WEBVTT
00:00:10.160 --> 00:00:18.079
We're gonna be talking about uh GTL Guaranteed Trust Life and their hospital indemnity product.
00:00:18.320 --> 00:00:23.679
So we're talking about GTL Guaranteed Trust Life, their Advantage Plus Elite.
00:00:24.239 --> 00:00:26.960
Um, it's really, really a great product.
00:00:28.000 --> 00:00:30.000
So you can add this.
00:00:30.160 --> 00:00:33.679
It's it's typically for people who are on a Medicare Advantage plan.
00:00:34.640 --> 00:00:37.280
So what is hospital indemnity insurance?
00:00:37.439 --> 00:00:41.600
So it's something that you add on attached to your Advantage plan.
00:00:42.079 --> 00:00:51.520
You pick the amounts based on what your out-of-pocket costs are could be with your Medicare Advantage plan.
00:00:53.359 --> 00:00:56.799
So as we saw in the video, here's the example, Beth.
00:00:56.880 --> 00:01:01.920
So she has uh her her inpatient copay is$300 a day for six days.
00:01:02.159 --> 00:01:09.519
So after six hours, this will kick in, but after six days, her copay would be eighteen hundred dollars.
00:01:09.760 --> 00:01:18.799
So we would look at, all right, well, your hospital co-pays$300 a day, we it would reimburse you for six days.
00:01:19.200 --> 00:01:25.359
So it does pay you directly cash, which is nice, it doesn't send it directly to the hospital.
00:01:26.879 --> 00:01:35.439
And also, what's nice about these is that after 60 days of not being in the hospital, the policy resets, and so you can use that again.
00:01:35.680 --> 00:01:37.840
You can use that hospital again.
00:01:38.719 --> 00:01:43.280
So they have not this company has not raised their rates in in over 10 years.
00:01:43.439 --> 00:01:47.920
They don't increase as you age, uh, which makes it really nice, makes it really affordable.
00:01:48.000 --> 00:01:54.640
Um, so if you're looking at you know potentially looking at a Medicare supplement plan, with Medicare supplement plans, those premiums will increase every year.
00:01:54.719 --> 00:01:56.640
That's that's a that's a guarantee.
00:01:56.959 --> 00:02:08.560
With GTL, with their hospital indemnity, there's it's guarantee issue, meaning you don't have to answer all those underwriting questions between eight the ages of 64 and a half up to 75.
00:02:09.039 --> 00:02:14.000
There are some additional questions if you want to add on other products as we'll as we'll see here.
00:02:15.520 --> 00:02:21.919
It included, it will give you money back if you go to the ER, which is which is nice.
00:02:22.400 --> 00:02:26.479
So, how you would choose to go about this is you choose your base benefit.
00:02:26.560 --> 00:02:32.800
Okay, do you want um so the base of it is is of course the hospital and the indemnity portion.
00:02:32.960 --> 00:02:37.520
You can add on a skilled nursing writer, an ambulance benefit rider, outpatient therapy.
00:02:37.599 --> 00:02:42.080
So the outpatient therapy would uh reimburse you for physical therapy.
00:02:42.159 --> 00:02:45.439
It even does up to 10 days of chiropractic or five days of chiropractic.
00:02:45.680 --> 00:02:48.000
You can do a cancer lump sum benefit rider.
00:02:48.400 --> 00:02:53.520
Um, also you do the guaranteed purchase for the option rider, which gives you the wellness rider.
00:02:53.680 --> 00:03:00.879
The wellness rider would reimburse you$100 for you know your wellness exam, your physical each year.
00:03:01.120 --> 00:03:08.080
You can also add it for outpatient surgical rider, critical accident, lump sum hospital, and then a dental envision benefit rider.
00:03:08.639 --> 00:03:13.840
So for the ambulance rider, your options you can choose from$50 up to$400.
00:03:14.319 --> 00:03:20.879
It can be used up to four times a year, lifetime max of 12 trips.
00:03:21.120 --> 00:03:29.599
It also does cover air ambulance, and you don't have to have any sort of uh hospital confinement required in order to use this.
00:03:31.520 --> 00:03:36.479
So you can also add a cancer lump sum benefit rider.
00:03:37.280 --> 00:03:48.960
With this, it does add a little bit of expense to it, but your coverage options are$2,500,$5,000,$7,500,$10,000,$15,000, or$20,000.
00:03:49.520 --> 00:03:54.159
So on average, it would be about$29.79,$2,975 a month.
00:03:54.479 --> 00:03:58.879
It does have specific benefits other than just giving you that lump sum.
00:03:58.960 --> 00:04:00.400
So cancer, cancer in situ.
00:04:01.199 --> 00:04:06.719
So this would get pay you 25% of the lump sum upon your diagnosis.
00:04:06.879 --> 00:04:13.199
For skin cancer, you would get a$500 benefit for basal cell or squamous cell, skin's carcinoma.
00:04:13.280 --> 00:04:16.399
This is payable three times over the life of the policy.
00:04:18.160 --> 00:04:21.439
I highly recommend adding the reoccurrence benefit writer.
00:04:21.519 --> 00:04:22.879
This is really, really cool.
00:04:23.199 --> 00:04:35.360
So if you have a$10,000 lump sum cancer writer with a reoccurrence, you're diagnosed with cancer, you submit a claim to GTL, you get a check for$10,000 after treatment.
00:04:35.439 --> 00:04:43.839
If you're in remission, um, even if you're in remission over five years, then the writer would be 100% restorable.
00:04:44.160 --> 00:04:55.759
So if you're diagnosed with cancer, go on remission, and then one year it comes back, or if it's an entirely new cancer, GTL will pay 10% of your lump sum benefit.
00:04:56.000 --> 00:05:05.439
Two to three years would be 25%, four years would be 50%, and any anything five years plus, it would pay that lump sum a hundred percent.
00:05:06.639 --> 00:05:08.560
You can also add it for skilled nursing.
00:05:08.639 --> 00:05:12.879
And I will I will tell you, let me go back to the the the cancer, the lump sum.
00:05:13.279 --> 00:05:21.279
You know, I've been doing this for going on nine years, and in my time, I've had five or six people that have hit their maximum out of pockets.
00:05:21.600 --> 00:05:23.519
It was all a few years ago.
00:05:23.839 --> 00:05:27.439
Five of the six people ended up passing away right after.
00:05:27.680 --> 00:05:33.519
The the the sixth person, she hit her maximum out of pocket because she had uh for radiation.
00:05:34.000 --> 00:05:36.480
So that's where this would come in handy.
00:05:36.560 --> 00:05:39.360
Now she is still alive, she's still with us and thriving.
00:05:39.439 --> 00:05:42.720
Um, but this is one of the ways that people hit their max out of pocket.
00:05:42.879 --> 00:05:57.759
Now it's important to remember that only 4% of people nationwide hit their max every year, you know, and the United States is a large country, and so the max out of pockets will vary from area to area.
00:05:58.240 --> 00:06:00.560
So some may be lower, some may be higher.
00:06:00.800 --> 00:06:02.639
So keep all that in mind.
00:06:02.879 --> 00:06:07.600
The other way that people hit their maximum out of pocket is with a skill is through skilled nursing.
00:06:07.839 --> 00:06:14.160
So typically, and I will say typically, um, the first 20 days are covered at zero cost.
00:06:14.319 --> 00:06:18.959
There may be, you know, this is I'm speaking to plans here in the Austin area.
00:06:19.120 --> 00:06:26.879
There are plans that have a little bit of a copay per day for the first 20 days, but typically the first 20 days are are at no cost to you.
00:06:27.199 --> 00:06:35.279
So with their skilled nursing benefit writer, you can choose an option for days 1 through 20, or you can choose an option for days 21 through 100.
00:06:35.439 --> 00:06:37.920
I recommend looking at the 21 through 100.
00:06:38.000 --> 00:06:41.439
You can choose up from 100 to$300 per day.
00:06:42.319 --> 00:06:44.000
Now it does have some requirements.
00:06:44.160 --> 00:06:55.120
The skilled nursing or SNF stay, it has to be for the same condition, and the stay has to begin within 30 days of your hospitalization, which has to be a minimum of three days.
00:06:55.279 --> 00:06:57.360
The observation time does not count.
00:06:57.439 --> 00:07:04.560
Um, and then this benefit also does restore after 60 days if there's no confinement in the hospital or skilled nursing facility.
00:07:05.519 --> 00:07:14.639
So if we're looking at days 21 through 100, a good average is about$225 a day.
00:07:14.720 --> 00:07:18.800
Um, and again, I'm speaking to the plans in the Austin area.
00:07:19.120 --> 00:07:27.439
The people that have hit, that have have um hit their maximum of pockets, they've had multiple, multiple, multiple full hospitalizations days.
00:07:27.600 --> 00:07:32.959
And then they're they're in days past day 20 with their still nursing.
00:07:33.120 --> 00:07:41.360
Now, for each of those days, if the benefit, if if your cost is$225, you're paying that$225 per day for those.
00:07:41.519 --> 00:08:00.399
Um, so that's and typically the people that are in there you know long term, it's people that may have a condition like ALS or they're they're pretty sick and they're not getting better at the rate that you know somebody their age who is healthy would be getting better.
00:08:00.720 --> 00:08:07.519
So this is add a little bit of protection and makes you feel a little bit better about having to be in there.
00:08:07.600 --> 00:08:10.560
You're not having to worry about, hey, I'm gonna be out of pocket all this money.
00:08:10.800 --> 00:08:14.399
You can also add on an outpatient therapy benefit writer.
00:08:14.480 --> 00:08:16.319
So you it pays up to$50.
00:08:16.720 --> 00:08:20.079
You can choose either for 15 days or 30 days.
00:08:20.240 --> 00:08:25.600
Now, if you let's say you have a physical therapy and a speech therapy appointment on the same day.
00:08:25.839 --> 00:08:28.560
If you have it on the same day, it will pay the$50.
00:08:29.040 --> 00:08:34.000
If you have it on two separate days, it'll pay you$50 for each visit.
00:08:34.320 --> 00:08:41.919
What's really nice is I mentioned earlier, that you can also get reimbursed for chiropractic, up to$50 for five days a calendar year.
00:08:42.159 --> 00:08:48.720
So adding that on, uh that's also a way that people hit their max out of pockets, is is um with physical therapy.
00:08:48.960 --> 00:08:54.960
A lot of the time you're having to go two, three times a week, and that adds up, especially if your co-pays 40-50 bucks.
00:08:55.120 --> 00:08:56.799
So this will help out with that.
00:08:58.000 --> 00:09:01.360
You can also do a critical accident uh benefit rider.
00:09:01.840 --> 00:09:08.559
With this, after an emergency room visit, this rider pays you a lump sum for these following types of accidents.
00:09:08.720 --> 00:09:12.559
So accidental death, if you have the$5,000 plan, it'll pay$5,000.
00:09:12.639 --> 00:09:16.720
If the$10,000 plan, it'll it'll reimburse you$10,000 or your family.
00:09:16.879 --> 00:09:23.679
Hip or skull fracture,$1250 on the$5,000 or$2,500 on the$10,000 plan.
00:09:23.919 --> 00:09:30.159
If you dislocate your hip, it's$1,000 on the five on the$5,000 plan,$2,000 on the$10,000.
00:09:30.320 --> 00:09:38.240
Um knee dislocation or knee ligament tear, it'll give you$500 on the$5,000 plan or$1,000 on the$10,000 plan.
00:09:38.559 --> 00:09:48.559
If you just fracture a fracture of bone or other$250 on the$5,000 plan and$500 on the$10,000 plan.
00:09:48.720 --> 00:09:52.159
Now this does have a 30-day waiting period before it can kick in.
00:09:52.320 --> 00:09:59.840
That means if you get the policy in the first 30 days, you break your break your break your hip.
00:10:00.080 --> 00:10:01.919
That amount would not be payable.
00:10:02.159 --> 00:10:07.360
So try to put keep yourself in bubble wrap until that 30 days is passed.
00:10:07.600 --> 00:10:10.960
You can also add on an outpatient surgical benefit writer.
00:10:11.120 --> 00:10:12.799
This would be if you have a day surgery.
00:10:12.879 --> 00:10:20.240
So thinking in an ambulatory or uh in an outpatient uh portion of an inpatient hospital.
00:10:20.399 --> 00:10:25.919
You can choose between 250, 500, 750, or$1,000 lump sum.
00:10:26.080 --> 00:10:27.519
You can use it twice a year.
00:10:27.600 --> 00:10:32.240
Um, but it's it can't be used for MRIs or x-rays or other non-surgical procedures.
00:10:32.480 --> 00:10:34.720
So that is something that you can also add.
00:10:35.600 --> 00:10:47.279
Now, when we add the guaranteed purchase option benefit writer, this will allow you to go back in and increase your hospital amount.
00:10:47.600 --> 00:10:52.799
So let's say if it's uh$300, you can increase it by 10% of the original value.
00:10:52.960 --> 00:10:58.399
So you could increase it up to$330, up to five times before you turn 85.
00:10:58.960 --> 00:11:07.360
Your increase in benefits will be based on issue H rates, um, no pre-existing uh condition limitation, and there's no additional underwriting.
00:11:07.600 --> 00:11:14.799
With this, you also get the wellness writer that pays you$100 for a physical examination performed by a healthcare.
00:11:14.879 --> 00:11:18.399
So it could be doctor, nurse, practitioner, or physician's assistant.
00:11:18.559 --> 00:11:33.039
Now, this also does have a 30-day waiting period, but it doesn't add that much, and at the very it doesn't add that much to to add the guaranteed purchase option benefit writer, and I have a little bit of a breakdown in um prices at the very end.
00:11:34.000 --> 00:11:37.600
So what's gonna be the best option for you?
00:11:39.360 --> 00:11:42.320
At the minimum, you could look at um the hospitalization.
00:11:42.399 --> 00:11:45.679
So choose what your daily rate is, how you want to be reimbursed.
00:11:45.919 --> 00:11:48.159
You can also get the ambulance benefit rider.
00:11:48.399 --> 00:11:51.919
The ambulance benefit rider is very low cost to add.
00:11:52.240 --> 00:12:02.480
Um better, you get the hospital indemnity option, you choose the outpate the apologies, ambulance benefit rider, and then also the outpatient therapy benefit rider.
00:12:02.799 --> 00:12:05.679
The best, it's uh it's kind of fully loaded.
00:12:05.759 --> 00:12:13.440
So you get the hospital indemnity portion, you choose the ambulance 7,500 lump sum cancer benefit rider.
00:12:13.600 --> 00:12:16.000
Remember, they do go up to 10,000 uh to 20,000.
00:12:16.159 --> 00:12:19.120
And then you can look at the outpatient therapy benefit writer.
00:12:19.200 --> 00:12:21.919
You can also customize it, you don't have to choose all of those things.
00:12:22.080 --> 00:12:29.039
That's what's really cool about this product is that you choose what's gonna be um good for you and your budget and what your health needs are.
00:12:29.519 --> 00:12:32.240
So this is a little breakdown.
00:12:32.720 --> 00:12:39.039
So let's say this is based on uh somebody who's turning 65 in March of 2026.
00:12:39.279 --> 00:12:44.080
So let's say your hospital co-pays$300 and you have to pay that for five days.
00:12:44.399 --> 00:12:50.240
So the GTL benefit, you would choose, all right, I'm gonna be reimbursed$300 for five days.
00:12:50.639 --> 00:12:57.440
Now the cool thing about it is if you if you're in the hospital for two days, you submit a claim, it'll pay you$600.
00:12:58.320 --> 00:13:06.399
Now, you still have three days, three days that you can use within that 60-day period if you are readmitted.
00:13:06.960 --> 00:13:09.200
And that does reset after 60 days.
00:13:09.279 --> 00:13:13.120
So that would put you around$22.08 a month.
00:13:14.080 --> 00:13:22.480
Something else that GTL does automatically, they give you an emergency uh ER copay benefit included.
00:13:22.639 --> 00:13:30.320
So let's say your emergency copay is$130, GTL reimburses you$150, and it doesn't add anything to your premium.
00:13:30.639 --> 00:13:32.399
Ambulance, let's say it's$300.
00:13:32.799 --> 00:13:38.879
So you choose for, all right, I want to be reimbursed$300, that costs you two dollars and 14 cents a month.
00:13:39.200 --> 00:13:47.519
So it does not add that much, and it helps you with you know with your$300 bill.
00:13:47.840 --> 00:13:54.000
Now, when we're looking at radiation chemotherapy max out of pocket, this is this is the max out of pocket of of your plan.
00:13:54.080 --> 00:13:57.360
So let's just say it's$7,000 in network.
00:13:57.759 --> 00:14:03.919
GTL, remember, you can do uh$2,500,$5,000,$7,8500, or$10,000.
00:14:04.000 --> 00:14:07.200
I went with a$10,000 here with 100% recurrence.
00:14:07.519 --> 00:14:12.799
That means that if you're cancer free for after five years, it'll pay you 100% back.
00:14:13.039 --> 00:14:20.000
If it's after one year, um, it'll be uh 10%, two to three years, it's 25%, at four years is 50%.
00:14:20.960 --> 00:14:25.919
That makes your premium, adds$33.78 to that.
00:14:26.159 --> 00:14:29.919
Now I highly recommend looking at the skilled nursing facility.
00:14:30.080 --> 00:14:35.919
So let's say your copay is$218 for the last 80 days.
00:14:36.080 --> 00:14:41.279
So this would kick it if you're in a skilled nursing facility from days 21 plus.
00:14:41.840 --> 00:14:47.120
So GTL, we would embrace you$220 for 80 days.
00:14:47.279 --> 00:14:50.879
That would add$14.23 to your monthly premium.
00:14:51.840 --> 00:14:56.240
Annual wellness physical, typically with advantage plans, they're covered at 100%.
00:14:56.799 --> 00:15:00.399
Um, GTL will automatically just give you this$100.
00:15:01.120 --> 00:15:13.039
Um, that's what that guaranteed purchase option writer, which allows you to increase your hospital confinement daily rate by 10% over five times up until um your age 85.
00:15:13.200 --> 00:15:21.919
So that adds$7.64, and you can get$100 back for going to get your physical, which you don't have to pay anything out of pocket for.
00:15:22.559 --> 00:15:26.720
For the outpatient therapy copay, let's say your copay is$45.
00:15:27.679 --> 00:15:33.519
The highest plan with GTL is you get reimbursed$50 for 30 days throughout the year.
00:15:33.679 --> 00:15:37.360
That also does include five days of chiropractic.
00:15:37.600 --> 00:15:40.399
That would add$6.99 a month.
00:15:40.960 --> 00:15:45.840
So this last bit, the dental vision average monthly cost, let's just say it's$50.
00:15:46.399 --> 00:15:49.360
You can add a GTL benefit for$400.
00:15:49.840 --> 00:15:54.159
That adds$26.80 a month to your premium.
00:15:54.639 --> 00:15:58.159
I don't necessarily think that that's something that you would have to add.
00:15:58.320 --> 00:16:12.000
Um, you know, choosing between dental and vision versus skilled nursing or um this cancer lump sum, I would probably choose the cancer lump sum or the skilled nursing facility if you have to choose from one.
00:16:12.480 --> 00:16:17.840
Automatically, there's a dollar sixty-eight uh cent a month policy fee.
00:16:18.000 --> 00:16:24.240
So if you had all of these items, that would make your premium$115.34 a month.
00:16:24.480 --> 00:16:29.279
All right, that does help protect your maximum out of pocket.
00:16:29.440 --> 00:16:38.799
This is a way that you can get more peace of mind without having to add on you know a Medicare supplement policy, which the rates will increase each year.
00:16:39.039 --> 00:16:45.360
Like I said, GTL has not increased their premiums in over 10 years, uh, and they're a really great company.
00:16:46.000 --> 00:16:49.600
So once you enroll, you'll get a welcome packet in the mail.
00:16:49.759 --> 00:16:59.120
It'll go through you know what your benefits are, it'll have a welcome, um, welcome letter and show you how to go online and access your policy.
00:16:59.440 --> 00:17:02.399
So let's talk a little bit about who GTL is.
00:17:02.639 --> 00:17:05.039
So they have an A, AM Best Rating.
00:17:05.200 --> 00:17:09.519
So an AM best rating rates a uh a company's financial solvency.
00:17:09.759 --> 00:17:11.759
It goes all the way to AAA.
00:17:12.880 --> 00:17:24.799
Um, so GTL, third generation family-run mutual insurance company, they've been offering insurance since 1936 and they have great customer service.
00:17:24.880 --> 00:17:28.559
They make it really easy to submit a claim and everything.
00:17:28.880 --> 00:17:32.640
So if you have any questions, please reach out to me.
00:17:32.720 --> 00:17:33.920
I know that was fast.
00:17:34.000 --> 00:17:42.559
Um, and if you are curious as to how does it look for me and my specific policy, call me, text me, send me an email.
00:17:42.880 --> 00:17:44.480
I'm here, I'm here for you.
00:17:44.720 --> 00:17:49.519
Thanks for listening to another episode of the Medicare Matters podcast with McKenzie.
00:17:49.680 --> 00:17:53.759
Please make sure to subscribe wherever you get your podcast so you don't miss an episode.
00:17:53.920 --> 00:17:58.960
Please also leave a review as that helps me reach more people that can benefit from this podcast content.
00:17:59.119 --> 00:18:07.519
If you have questions or topics that you want me to cover for a future episode, please email them to McKenzie at Premier Medicare Solutions.com.
00:00:10.160 --> 00:00:18.079
We're gonna be talking about uh GTL Guaranteed Trust Life and their hospital indemnity product.
00:00:18.320 --> 00:00:23.679
So we're talking about GTL Guaranteed Trust Life, their Advantage Plus Elite.
00:00:24.239 --> 00:00:26.960
Um, it's really, really a great product.
00:00:28.000 --> 00:00:30.000
So you can add this.
00:00:30.160 --> 00:00:33.679
It's it's typically for people who are on a Medicare Advantage plan.
00:00:34.640 --> 00:00:37.280
So what is hospital indemnity insurance?
00:00:37.439 --> 00:00:41.600
So it's something that you add on attached to your Advantage plan.
00:00:42.079 --> 00:00:51.520
You pick the amounts based on what your out-of-pocket costs are could be with your Medicare Advantage plan.
00:00:53.359 --> 00:00:56.799
So as we saw in the video, here's the example, Beth.
00:00:56.880 --> 00:01:01.920
So she has uh her her inpatient copay is$300 a day for six days.
00:01:02.159 --> 00:01:09.519
So after six hours, this will kick in, but after six days, her copay would be eighteen hundred dollars.
00:01:09.760 --> 00:01:18.799
So we would look at, all right, well, your hospital co-pays$300 a day, we it would reimburse you for six days.
00:01:19.200 --> 00:01:25.359
So it does pay you directly cash, which is nice, it doesn't send it directly to the hospital.
00:01:26.879 --> 00:01:35.439
And also, what's nice about these is that after 60 days of not being in the hospital, the policy resets, and so you can use that again.
00:01:35.680 --> 00:01:37.840
You can use that hospital again.
00:01:38.719 --> 00:01:43.280
So they have not this company has not raised their rates in in over 10 years.
00:01:43.439 --> 00:01:47.920
They don't increase as you age, uh, which makes it really nice, makes it really affordable.
00:01:48.000 --> 00:01:54.640
Um, so if you're looking at you know potentially looking at a Medicare supplement plan, with Medicare supplement plans, those premiums will increase every year.
00:01:54.719 --> 00:01:56.640
That's that's a that's a guarantee.
00:01:56.959 --> 00:02:08.560
With GTL, with their hospital indemnity, there's it's guarantee issue, meaning you don't have to answer all those underwriting questions between eight the ages of 64 and a half up to 75.
00:02:09.039 --> 00:02:14.000
There are some additional questions if you want to add on other products as we'll as we'll see here.
00:02:15.520 --> 00:02:21.919
It included, it will give you money back if you go to the ER, which is which is nice.
00:02:22.400 --> 00:02:26.479
So, how you would choose to go about this is you choose your base benefit.
00:02:26.560 --> 00:02:32.800
Okay, do you want um so the base of it is is of course the hospital and the indemnity portion.
00:02:32.960 --> 00:02:37.520
You can add on a skilled nursing writer, an ambulance benefit rider, outpatient therapy.
00:02:37.599 --> 00:02:42.080
So the outpatient therapy would uh reimburse you for physical therapy.
00:02:42.159 --> 00:02:45.439
It even does up to 10 days of chiropractic or five days of chiropractic.
00:02:45.680 --> 00:02:48.000
You can do a cancer lump sum benefit rider.
00:02:48.400 --> 00:02:53.520
Um, also you do the guaranteed purchase for the option rider, which gives you the wellness rider.
00:02:53.680 --> 00:03:00.879
The wellness rider would reimburse you$100 for you know your wellness exam, your physical each year.
00:03:01.120 --> 00:03:08.080
You can also add it for outpatient surgical rider, critical accident, lump sum hospital, and then a dental envision benefit rider.
00:03:08.639 --> 00:03:13.840
So for the ambulance rider, your options you can choose from$50 up to$400.
00:03:14.319 --> 00:03:20.879
It can be used up to four times a year, lifetime max of 12 trips.
00:03:21.120 --> 00:03:29.599
It also does cover air ambulance, and you don't have to have any sort of uh hospital confinement required in order to use this.
00:03:31.520 --> 00:03:36.479
So you can also add a cancer lump sum benefit rider.
00:03:37.280 --> 00:03:48.960
With this, it does add a little bit of expense to it, but your coverage options are$2,500,$5,000,$7,500,$10,000,$15,000, or$20,000.
00:03:49.520 --> 00:03:54.159
So on average, it would be about$29.79,$2,975 a month.
00:03:54.479 --> 00:03:58.879
It does have specific benefits other than just giving you that lump sum.
00:03:58.960 --> 00:04:00.400
So cancer, cancer in situ.
00:04:01.199 --> 00:04:06.719
So this would get pay you 25% of the lump sum upon your diagnosis.
00:04:06.879 --> 00:04:13.199
For skin cancer, you would get a$500 benefit for basal cell or squamous cell, skin's carcinoma.
00:04:13.280 --> 00:04:16.399
This is payable three times over the life of the policy.
00:04:18.160 --> 00:04:21.439
I highly recommend adding the reoccurrence benefit writer.
00:04:21.519 --> 00:04:22.879
This is really, really cool.
00:04:23.199 --> 00:04:35.360
So if you have a$10,000 lump sum cancer writer with a reoccurrence, you're diagnosed with cancer, you submit a claim to GTL, you get a check for$10,000 after treatment.
00:04:35.439 --> 00:04:43.839
If you're in remission, um, even if you're in remission over five years, then the writer would be 100% restorable.
00:04:44.160 --> 00:04:55.759
So if you're diagnosed with cancer, go on remission, and then one year it comes back, or if it's an entirely new cancer, GTL will pay 10% of your lump sum benefit.
00:04:56.000 --> 00:05:05.439
Two to three years would be 25%, four years would be 50%, and any anything five years plus, it would pay that lump sum a hundred percent.
00:05:06.639 --> 00:05:08.560
You can also add it for skilled nursing.
00:05:08.639 --> 00:05:12.879
And I will I will tell you, let me go back to the the the cancer, the lump sum.
00:05:13.279 --> 00:05:21.279
You know, I've been doing this for going on nine years, and in my time, I've had five or six people that have hit their maximum out of pockets.
00:05:21.600 --> 00:05:23.519
It was all a few years ago.
00:05:23.839 --> 00:05:27.439
Five of the six people ended up passing away right after.
00:05:27.680 --> 00:05:33.519
The the the sixth person, she hit her maximum out of pocket because she had uh for radiation.
00:05:34.000 --> 00:05:36.480
So that's where this would come in handy.
00:05:36.560 --> 00:05:39.360
Now she is still alive, she's still with us and thriving.
00:05:39.439 --> 00:05:42.720
Um, but this is one of the ways that people hit their max out of pocket.
00:05:42.879 --> 00:05:57.759
Now it's important to remember that only 4% of people nationwide hit their max every year, you know, and the United States is a large country, and so the max out of pockets will vary from area to area.
00:05:58.240 --> 00:06:00.560
So some may be lower, some may be higher.
00:06:00.800 --> 00:06:02.639
So keep all that in mind.
00:06:02.879 --> 00:06:07.600
The other way that people hit their maximum out of pocket is with a skill is through skilled nursing.
00:06:07.839 --> 00:06:14.160
So typically, and I will say typically, um, the first 20 days are covered at zero cost.
00:06:14.319 --> 00:06:18.959
There may be, you know, this is I'm speaking to plans here in the Austin area.
00:06:19.120 --> 00:06:26.879
There are plans that have a little bit of a copay per day for the first 20 days, but typically the first 20 days are are at no cost to you.
00:06:27.199 --> 00:06:35.279
So with their skilled nursing benefit writer, you can choose an option for days 1 through 20, or you can choose an option for days 21 through 100.
00:06:35.439 --> 00:06:37.920
I recommend looking at the 21 through 100.
00:06:38.000 --> 00:06:41.439
You can choose up from 100 to$300 per day.
00:06:42.319 --> 00:06:44.000
Now it does have some requirements.
00:06:44.160 --> 00:06:55.120
The skilled nursing or SNF stay, it has to be for the same condition, and the stay has to begin within 30 days of your hospitalization, which has to be a minimum of three days.
00:06:55.279 --> 00:06:57.360
The observation time does not count.
00:06:57.439 --> 00:07:04.560
Um, and then this benefit also does restore after 60 days if there's no confinement in the hospital or skilled nursing facility.
00:07:05.519 --> 00:07:14.639
So if we're looking at days 21 through 100, a good average is about$225 a day.
00:07:14.720 --> 00:07:18.800
Um, and again, I'm speaking to the plans in the Austin area.
00:07:19.120 --> 00:07:27.439
The people that have hit, that have have um hit their maximum of pockets, they've had multiple, multiple, multiple full hospitalizations days.
00:07:27.600 --> 00:07:32.959
And then they're they're in days past day 20 with their still nursing.
00:07:33.120 --> 00:07:41.360
Now, for each of those days, if the benefit, if if your cost is$225, you're paying that$225 per day for those.
00:07:41.519 --> 00:08:00.399
Um, so that's and typically the people that are in there you know long term, it's people that may have a condition like ALS or they're they're pretty sick and they're not getting better at the rate that you know somebody their age who is healthy would be getting better.
00:08:00.720 --> 00:08:07.519
So this is add a little bit of protection and makes you feel a little bit better about having to be in there.
00:08:07.600 --> 00:08:10.560
You're not having to worry about, hey, I'm gonna be out of pocket all this money.
00:08:10.800 --> 00:08:14.399
You can also add on an outpatient therapy benefit writer.
00:08:14.480 --> 00:08:16.319
So you it pays up to$50.
00:08:16.720 --> 00:08:20.079
You can choose either for 15 days or 30 days.
00:08:20.240 --> 00:08:25.600
Now, if you let's say you have a physical therapy and a speech therapy appointment on the same day.
00:08:25.839 --> 00:08:28.560
If you have it on the same day, it will pay the$50.
00:08:29.040 --> 00:08:34.000
If you have it on two separate days, it'll pay you$50 for each visit.
00:08:34.320 --> 00:08:41.919
What's really nice is I mentioned earlier, that you can also get reimbursed for chiropractic, up to$50 for five days a calendar year.
00:08:42.159 --> 00:08:48.720
So adding that on, uh that's also a way that people hit their max out of pockets, is is um with physical therapy.
00:08:48.960 --> 00:08:54.960
A lot of the time you're having to go two, three times a week, and that adds up, especially if your co-pays 40-50 bucks.
00:08:55.120 --> 00:08:56.799
So this will help out with that.
00:08:58.000 --> 00:09:01.360
You can also do a critical accident uh benefit rider.
00:09:01.840 --> 00:09:08.559
With this, after an emergency room visit, this rider pays you a lump sum for these following types of accidents.
00:09:08.720 --> 00:09:12.559
So accidental death, if you have the$5,000 plan, it'll pay$5,000.
00:09:12.639 --> 00:09:16.720
If the$10,000 plan, it'll it'll reimburse you$10,000 or your family.
00:09:16.879 --> 00:09:23.679
Hip or skull fracture,$1250 on the$5,000 or$2,500 on the$10,000 plan.
00:09:23.919 --> 00:09:30.159
If you dislocate your hip, it's$1,000 on the five on the$5,000 plan,$2,000 on the$10,000.
00:09:30.320 --> 00:09:38.240
Um knee dislocation or knee ligament tear, it'll give you$500 on the$5,000 plan or$1,000 on the$10,000 plan.
00:09:38.559 --> 00:09:48.559
If you just fracture a fracture of bone or other$250 on the$5,000 plan and$500 on the$10,000 plan.
00:09:48.720 --> 00:09:52.159
Now this does have a 30-day waiting period before it can kick in.
00:09:52.320 --> 00:09:59.840
That means if you get the policy in the first 30 days, you break your break your break your hip.
00:10:00.080 --> 00:10:01.919
That amount would not be payable.
00:10:02.159 --> 00:10:07.360
So try to put keep yourself in bubble wrap until that 30 days is passed.
00:10:07.600 --> 00:10:10.960
You can also add on an outpatient surgical benefit writer.
00:10:11.120 --> 00:10:12.799
This would be if you have a day surgery.
00:10:12.879 --> 00:10:20.240
So thinking in an ambulatory or uh in an outpatient uh portion of an inpatient hospital.
00:10:20.399 --> 00:10:25.919
You can choose between 250, 500, 750, or$1,000 lump sum.
00:10:26.080 --> 00:10:27.519
You can use it twice a year.
00:10:27.600 --> 00:10:32.240
Um, but it's it can't be used for MRIs or x-rays or other non-surgical procedures.
00:10:32.480 --> 00:10:34.720
So that is something that you can also add.
00:10:35.600 --> 00:10:47.279
Now, when we add the guaranteed purchase option benefit writer, this will allow you to go back in and increase your hospital amount.
00:10:47.600 --> 00:10:52.799
So let's say if it's uh$300, you can increase it by 10% of the original value.
00:10:52.960 --> 00:10:58.399
So you could increase it up to$330, up to five times before you turn 85.
00:10:58.960 --> 00:11:07.360
Your increase in benefits will be based on issue H rates, um, no pre-existing uh condition limitation, and there's no additional underwriting.
00:11:07.600 --> 00:11:14.799
With this, you also get the wellness writer that pays you$100 for a physical examination performed by a healthcare.
00:11:14.879 --> 00:11:18.399
So it could be doctor, nurse, practitioner, or physician's assistant.
00:11:18.559 --> 00:11:33.039
Now, this also does have a 30-day waiting period, but it doesn't add that much, and at the very it doesn't add that much to to add the guaranteed purchase option benefit writer, and I have a little bit of a breakdown in um prices at the very end.
00:11:34.000 --> 00:11:37.600
So what's gonna be the best option for you?
00:11:39.360 --> 00:11:42.320
At the minimum, you could look at um the hospitalization.
00:11:42.399 --> 00:11:45.679
So choose what your daily rate is, how you want to be reimbursed.
00:11:45.919 --> 00:11:48.159
You can also get the ambulance benefit rider.
00:11:48.399 --> 00:11:51.919
The ambulance benefit rider is very low cost to add.
00:11:52.240 --> 00:12:02.480
Um better, you get the hospital indemnity option, you choose the outpate the apologies, ambulance benefit rider, and then also the outpatient therapy benefit rider.
00:12:02.799 --> 00:12:05.679
The best, it's uh it's kind of fully loaded.
00:12:05.759 --> 00:12:13.440
So you get the hospital indemnity portion, you choose the ambulance 7,500 lump sum cancer benefit rider.
00:12:13.600 --> 00:12:16.000
Remember, they do go up to 10,000 uh to 20,000.
00:12:16.159 --> 00:12:19.120
And then you can look at the outpatient therapy benefit writer.
00:12:19.200 --> 00:12:21.919
You can also customize it, you don't have to choose all of those things.
00:12:22.080 --> 00:12:29.039
That's what's really cool about this product is that you choose what's gonna be um good for you and your budget and what your health needs are.
00:12:29.519 --> 00:12:32.240
So this is a little breakdown.
00:12:32.720 --> 00:12:39.039
So let's say this is based on uh somebody who's turning 65 in March of 2026.
00:12:39.279 --> 00:12:44.080
So let's say your hospital co-pays$300 and you have to pay that for five days.
00:12:44.399 --> 00:12:50.240
So the GTL benefit, you would choose, all right, I'm gonna be reimbursed$300 for five days.
00:12:50.639 --> 00:12:57.440
Now the cool thing about it is if you if you're in the hospital for two days, you submit a claim, it'll pay you$600.
00:12:58.320 --> 00:13:06.399
Now, you still have three days, three days that you can use within that 60-day period if you are readmitted.
00:13:06.960 --> 00:13:09.200
And that does reset after 60 days.
00:13:09.279 --> 00:13:13.120
So that would put you around$22.08 a month.
00:13:14.080 --> 00:13:22.480
Something else that GTL does automatically, they give you an emergency uh ER copay benefit included.
00:13:22.639 --> 00:13:30.320
So let's say your emergency copay is$130, GTL reimburses you$150, and it doesn't add anything to your premium.
00:13:30.639 --> 00:13:32.399
Ambulance, let's say it's$300.
00:13:32.799 --> 00:13:38.879
So you choose for, all right, I want to be reimbursed$300, that costs you two dollars and 14 cents a month.
00:13:39.200 --> 00:13:47.519
So it does not add that much, and it helps you with you know with your$300 bill.
00:13:47.840 --> 00:13:54.000
Now, when we're looking at radiation chemotherapy max out of pocket, this is this is the max out of pocket of of your plan.
00:13:54.080 --> 00:13:57.360
So let's just say it's$7,000 in network.
00:13:57.759 --> 00:14:03.919
GTL, remember, you can do uh$2,500,$5,000,$7,8500, or$10,000.
00:14:04.000 --> 00:14:07.200
I went with a$10,000 here with 100% recurrence.
00:14:07.519 --> 00:14:12.799
That means that if you're cancer free for after five years, it'll pay you 100% back.
00:14:13.039 --> 00:14:20.000
If it's after one year, um, it'll be uh 10%, two to three years, it's 25%, at four years is 50%.
00:14:20.960 --> 00:14:25.919
That makes your premium, adds$33.78 to that.
00:14:26.159 --> 00:14:29.919
Now I highly recommend looking at the skilled nursing facility.
00:14:30.080 --> 00:14:35.919
So let's say your copay is$218 for the last 80 days.
00:14:36.080 --> 00:14:41.279
So this would kick it if you're in a skilled nursing facility from days 21 plus.
00:14:41.840 --> 00:14:47.120
So GTL, we would embrace you$220 for 80 days.
00:14:47.279 --> 00:14:50.879
That would add$14.23 to your monthly premium.
00:14:51.840 --> 00:14:56.240
Annual wellness physical, typically with advantage plans, they're covered at 100%.
00:14:56.799 --> 00:15:00.399
Um, GTL will automatically just give you this$100.
00:15:01.120 --> 00:15:13.039
Um, that's what that guaranteed purchase option writer, which allows you to increase your hospital confinement daily rate by 10% over five times up until um your age 85.
00:15:13.200 --> 00:15:21.919
So that adds$7.64, and you can get$100 back for going to get your physical, which you don't have to pay anything out of pocket for.
00:15:22.559 --> 00:15:26.720
For the outpatient therapy copay, let's say your copay is$45.
00:15:27.679 --> 00:15:33.519
The highest plan with GTL is you get reimbursed$50 for 30 days throughout the year.
00:15:33.679 --> 00:15:37.360
That also does include five days of chiropractic.
00:15:37.600 --> 00:15:40.399
That would add$6.99 a month.
00:15:40.960 --> 00:15:45.840
So this last bit, the dental vision average monthly cost, let's just say it's$50.
00:15:46.399 --> 00:15:49.360
You can add a GTL benefit for$400.
00:15:49.840 --> 00:15:54.159
That adds$26.80 a month to your premium.
00:15:54.639 --> 00:15:58.159
I don't necessarily think that that's something that you would have to add.
00:15:58.320 --> 00:16:12.000
Um, you know, choosing between dental and vision versus skilled nursing or um this cancer lump sum, I would probably choose the cancer lump sum or the skilled nursing facility if you have to choose from one.
00:16:12.480 --> 00:16:17.840
Automatically, there's a dollar sixty-eight uh cent a month policy fee.
00:16:18.000 --> 00:16:24.240
So if you had all of these items, that would make your premium$115.34 a month.
00:16:24.480 --> 00:16:29.279
All right, that does help protect your maximum out of pocket.
00:16:29.440 --> 00:16:38.799
This is a way that you can get more peace of mind without having to add on you know a Medicare supplement policy, which the rates will increase each year.
00:16:39.039 --> 00:16:45.360
Like I said, GTL has not increased their premiums in over 10 years, uh, and they're a really great company.
00:16:46.000 --> 00:16:49.600
So once you enroll, you'll get a welcome packet in the mail.
00:16:49.759 --> 00:16:59.120
It'll go through you know what your benefits are, it'll have a welcome, um, welcome letter and show you how to go online and access your policy.
00:16:59.440 --> 00:17:02.399
So let's talk a little bit about who GTL is.
00:17:02.639 --> 00:17:05.039
So they have an A, AM Best Rating.
00:17:05.200 --> 00:17:09.519
So an AM best rating rates a uh a company's financial solvency.
00:17:09.759 --> 00:17:11.759
It goes all the way to AAA.
00:17:12.880 --> 00:17:24.799
Um, so GTL, third generation family-run mutual insurance company, they've been offering insurance since 1936 and they have great customer service.
00:17:24.880 --> 00:17:28.559
They make it really easy to submit a claim and everything.
00:17:28.880 --> 00:17:32.640
So if you have any questions, please reach out to me.
00:17:32.720 --> 00:17:33.920
I know that was fast.
00:17:34.000 --> 00:17:42.559
Um, and if you are curious as to how does it look for me and my specific policy, call me, text me, send me an email.
00:17:42.880 --> 00:17:44.480
I'm here, I'm here for you.
00:17:44.720 --> 00:17:49.519
Thanks for listening to another episode of the Medicare Matters podcast with McKenzie.
00:17:49.680 --> 00:17:53.759
Please make sure to subscribe wherever you get your podcast so you don't miss an episode.
00:17:53.920 --> 00:17:58.960
Please also leave a review as that helps me reach more people that can benefit from this podcast content.
00:17:59.119 --> 00:18:07.519
If you have questions or topics that you want me to cover for a future episode, please email them to McKenzie at Premier Medicare Solutions.com.
