Real Results

Client Success Stories

Real savings from real people. Every case below was handled by a Licensed Medicare Advisor — no call center scripts, no upsells, just the right Medicare plan for the situation.

Cases Highlighted

$12,500+

Combined Annual Savings

Cost to Client

Christopher O'Kieffe

Senior Medicare Advisor

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Veteran — VA + Medicare Coordination

Veteran Thought He Was Disqualified from Medicare Advantage

$1,500+

Est. Annual Savings

A veteran believed he couldn't enroll in a MAPD plan because he never had Part D or dental. He was also afraid of a late enrollment penalty. Chris confirmed his VA benefits counted as creditable drug coverage — meaning no penalty — and enrolled him in a plan with dental, vision, and hearing included. He also walked the client through reporting VA coverage to Medicare to keep his record clean.

Savings Formula

Part D late penalty avoided: ~$36–$60/mo (permanent, cumulative)

Dental/vision/hearing added: ~$50–$80/mo value (was uninsured OOP)

Penalty savings: $36–$60 × 12 = $432–$720/yr (compounds annually)

Benefit value: $50–$80 × 12 = $600–$960/yr

$432 + $600 = $1,032/yr minimum → $1,500+ with avoided OOP dental

Part D late enrollment penalty is 1% of the national base premium per month for every month without creditable coverage. VA coverage prevents this penalty entirely. Dental savings assume routine cleanings, X-rays, and one procedure per year.

Veteran — Prescription Coverage Gap

VA Didn't Cover Key Medications — Client Was Paying Cash

$2,000+

Est. Annual Savings

A veteran relied solely on the VA for prescriptions, but the VA wouldn't cover needed pain management medications. He assumed he was stuck paying out-of-pocket. Chris enrolled him in a MAPD plan with Part D coverage for the drugs the VA wouldn't provide, while keeping VA access for everything else — eliminating the gap entirely.

Savings Formula

OOP pain meds (cash price): ~$200–$400/mo

MAPD Part D copay (Tier 2/3): ~$20–$47/mo

Monthly delta: $200 − $35 avg = ~$165/mo

$165 × 12 = ~$1,980/yr → $2,000+ est. savings

Cash prices for pain management medications vary widely. Estimate assumes mid-range brand/specialty medication. MAPD plan had $0 premium, so no offsetting plan cost.

Medicaid Loss — IRMAA Surcharge

Lost Medicaid After Selling Home — Premiums Spiked

$3,500+

Est. Annual Savings

A client lost Medicaid after selling her house — the proceeds temporarily boosted her assets, triggering full Medicare premiums and IRMAA surcharges. Chris explained exactly why it happened, walked her through the SSA appeal process, and sent her the correct form to document the home sale as a one-time life event so she could get the surcharge reduced.

Savings Formula

Standard Part B (2026): ~$202.90/mo

IRMAA Tier 1 surcharge: +$81.20/mo (based on temp. income spike)

Part D IRMAA: +$14.50/mo

Lost Medicaid MSP: +$202.90/mo (was paying $0 for Part B)

Total surcharge exposure: $81.20 + $14.50 = $95.70/mo IRMAA

If appeal succeeds: IRMAA removed retroactively

$95.70 × 12 = ~$1,148 IRMAA + MSP restoration → $3,500+ total

IRMAA tiers depend on MAGI from two years prior. Home sale proceeds can create a one-year spike that SSA will adjust via Form SSA-44 (Life-Changing Event). MSP restoration depends on state Medicaid re-determination after asset spend-down.

New to Medicare

New Beneficiary Shocked by Medicare Costs vs. Employer Plan

Lower OOP

Net Cost Reduction

Peggy was new to Medicare and frustrated that Part B plus a supplement cost more than her employer plan. Chris reviewed her total cost picture and showed her that while premiums were higher, her actual out-of-pocket exposure was lower under Medicare — and a long-delayed surgery would be easier to get approved. She moved forward with confidence.

Savings Formula

Employer plan: ~$250/mo premium, $5,000–$8,000 OOP max

Medicare + Plan G: ~$202.90/mo + $150 = $352.90/mo premium

Plan G OOP max: $0 after Part B deductible ($283/yr)

Premium difference: +$102.90/mo ($1,235/yr more in premiums)

OOP exposure reduction: −$5,000 to −$8,000/yr

Net benefit: $4,000–$7,000/yr lower worst-case cost

Medicare Supplement Plan G covers all Medicare-approved costs after the annual Part B deductible. For someone needing surgery, this eliminates coinsurance and hospital deductibles that would apply under most employer plans.

TRICARE Coordination

Client Overpaying Because Claims Weren't Going to TRICARE

Immediate

Cost Recovery

A client was overwhelmed by medical bills and couldn't understand why out-of-pocket costs were so high. Chris discovered she had TRICARE but wasn't submitting claims for secondary coverage — none of her bills were being processed through it. He showed her exactly how to submit claims correctly, immediately reducing her financial burden.

Savings Formula

Medicare pays: 80% of approved amount

TRICARE (secondary) pays: remaining 20% coinsurance

Client was paying: full 20% OOP (claims not submitted)

Example: $10,000 in annual claims

20% coinsurance not submitted: $2,000/yr paid OOP

TRICARE secondary filing recovers ~$2,000/yr going forward

TRICARE for Life acts as secondary payer to Medicare, covering most remaining out-of-pocket costs. Savings scale with utilization — higher medical spend means higher recovery.

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