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We're gonna be talking about uh GTL Guaranteed Trust Life and their hospital indemnity product.
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So we're talking about GTL Guaranteed Trust Life, their Advantage Plus Elite.
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Um, it's really, really a great product.
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So you can add this.
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It's it's typically for people who are on a Medicare Advantage plan.
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So what is hospital indemnity insurance?
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So it's something that you add on attached to your Advantage plan.
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You pick the amounts based on what your out-of-pocket costs are could be with your Medicare Advantage plan.
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So as we saw in the video, here's the example, Beth.
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So she has uh her her inpatient copay is$300 a day for six days.
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So after six hours, this will kick in, but after six days, her copay would be eighteen hundred dollars.
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So we would look at, all right, well, your hospital co-pays$300 a day, we it would reimburse you for six days.
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So it does pay you directly cash, which is nice, it doesn't send it directly to the hospital.
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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.
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You can use that hospital again.
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So they have not this company has not raised their rates in in over 10 years.
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They don't increase as you age, uh, which makes it really nice, makes it really affordable.
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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.
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That's that's a that's a guarantee.
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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.
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There are some additional questions if you want to add on other products as we'll as we'll see here.
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It included, it will give you money back if you go to the ER, which is which is nice.
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So, how you would choose to go about this is you choose your base benefit.
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Okay, do you want um so the base of it is is of course the hospital and the indemnity portion.
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You can add on a skilled nursing writer, an ambulance benefit rider, outpatient therapy.
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So the outpatient therapy would uh reimburse you for physical therapy.
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It even does up to 10 days of chiropractic or five days of chiropractic.
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You can do a cancer lump sum benefit rider.
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Um, also you do the guaranteed purchase for the option rider, which gives you the wellness rider.
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The wellness rider would reimburse you$100 for you know your wellness exam, your physical each year.
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You can also add it for outpatient surgical rider, critical accident, lump sum hospital, and then a dental envision benefit rider.
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So for the ambulance rider, your options you can choose from$50 up to$400.
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It can be used up to four times a year, lifetime max of 12 trips.
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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.
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So you can also add a cancer lump sum benefit rider.
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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.
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So on average, it would be about$29.79,$2,975 a month.
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It does have specific benefits other than just giving you that lump sum.
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So cancer, cancer in situ.
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So this would get pay you 25% of the lump sum upon your diagnosis.
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For skin cancer, you would get a$500 benefit for basal cell or squamous cell, skin's carcinoma.
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This is payable three times over the life of the policy.
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I highly recommend adding the reoccurrence benefit writer.
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This is really, really cool.
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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.
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If you're in remission, um, even if you're in remission over five years, then the writer would be 100% restorable.
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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.
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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.
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You can also add it for skilled nursing.
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And I will I will tell you, let me go back to the the the cancer, the lump sum.
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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.
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It was all a few years
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ago.
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Five of the six people ended up passing away right after.
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The the the sixth person, she hit her maximum out of pocket because she had uh for radiation.
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So that's where this would come in handy.
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Now she is still alive, she's still with us and thriving.
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Um, but this is one of the ways that people hit their max out of pocket.
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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.
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So some may be lower, some may be higher.
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So keep all that in mind.
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The other way that people hit their maximum out of pocket is with a skill is through skilled nursing.
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So typically, and I will say typically, um, the first 20 days are covered at zero cost.
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There may be, you know, this is I'm speaking to plans here in the Austin area.
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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.
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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.
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I recommend looking at the 21 through 100.
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You can choose up from 100 to$300 per day.
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Now it does have some requirements.
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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.
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The observation time does not count.
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Um, and then this benefit also does restore after 60 days if there's no confinement in the hospital or skilled nursing facility.
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So if we're looking at days 21 through 100, a good average is about$225 a day.
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Um, and again, I'm speaking to the plans in the Austin area.
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The people that have hit, that have have um hit their maximum of pockets, they've had multiple, multiple, multiple full hospitalizations days.
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And then they're they're in days past day 20 with their still nursing.
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Now, for each of those days, if the benefit, if if your cost is$225, you're paying that$225 per day for those.
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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.
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So this is add a little bit of protection and makes you feel a little bit better about having to be in there.
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You're not having to worry about, hey, I'm gonna be out of pocket all this money.
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You can also add on an outpatient therapy benefit writer.
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So you it pays up to$50.
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You can choose either for 15 days or 30 days.
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Now, if you let's say you have a physical therapy and a speech therapy appointment on the same day.
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If you have it on the same day, it will pay the$50.
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If you have it on two separate days, it'll pay you$50 for each visit.
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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.
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So adding that on, uh that's also a way that people hit their max out of pockets, is is um with physical therapy.
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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.
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So this will help out with that.
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You can also do a critical accident uh benefit rider.
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With this, after an emergency room visit, this rider pays you a lump sum for these following types of accidents.
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So accidental death, if you have the$5,000 plan, it'll pay$5,000.
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If the$10,000 plan, it'll it'll reimburse you$10,000 or your family.
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Hip or skull fracture,$1250 on the$5,000 or$2,500 on the$10,000 plan.
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If you dislocate your hip, it's$1,000 on the five on the$5,000 plan,$2,000 on the$10,000.
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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.
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If you just fracture a fracture of bone or other$250 on the$5,000 plan and$500 on the$10,000 plan.
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Now this does have a 30-day waiting period before it can kick in.
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That means if you get the policy in the first 30 days, you break your break your break your hip.
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That amount would not be payable.
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So try to put keep yourself in bubble wrap until that 30 days is passed.
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You can also add on an outpatient surgical benefit writer.
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This would be if you have a day surgery.
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So thinking in an ambulatory or uh in an outpatient uh portion of an inpatient hospital.
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You can choose between 250, 500, 750, or$1,000 lump sum.
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You can use it twice a year.
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Um, but it's it can't be used for MRIs or x-rays or other non-surgical procedures.
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So that is something that you can also add.
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Now, when we add the guaranteed purchase option benefit writer, this will allow you to go back in and increase your hospital amount.
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So let's say if it's uh$300, you can increase it by 10% of the original value.
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So you could increase it up to$330, up to five times before you turn 85.
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Your increase in benefits will be based on issue H rates, um, no pre-existing uh condition limitation, and there's no additional underwriting.
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With this, you also get the wellness writer that pays you$100 for a physical examination performed by a healthcare.
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So it could be doctor, nurse, practitioner, or physician's assistant.
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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.
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So what's gonna be the best option for you?
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At the minimum, you could look at um the hospitalization.
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So choose what your daily rate is, how you want to be reimbursed.
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You can also get the ambulance benefit rider.
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The ambulance benefit rider is very low cost to add.
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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.
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The best, it's uh it's kind of fully loaded.
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So you get the hospital indemnity portion, you choose the ambulance 7,500 lump sum cancer benefit rider.
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Remember, they do go up to 10,000 uh to 20,000.
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And then you can look at the outpatient therapy benefit writer.
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You can also customize it, you don't have to choose all of those things.
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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.
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So this is a little breakdown.
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So let's say this is based on uh somebody who's turning 65 in March of 2026.
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So let's say your hospital co-pays$300 and you have to pay that for five days.
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So the GTL benefit, you would choose, all right, I'm gonna be reimbursed$300 for five days.
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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.
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Now, you still have three days, three days that you can use within that 60-day period if you are readmitted.
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And that does reset after 60 days.
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So that would put you around$22.08 a month.
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Something else that GTL does automatically, they give you an emergency uh ER copay benefit included.
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So let's say your emergency copay is$130, GTL reimburses you$150, and it doesn't add anything to your premium.
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Ambulance, let's say it's$300.
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So you choose for, all right, I want to be reimbursed$300, that costs you two dollars and 14 cents a month.
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So it does not add that much, and it helps you with you know with your$300 bill.
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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.
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So let's just say it's$7,000 in network.
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GTL, remember, you can do uh$2,500,$5,000,$7,8500, or$10,000.
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I went with a$10,000 here with 100% recurrence.
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That means that if you're cancer free for after five years, it'll pay you 100% back.
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If it's after one year, um, it'll be uh 10%, two to three years, it's 25%, at four years is 50%.
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That makes your premium, adds$33.78 to that.
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Now I highly recommend looking at the skilled nursing facility.
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So let's say your copay is$218 for the last 80 days.
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So this would kick it if you're in a skilled nursing facility from days 21 plus.
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So GTL, we would embrace you$220 for 80 days.
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That would add$14.23 to your monthly premium.
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Annual wellness physical, typically with advantage plans, they're covered at 100%.
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Um, GTL will automatically just give you this$100.
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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.
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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.
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For the outpatient therapy copay, let's say your copay is$45.
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The highest plan with GTL is you get reimbursed$50 for 30 days throughout the
year.
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That also does include five days of chiropractic.
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That would add$6.99 a month.
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So this last bit, the dental vision average monthly cost, let's just say it's$50.
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You can add a GTL benefit for$400.
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That adds$26.80 a month to your premium.
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I don't necessarily think that that's something that you would have to add.
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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.
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Automatically, there's a dollar sixty-eight uh cent a month policy fee.
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So if you had all of these items, that would make your premium$115.34 a month.
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All right, that does help protect your maximum out of pocket.
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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.
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Like I said, GTL has not increased their premiums in over 10 years, uh, and they're a really great company.
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So once you enroll, you'll get a welcome packet in the mail.
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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.
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So let's talk a little bit about who GTL is.
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So they have an A, AM Best Rating.
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So an AM best rating rates a uh a company's financial solvency.
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It goes all the way to AAA.
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Um, so GTL, third generation family-run mutual insurance company, they've been offering insurance since 1936 and they have great customer service.
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They make it really easy to submit a claim and everything.
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So if you have any questions, please reach out to me.
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I know that was fast.
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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.
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I'm here, I'm here for you.
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Thanks for listening to another episode of the Medicare Matters podcast with McKenzie.
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Please make sure to subscribe wherever you get your podcast so you don't miss an episode.
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Please also leave a review as that helps me reach more people that can benefit from this podcast content.
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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.