ENCORE: How to Prioritize a Patient First Mindset

Medicare 101, Part 3: Medicare Advantage vs. Original Medicare with a Supplement

Erin explains what happens after you enroll in Original Medicare Parts A and B and realize there are still gaps in your coverage. She walks through the two main paths people usually choose to fill those gaps: enrolling in a Part C Medicare Advantage plan, or keeping Original Medicare and pairing it with a Medigap supplement and a standalone Part D drug plan. You'll hear how Medicare Advantage plans are funded, what it means to assign your A and B benefits to a private insurance company, and how networks, HMOs, and PPOs work in this space. You'll also hear about important timing rules, including guaranteed acceptance periods for Medigap, when underwriting can apply, and how trial rights work if you move between Medicare Advantage and supplements. Erin closes with a clear recap of the trade‑offs so you can start to identify which approach best aligns with your budget, your providers, and the level of flexibility you want from your Medicare coverage. Follow Erin's company, Black Point Insurance, on Instagram here [https://www.google.com/url?q=https://www.instagram.com/blackpointinsurance/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw0Mn4Ymycav-LR7ek_zeegV]. Follow Erin on Facebook here [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw29oHwhTbY3sHhGVwIXwrck]. Follow Erin on LinkedIn here [https://www.google.com/url?q=https://www.linkedin.com/in/erinackenheil&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw3Kpp2oCTSdHyU0pqruZv53]. Learn more about Erin's company, Black Point Insurance here [https://www.google.com/url?q=https://www.blackpointinsurance.com/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw2ywPuDizLrHBd52EC_1F4q]. Key Takeaways 1. Original Medicare Parts A and B usually are not enough on their own; you'll need additional coverage to address deductibles, coinsurance, and the lack of prescription drug coverage. 2. Path one is Medicare Advantage (Part C), where you assign your A and B benefits to a private plan that typically bundles hospital, medical, often prescription drugs, and extra benefits into one card. 3. Medicare Advantage plans use networks, may require referrals, and can differ significantly by county and carrier, but often offer low or zero premiums with built‑in extras. 4. Path two is keeping Original Medicare as your primary coverage and pairing it with a Medigap supplement and standalone Part D plan, which can give broad provider choice and very low out‑of‑pocket costs when you use care. 5. Medigap plans generally have higher monthly premiums, do not bundle Part D or routine dental, vision, and hearing, and those extras are usually purchased separately. 6. Enrollment rules, guaranteed issue periods, underwriting, and 12‑month trial rights can affect when and how you move between Medicare Advantage and Medigap, so your initial choices at 65 can impact your long‑term options.

Medicare 101, Part 2: Do I Have to Take Medicare at 65?

In this episode, Erin dives into one of the most common questions she gets: "Do I have to sign up for Medicare when I turn 65?" She explains how the answer depends on your current coverage and whether Medicare will be considered primary or secondary in your situation. Erin breaks down what happens if you are on an individual plan, COBRA, a family plan, Medicaid, or employer group coverage so you understand when you must enroll to avoid costly gaps and penalties. You'll hear how rules differ for large employer plans versus small employer plans, when it may make financial sense to stay on group coverage, and when Medicare can actually provide better value. Erin also covers late retiree rules, timing your enrollment so coverage lines up smoothly with your retirement date, how health savings accounts interact with Medicare, and why keeping documentation of your coverage history is critical. Follow Erin's company, Black Point Insurance, on Instagram here [https://www.google.com/url?q=https://www.instagram.com/blackpointinsurance/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw0Mn4Ymycav-LR7ek_zeegV]. Follow Erin on Facebook here [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw29oHwhTbY3sHhGVwIXwrck]. Follow Erin on LinkedIn here [https://www.google.com/url?q=https://www.linkedin.com/in/erinackenheil&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw3Kpp2oCTSdHyU0pqruZv53]. Learn more about Erin's company, Black Point Insurance here [https://www.google.com/url?q=https://www.blackpointinsurance.com/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw2ywPuDizLrHBd52EC_1F4q]. Key Takeaways 1. When Medicare is required as your primary coverage and why missing your initial enrollment period can lead to penalties. 2. How large employer coverage (more than 20 employees) differs from small employer coverage when you turn 65. 3. Why it's important to compare the cost, deductibles, and out‑of‑pocket maximums of your group plan against Medicare options. 4. How late retirees can use a special enrollment period to transition from employer coverage to Medicare without penalties. 5. Why contributing to an HSA while on Medicare is not allowed and how to time your contributions and enrollment. 6. The importance of a pre‑assessment to review your prescriptions, doctors, and current coverage before making any decisions.

Medicare 101, Part 1: The A, B, C and D of Medicare

Erin kicks off the Medicare 101 series and walks you through the basics of Medicare in a clear, approachable way. You'll learn what Original Medicare Parts A and B cover, what that red, white, and blue card really means, and why those benefits alone often leave important gaps. Erin previews how Medicare Advantage, Medicare Supplement (Medigap), and Part D prescription drug plans work together so you can start to see which path might fit your needs. This is a foundational conversation designed to help you feel more confident, less overwhelmed, and ready for the next steps in your Medicare journey. Follow Erin's company, Black Point Insurance, on Instagram here [https://www.google.com/url?q=https://www.instagram.com/blackpointinsurance/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw0Mn4Ymycav-LR7ek_zeegV]. Follow Erin on Facebook here [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw29oHwhTbY3sHhGVwIXwrck]. Follow Erin on LinkedIn here [https://www.google.com/url?q=https://www.linkedin.com/in/erinackenheil&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw3Kpp2oCTSdHyU0pqruZv53]. Learn more about Erin's company, Black Point Insurance here [https://www.google.com/url?q=https://www.blackpointinsurance.com/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw2ywPuDizLrHBd52EC_1F4q]. Key Takeaways 1. Why Black Point Insurance leads with education, relationships, and long‑term support instead of one‑time transactions. 2. How independent agents can compare multiple carriers and plan types to find a better fit for your needs and location. 3. What Medicare Parts A and B cover, where the gaps are, and why most people need additional coverage. 4. The two main paths to close those gaps: Medicare Advantage (Part C) or Original Medicare with a Medigap plan and a standalone Part D plan. 5. Why ongoing plan reviews matter as your health, premiums, and Medicare rules change over time.

Inside Bales Orthodontics: Patient-Focused Innovations and Community Involvement

Katie Bales built on her father's foundation, leading Bales Orthodontics with an all-female team and a focus on patient comfort and cutting-edge care. Her approach has made orthodontics accessible and welcoming for both children and adults. From airway-focused treatment to compassionate service, she continues to redefine the patient experience. Learn more about Bales Orthodontics here [https://www.google.com/url?q=https://www.balesorthodontics.com/meet-dr-katie-bales/&sa=D&source=calendar&ust=1763216337980662&usg=AOvVaw2bAV7FYFrU3v-B71IM9CqZ], and follow them on Facebook here [https://www.google.com/url?q=https://www.facebook.com/balesorthodontics&sa=D&source=calendar&ust=1763216337980662&usg=AOvVaw3lASG1dY8Plp0HD6UGK2Mm]. Follow Erin's company, Black Point Insurance, on Instagram here [https://www.google.com/url?q=https://www.instagram.com/blackpointinsurance/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw0Mn4Ymycav-LR7ek_zeegV]. Follow Erin on F [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw29oHwhTbY3sHhGVwIXwrck]acebook here [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw29oHwhTbY3sHhGVwIXwrck]. Follow Erin on LinkedIn here [https://www.google.com/url?q=https://www.linkedin.com/in/erinackenheil&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw3Kpp2oCTSdHyU0pqruZv53]. Learn more about Erin's company, Black Point Insurance here [https://www.google.com/url?q=https://www.blackpointinsurance.com/&sa=D&source=calendar&ust=1763216381420992&usg=AOvVaw2ywPuDizLrHBd52EC_1F4q]. Key Takeaways 1. The Evolution and Legacy of Bales Orthodontics Takeaway: Erin Ackenheil and Katie Bales discuss the long history and local legacy of Bales Orthodontics, founded by Dr. Tom Bales and carried on by Katie Bales. The main point is the importance of continuity, innovation, and community involvement in building not just a practice but a trusted local institution. 2. Leadership, Mentorship, and Female Empowerment in Dentistry Takeaway: Katie Bales highlights her journey as a woman leading an all-female dental team, emphasizing the mentorship she received from her father and her efforts to bring a nurturing, collaborative, and empathetic approach to patient care. The conceptual takeaway is that leadership grounded in empathy and support—especially when women empower other women—elevates patient experience and workplace culture. 3. Innovation and Patient-Centered Care in Orthodontics Takeaway: The conversation explores advancements such as airway-focused orthodontics and individualized treatment plans that consider the patient's lifestyle and goals. Katie Bales underscores that tailoring care to each patient's unique needs—from minimal touch-ups to full treatments—demonstrates how modern orthodontics is both innovative and deeply patient-focused. 4. The Growing Trend of Adult Orthodontics Takeaway: There's significant discussion about the rise of adult patients seeking orthodontic care, influenced by aesthetics, new technology (such as Invisalign), and increased self-awareness due to video conferencing. The main lesson is that orthodontic care is relevant at any age, and practices are adapting to make treatments appealing and accessible to adults as well as children. 5. The Value of Community Involvement and Giving Back Takeaway: Erin Ackenheil and Katie Bales talk about the practice's commitment to supporting local schools, sports, charities, and pro bono cases. The key message is that sustainable business success is rooted in genuine community engagement—giving back is not just a duty, but a core part of making a meaningful impact.

ENCORE: How to Prioritize a Patient First Mindset

*This episode previously aired on November 13, 2013. What does it mean when a health plan asks, "How would we want this to work for our own parents?" Sharon Jawar has worked for over 20 years as the chief pharmacy officer at SCAN Health Plan, making choices that focus on seniors' health—not shareholders. * Why did she choose managed care pharmacy over traditional pharmacy roles? * How does SCAN Health Plan support members, agents, and brokers in the Medicare space? * What recent changes make SCAN's Medicare Advantage plans different for 2024, especially in pharmacy benefits? Hear what drives Sharon's work and how SCAN aims to keep care simple for every member. Key Takeaways 1. SCAN Health Plan's Unique Approach and Values * Takeaway: SCAN Health Plan is a nonprofit organization focused on senior care with the guiding philosophy of treating members as they would their own parents. This member-first approach is enabled by their nonprofit status, allowing them to prioritize patient outcomes and ethical decision-making over shareholder profit, which in turn generates trust and satisfaction among beneficiaries and providers. 2. Pharmacy Benefits & Innovative Programs * Takeaway: SCAN Health Plan stands out for its proactive, personalized approach to pharmacy benefits. They run targeted programs to support medication adherence, deprescribing (evaluating and reducing unnecessary medications), and streamline prior authorization for new members. These innovations are designed to make medications more accessible and safe, ultimately improving both member outcomes and satisfaction. 3. High Star Ratings and Industry Recognition * Takeaway: Consistently earning high Medicare star ratings and prestigious awards (such as the J.D. Power ranking for customer service) is a reflection of SCAN's commitment to quality. These ratings, which encompass factors like member satisfaction, medication management, and provider partnerships, reinforce the plan's reputation for dependable and superior service in both pharmacy and general healthcare. 4. 2024 Product & Benefit Enhancements * Takeaway: SCAN is introducing game-changing benefits in 2024, including a new emphasis on making high-value brand-name medications for heart and diabetes care affordable (with $0 or $11 copays). They've also personalized product offerings, like plans tailored for women and the LGBTQ community, reflecting their commitment to providing individualized care and addressing the specific needs of diverse populations. 5. Support for Brokers, Agents, and Members * Takeaway: SCAN provides robust support and resources for both members and the agents/brokers who serve them. Their onboarding processes, training, and partnership with healthcare providers are geared towards delivering the best possible experience—ensuring new members have needed medications right away, making the contracting process for agents simple, and offering detailed information online. Follow Erin's company, Black Point Insurance, on Instagram here [https://www.google.com/url?q=https://www.instagram.com/blackpointinsurance/&sa=D&source=calendar&ust=1757824989439233&usg=AOvVaw1y4Vu33aOtZY8HerteSpXj]. Follow Erin on F [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1757824989439233&usg=AOvVaw2Q0_n5QISzQrRSJ_91GzM0]acebook here [https://www.google.com/url?q=https://www.facebook.com/erin.ackenheil/&sa=D&source=calendar&ust=1757824989439233&usg=AOvVaw2Q0_n5QISzQrRSJ_91GzM0]. Follow Erin on LinkedIn here [https://www.google.com/url?q=https://www.linkedin.com/in/erinackenheil&sa=D&source=calendar&ust=1757824989439233&usg=AOvVaw1k8DuObl0QsB_khY6D2z9Q]. Learn more about Erin's company, Black Point Insurance here [https://www.google.com/url?q=https://www.blackpointinsurance.com/&sa=D&source=calendar&ust=1757824989439233&usg=AOvVaw3x4peJ2SGIzTLmD6lAFJ2q].