In this episode of The Amber Stitt Show, host Amber Stitt welcomes Diane Poythress, founder of Biltmore Health Insurance Solutions, to discuss the hot topic of Medicare and insurance planning solutions.
Diane shares her own journey of how she got into the health insurance industry and highlights the need for expert guidance when it comes to navigating the Medicare network.
Join Amber and Diane as they explore the importance of planning for the future, having open conversations about insurance, and finding solutions to meet your specific needs.
Don't miss this insightful episode packed with valuable information for all ages. So get ready to gain valuable insights and inspiration from Diane as we explore the pathways of peak performance and resilience in life.
Let's dive in!
To learn more about Diane, or to contact her please use the following:
Diane Poythress - Advisor/Broker - Biltmore Health Insurance Solutions:
Diane is licensed in these states: AL, AZ, CA, GA, ID, IL, LA, MT, NE, NM, OH, OK, PA, SD, TN, TX, WA, WI, WY
Amber Stitt [00:00:00]:
Welcome to the Amber Stitt show. I am your host, Amber Stitt. And today we welcome the lovely Diane of Biltmore Health Insurance Solutions. Thanks for being with me today, Diane.
Diane Poythress [00:00:11]:
You're so welcome. It's such a pleasure to be here.
Amber Stitt [00:00:13]:
So this is not the first time we were able to podcast together this year, so it's pretty cool that we were on the "Counting On Her" podcast earlier this year. And now you are on The Amber Stitt Show to talk about the hot topic -- 'tis the season for Medicare, among other insurance planning solutions. So, I thought I'd bring the pro in to share a little bit more and kind of take that tension out of the topic because I think a lot of people hear this term Medicare, or some of the risk management tools that we work within. We're trying to kind of get that stigma out of. There are things that you can do, there are some solutions, but you need to be working with an expert. And here you are. So the previous episode on "Counting On Her", we talked a little bit about your story. I would love to talk about it here, too, because on my podcast we talk about Pathways of Peak Performance and we talk about five steps to have resilience in life.
Amber Stitt [00:01:02]:
Really focusing on talents is one of them, and that's really this personal development category that we have, and that's really the core. And I know that you've changed over time, not recently, but there was kind of a drastic change all stemming upon working with your family. So do you mind sharing a little bit about your business today and how you got into it?
Diane Poythress [00:01:21]:
Okay, well, right now it's Biltmore Health Insurance Solutions, and what I offer is I help seniors navigate the Medicare network. How I originally started was I was private duty home healthcare. I was a CNA, and I was working with clients, and my mother was getting ready to retire, so she needed to join Medicare, but she didn't know where to start. And I have found out that that's where a lot of seniors are at this point in time, and confusion is just part of the deal. That's the way I was. I had to go out to different carriers because everybody's a captive agent and so they can't compare plans. So I had to go to each carrier and then I had to gather all the information and then help my mother make the best decision for which plan was going to work best for her. And that took me about four weeks.
Diane Poythress [00:02:02]:
And what I realized is, here I am, younger and should be able to figure things out, but it wasn't that easy. And then you still are wondering and asking questions because if you don't do things by a certain time, there's a penalty or for not enrolling, as well as picking up plans that you should have picked up or making the right decision for the right plan. So I decided to become an advisor for seniors. I saw the need. So once again, now I'm sitting across from people who are retiring. However, somebody younger, their spouse is younger, or they had to adopt their grandkids, as when it was in the opioid epidemic, right? And they needed to be able to afford health insurance for the younger ones because they couldn't work 10, 12 hours anymore. And so that's how I got into the health insurance portion of it. But, yeah, it was from a need.
Amber Stitt [00:02:52]:
Diane Poythress [00:02:52]:
And seeing the questions and the people out there not knowing who to go to, or the questions to ask.
Amber Stitt [00:02:57]:
A couple of things here for the audience. I want to focus on this journey that sometimes we start in some sort of specialty, but then something else, some solution that people can provide can then create this other opportunity for them. And so if there's this wild, crazy idea of some other life outside of the one you know, explore it. It might not be for right now, but we can always either add another path or completely change like you have. I just want to leave that for some inspiration. If there's something that's kind of noodling on your mind and you're not really sure what's happening there, you can create the possibility of another opportunity, especially to help people. And so when we work with WIFS Women in Insurance and Financial Services, as I do some work there too, the board or the group that we work with, we're always talking about this way to maybe even go through entrepreneurship or have some other business opportunities within some other type of employment. And eventually it could turn into a new business model.
Amber Stitt [00:03:49]:
So always pay attention to those feelings that are kind of coming through. You might be onto something. The other part of this is to motivate the younger person out there. There's this time frame when you hit, like, a 40 year old range where I'm at here, and you think, well, I don't need to really pay attention to what's out there. We talk about on the podcast where we're talking about Focusing on Money is step # 2. Focusing on Risk Management is step #3. Risk management could be helping mom go through and work through what's available to you.
Amber Stitt [00:04:19]:
Let's get organized. What's the game plan? And it's not even about products yet. I think anybody that has a family I know, Diane, we've talked about this. It's like, if we have not discussed even the plan of what are we going to do as we age, aging is not something we can say, oh, maybe that's happening. No, we know this happens. This is definite. Like they say, death and taxes is always, like, a certainty. Let's have a nice journey along that aging process.
Amber Stitt [00:04:43]:
And it's having conversations. So I know that you work with your clients to help them in that regard.
Diane Poythress [00:04:48]:
And not just my clients, but my family, I'm telling my girls, "I'm getting older. I'm not getting younger. How about let's take a life insurance policy out on me so you have a guaranteed," "Oh, mom, we don't want to talk about that." And then I even go to my mother and I'm like, if I even sit down, I mean, to open the dialogue. She takes it as an insult. I'm like, no, mom, we're on the same team. Let's start getting a plan. Well, I've been doing this for so long.
Amber Stitt [00:05:14]:
But this is common. This is not abnormal. And I think that's part of the conversation I want to have with people, too. There's always going to be one person, maybe my husband, that is like, "Hey, I'm not going to conjure up this negativity and talk about these bad things because that's just negative." But planning as weird as it sounds, and I mean, I guess other insurance nerds like me would feel the same way. When you plan in advance, it actually feels so good to have that organized life, and it's almost like cleaning out that pantry or the closet and you're like, I purged and did all these things and now I'm ready. It feels really good. But it seems kind of daunting at first, right?
Diane Poythress [00:05:52]:
Especially if they've never been around people to just open the dialogue. That's 99% of the battle. Just open the dialogue. I mean, I didn't want to talk about life insurance because what's life insurance about? It's when you die and somebody else gets it or you leave it. That takes us into the long term care one. The long term care is when they're alive and living, right. It's to help them while they're alive and living and not waiting till they pass. It's money that's there for them to take care of their needs and make it a little bit easier for them.
Diane Poythress [00:06:23]:
Amber Stitt [00:06:23]:
And I think it's like as we go through life, even relationships, marriage, partnerships, children, sometimes we have to work within their communication style. What I mean by this is some of us will just know this is a statistic for this, that or whatever, it might not be received as well. So it's kind of like speaking to this new audience, what are people going to want to hear to help them? But other people might just need more of a softer approach. I might be a little more rigid in mine, and I have to watch that. So this episode, truly, I want people to think about, how can you start that conversation? And so, Diane, I told you, I want to do a little bit of myth busting with what are some common things that people assume about Medicare and like, the Medicaid, Medicare, like, things are covered. I got it. Medicare is going to cover that. So as we're packaging a conversation and we're talking with these other younger people, older people, what would be useful to help them receive it and not be scared about the what ifs, but almost like there are some solutions.
Amber Stitt [00:07:21]:
Let's figure out what those are for you. So can you tell us a little bit about maybe even conversations you have with either family or clients? Where what is the true story behind Medicare covering long term care? There all medical expenses. Let's kind of stop there and put some facts on the table.
Diane Poythress [00:07:36]:
Medicare does not cover long term care. It's medicare only. So if you need somebody to come in and work with you 24 hours a day, medicare does not cover that. So I have clients that they're fall risks and they have to have somebody with them 24 hours a day. That is money. The family has to come in or if they have that set aside and pay for that to keep them in their house. So there's a book called "Medicare and You" and that tells you everything that medicare will pay for. They don't pay for cosmetic, and they typically only pay for diagnostic, not preventive.
Amber Stitt [00:08:10]:
Okay, so stop there for a minute. Let's do a vocabulary diagnostic. Are you talking about blood tests?
Diane Poythress [00:08:15]:
If they're looking for something, okay, let's say they think you might be diabetic, okay. So they'll look at your blood sugar levels and other things, and so that's diagnostic. Now if you go in and say, you know, I'm just not feeling good, can you check for maybe I might have a fungus or a parasite? Can't do that. You have to have symptoms of something that they're looking for.
Amber Stitt [00:08:34]:
Diane Poythress [00:08:35]:
That's called diagnostic.
Amber Stitt [00:08:37]:
So these other things that could be potentially a culprit of a problem are out of pocket or could be? Exactly. Okay. Exactly. So people that have to take care of people that have no plan, that's going to be a big problem in your current plan, what are you working on? How many children are you having? Where do you want to live? One day, your goals could be affected by you not having that conversation with that family member, and that could just derail all your personal choices. So that in itself should be motivation. Not to be like pushy or nagging for that conversation, but really try to find those common grounds of language with your loved one to help say, "Hey, we are all on the same team and we are all trying to get there and have just the best time together that we can." Right?
Diane Poythress [00:09:19]:
You're looking at a family unit as being functional instead of dysfunctional.
Amber Stitt [00:09:25]:
Diane Poythress [00:09:26]:
Which a lot of it normal drama.
Amber Stitt [00:09:28]:
Right. There are still normal things that are going to happen. So people just know, full disclosure, this does not fix all your problems, but it can certainly take some stress out, right? Yeah.
Diane Poythress [00:09:40]:
So let's say a couple, they're already strained and not doing well, and the wife has not been a breadwinner for a long time. How can she open up a conversation with her husband by saying, "Hey, honey, you got this figured out. Yeah, because I'm worried."?
Amber Stitt [00:09:54]:
The other thing, too, is I talk about this in some other things that I write about that I skipped being in this industry, financial services, we'll call it. And I talk a lot with a lot of younger people about it because I did not have the best grades in accounting and math, but yet I'm in financial services. So how is that but I was a paralegal before this life about a decade ago. I love words and contracts and concepts and getting things organized and arranging. Maybe that came from being a first born of seven, but there's this age, 20 to 30, where I thought, I'm not going to be a business owner. I'm not smart enough. I'm not great with numbers.
Amber Stitt [00:10:28]:
These types of things are in our heads. I want to challenge people to think about. Even if you're like me and you're like, "I don't have the financial competence to handle some of these conversations," it doesn't mean you have to literally be running the numbers. You're working with a team like yourself, like a broker that has the independent thought processes, contracts with multiple places, but you still need to ask the questions and do the work so you are on level up and be on the same page, even if you're not the one handling the hard part for you, whatever that is. Some people love the financial aspect, but ask the questions so you are aware that is something that's important. You have to do that work for yourself to then be on the same page. And some people might feel a little insecure, but there's so many resources now. If that feels like it's you, wouldn't you agree that people can truly still stay lost if they're not bringing themselves into the conversation for their own selves?
Diane Poythress [00:11:18]:
And sometimes it's women just don't feel like maybe it's the confidence to ask the questions because the answers they're going to get is, "Honey, maybe you need to go get a job."
Amber Stitt [00:11:28]:
So coming at it with love helps and maybe some persistence. Any helpful tips that you found has worked for some difficult conversations with clients?
Diane Poythress [00:11:37]:
It's having another family member maybe come in and ask some questions. So sometimes it can be good cop, bad cop. That's what I'm doing with my sister right now with my mom. I'm the bad cop because I'm asking the questions and they go to her and then she can say, well, it opens the dialogue between the two of them. The husband is probably more of the dictator and the wife is just trying to make things work. And when he gets asked those questions by another person outside of that unit, it's like I say, it opens dialogue. I don't know how quickly things will move at that point in time, but you just want to get that opened before their cognitive abilities start to decline. Because that's huge.
Diane Poythress [00:12:20]:
And once that happens, it's sad.
Amber Stitt [00:12:23]:
I met with a woman the other day, and she said, "My husband will say no to the long term care plan we were looking at because of the money." But I said, "If I give him data and it could be overwhelming for another person, but if I give him data, will he look at that?" She said, "Yeah." So there's also other resources. It could be a video for one. It could be something to read. But see, what is that person that you care about? How do they tend to enjoy, like, say, reading a hard copy book? Some people just want to listen, maybe come to the with some other resources. And there's a ton out there. We can always link up and provide that, too.
Amber Stitt [00:12:54]:
But that's the point of people have these types of questions. I want them to be reaching out to you, Diane, and we'll get your contact information in the description boxes, but you have gone through this yourself with your mom, but on a different level. Now you're at least a decade from the original. At least a decade. Now you're having the conversation with your sister, but then you're trying to also help your daughters see what's possible. And it is a lot of work, but alternatively, it could be a lot harder if we don't even start it.
Diane Poythress [00:13:21]:
I would feel terrible if I just at least didn't even open up the conversation with them, because they need to be exposed to it. Now, granted, they're going to go do their on research, unlike my mother. She doesn't even have a computer. I mean, I'm lucky if I can get her on a mobile phone because she's been hacked so many times now that she won't even touch a computer. And I'm like, mom, the computer is your best your best friend. That's how you do your research. So everything has to be in a hard copy. So I print things down off the computer and I send them to her in the mail, and then I call her.
Amber Stitt [00:13:52]:
A couple of days later, early, with some consistency. Like, anything in life has got to be consistent, right?
Diane Poythress [00:13:58]:
Yeah. The only thing is now it's almost to the point to where it's at a crisis point that she needs to move quickly now. And that's just not even in the equation.
Amber Stitt [00:14:07]:
So that's where I say, take action today a lot on the show, and it can seem a little cheesy. Little action items before crisis mode is the goal. So if you're thinking that I'm 30 and I don't need to think about this, we have to look at even using yourself. So if you do your initial audit for your own life, then you can go, "Okay, what does mom and dad have?" Or another whoever it might be that could need some help, that might be calling you, you can even just start with yourself to see, what would I need? And even if you're not doing everything right now, that can help you audit your life and say, okay, that other person that I love who's not tech savvy is probably doing none of this. And that's where you could start even using yourself to figure out what the other person might need, that could be helpful. Diane, how can people find you to contact you if they do have some questions? And it's strictly Arizona, is that correct?
Diane Poythress [00:14:55]:
No, I'm in about eleven other states also.
Amber Stitt [00:14:58]:
You might have told me that. Okay, so let's put that in the description box and contact information for you and to wrap this up today and give people kind of some other little nuggets to think about. We talked about how Medicare does not cover long term care the way we think it does. Medicaid is something different and thinking like pharmacy benefits. So is there any other little tips to say, "Hey, here's what I help you with and here's what..." Like some of those common misunderstandings when you meet people, because I want to kind of leave that takeaway to say, if this is you and you're trending on these thought processes, give Diane a call. Okay.
Diane Poythress [00:15:33]:
When it comes to Medicare, most people think the Medicare Advantage plans are zero cost. They are zero monthly premium. Traditionally, a lot of counties, especially Maricopa, have zero cost premiums. However, you'll have copays and deductibles to pay along the way. A Medicare supplement plan is you stay with original Medicare and you pick up a supplement plan to fill in the gaps.
Amber Stitt [00:15:58]:
Diane Poythress [00:15:58]:
As well as you'll need to pick up a prescription drug plan. The minimum in Maricopa right now there are $6.70. So it depends on your prescriptions is going to tell you what plan you're going to be needing. So there's a couple of different ways for people to go. It's just your lifestyle and it's your health that's going to dictate which plan is going to work best for you.
Amber Stitt [00:16:19]:
And that's where people can have you help them, right?
Diane Poythress [00:16:22]:
Amber Stitt [00:16:23]:
Wonderful. So hopefully this episode was a little enlightening to say, hey, there are so many resources, we have people in place to connect you with if you need some help to start those conversations early. This is the best thing you can do. I'm going to let people know where the "Counting On Her" podcast is with you, too, because we talked more about your journey during that one as well. So thank you so much for being here, Diane.
Diane Poythress [00:16:42]:
Well, thank you, Amber, for having me. It was such a pleasure. I'm so honored.
Amber Stitt [00:16:46]:
We'll see you soon at the next event too, right? Oh, absolutely. Thank you so much. Thanks to the listeners. We'll see you soon.
Diane Poythress [00:16:51]:
Thank you. Bye now.