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October 24, 2026
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Show Notes
Eddie and Betty's Conversation
Welcome to The American Retirement Advisor. I'm here with Eddie, as always, and Eddie, I have to tell you, today's topic came out of something that actually happened in a room full of real people, not a whiteboard, not a spreadsheet. Ian Schaeffer wrote up a recap of Fiscal Fridays, their live educational show, and it is full of the kind of stuff that makes you go wait, I didn't know that.
Yeah, I read it this morning and there were genuinely a couple of moments where I stopped and thought, okay, that's a real thing people get wrong. And we're talking Medicare, which sounds dry until you realize it's the thing standing between you and a very large hospital bill.
Right, and the framing they used at this event was so good. David Schaeffer, who hosts the show, opened by asking the whole room to close their eyes and picture their dream retirement. His was a trip to Germany, a watch workshop, and driving on the Autobahn at 200 kilometers an hour.
That's about 124 miles an hour for those of us who didn't grow up metric.
Which, on a public road, is insane and also kind of wonderful. But his point was serious: it all starts with a plan. You have to know what you're building toward before you can figure out how Medicare, income, all of it, fits together.
And it's a big piece of that plan, especially for people who are right at or near 65. So they did this thing at the event where David asked everyone on Medicare to raise their hand, and then asked who could name all four parts.
And how'd the room do?
Most people got three. The front row got all four.
Of course they got them all. Overachievers, sitting up there, raising their hands. Okay so walk me through the four, because I know some of our listeners are sitting there counting on their fingers right now.
Part A is hospital coverage. Part B is doctors and medical services. Part D is prescription drugs. And then Part C is Medicare Advantage, the all-in-one version that bundles the others together.
That's the one people mix up, right? Part C?
Almost every time. It trips folks up because you know hospital, doctors, drugs, but Part C being the combo plan is its own thing. And if you don't understand what you have, you can't really use it well.
Then David asked who had actually read their Annual Notice of Change. The letter that comes every fall from your plan.
His count was two and a half people. The room laughed, but it's not really a laughing matter.
Two and a half! I love that he said two and a half. Someone was halfway through it, I guess.
Probably fell asleep on page three. But here's what Ian Schaeffer pointed out in the piece: that letter tells you what changed on paper. It does not tell you what next year is going to feel like when you actually go fill a prescription or call your doctor.
That distinction matters so much. Like, the letter might say your copay went from ten dollars to twelve, but if your specific drug got moved to a different tier, that's a completely different story.
And that brings us to the number that stopped the whole room. Nine hundred seventy-two thousand dollars.
Okay wait. In drug costs?
That's what the system spit out for one client's prescription list. Before anyone had looked carefully at it.
Almost a million dollars in prescriptions.
Not real. Not even close to real. But the system showed it because the drugs she'd typed in weren't quite the drugs she actually takes. Ian Schaeffer mentioned one specific mix-up: capsule versus tablet. Same medication, different form, and the system treated it as a completely different drug.
A capsule versus a tablet. That's it. That's the whole error.
And it took David and Jason, two hours, to sort through which drugs she actually takes and which doctors she actually sees. Once they got it right, the number came back down to something normal, and she was happy to keep her current plan.
So two hours of professional time saved her from potentially switching plans over a fake million-dollar drug bill.
David's exact line was, it took two hours of people that do this for a living. Which I think is the whole argument for not doing this alone.
You know what this reminds me of? Doing your own taxes. You feel totally confident, and then someone who does it for a living takes one look and finds three things you missed. Same idea. Confidence is not the same as accuracy.
And with Medicare the stakes are higher than a tax refund.
Significantly. Okay so they also had a secret guest at this event, someone who spent their career on the health plan side. Like, inside the insurance industry.
Which is rare. That's the view you almost never get. This person walked the room through how a plan actually gets built each year: the framework the government sets, how networks get put together, the decisions about what goes in and what gets cut.
I have genuinely always wondered who decides that. Like who sits in a room and says, we're covering this but not that.
Everyone in that room got the inside view. That's the fun of being there in person.
And the next Fiscal Fridays is November 20, back in their Scottsdale studio. Ian Schaeffer mentions seats are limited. So if you're in the area and curious, keep an eye out for how to save a seat.
Alright, so the part of the article I really want to dig into is the scenario round. They gave each panelist 30 seconds to answer, and if you ran long, there was a spray bottle waiting.
Like for a cat.
Like for a cat. And some came closer than others to staying in bounds.
I respect the spray bottle approach to time management. So what were the scenarios?
Three that Ian Schaeffer highlighted. First one: a man at a barbecue says his Medicare plan costs nothing.
Oh, we've all met that guy.
Kyle Jacobs pointed out what he forgot: his Part B premium. If you get Social Security, it comes straight out of your check automatically. So it doesn't feel like you're paying it.
It's like when you set up autopay for something and then six months later you're like, wait, I'm still on the hook for that?
Exactly. Out of sight, out of mind. But you're still paying it. It's just invisible.
The second scenario is the one I want to talk about because it genuinely surprised me. The couple married 38 years. She takes seven prescriptions, sees three specialists. He takes one pill. Do they need the same plan?
And the answer is no, not necessarily. Because Medicare coverage is individual. There is no family plan.
Wait, really? I think a lot of people assume it works like employer insurance where you have a family option.
It doesn't. Each person has their own Medicare. And when they asked Jason Tweet whether he'd ever put a husband and wife on different plans, he said yes, immediately, and the room laughed because it sounds counterintuitive but it makes complete sense.
When you think about it, she's managing seven drugs and three specialists. That plan needs to be built around her situation. His situation is completely different.
Same house, same breakfast table, but their coverage needs aren't even close. And putting them both on the same plan because it's simpler could cost one of them real money.
Or leave them without the doctors they need in their network. Okay, third scenario. This one involves a rental property.
This is the one that I think blindsides the most people. A couple sells it in 2026. Two years later, their Medicare premiums jump, and they have no idea why.
Because it happened so long before the bill shows up. They've probably forgotten all about it by then.
Kyle Jacobs explained IRMAA at the event. It's the income-related surcharge on Part B and Part D. And the key thing is it looks back at your income from two years prior. So one big year, a property sale, a business transaction, whatever it is, can show up on your Medicare bill much later.
So it's like a delayed bill from a party you had two years ago.
That's a good way to put it. And according to the article, it can drop back off when your income comes back down. But if you don't know IRMAA exists, that premium jump looks like a mistake or some kind of glitch.
When it's actually the system working exactly as designed, just with a two-year lag that nobody warned you about.
The specific rules around how IRMAA gets calculated and whether you can appeal it in certain situations, that's something I'd genuinely put on a list to ask one of our advisors at American Retirement Advisors. Because the mechanics matter and I wouldn't want to guess at them.
That's a fair point. It's one of those things where knowing it exists is step one, and then understanding how it applies to your specific situation is a whole separate conversation.
And a worthwhile one to have before you sell something, not after.
That's always the better way to do it. Okay, so David brought it home at the end with this image that I thought was really good. Medicare is one room in your house.
And your income is in there too. Your plan for passing things on to your family is in there. All of it connected.
So you can't just renovate the kitchen and ignore the fact that the roof might need work. It's all one structure.
Which is why the article says it makes sense to give every room a spring cleaning once a year. Review the whole thing, not just the part that's bothering you right now.
And the practical deadline for the Medicare piece of that is the Annual Enrollment Period, October 15 through December 7.
David's line at the end of the event was, please don't call on that last day thinking we have magic pills. Which, fair.
Ha! I mean, December 7 is the last day. If you call that day, your options are significantly narrowed.
You want to be in the conversation in October, not sprinting to the finish line at the last minute.
And if you want help getting that review on the calendar, the number Ian Schaeffer included in the article is 602-281-3898. You can call that and set something up now, before the enrollment window gets busy.
The other thing I want to name is that the scenarios we talked about, the barbecue guy, the couple on different plans, the IRMAA surprise, those aren't edge cases. Those are things happening to regular people all the time.
The barbecue guy is at every barbecue.
Yeah, pretty much all of them.
And he's very confident.
Always. The confidence is part of the problem.
So whether you're that person, or you're sitting next to that person at the cookout, this is the kind of stuff that's worth knowing.
And that goes double if your plan felt fine last year, because the drugs it covers, the doctors in the network, the premium, all of that can shift. That's what the Annual Notice of Change is supposed to tell you, but as we established, almost nobody reads it.
Two and a half people.
Two and a half. Heroes, all of them.
If you want to read Ian Schaeffer's full recap of the event, it's worth a few minutes. He covers a bit more detail on some of these scenarios, and there's more context on the secret guest and what they shared about how plans actually get built.
And if the Fiscal Fridays format sounds like something you'd want to experience in person, November 20 in Scottsdale. Keep an eye out for how to grab a seat.
Sit in the front row. That's where the action is.
At minimum you'll know all four parts of Medicare, which puts you ahead of most people at most barbecues.
And on that note, if this conversation made you realize there's a room in your house you haven't looked at in a while, sit down with someone who does this for a living. That's what the team at American Retirement Advisors is there for. Call 602-281-3898, get it on the calendar, and don't wait until December 7. We'll see you next time.