✅ Medicare and You Guide Book – Medicare Overview

I’m gonna go through the Medicare & you guidebook 2019 and this is every piece of Medicare that you need to know so whether you’re coming into Medicare at age 65 you’re retiring you’re already past 65 lots of questions lots of answer so I’m gonna go through it right now stay tuned okay we are going to go through the entire Medicare and you 2019 guidebook this comes straight from the horse’s mouth center of Medicare Services put this out every year has pretty much every piece of Medicare covered so we’re gonna discuss it and I’m gonna walk through it with you so that way you’ll have an understanding of what it actually means and you’ll know how it relates to you so that’s what we’re gonna do and if you stick with me I’m gonna show you where to find a lot of other information that you’re gonna need coming into Medicare first thing we need to do is if you do not have this book and Medicare usually sends it out when you’re 65 but if you do not have it you can go right to my website Medicare on video comm if you go up into the top left into the Resource Center it’ll drop down and you want to choose guides and forms and it’s gonna bring you into guides and forms and you can see right here is the Medicare & you guidebook if you click on it it’ll download right onto your computer onto your iPad whatever it may be it’s great to have it just keep it on your iPad so go ahead and download it we’re gonna walk through would pretty much page by page I’ll show you I’ll try and keep up with page numbers and things like that to make it easy as we go so let’s get right into it and if you stick with me at the end I’m gonna show you where to get a lot of other information that you’re gonna need either now or you’re gonna need later so make sure you you know where to find the stuff so in the beginning of this guy it starts off talking about you’re getting a new Medicare card well if you’re coming into Medicare you don’t have a Medicare card yet so you’re gonna likely gonna get the new Medicare card and the biggest difference on the Medicare card it used to have people’s Social Security number on it forever which is obviously ridiculous and so they finally changed it and put a random number which may make it a little more complicated when you need that number to find it but you should get the new card if you don’t get the new card the new card will be right behind it because it’s almost through that whole phase on replacing the old cards so getting started if you’re new to Medicare and again we’re gonna go through this piece by piece I’m gonna kind of jump around a little bit but I’ll try and keep it all together so that you understand it you know you need to learn about your Medicare choices you need to find out how and when you can sign up and if you already have Medicare you don’t need to sign up each year and the Medicare open enrollment period does confuse a lot of folks and I’ll discuss that as we go through the annual election period which comes along in October through December it’s for certain things and we’ll get through that when we get there so you can see here you can mark your calendars with these important dates and again this is primarily related to Medicare Advantage plans and Medicare drug plans so when you come into Medicare you have two different ways you can go you can go Original Medicare with generally with a Medicare supplement plan or you can choose to go Medicare Advantage which kind of rolls everything into one and then you kind of run through an insurance company instead of running through Medicare so I’ll explain all that to you as well so the timelines on this stuff October 1 you start comparing coverage so this is really if you’re on a Medicare Advantage plan because a Medicare supplement plan you can change any time any time you want so there are no time limits on Medicare supplements confusing already I know so Medicare Advantage is an open enrollment period each year so from October 15th to December 7th that’s when if you want to change your Medicare Advantage plan you have to make your choice so you have to make your choice between October 15th and December 7th and then it’s gonna go into effect on January 1st you got to choose way ahead of time but it’s not going to take effect till January 1st and then if you messed it up and you still want to change there’s another period right behind that from January 1st to March 31st which still allows you to change your Medicare Advantage plans so keep that in mind and keep in mind with all this stuff if you get confused that’s what we do is we so you certainly want somebody on your side there’s no cost to use me to help you figure everything out so I’m an independent insurance broker I help people primarily with their Medicare supplement plans but I’m happy to help with all of it now I will show you some URLs that I’ve made that’ll make it easier to do the things that you need to do but let’s talk about the parts of Medicare you have Part A Part B well what they do with Part C there is a Part C I’m not sure why it’s not on this page Part D so Part A it’s it’s not as complicated as it sounds Part A pretty much covers what goes on in the hospital so it’s inpatient medical care Part B

pretty much covers what goes on outside the hospital so how patient medical care doctor’s visits physical therapy things of that nature and Part D is prescription drug coverage so this right here a B and B would be considered Original Medicare Part C is Medicare Advantage which kind of takes you away from Original Medicare and again runs to an insurance company instead of through Medicare so when you have this Original Medicare a B and D you’d probably also have a supplement plan that covers what a and B does not so we’ll also discuss that as we get there so here we go with our two options it’s like I say you kind of have two different roads you can go down you can either stay on Original Medicare or you can go on Medicare Advantage and really the the big difference between them is Original Medicare gives you a little more freedom and flexibility it doesn’t have any networks some doctors or hospitals you go to any doctor any Hospital in the country that takes Medicare Medicare Advantage plans a little more restrictive so you do have a network of doctors you have an in-network type scenario where you choose doctors and hospitals that are in network and if you travel and leave your general area very often they can be a little complicated because your network is generally where you live so it kind of just depends on what you’re more used to so Medicare Advantage has level’s goes from an HMO type environment on up to a PPO type environment and Original Medicare is pretty much a straight out PPO you can give it any doctor or any hospital that accepts medicare so you can see on Original Medicare you have a and B that’s what Original Medicare is you can add a drug plan to it and you can add a supplement to it and I can tell you if you have a BD in a supplement not that expensive and it is it’s super good coverage so it really is almost too good a coverage where your out-of-pocket costs for the year on the medical side is as low as $185 so that’s your max deductible and your max out-of-pocket on the Medicare on the medical side the drug sides a little more convoluted so they’ve kind of made that a more complicated scenario but we’ll talk about that a little bit as well Medicare Advantage plan it depends on which plan you choose really because you can have as much as a $6,600 out-of-pocket on Medicare Advantage plan and they do include some other things like some will include dental some will some will include the cost of your Part B some can have absolutely no premium and you know understand and definitely when you’re looking at that stuff in the back of your mind you understand you get what you pay for so the lower the cost kind of the more restrictive it will be so an HMO type plan may very well have no premium but you’re gonna need to get referrals to go to specialists and it’s going to make you jump through a lot more hoops than you normally would so that’s your first big decision on which Avenue to take so Original Medicare versus Medicare Advantage so you can see as we go down the list of Original Medicare you can go to any doctor that accepts medicare and that’s to me the most advantageous thing is and again I don’t know why they call it Medicare Advantage Medicare Advantage because to me it’s really not an advantage it’s more of a disadvantage because it’s going to take away some of your flexibility so you can see in most cases you’ll need to use doctors who are in the plan you know sometimes an emergency may happen and you can use that network stuff but it gets complicated costs Original Medicare Part B you’re gonna pay your Part B premium which right now is 185 dollars a month on both of these you’re going to pay your Part B premium which is 185 dollars a month so under original Medicare Part B is pretty much 80/20 so that’s going to cover 80% and you’re gonna be responsible for 20% and then if you go into the hospital which it gets into Part A probably on the next page there’s a deductible in the hospital but that’s why you’ll get a Medicare supplement plan to cover what a and B do not so pretty simple so yeah a and B there’s some out-of-pocket expenses on a and B supplement takes care of those out-of-pocket expenses there’s no yearly limit on what you pay out-of-pocket but it is limited so there’s really it’s pretty black and white you don’t have an open hole as long as you have a supplement if you didn’t have a supplement then that 20% does not have a stop on you can buy supplemental coverage to help pay for your out-of-pocket costs like your deductible in your 20% on Medicare Advantage you got a pretty much go to the doctors that are in network out-of-pocket costs vary and again they have different levels and it will be based on how much they charge in premium for the most part on what your out-of-pocket costs may be you may pay a premium for the plan some have no plan premium so again just keep in the back of your mind get what you

pay for so if you go into a very low cost Medicare Advantage plan you know just be prepared that you understand exactly what you’re getting into plans have a yearly limit on what you pay out-of-pocket some of it can be pretty hot so you need to understand that as well when you’re looking specifically at a Medicare Advantage plan what is my maximum out-of-pocket each year and you can’t buy or use separate supplement coverage but some plans have lower out-of-pocket costs and Original Medicare so you can’t put these two together you’ll pick it in one or the other as you go so again that’s your first choice Original Medicare Medicare Advantage so coverage original medicare covers pretty much medical insurance kind of stuff so if it’s medically necessary and your doctor says is medically necessary pretty much I don’t I don’t hear too many people complaining about Medicare not covering something that would be standard medical coverage you can join a separate Medicare prescription drug plan now I do hear people complain about that sometimes because the drug plan is a little crazy it has different levels of benefit when you have it and you need to understand especially if you take a lot of prescription drugs you need to understand how to do it and with drug plans they’re not standardized like Medicare supplement plans so they’re completely different from each other so generally I find it best to do it yourself to find and Medicare has a very good tool you put in your prescriptions and it tells you what the best drug plan is in your zip code and I have a video that walks you right through it you can go to drug plan video comm if you get a drug plan video comm brings up the video where I’ll walk you right through on Medicare sites show you how to find the best drug plan and really what that does is it makes it so that there’s not somebody selling you a drug plan that may not be the best drug plan for you gives you the ability to make sure that you get the right one for your situation Medicare Advantage they can cover prescription drugs and Medicare Advantage sometimes you know it depends on the plan and whether it’s on tier one or two T or tier two tier three if it’s in their formulary or not in their formulary so it takes some real homework to make sure if you take a lot of prescription drugs and you’re gonna go Medicare Advantage that you get the right Medicare advance all most like picking a drum plan you got to pick it within your Medicare Advantage plan so looking down at the bottom here for travel this is a pretty big deal so with Original Medicare it generally does not cover care outside of the US however medicare supplement plans do they will give you a fixed benefit for out of country coverage on Medicare Advantage you really don’t have that option it does not cover care outside of the US so if you’re on you know retired and you’re traveling and you’re in Mexico or Europe or Ireland or wherever you may be and your problem it can be a real problem so with Original Medicare if you have a supplement you got a pretty healthy amount that is covered so that in your favor Medicare Advantage you’d probably looking to buy some kind of international health insurance which can also kind of complicate things as you go along so topics as we go through and you can see there’s a lot of pages here when I go through every single page but we’re gonna just kind of breeze over some of them but we’re gonna get specific on a lot of them so we want to make sure we understand that so signing up for Medicare some people get Part A or Part B automatically now I’m gonna just kind of paraphrase what things say here and tell you how it is if you are currently drawing Social Security so if you took Social Security starting at age 62 and you’re now turning age 65 your Part A is going to start on the first of the month that you turn 65 your Part B is also going to start on the first of the month that you turn 65 they’re gonna send you a postcard saying unless you tell us not to we’re going to start your Part B on the first of the month that you turn 65 and the reason for that is if you already do on Social Security they assume you’re not working that you’re already retired so your Part B is going to start at the first of the month of age 65 now if you are not drawing Social Security if you have not elected to take it when you turn 65 your Part A is going to start automatically so Part A starts automatically and then Part B you need to initiate so you need to get online or call Social Security and that’s one of the other kind of crazy things you got to do all this through Social Security not through Medicare and I have a length it makes it easy for you to do that so if you need to sign up for Part B you can simply go to www.uwec.edu/career Saul done in so do it three months before you’re going

to turn 65 two months it’s the latest before you turn 65 get it done get it in place get it over with and just you know make sure it’s easy and that’s what we look to do is keep things simple if you need help give me a call so I me an email will walk you’re right food it’s really pretty easy to do but you got to do it so that’s that’s kind of getting it going and I’d give people all the time that missed their time line when you miss your time line it’s a big deal it is a big deal cuz you will then be delayed and you may not have any health insurance for as many as three or four months so get it done early and get it done when you’re supposed to do it and we’re happy to help you do that some people have to sign up for a and B like I just said it’s going to tell you it’s a little different if you work for the railroad so if you want to read through there if you do work for the railroad for some reason they separate out if someone has end-stage renal disease it’s a little more specific in that situation or if you live in Puerto Rico or if you get benefits from Social Security or the railroad board so you’re welcome to look through that if you have any questions on that just let me know if you’re not automatically enrolled when can you sign up and it’s called your initial enrollment period so you can sign up three months before you turn 65 the month that you turn 65 or three months after you are 65 but do not wait till after you turn 65 it gets complicated you need to do it within those three months before you turn 65 and then it just works super easy super simple special enrollment periods there are some different scenarios that will give you other rights to do it but again gets a little complicated and takes a little more personal attention so if you feel you were in that scenario give a call we’re happy to help you with that Cobra and this is this is important so if you’re still working so understand this and are probably covered later but let’s talk about it now if you are still working and you’re aged 65 and you have terrific health insurance at work so you don’t want to go into Medicare because you’re gonna continue working you’re gonna keep your health insurance so what you want to have happen is your Part A is gonna start automatically on the first of the month of your 65th birthday no big deal but you do not want Part B to start while you are still working while you still have group coverage and why that is so we understand it so when you turn 65 and you come into Medicare it gives you an open window to pick anything you want without any questions you can choose anything you want once you’re in Medicare that goes away you have to go through medical underwriting in order to choose things so if you are continuing to work and let’s say you work age 68 or 72 when you retire your Part B will then start and when you Part B starts it’s just like you’re turning 65 so you will then have an open window to choose anything you want without any medical questions and you can put things in place exactly the way you want to do it if for some reason you stay at work and you stand your group plan and you started your Part B number one you’re gonna pay one hundred and thirty five dollars a month for no benefit because it’s not going to help you if you’re staying at work if you started it then it’s gonna close that window down the road now it is different and again we throwing all these caveats as we go if you work for an employer that has less than 20 employees that’s a different scenario where Medicare then becomes the primary so if you were in an employer less than 20 employees you do want to come into Medicare because it’s gonna be your primary right when you turn 65 regardless so keep that in mind and again just give us a call send an email we’ll walk you right through it we’ll make sure everything gets done exactly the way it’s supposed to be so that kind of gives you a pretty good idea and then what people don’t understand also is continuing to work or staying on your group plan and then five years later you start your Part B just like you’re turning 65 that’s great there’s no penalties as long as you can show you had credible coverage before so your employer group plan as long as you get credible coverage then your Part B starts just like you turned 65 now what folks don’t understand and I don’t really understand it either his Cobra coverage does not count as credible coverage we tire read coverage does not count as credible coverage so let’s say you retired at age 64 and you got on your company’s retirement health insurance benefits and you liked it so you keep it up to leave 68 well that’s not credible courage for Part B so when you’re ready to come into Medicare and start your Part B there’s going to be a penalty so you need to understand that as well so only while you’re still working on a regular group insurance plan can you extend it past age 65 without a penalty

on your Part B hope that clears that up so different scenarios with marketplace coverage and health savings accounts and how savings accounts can be complicated as well because the rule is you can’t contribute to your HSA once your Medicare coverage begins however you may use the money that’s in there after you enroll so once you start your Medicare you can’t contribute to a health savings account any longer but you can still obviously whatever you’ve built up in there over the years use it you can see here we’re now on page 19 of the book so if you fall behind you want to see where we’re going I put the page number up there every once in a while to kind of keep us on track so how does my other insurance work with Medicare and here we go I just explained all that so you know this is the page that goes through it if you have 20 or more employees if you have 20 or less employees and kind of the way that I just explained it is the way that you want to approach it but it’s really not that complicated but you got to do it within the parameters or else it will be complicated so here are some facts to remember the insurance that pays first pays updating the limits of its coverage the insurance and pays second only pays if there are costs the primary insurer didn’t code so that’s if you’re over 20 employees under 20 employees and one of you max out our view it would take a real catastrophic event for that to happen not likely to happen now when we have these little blue arrows that say important we want to read them so let’s see what this one says if you have Medicare Part A including coverage in a Medicare Advantage plan you meet the requirement for having health coverage you have to report this on your federal income tax and they’re going to tell you got to pay income tax on your Medicare premium that you’re getting on party how much does Part A cost usually most people do not pay for Medicare Part A so if you’ve been working all your life and you’ve been taxes all your life you’re covered under your party now if that’s not the case you may need to buy part a if you have not been working for your entire life or your spouse has now been working or whatever the scenario may be then you may have to buy into Part A and people have to buy part a will pay up to four hundred and thirty seven dollars a month for their part a coverage so that kind of takes care of that on when to do it so how much does Part B coverage cost and this one you need to understand so the standard Part B premium is one hundred thirty-five dollars and fifty cents in 2019 so it’s gonna cost one hundred thirty-five dollars and fifty cents a month if you’re already drawing Social Security it’s gonna come out of your social security check makes it easy to do like not be happy about it but it makes it easy to do if you are not drawing Social Security they’re gonna send you a bill and they’re gonna send you a quarterly bill so you’re gonna have to pay three months at a time of your 135 fifty now the 135 fifty is the base amount this is an income-driven premium amount so if you make more than X amount of dollars you’re gonna pay more for your Medicare Part B and I do have a video on that specifically and I just did one recently for 2019 and it’s called herma and just look through my videos on the site type in homeland or bring up that video if you make more than believe it’s $85 single or one hundred and seventy dollars joint that premium is gonna go up and it can go up significantly you can go up to four hundred and change a month depending upon your income and its income from two years ago so you need to understand that so make sure you watch that video if you are a high earner and you might have to pay more for your Medicare what is the part be late enrollment penalty that’s when you miss your deadline and you don’t sign up for your Part B when you’re supposed to sign up for your Part B and then you want to sign up for it later it’s gonna cause significant Lemoore so let’s make sure that we do it when we’re supposed to do it and again I just talked about how you’re gonna pay the premium if you draw so security comes out of your check if you’re not they’re going to Billy you quarterly for your Medicare Part B okay page 25 find out if Medicare covers your test service or item what services does medicare cover and and again it’s pretty typical health insurance if you’re old health insurance covered in Medicare is probably gonna cover it Medicare might even cover it better Medicare really really is a very good health insurance plan you were likely gonna be thrilled to death with your Medicare as long as they don’t change it next year the year after the year after as long as it stays where it is right now it’s terrific stuff and you will find that as you go I have literally thousands of clients and if I get to customer service phone calls in a month that’s a lot lower I don’t think I get to in a month so it’s wonderful on my side wonderful on your side and just as long as you set it up right then you’re gonna just go off without any troubles

whatsoever so we just got to make sure we get it set up right so what do I pay for Part A we just talked about that oh these are for the services and you can go through this you know it’s in the book if you downloaded it you’re welcome to look through this individually and talks about some of the different things that are covered and it goes through a whole list of different things and hospital inpatient care let’s talk about that real quick so this would fall under Medicare Part A if you’re on Original Medicare and you’re admitted into the hospital inpatient care is going to fall under Part A and with Part A you have a deductible of thirteen hundred and sixty four dollars so it’s pretty big deductible if you’re admitted into the hospital now if you have a Medicare supplement plan most likely it’s gonna cover that entire deductible so it won’t cost you a nickel out of pocket to go into the hospital it’s going to cover the entire thirteen hundred sixty four dollars and it runs on a benefit period so you can have more than one deductible during the year and if you go in if you’re admitted in the hospital multiple times you can have multiple deductibles but again your supplement would cover them each time assuming that you have a supplement so there’s some other charges that if you’re in the hospital for extended period of time but also your supplement would cover that as well so am i inpatient or outpatient this is a big deal and they’ve changed this recently really not in your favor and this is one of the one of the rare instances where you can have some some not happy moments with Medicare is whether you’re inpatient or outpatient a hospital so I’ve had somebody before that broke their arm went to the hospital and was in the hospital for three days so through two nights and three days they were in the hospital and they were listed as observation not inpatient and when you were listed as observation it limits you on some other scenarios number one skilled nursing so Medicare won’t cover skilled nursing unless you’ve been in patient in the hospital so if they put you in as observation and then and this poor lady needed to go to skilled nursing for some rehab I think for two weeks after and it was costing $350 a day for the rehab in the skilled nursing so just to understand if you’re in the hospital understand if you’re inpatient or observation and then outpatient is completely different so outpatient is Medicare Part B where that covers all these stuff outside the hospital regardless of whether it’s outpatient surgery or doctor’s visits physical therapy things of that nature some other stuff in here in skilled nursing facility care let’s talk about that real quick Medicare is not designed for long-term care Medicare is not a long-term care policy Medicare will pay X amount of days on skilled nursing and you can see here you pay nothing for the first 20 days of skilled nursing coinsurance of 170 54 days 21 to 100 so you can pay one hundred and seventy one fifty cents up to day 100 and then all cost after day 100 in that benefit period so the maximum amount they’re gonna pay for anything is up to a hundred days the only going to pay a hundred percent for the first 20 days so big deal to understand that as well and to absolutely understand that it is not a long-term care policy so if you have run into or have a relative that is in need of nursing home care for whatever it may be Medicare is not gonna pay for it for a long term so you need to make other arrangements for that type scenario what does Part B cover and again medically necessary stuff outside the hospital for the most part what do I pay for my Part B it’s gonna start at that $135 a month premium and then it can go up from there based on your income and then Part B has a $185 deductible in 2019 so when you go to use it January to January $185 deductible you’re gonna pay the first hundred eighty-five dollars then Part B is gonna pay 80 percent you’re gonna be responsible for 20 percent if you have a Medicare supplement plan it’s likely going to cover that 20 percent it’s not likely gonna cover the hundred eighty-five dollar deductible which is no big deal who has a hundred eighty five dollar deductible now so if we have a hundred eighty-five dollar deductible and then pretty much a hundred percent coverage after that that is terrific health insurance without a doubt so some of the Part B covered services and again you’re welcome to go through that stuff and I don’t think I put all the pages in here but it’s all listed in there for you and we’ve talked about travel and kind of how that works Urgent Care medicare covers originally needed care you know wherever you are pretty much and it’s gonna cover your regardless on Original Medicare because you can go to any doctor any Hospital in the country medicare has preventive services that they cover without any cost whatsoever

which is good stuff so you want to make sure you understand that as well you have a yearly wellness visit now don’t confuse that with a physical a wellness visit is not a physical it is simply a wellness visit your doctor absolutely should be Oh to help you differentiate with the things that Medicare does cover Medicare doesn’t cover a hundred percent kind of thing and then what’s not covered by Part A and Part B most people don’t necessarily understand that Medicare does not cover dental does not cover eye exams dentures cosmetic surgery massage therapy acupuncture hearing aids long-term care concierge care and you know a lot of that’s on regular health insurance but dental care and hearing aids are kind of some of the two big ones it does cover it says eye exams but it absolutely covers cataract surgery a lot of people wait till they get to Medicare and then go get their cataract surgery done immediately after their Medicare it usually works out terrific but dental care if you have had a history of needing dental care in the past you absolutely want to look into some dental care and then We certainly have that available it’s pretty simple and pretty easy and not terribly expensive so it can be a good thing to have paint for a long-term care you know it does not cover it under Medicare so Original Medicare how does Original Medicare work and again pretty simple pretty open pretty easy can I get my health care from any doctor or other health care provider or Hospital yes cause they accept Medicare yes or prescription drugs covered no so you need to get a Medicare drug plan to cover prescription drugs do I need to choose a primary care no do I have to get a referral no should I get a supplement policy yes you really should now there are some that don’t but you know my feeling with a Medicare supplement policy and you know having an Original Medicare with a thirteen hundred dollar deductible in the hospital eighty twenty care that’s not too bad that’s pretty good coverage the problem is on the 80/20 the 20 has no stop so if you have just a normal year and you had a thousand dollars in medical expenses and you had to pay $200 for the 20% no big deal but if you have $100,000 a year and you got to pay 20% or god forbid you have a million dollar a year and you’re on the hook for 20% that’s why you need to have a supplement because it just puts everything crystal clear and you’re gonna be retiring and doing other fun things you don’t want to be worried about medical expenses and a supplement can be anywhere from $80 a month one hundred and fifty dollars a month so not usually much more than that so it’s pretty easy to have and pretty simple and again you need to get it when you first come in because you don’t have to answering medical questions later you would have to answer medical questions so what do I pay you got a pocket costs in Original Medicare depend on whether you know whether you have Part A and Part B of course you would have both whether your doctor accepts medicare assignment that’s a little different thing we’ll talk about it in a minute the difference between a doctor taking Medicare assignment and a doctor that just takes Medicare there is a difference there whether you have other health insurance so forth and so on so it’s really just kind of questions on what you have or what you don’t have and then you can get your Medicare summary notices by email makes it easy so you’ll get kind of an explanation of benefits when you go to the doctor you can see with the doctor billed you can see what Medicare paid you can see what your supplement paid so forth and so on what is assignment so assignment means if you go to a doctor and they take Medicare assignment then they agree to accept what Medicare is going to pay them as payment in full if you go to a doctor that just accepts medicare and does not take assignment then they take what Medicare pays them and they can then bill you 15% or up to 15% more than what Medicare pays them it’s generally not a big deal but certainly it could be in a in kind of a severe situation but a lot of supplement plans cover what’s called Medicare excess charges so that is what that would be as Medicare excess charges if they do not take assignment so you can go into a doctor’s office and ask at the front desk do you take Medicare assignment and they don’t know they think they do they might they’ll confuse it with Medicare Advantage and maybe say no and so they don’t always necessarily know themselves because it’s pretty complicated at the doctor’s office as well with all the different kinds of insurer they deal with so you know you need to understand and you kind of hope you get a clear answer on whether they take Medicare assignment it’s a high percentage that do 96% I believe take Medicare assignments would be pretty hard to find one that did not take

Medicare assignment but it’s certainly possible so Medicare Advantage plans and other options what are Medicare Advantage plans and again it’s like an HMO or a PPO where it takes you out of Original Medicare and kind of runs you through an insurance company whether it’s United Healthcare whether it’s Edna whether it’s Humana you kind of go under their control and follow their rules although Medicare does require that they follow a lot of Medicare rules but it just kind of limits your flexibility and your freedom within the plan so certainly something you want to give a lot of understanding to and a lot of thought about how much money you might save and generally they can look really good on the outside and maybe not be so good on the inside if you do some google review search generally dissatisfaction is almost all a medicare advantage almost no no Medicare supplement so that kind of speaks volumes right there people are very happy making their own decisions versus having to be in a situation where they have to ask permission sometimes to do the things that they’re wanting to do so you can see here the different types of Medicare Advantage plans HMO PPO a private fee-for-service special needs plans and special needs plans are for people that have a very significant ongoing chronic condition like diabetes or something that would require kind of special needs it can work out very well for that HMO point of service so I can get convoluted here especially when you have somebody trying to sell you into one of these and trying to you know make the most money they can by selling you what may not be the best for you but again you get which pay for so the higher the cost probably the better the plan to lower the cost the more restrictive the plan so if you’re looking at something with zero premium that’s giving free dental and free drugs and free fitness memberships and free you know it’s probably not gonna be as rosy as you think it is and it’s great as long as you’re not using it but then when it comes time that you need it then you find out exactly you know where the the troubles may lie so just be careful when you’re when you’re trying to choose Medicare Advantage plans cover all Medicare Part A and Part B services and again you may have to get special permissions for that but it is covered let’s see Medicare Advantage plans must follow Medicare rules so they are required to do certain things but they can also do their own things so just kind of go in with your eyes wide open read the information that you get from your plan and most people you know they read the stuff it’s a marketing piece so it’s gonna all sound really good when they get it and then what else should you know about Medicare Advantage you have Medicare rights and protections and then they give you some outs if you if you join a plan and you hate it as long as it’s the very first time you did it and you started right when you came into Medicare then you can get out of it and a lot of people do that so just but that’s complicated too you need some help doing that prescription drug coverage is usually part of a Medicare Advantage plan so again but it depends on what levels of what they cover them what they don’t cover and how they cover and how much out of pocket and deductible all that kind of stuff if you had an stage renal disease it makes things a little bit different you can read through that as well but that’s kind of the overview on Medicare Advantage your out-of-pocket costs depend on whether you’re playing charges a monthly premium and then your deductible and then really your out-of-pocket maximum make sure you understand your out-of-pocket maximum Original Medicare with a supplement doesn’t have much of an out-of-pocket maximum at all the Medicare Advantage plan can have up to over $6,000 on there not a pocket cost so make sure you understand that types of plans it just discussed that before now I wants to discuss it again so I don’t know why they go over twice HMO PPO private fee-for-service special needs plans Ling can I join or drop a Medicare Advantage plan and again this is during the open enrollment period so if you got into a Medicare Advantage plan and it turned out to be the wrong one or you don’t like it at all during the open enrollment period at the end of each year you can make changes now you can come back to Original Medicare but if you want to get a Medicare supplement at that point you have to go through medical underwriting so you have to be pretty healthy to be able to do that if it was just the wrong Advantage plan and there’s a better Advantage plan you can jump around in between Advantage plans during open enrollment period and that’ll take effect on January 1st the change so you’ve got some flexibility there to kind of move around if things change or if the drug plan changed or if the doctor that you love left the plan

which also happens quite a bit there networks can change quite frequently so gives you the ability to get into a different plan if you want more if you’re healthy you can get back into Original Medicare with a supplement special enrollment periods a little different little more complicated if you’re in a Medicare Advantage plan you move out of the area it gives you some rights to change plans if you plan went out of business it gives you some rights to change plans things of that nature Medicare supplement plans so page 69 in the guide and again medicare supplement it’s pretty simple it’s pretty much a PPO and it’s gonna cover what Medicare doesn’t and it’s whether you take plan G your plan n or Plan F and I have a video best Medicare supplement plan that I explain what I think is the way people should go or at least the choices that they should look at and absolutely you need to watch that video to make sure you understand your Medicare supplement choices but if it were me and I’m coming into Medicare hands down without any doubt whatsoever I’m going Medicare aid B gonna have a drug plan gonna have a Medicare supplement plan and my overall monthly cost for everything is probably probably less than 300 bucks so it’s probably too much change and just depends on what part of the country that you live in as to where it’s going to be on your total cost out of pocket wise so this is the different chart on choices for Medicare supplement plans it’s too complicated it’s too confusing I break it down in the other video best Medicare supplement plan make it much easier to figure out so you know exactly what you’re doing what to know about Medicare supplements you must have a and B just like on on Medicare Advantage so you always have to have a and B you pay the private insurance company a monthly premium and again that premiums anywhere from $80 actually could be lower than that we’re up to $150 it can be a little higher than that if you live in some of the more expensive parts of the country it covers one person so far it’s pretty basic information it’s gonna cover the stuff that your plan doesn’t and just depending upon exactly how much whether you choose plan G or plan n and wind a BA the wind to buy is when you first come into Medicare because again you get one shot at Medicare supplement where you don’t have to answer any questions after that you have to answer questions so you know if you’re super healthy no big deal but if you are not then you’re gonna be where ever you’re gonna be without being able to change so we will make sure we get it right the first time how does Medigap or a supplement work with a Medicare Advantage plan they don’t you cannot use the two together so a Medicare supplement also known as a Medigap does not work with an advantage plan vice versa is the same Medicare prescription drug coverage Part D so if you’re staying in Original Medicare probably getting a supplement probably getting a drug plan drug plans are a little more complicated again I have the video drug plan video com2 the dot town yep drunk playing video comm or walk you through how to get it and how to do it I have another video that shows you kind of how it all functions and you need to understand that as well but again we’ll help you with that so just give us a call and we’ll be happy to walk you through it again we don’t sell it so you’re getting a completely unbiased opinion on the right Medicare plan because we’re not selling it we’re just gonna show you the best one that should work for you so when can I join or drop a drug plan same as Medicare Advantage so a drug plan runs in that open enrollment period so if you take certain drugs now and you got a drug plan and then during the middle of the year your drugs all changed and you’re drunk planted and the right drug plan for the drugs that have changed it then during an open enrollment you can change to a new drug plan so just keep that in my Medicare Advantage Medicare drug plan give you the ability to change at the end of each year so if your situation changes it gives you that ability as well so how do I switch it’s not that complicated you can go from one to another during Medicare open enrollment so if you enroll in a new one it’s gonna pretty much disenroll you from the other one how much will you pay for your drug plan premiums can run as low as $17 a month up to $35 a month depends on when you get it and what deductible you’re choosing and overall coverage and again it’s a little more convoluted so make sure you watch the video or let us help you walk you through it and that way we’ll make sure you get the right one and with drug plans lower premium isn’t always the right way to go so it depends on what drugs you take and how much they’re gonna pay for those drugs you absolutely might want to pay a higher premium to get better coverage for the drugs that you currently take so that’s how it all works here with the monthly premium there’s also in a drug plan called a coverage gap which is more

widely known as the doughnut hole and then catastrophic coverage so it has different levels of coverage there’s like four quadrants where you have starting coverage middle coverage doughnut hole and then catastrophic coverage so again if you take a significant amount of expensive prescription drugs you’re gonna need some assistance figuring out which one is the right way to go so it gives you the example on how a penalty works if you don’t get in the beginning you want it later and again that’s something that you can walk through if you want to do that what drugs are covered goes by different plants so it depends on the formulary and when water or the goal is to find the right formula for what you currently take we obviously can’t see into the future what we’re going to take so let’s get it right now and then if things changed or an open enrollment we can change as well so you can also get refills in the mail you can get mail order all that kind of stuff and part deed doesn’t generally work with other coverages so the drunk plan you get is pretty much gonna be the drug plan that you use and then there’s some other information here on government insurance so forth and so on so getting help with your health and prescription drug costs so if you are lower income or you need help paying for Part B premium or drug plan premium or not a pocket expenses Medicare does have places for you to go you’re welcome to walk right through this this is on page 83 it shows you where to go to find assistance with the out-of-pocket cost and they’re actually pretty good to work with so Medicare is likely might even be the best government-run program that we have they’re actually very helpful very accommodating and the benefits are overall very good the exception might be on the drug plan where it gets a little crazy and you know hopefully they’re working on that now where they’re supposed to start to negotiate drug prices and things of that nature but you know obviously we know we pay much more than just about anywhere else in the world for prescription drugs but Part A Part B supplement plan and a drug plan and you have terrific health insurance really for the rest of your life Medicare Advantage can work as well but you got to understand what you’re getting into and you got to be willing to kind of jump through the hoops to get some extra kind of benefits that you you might not have included with Original Medicare but you can still get on the side without any problem at all so it all works out it’s all relative and again this is one big puzzle that we just got to figure out if you’re turning 65 and you’re coming into Medicare we just got to get it right if you’re going to stay at work number one don’t start your Part B until you’re ready to come into Medicare and then when you do we just got to get it right so just make sure you can send me an email you can give me a call you can visit the site you can see right here you can get a quote for your Medicare supplement coverage and I’ll give you a little overview of the site right now hope you found this helpful and stay tuned I hope you found this video helpful and I’m certainly always happy to help with any questions any issues that arise and they always do so feel free to give me a call or send me an email you’ll certainly want to visit my website I have a tremendous amount of information there for now and in the future so just visit Medicare on video comm right in the middle you’ll see is where you get a quote for a Medicare supplement plan and this is obviously what I do for a living is I help people make sure that we get the right plan at the right price with the right company whichever zip code you’re located in so you certainly want to run a quote on a Medicare supplement plan you can also get a free discount prescription drug card and I get really good feedback on this so you might as well go ahead and download a prescription drug card and it’s likely gonna save you some money at the pharmacy while you’re there you want to go into the Resource Center and the Resource Center tab is gonna drop down and what you’ll find is guides and forms where I have pretty much any piece of information that you need for Medicare right here so if you need something like the employer form where you’re going to retire and you’re coming into Medicare and your employer needs to fill this form out you can download it right on my website and then email it to your HR department get them to fill it out so that you’ll have it when you need it and you can also get a copy of my book so you can download a copy of Medicare made clear and I cover just about every topic in Medicare so it’s great thing to have on your iPad or on your computer whatever it may be for now and again in the future certainly very helpful to have now you’re also in the resource center find the video librarian if you

click on video library takes you right to my youtube channel I have over a hundred videos on pretty much everything Medicare so now we’ve got so many it’s kind of hard to find what you’re looking for but if you’re looking for something specific just use the magnifying glass at the top put in whatever topic you’re looking for and it’ll bring up the videos that relate to that topic so it makes it easy to find exactly what you’re looking for so I’m happy to help with any of it and obviously I’d appreciate it if you allow me to help you with your Medicare supplement plan that’s what keeps this whole thing going and I’m happy to do it and we will make sure that you get it right from the start so I hope you found all this helpful then have a fantastic day