fill that 20% gap.

Take care of those co-pays and those coinsurances.

Works really well with Original Medicare.

And what a Medigap policy will offer is it has an additional premium.

These premiums are similar to your Part B premium, coming in around $200 to $250 a month.

So, on a Medigap policy, you're paying more monthly for your Medicare, because you have Part B and your Medigap premium.

But you have predictable medical costs, because on a Medigap policy, you won't have any additional hospital bills.

You also don't have provider networks. So, I love a Medigap policy for people who spend a lot of time out of their home state.

Travel a lot, want to see providers anywhere in the United States. A Medigap policy is built for people that really like that flexibility, and to be able to see whoever they want to see, and know that they have great healthcare coverage.

with a Medigap policy, it has… it has really good health coverage.

But it doesn't cover your prescription drugs. So we'll want to tag on a prescription drug policy. That's an easy application, an easy enrollment.

A lot of drug policies are coming in at $0 a month premium, which is great, because we're already paying two premiums. We definitely don't want to have to pay one more if we don't have to.

We'll take a look at the prescriptions that you're on, if you're taking any, and line up the best drug policy for you.

So, that's option one. You have Medicare A and B, you choose a Medigap policy, have your premium paid, and your Part D policy. That could be an option for you. Let's talk about your second option.

Medicare Advantage plans.

Medicare Advantage plans are built slightly differently than the Medigap plans. These plans are built within networks, so you have your doctors and your specialists and your hospitals all have to be an in-network, like an HMO,

Or an out-of-network, like a PPO.

These will also cover your full 20% of that Medicare gap that you have missing.

They'll have a much lower monthly premium, if any monthly premium. A lot of policies have $0 a month premium.

That's a big…

appeal to people who are coming on to Medicare, because they don't want to pay an additional premium besides their Part B.

Medicare Advantage plans do work for people that like to travel or spend time in other places. You just want to go on a PPO policy.

Medicare Advantage plans are often called all-in-one plans, because they not only include really good health coverage, they'll include your prescription drug coverage, and a lot of times, dental, vision, and hearing, and other things like gym memberships, transportation to appointments, other little benefits like that.

Advantage plans are based on co-pays and coinsurance, so while you might not have a monthly premium, and maybe you're healthy, and you just go to your wellness visit, then you won't have a lot of out-of-pocket costs for the year.

If you have overnight stays, outpatient doctor's appointments, lots of labs, anything that's gonna… more services, then you're gonna have more co-pays.

And those co-pays are going to add up, and that's how you can have an unpredictable cost on an Advantage plan.

So those are kind of the two options that you have when it comes to adding in that 20% gap, that 20% coverage on your original Medicare A and B.

Let's see what they are side by side.

Oh, first we're going to talk about prescription drug policies.

I went over these briefly and why they're so important, but prescription drug policies help cover your prescriptions. A lot of people say, I don't take prescriptions, I don't need a drug policy. You have to have one, and we'll talk about penalties in a little bit.

Prescription drug policies are available at really no extra cost, or they're already rolled into your Advantage plan.

So, really a no-brainer. They protect you for any high drug costs that might come your way. Sometimes your drugs can even cost you nothing if you're on these drug policies, because they're lower-tiered drugs.

So, having a good prescription drug policy is going to keep you out of penalties, and it's going to keep you covered, and it's probably going to save you money on your prescriptions every month.

So, how do you know which one's right for you? I run into this a lot. People often ask me, Lindsay, what would you do? Everybody's different. So, if you just enroll in Medicare A and B, you're covered 80% of your coverage. Great.

That kind of feels a little scary. So then we talk about Medigap. Medigap will cover your AM, you have A and B, great. You'll have full Medicare coverage, because they're covering that 20%, and Medigap gives you those predictable costs every month, because you have that additional premium, not a lot of bills going forward, if any.

So, predictable costs, also nationwide coverage and a Medigap policy. And we're going to tag on, remember your prescription drug policy, into that Medigap.

Advantage plans will cover your A and your B. They'll help fill in that 20% gap to give you that full Medicare coverage, but these are pay-as-you-go structures. While monthly costs are low, the more you use the policy, the more out-of-pocket you might have throughout the year.

Medicare Advantage plans are also based on networks, so looking at your providers, what insurance companies do they work with, who don't they work with, making sure you're in the provider network, that's a tricky one.

So now that we've talked about the different types of Medicare that's available to you, your choices, options, now let's talk about enrollment.

So there's a few things that you can do just before you turn 65. Remember, 65 is that magic Medicare number. You can enroll in Medicare Part E, or Part

Medicare Part A and B before you turn 65. You're going to do this through the Social Security. Social Security is like Medicare's financial advisor. They're gonna figure out how you're going to pay for your Medicare, and how much you pay.

At 65, you can still enroll in Medicare A and B, but you'll also want to make sure that you add additional coverage to your policy.

That's when you look at Medigap policies or Advantage plans.

Some people collect Social Security early, as you can, and if you're already on Social Security, Medicare A and B is automatic. You'll automatically be enrolled.

If you're not collecting Social Security, you'll need to actively enroll in Medicare, and I can walk you through that process of how to enroll, when to enroll, and set up a timeline for you. Everyone's enrollment period is a little different, whether you want to enroll when you're 65,

or you want to continue working and enroll later down the road when you're 66, or 67, or 70, we want to make sure that we keep you on a Medicare timeline, and we will make sure that your enrollment happens when you need it to happen.

Okay.

Now, if you delay your enrollment, which can happen for several reasons, everyone's different, you want to make sure that you understand the penalties if you don't have health insurance coverage.

So if you delay Medicare, and you don't have health insurance, then you can get penalties. Those penalties are with you for the rest of your life.

Doesn't sound good. So I'm going to talk about just the two types of penalties that you can get if you delay your Medicare.

Medicare Part B. If you delay your Part B of Medicare, you're going to have a 10% penalty of the Part B premium. Remember we said it's around $200?

for every year that you delay. So if you delay a year, 10% of Part B, right now it's $200, an extra 20 bucks a month. That extra $20 a month is added on every single month for the rest of your life… lifetime.

If you delay 5 years, which I've met people that have delayed 5 years, that's a 50% penalty of the Part B premium added onto their premium every month for the rest of their life. So, adds up.

Same coverage that the normal person has and enrolled on time, you're just paying more.

For Part D coverage, people don't enroll in Part D, especially because they're not taking prescriptions, and they don't need that policy. You do, and it works a little differently. Part D policy is a 1% penalty of the Part D premium for every month you delay.

So if you delay 5 months, it's a 5% penalty. If you delay 12 months, it's a 12% penalty.

those penalties are also with you for your lifetime. So, because I know you're here watching this today, and you're understanding these penalties, I want to make sure that none of this happens to you. We certainly don't want to have to pay more for our Medicare than we need to.

So, the process.

I talked about it briefly, but now we're going to go over it in just a few more details. Your enrollment date. Your enrollment date could be as early as the first day of the month that you turn 65.

That's a common enrollment date for people. If that's your goal, you want to give yourself a 4-6 week timeline prior to that.

to enroll in A and B,

to learn about the different types of Medicare that are going to work for you, to get your Medicare card in the mail, which looks like a Social Security card, it's like a little flimsy paper.

And then you're going to enroll in your Medigap or your Medicare Advantage plan.

In this process, there's a lot to think about.

There's your lifestyle, there's how you want your healthcare taken care of, there's what your budget is, there's what your needs are, there's all kinds of things to think about, and sometimes those things change annually.

So every year that you're on Medicare, you'll want to make sure that you get a review.

Working with me ensures that you will not miss your review. I reach out personally. I say, hey, why don't you come into the office? Do you have time for a 15-minute phone call? Well, I want to touch base with you and talk about who your doctors are.

What prescriptions you are, has anything in your life changed? How did you like your policy? And then I can say, these are the policy updates, or these are some new policies that are available that could work for you. So we ensure that you are on the best policy that you can be on, because I want you to feel confident.

Confident in your coverage, knowing that you know what's covered, how it's covered, and when it's covered.

I'm also here for support, so with anything across this whole enrollment timeline, if there's any questions, if you receive something in the mail that's confusing, if you sign an ad on TV, any of those things come up, reach out to me, I'll support you, I'll help you get enrolled, and we'll walk you through each step.

So, thank you. Thanks for your time today. Really, I want you to know that my job doesn't stop at just this educational piece. I not only walk you through your own personal plan, but I talk about all the things that you need to think about, and I give you some ideas and insights.

I do the enrollment for you. I take some things off your plate that you might feel overwhelmed with. I make phone calls on your behalf. And once you're enrolled in a Medicare policy, I'm there for you for the entire year of that policy, and then beyond that, I'm there for you for your entire lifetime of that policy.

Really, my goal is to make sure that you are taken care of, that you're not confused, and that you have someone that you can reach out to if you have any questions.

Thank you, Jac, for having me today. It's been great to be here. I'm really looking forward to touching base with some of these people to see how I can help them.

Jac Arbour

22:13

Thank you, Lyndsay. I did turn my video back on, but for some reason it's not registering with the driver, so I am here, no big deal. My first question was going to be along the lines of something that you just mentioned, but before I ask you that, folks, down at the bottom of your screen, you will see that there is a Q&A function. If you do have a question that you want to type in, we will get that answered before 30 past the hour. But Lyndsay, the first one you just mentioned is.

After the enrollment. So, we just talked about all the educational pieces that you cover, in terms of topics. So, after somebody enrolls with you and becomes your client, can you just talk a little bit about what it's like after that, in terms of working with you and Medvocate?

Lyndsay Stretch, Licensed Agent

22:53

Yes, so once we've enrolled into any sort of Medicare program, then there's some follow-up. So there's a two-week follow-up and a one-month follow-up, where I talk about what's the best way to communicate with you, and we either email or we call each other, or you can even stop into the office. I really want to make sure that you've received your plan material, that you, if you need to create an online portal with that insurance company.

And I walk you through the steps on how to do that, and any questions that might come up while you're just getting onto the policy, I'm there to support you. And then beyond that, if you have a new doctor, or a new… something… a new prescription that's provided to you, and you want to add that to your file for me to keep up with.

Happily to do that, because my job is to make sure that you're covered when you go to your doctor's office, and that your prescriptions are going to be covered when you pick them up from the pharmacy.

Jac Arbour

23:45

Awesome. And then let's just cover, people getting in touch with you. So I see here, you know, the number of folks on the screen, 207-466-6789. You can also email Lyndsay. Lindsay, could you just share your email address with us as well?

Lyndsay Stretch, Licensed Agent

23:58

Yes, so my first name is Lyndsey, L-Y-N-D-S-A-Y@MedvocateHealth.com.

That's lyndsay@medvocatehHealth.com.

Jac Arbour

24:10

Great. Lyndsay, as always, this has been very educational.

Folks, we are going to send this recording out tomorrow. If you feel as though it has been beneficial and educational and insightful, and you believe that you have friends or family that could benefit from this information, please feel free to forward it to them. And if they would like to speak with Lyndsay, they can do that by calling this number as well. And then, Lyndsay, you know, we do get a lot of questions around contacting you and you contacting people. Could you just comment a little bit on

the rules, the laws, the governance with Medicare in terms of what you are allowed to do and not do. I just want to make sure people understand, you know, maybe why, if you don't call, why are you not calling? Or who can you not call?

Lyndsay Stretch, Licensed Agent

24:52

That's a great point, Jack. Thank you so much. So, Medicare's really protected, and it's protected on behalf of the beneficiary, which is a wonderful thing for you guys, so you aren't solicited.

But I do need your permission to contact you. So if you do want me to reach out, send me an email, call me, you can even call Jac's office at J.M. Arbour, and…

asked to speak to me, so I can't personally reach out to you unless I have your permission, but you can reach out to me.

Jac Arbour

Excellent. Lyndsay, very well done. We appreciate this, and folks, we host these webinars pretty much once per month, so we will send the recording out tomorrow. Look for an email from JMA. We will be hosting another one soon. We hope you found this to be educational and insightful, and we'll see you on the next time.

Thank you, Lindsay.

Lyndsay Stretch, Licensed Agent

25:44

Thanks, Jac. Thanks for having me. Bye-bye, everybody.