Your Medicare Community - MedicareFAQ: Recent Episodes
MedicareFAQ
This podcast will help beneficiaries understand their options, keep them aware of changes that could impact their coverage, and be better prepared for healthcare costs after retirement.
In 2026, the stakes are higher than in previous years. The federal program that has kept Part D premiums artificially low is ending, which means drug plan costs could rise significantly for 2027. That makes this year's AEP more consequential than most. Below are the six most common and costly mistakes beneficiaries make during the Annual Enrollment Period, along with clear guidance on how to avoid each one.
D-SNPs are offered by private insurance companies (such as UnitedHealthcare, Humana, Aetna, and Centene) that contract with both Medicare and your state's Medicaid program. According to CMS data, D-SNP enrollment has grown by more than 150% over the past five years, making it the fastest-growing segment within Medicare Advantage
Medicare requires that Plan G cover the same benefits regardless of insurer. Pricing, however, is set independently by each company based on their own rating method, claims history, and business strategy. That is why identical coverage can carry very different price tags.
The right question is not simply how much Plan G costs. It is what you receive in exchange for that monthly premium.
Medicare Supplement Plan G is often described as one of the most comprehensive Medicare coverage options available.
That description is accurate. It is also only half the story.
Plan G covers nearly all the out-of-pocket costs left behind by Original Medicare. For people who want predictable healthcare expenses and the freedom to see Medicare-accepting providers nationwide, that can be extremely valuable.
A 2024 federal watchdog report found that when Medicare Advantage enrollees appealed prior authorization denials for Skilled Nursing Facility (SNF) admission, they won 95% of the time.
When an independent reviewer looks at the same cases a plan rejected and reverses the decision nearly every single time, that is not a system working correctly. It is a system producing denials that consistently fail review.
A phone call to schedule your next appointment turns into unexpected news: your doctor no longer accepts your plan. That moment can shake your confidence, especially if you have seen this doctor for years.
This concern comes up often for people turning 65 or reviewing their coverage during enrollment season. Headlines about doctors leaving Medicare only add to the worry.
Understanding what is actually happening can help you compare coverage with a clearer head and fewer surprises.
Every summer, CMS releases its proposed Medicare Physician Fee Schedule for the following year, and the 2027 proposal carries one of the most significant financial signals in recent memory. A $0.56 reduction to the conversion factor would translate to a 2.2% cut for standard physicians and a 2.1% reduction for those participating in Alternative Payment Models (APMs).
Millions of Americans are returning to work after retirement, but most do not realize that going back to work while on Medicare triggers a series of coverage decisions that can be costly if handled incorrectly. This article walks through the three most critical factors every Medicare beneficiary needs to understand before accepting a job offer: how employer size determines which insurance pays first, why cancelling a Medigap plan during employment can leave you uninsurable when you retire again, and how to protect yourself from permanent Part B and Part D penalties when you eventually leave the workforce. Written in plain language with real-world examples, the article gives readers a clear, actionable checklist so they can make informed decisions about their Medicare coverage before — not after — they sign an offer letter.
Medicare beneficiaries can get their Part D late enrollment penalty waived, reduced, or appealed — covering the three main routes: qualifying for Extra Help/LIS, proving you had creditable coverage, and filing a formal appeal if an administrative error caused the delay
Understand the Medicare Advantage Annual Enrollment Period (AEP) for 2027. Learn key dates, what changes you can make, and how to prepare for your healthcare coverage.
Navigating Medicare at 65? Use our step-by-step checklist to avoid penalties, choose the right plan, and ensure comprehensive coverage.
Learn how to apply for Medicare independently of Social Security benefits in 2026. Discover when it makes sense to enroll in Medicare without Social Security.
Uncover 5 common Medicare myths about incontinence coverage for seniors. Learn what Original Medicare covers, what it doesn't, and what to know for 2026.
This episode explains 2026 Medicare premiums for Parts A, B, C, and D. It also covers income-based IRMAA surcharges, late penalties, and tips to manage your healthcare budget
Key advice includes comparing your total annual healthcare costs rather than just looking at monthly premiums, verifying directly with your doctors to ensure they accept the plan, and carefully checking prescription drug coverage tiers. Lastly, it provides guidance on how to safely delay Part B enrollment to avoid late penalties and outlines the steps to take once you officially retire.
This podcast explores how to navigate Medicare alternatives in 2026 without triggering permanent late enrollment penalties. It explains the crucial concept of "creditable coverage" and evaluates various healthcare options—including employer-sponsored plans, Medicare Advantage, COBRA, TRICARE, and VA benefits—to determine which ones allow you to safely delay Medicare enrollment. The episode highlights common enrollment pitfalls to avoid, helping listeners understand how to properly coordinate benefits and protect themselves from lifelong premium surcharges.
We break down the top 10 medicare supplement companies for 2026. Each ranking is based on financial strength, customer satisfaction data, pricing competitiveness, and rate increase history, the factors that matter most when you are choosing coverage you plan to keep for years.
Medicare costs rose again in 2026, and for beneficiaries on fixed incomes, even small changes to premiums and deductibles can shift a carefully planned budget. The Medicare Part B premium alone increased from prior years, the Part D out-of-pocket cap is now fully in effect at $2,100, and income-based surcharges continue to catch people off guard.
Choosing a Medigap plan isn’t just about price. This episode covers the top companies for 2026, why Plan G leads the pack, and how to avoid costly rate increases down the road.
Not sure whether you’ll be automatically enrolled in Medicare or need to sign up yourself? In this episode, we break down the key differences between automatic and manual Medicare enrollment, when you need to apply, and how to avoid costly late enrollment penalties. You’ll also learn why many retirees consider Medicare Supplement plans for stronger financial protection and more predictable healthcare costs.
Medicare Advantage plans often promote extra benefits like dental, vision, hearing, and even Special Supplemental Benefits for the Chronically Ill (SSBCI). But what do these benefits actually cover—and what are the limitations? In this episode, we break down how these extras work, what restrictions may apply, and why many retirees ultimately prefer the financial security and predictable coverage of Medicare Supplement plans.
Trying to understand what you’ll actually pay for healthcare on Medicare? In this episode, we compare the coverage transparency of Medicare Supplement vs. Medicare Advantage and explain why many retirees prefer the financial predictability of Medigap. Learn how clearer benefits, fewer surprise costs, and simpler coverage can make a big difference when planning for healthcare in retirement.
Wondering how the 2026 Medicare Part B annual deductible works? In this episode, we break down what the deductible means, how it affects what you pay for outpatient care and doctor visits, and what to expect in the coming year. Learn how Medicare Supplement plans can help cover these gaps and protect your retirement savings from unexpected medical costs.
Still working and unsure when to enroll in Medicare? In this episode, we explain when you should sign up while covered by employer health insurance, how Medicare coordinates with employer plans, and the key rules that determine who pays first. Learn how making the right enrollment decision—and considering a Medicare Supplement plan—can help protect both your healthcare access and your retirement savings.
Discover exactly how the Medigap free look period protects you. Learn how to test a new Medicare Supplement policy for 30 days without losing your current coverage.
Curious about the Medicare Part B Giveback benefit? In this episode, we explain how this feature works to reduce your monthly Part B premium, who qualifies for it, and the important trade-offs that come with it. Discover why, despite the short-term savings, many retirees find that Medicare Supplement plans provide stronger long-term protection, broader access to care, and more predictable healthcare costs.
Managing a chronic condition on Medicare? In this episode, we explore how Medicare Advantage plans and Special Needs Plans (SNPs) work for individuals with ongoing health conditions, including the limitations and requirements that can affect your care. Discover why many people choose Medicare Supplement plans for greater freedom, broader doctor access, and fewer restrictions when managing their long-term health.
Still working or covered by an employer health plan? In this episode, we break down how Medicare coordinates with employer coverage, including who pays first, when Medicare becomes the primary or secondary payer, and the key enrollment timelines you need to know. Learn how understanding these rules, and considering a Medicare Supplement plan, can help protect your healthcare access and your retirement savings.
Trying to decide between Medicare Supplement and Medicare Advantage? In this episode, we walk you through the key differences and the most important questions to ask before enrolling. Learn how to evaluate costs, provider networks, coverage flexibility, and long-term stability so you can choose the Medicare option that best protects your health and retirement finances.
Are you a veteran trying to choose between Medicare Supplement and Medicare Advantage? In this episode, we break down how each option works alongside your VA benefits. Discover how Medigap plans can offer nationwide doctor access, more predictable healthcare costs, and the freedom to seek care outside the VA system when you need it—giving you greater flexibility and peace of mind in retirement.
Looking for greater peace of mind in retirement? In this episode, we explore why Medicare Supplement plans are designed to provide stability and confidence—offering predictable healthcare costs, nationwide access to doctors and hospitals, and the flexibility to live and travel without network restrictions. Learn how Medigap coverage can help protect both your health and your retirement lifestyle.
Discover the peace of mind that comes with network-free healthcare. In this episode, we explain how Medicare Supplement plans give you the freedom to choose your doctors, specialists, and hospitals nationwide—without the restrictive networks, referrals, or prior authorizations common in many Medicare Advantage plans. Learn how this flexibility can help you maintain control over your healthcare and enjoy greater confidence in retirement.
Concerned about how pre-existing conditions affect your Medicare coverage? In this episode, we explain how Medicare Supplement plans handle pre-existing conditions, including the importance of enrollment timing, your guaranteed issue rights, and when medical underwriting may apply. Learn how making the right decision at the right time can help protect your healthcare access and your retirement savings.
Want access to the best hospitals when it matters most? In this episode, we compare Medicare Supplement vs. Medicare Advantage and explain why many retirees choose Medigap plans for greater medical access, fewer restrictions, and more predictable healthcare costs. Learn how your Medicare choice can impact your ability to receive care at top hospitals and specialists nationwide.
Living in a rural area? A limited provider network can quickly become a major healthcare headache. In this episode, we explain why Medicare Supplement plans often outperform Medicare Advantage for rural residents, offering broader doctor access, fewer restrictions, better flexibility for travel, and more peace of mind when care options are limited.
What happens if you have a medical emergency while on Medicare? In this episode, we compare how Medicare Supplement and Medicare Advantage plans handle emergencies, covering key differences in costs, provider networks, and travel coverage. Learn which option may offer stronger protection for both your health and your finances when the unexpected happens.
Your first Medicare enrollment decision can shape your healthcare access and costs for years to come. In this episode, we explain why your initial choice matters so much, how it affects long-term flexibility and budgeting, and why enrolling in a Medicare Supplement plan early is often the smartest strategy for stable coverage and lasting peace of mind.
Worried about Medicare Advantage claim denials? In this episode, we break down why services get denied, how prior authorization and medical necessity rules work, and what these restrictions can mean for your access to care. Learn why a Medicare Supplement plan may offer a safer, more predictable option for protecting your health and peace of mind.
Looking for long-term stability in your healthcare coverage? In this episode, we explore how Medicare Supplement plans deliver consistent benefits year after year, broad doctor access without network restrictions, and stronger financial protection against rising medical costs. Learn how this reliable coverage can help safeguard both your health and your retirement savings for the years ahead.
Confused by what Medicare Advantage really costs? In this episode, we break down how copays, coinsurance, and deductibles work in 2026, and why these out-of-pocket expenses can add up faster than many retirees expect. Learn how a Medicare Supplement plan may provide more predictable costs and stronger financial protection for your retirement.
Is Medicare’s 20% coinsurance costing you more than you realize? In this episode, we break down how the 20% gap in Original Medicare works—and why there’s no cap on what you could owe in a major medical year. Learn how a Medicare Supplement plan can help shield you from potentially unlimited bills, giving you greater financial protection and peace of mind in retirement.
Many retirees are shocked to learn Medicare doesn’t cover everything. In this episode, we uncover the hidden and unexpected costs that can catch you off guard—like deductibles, coinsurance, excess charges, and common gaps such as dental and vision. Learn what Original Medicare doesn’t cover and how a Medicare Supplement plan can help protect your savings from costly surprise medical bills.
Wondering what Original Medicare doesn’t cover? In this episode, we break down the most common coverage gaps that can lead to expensive out-of-pocket costs—and how Medicare Supplement plans help fill them. Learn about 2026 deductibles, foreign travel emergency benefits, and smart ways to protect your retirement savings with more predictable coverage.
Looking to keep your Medicare Supplement premiums under control? In this episode, we share proven strategies to help you lower your costs—by understanding pricing methods, taking advantage of household discounts, and enrolling at the right time. Learn how small, informed decisions today can lead to long-term savings and more affordable coverage in retirement.
Traveling outside the U.S.? In this episode, we explain how Medicare Supplement plans can help cover foreign travel emergency medical costs—and what Medicare typically won’t pay for overseas. Learn the key differences between Plan G, Plan N, and other Medigap options, so you can travel with confidence while protecting both your health and your wallet.
Discover why the Maximum Out-of-Pocket limit in Medicare Advantage plans may not offer the financial safety you expect. Learn what is covered, what is excluded, and how Medicare Supplement plans can provide better protection for your retirement savings.
Did you know Original Medicare has no annual out-of-pocket maximum? That means there’s technically no limit to what you could pay in a serious medical year. In this episode, we explain why this coverage gap exists, how it can impact your retirement savings, and how a Medicare Supplement plan can help protect you from potentially unlimited medical bills and costly surprises.
Is a Medicare Supplement plan really worth the premium? In this episode, we break down the true price vs. value of Medigap coverage—comparing monthly costs to potential out-of-pocket exposure, long-term savings, and the peace of mind that comes with predictable healthcare expenses. Get the clarity you need to decide if the investment pays off for your retirement.
Are your doctors suddenly leaving your Medicare Advantage network? In this episode, we explain why provider dropouts happen, how losing in-network access can lead to higher costs and disrupted care, and what you can do to protect yourself. Learn how Medicare Supplement plans can offer broader provider access, fewer restrictions, and the peace of mind that comes with true network freedom.
Considering a switch from Medicare Advantage to Original Medicare? In this episode, we break down the key differences between the two, the important enrollment windows you need to know, and how to secure a Medicare Supplement plan for more flexibility, fewer restrictions, and stronger long-term coverage. Tune in to learn the smart steps to make the transition with confidence.
Want to protect your retirement savings from rising healthcare costs? In this episode, we explain how Medicare Supplement plans help shield you from high out-of-pocket expenses with predictable premiums, fewer surprises, and nationwide coverage. Learn why this long-term, stable approach can offer greater value and peace of mind compared to pay-as-you-go Medicare options.
Wondering what really determines the cost of a Medicare Supplement plan? In this episode, we break down the key factors that affect your premiums—from pricing methods and age to health, location, and the timing of your enrollment. Learn smart strategies to control your costs and find the best value for the coverage and peace of mind you deserve. Start exploring your Medicare Supplement options today.
Feeling frustrated with your health plan? In this episode, we reveal the top 10 most common Medicare Advantage complaints—from hidden out-of-pocket costs and denial letters to provider network restrictions and unexpected hassles. Learn why more seniors are turning to Medicare Supplement plans for greater freedom, stability, and peace of mind. Find out which option may be the better fit for your future.
Want to make sure you’re comparing Medicare Supplement quotes the right way? In this episode, we walk you through a simple, step-by-step process to evaluate premiums, pricing methods, and carrier stability—so you can spot the best value, avoid costly surprises, and choose the plan that truly fits your needs.
Concerned about unexpected medical bills in retirement? In this episode, we explain Medicare excess charges—what they are, how much they can cost, and why they catch so many people off guard. Discover how Medicare Supplement Plan G can help protect your finances and provide greater peace of mind. Ready to safeguard your coverage? Get your free quote today.
Feeling overwhelmed by Medicare choices? In this episode, we break down the critical differences between Managed Care (Medicare Advantage) and Patient Choice (Original Medicare + Medicare Supplement). Learn how provider networks, referrals, and prior authorizations can affect your access to care—and your freedom in retirement. Get the clarity you need to choose the coverage that truly fits your lifestyle.
When it comes to Medicare, provider access can matter far more than flashy extra benefits. In this episode, we explore why the freedom to choose your doctors and hospitals is so important—and how Medicare Supplement plans offer fewer restrictions, broader access, and more peace of mind compared to Medicare Advantage. Tune in to learn which option may better protect your healthcare choices in retirement.
Feeling stuck with network limits, unexpected denial letters, or rising out-of-pocket costs? In this episode, we break down the 9 clear warning signs that your Medicare Advantage plan may no longer be meeting your needs. Learn how a Medicare Supplement plan can provide greater flexibility, more predictable expenses, and the peace of mind that comes with true healthcare freedom. Don’t miss this must-hear guide to protecting your coverage and your wallet.
Ever wonder who really decides what care your Medicare Advantage plan will approve? In this episode, we uncover how prior authorization and medical necessity rules can impact your access to treatment—sometimes delaying or denying the care you need. Learn why a Medicare Supplement plan may offer more freedom, fewer restrictions, and greater peace of mind. Ready to explore your options? Get your free quote today.
Is your Medicare plan really protecting you if cancer strikes? In this episode, we break down how Medicare Supplement cancer coverage stacks up against Medicare Advantage, uncovering the real differences in out-of-pocket costs, prior authorization roadblocks, and freedom to choose your doctors. Learn why Medicare Supplement plans can offer stronger, more predictable protection when you need it most.
Discover how Medicare Supplement plans provide complete doctor freedom nationwide. Learn why Medicare Supplement insurance offers no networks, no referrals, and access to any doctor who accepts Medicare.
Discover why Medicare Supplement is the most transparent Medicare option. Learn how standardized benefits, clear pricing, and nationwide access eliminate insurance confusion and hidden costs.
Tired of jumping through hoops just to get the care you deserve? In this episode, we break down how Medicare Supplement plans can help you sidestep prior authorization headaches, so you can avoid delays, reduce stress, and get timely access to the treatment your doctor recommends, without the insurance runaround.
Sick of insurance companies standing between you and your doctor? In this episode, we break down how Medicare Supplement coverage eliminates roadblocks like prior authorizations and restrictive networks, so your healthcare decisions stay exactly where they belong: between you and your physician.
Discover the 7 most common Medicare Advantage surprise costs that can drain your retirement savings. Learn why Medicare Supplement plans may offer the financial predictability you need.
What does Medicare really cover when it comes to preventive care, and what can still cost you? In this episode, we break down Medicare’s preventive benefits, including wellness visits, essential screenings, and vaccines, and reveal how Medicare Supplement plans can shield you from surprise diagnostic expenses so you can focus on your health, not the bills.
Medicare doesn’t have to be confusing. In this episode, we break down Medigap standardization and reveal how plans with the same letter offer identical benefits, no matter the company. Learn how this system protects you from surprise gaps in coverage and empowers you to choose confidently, knowing exactly what you’re getting for your healthcare needs.
Ever wonder why certain medications fall under Medicare Part B instead of Part D? In this episode, we break down the key rules that determine where drugs are covered, how those differences impact your out-of-pocket costs, and why those expenses can add up fast. Plus, we explain how Medicare Supplement (Medigap) plans can step in to help reduce or even eliminate those costs—so you can make smarter, more confident Medicare decisions.
Medicare Advantage plans often look great on paper, but what aren’t they telling you? In this episode, we uncover the hidden costs, network limits, and out-of-pocket surprises many beneficiaries don’t see until it’s too late, and explain why Medicare Supplement plans can provide more stable, predictable coverage and long-term peace of mind.
Medicare costs are changing, and your wallet could feel it. In this episode, we break down why Medicare Advantage out-of-pocket limits are climbing in 2026, what that really means for your healthcare expenses, and how these increases could impact your retirement budget. Plus, we explore why Medicare Supplement plans may provide the long-term financial stability and peace of mind many beneficiaries are looking for.
Medicare Advantage promises extra perks like dental, vision, and hearing, but what’s the real cost? In this episode, we uncover the hidden limitations behind these popular “extras,” why they often disappoint when you actually need care, and how pairing a Medicare Supplement with standalone coverage can deliver stronger protection, broader access, and true freedom of choice.
Turning 65? This is the most important Medicare decision you’ll ever make. In this episode, we break down why your 65th birthday opens a once-in-a-lifetime window to choose Medicare Supplement instead of Medicare Advantage, and what it could cost you if you miss it. Learn how to secure lower lifetime premiums, avoid medical underwriting and coverage denials, and gain the freedom to see doctors nationwide without referrals or network restrictions. Make the choice that protects your health, your finances, and your future, before the window closes.
Living with a chronic condition means your healthcare choices matter more than ever. In this episode, we break down why Medicare Supplement can be a smarter, less restrictive option than Medicare Advantage—from broader access to top specialists and nationwide coverage to predictable out-of-pocket costs and fewer prior authorizations. If managing your health is a priority, this conversation could change how you think about your Medicare coverage.
Are rising premiums straining your budget? Discover how to know if it is time to switch to a lower Medicare Supplement plan like Plan G or N to save money without sacrificing care.
Did you know some Medicare penalties never go away? In this episode, we break down how Part B and Part D late enrollment penalties work, why they can follow you for life, and—most importantly—how to avoid costly mistakes that can drain your retirement savings. A must-listen if you want to protect your income and make confident Medicare decisions.
Medicare benefit periods can be one of the most confusing—and costly—parts of your coverage. In this episode, we break down how benefit periods work, how they can trigger multiple hospital deductibles in the same year, and why a Medicare Supplement plan may protect you from unexpected out-of-pocket expenses.
Why do doctors often prefer Medicare Supplement over Medicare Advantage? In this episode, we break down what most ads don’t tell you, how Medicare Supplement plans can mean broader provider access, fewer claim denials, and the freedom to get care without referrals or network restrictions. If you want to understand how your Medicare choice impacts the care you receive, this is a must-listen.
Prior authorization can cost you more than time. In this episode, we uncover the hidden impact of prior authorization in Medicare Advantage plans, from delayed care and denied treatments to frustrating administrative roadblocks. Learn how these barriers affect your health and peace of mind, and discover why a Medicare Supplement plan may provide the flexibility, access, and control you deserve.
Tired of surprise denials, shrinking provider networks, and healthcare uncertainty? In this episode, we break down why a growing number of retirees are leaving Medicare Advantage in 2025—and making the switch to Medicare Supplement for greater freedom, stability, and peace of mind. Learn what’s driving this shift and what it could mean for your healthcare choices moving forward.
Did your Medicare plan end or change unexpectedly? This episode explains what happens when a plan exits the market, isn’t renewed, or reduces its service area—and how these events may qualify you for a Special Enrollment Period (SEP). Learn your options for switching plans, returning to Original Medicare, or enrolling in a Medicare Supplement plan with Guaranteed Issue rights, all without waiting for the next enrollment window.
Worried about rising hospital costs with Medicare? Tune in to unpack how Medicare Supplement pairs with Medicare Part A to cover major expenses—like deductibles, coinsurance, and long hospital stays—that can quickly add up. In this episode, you’ll learn what’s really covered, what’s not, and how the right Medicare Supplement plan can safeguard your savings and give you greater peace of mind.
Unlock the true power of your Medicare Supplement plan. In this episode, we spotlight the most overlooked benefits that can save you thousands — including protection from excess charges, extended skilled nursing care, and other little-known perks hiding in your coverage. If you want to get more out of Medicare without paying more, this is the episode you can’t afford to miss.
Unlock the hidden benefits of Medicare Supplement that most retirees never hear about. In this episode, we reveal five surprising Medicare Supplement facts that can save you money, expand your coverage, and give you greater peace of mind. From unexpected foreign travel perks to the power of guaranteed renewability, you’ll learn why choosing a Medicare Supplement plan could be one of the smartest decisions you make for your retirement healthcare.
Is Medicare Supplement Plan F still worth the price tag in 2026? In this episode, we break down everything you need to know before deciding between Plan F and Plan G. You’ll hear how each plan’s rate increases, coverage differences, and long-term premium trends stack up so you can make the most informed choice for your Medicare coverage in 2026 and beyond. Tune in to get the facts—and discover which plan truly delivers the better value.
Unlock the truth behind the most talked-about Medicare Supplement plans. In this episode, we break down why Medicare Supplement Plan G is rapidly becoming the top choice for beneficiaries as Plan F phases out. Discover how MACRA changed the Medicare landscape, explore the real differences between these two popular Supplement plans, and learn how to confidently choose the coverage that fits your needs. Whether you're new to Medicare or re-evaluating your options, this episode delivers the clarity you’ve been looking for.
Thinking about leaving your job? Don’t let Medicare penalties catch you off guard. In this episode, we break down the must-know differences between COBRA and Medicare Supplement, so you can confidently choose the coverage that protects both your health and your wallet. Learn what retirees, soon-to-be retirees, and anyone transitioning off employer insurance needs to know before making a move.
Headed overseas? Don’t leave your health coverage to chance. In this episode, we break down exactly how Medicare Supplement's foreign travel emergency benefits work, which specific Medicare Supplement plans include this valuable coverage, and the crucial limits and exclusions every traveler should know before stepping outside the U.S. Whether you’re planning a weekend abroad or an extended international adventure, this quick guide helps you understand what’s covered—and what isn’t—so you can travel with confidence.
Struggling to understand Medicare Supplement underwriting and how preexisting conditions can impact your coverage options? This episode breaks down exactly how health questions influence Medicare Supplement eligibility, when underwriting applies, and the key situations where you can bypass it entirely. Tune in to protect your coverage, avoid costly mistakes, and feel confident choosing the right Medicare Supplement plan.
In this episode, we break down what happens next: from navigating medical underwriting to understanding guaranteed issue rights and the special situations that let you enroll without health questions. Learn how to avoid common pitfalls, what insurers look for during underwriting, and how you can still secure the Medicare Supplement plan that fits your needs. Tune in to make confident, informed decisions about your Medicare coverage, starting today.
Trying to decide whether to keep your employer’s retiree health plan or switch to Medicare Supplement once you hit Medicare? In this episode, we break down the real differences between Retiree Health Coverage and Medicare Supplement, what they cost, how they protect you, and how stable they are in the long term. Get clear, straightforward guidance to help you choose the coverage that delivers the best value, flexibility, and peace of mind in retirement.
Struggling to understand Medicare Part B? In this episode, we break down exactly what Part B covers, reveal the official 2026 premium and deductible, and explain why you’re still responsible for 20% coinsurance on most medical services. Plus, learn the smartest ways to protect yourself from that costly gap.
Many people assume Medicare covers all types of long-term care, but it doesn’t. In this episode, we break down the critical differences between skilled nursing care and custodial care, what Medicare actually covers, how the costs stack up, and why having a Medicare Supplement (Medigap) plan can be essential to protecting your health and your savings.
Choosing Medicare coverage can be overwhelming, and the wrong decision can lead to lifelong penalties, higher premiums, and limited access to care. In this episode, we uncover the most common and costly Medicare mistakes—from missing key enrollment deadlines to misunderstanding Medicare Supplement vs. Medicare Advantage—and show you exactly how to steer clear of them.
Medicare Supplement plans do more than fill coverage gaps, they can protect your savings from thousands in unexpected medical bills. In this episode, we break down the true value of Medicare Supplement coverage, compare real costs against Medicare Advantage, and share real-world examples that show how Medicare Supplements can offer unmatched financial protection and peace of mind.
Want to know exactly what you’ll be paying for Medicare in 2026? We’ve got you covered. In this episode, we walk through the official 2026 Part A and Part B premiums, deductibles, and the dreaded IRMAA income brackets. Plus, we’ll show how pairing Original Medicare with a Medicare Supplement plan can save you from unexpected costs and give you greater peace of mind.
$0 premium plans sound great, but the real costs are often hidden in copays, networks, and strict prior authorizations. In this episode, we break down the truth behind Medicare Advantage marketing, what those “zero-dollar” premiums really mean, and how pairing Original Medicare with a Medicare Supplement plan can give you more freedom, fewer restrictions, and predictable healthcare costs.
Did you know that a single word, observation or inpatient, in your hospital status can determine whether Medicare covers your stay or leaves you with massive bills? In this episode, we break down the critical difference between observation and inpatient status, how it can affect your eligibility for skilled nursing care, and what steps you can take to protect yourself and your wallet.
If your doctor accepts Medicare assignment, it can save you from surprise bills, but if they don’t, you could face up to 15% in excess charges. In this episode, we explain exactly how Medicare Assignment works, how to check if your provider accepts it, and how the right Medicare Supplement plan can protect you from paying more than you should.
Many people are surprised to learn that Original Medicare doesn’t cover routine vision, dental, or hearing care, some of the most common (and costly) health needs as we age. In this episode, we break down exactly what’s covered, what’s not, and how you can fill those gaps with the right plan, from Medicare Advantage to Medicare Supplement. Get the clarity you need to protect both your health and your wallet.
Choosing the right Medicare plan for your parent doesn’t have to be confusing. In this episode, we break down the essentials, from comparing Original Medicare + Medigap vs. Medicare Advantage, to checking prescription coverage and finding the plan that fits their health and budget needs. Tune in for clear, practical guidance that makes Medicare decisions easier for families.
Confused about Medicare Supplement (Medigap) plans? This episode breaks down everything you need to know, from how standardized plans work to comparing premiums and understanding your enrollment rights. Learn how to find the right coverage for your needs and budget, and avoid costly mistakes when choosing your plan.
Turning 65 soon? Don’t let Medicare confusion catch you off guard. In this episode, we break down everything you need to know, from enrollment timelines and costs to coverage gaps and how to choose the right plan for your needs. Whether you’re planning ahead or signing up now, get the insider tips that help you make confident, money-smart Medicare decisions.
About to turn 65 and putting off Social Security? Don’t forget, Medicare doesn’t happen automatically! Join us as we explain when and how to manually enroll in Medicare Parts A and B, plus insider tips to make sure you stay penalty-free and fully covered.
Don’t let your Medicare Advantage plan make decisions for you! Auto-renewing could mean higher costs, fewer benefits, or losing your doctor. Join us as we uncover what changes every year, and how a quick annual review can save you money, protect your coverage, and even unlock better perks.
Drowning in Medicare’s alphabet soup of Parts A, B, C, and D? You’re not alone, and we’re here to help. In this episode, we break down the most common Medicare terms and coverage options in simple, everyday language. From Original Medicare and Medicare Advantage to Part D drug plans and Medigap, we’ll help you finally make sense of your healthcare choices. Tune in to gain clarity, avoid costly mistakes, and feel confident about your Medicare decisions.
Thinking about delaying Medicare Part B or Part D? It could cost you for the rest of your life. In this episode, we reveal the real financial impact of waiting to enroll, including permanent late penalties, coverage gaps, and higher out-of-pocket costs. Before you make a costly mistake, find out who can safely delay, who can’t, and how to avoid lifelong penalties with smart Medicare timing. Tune in now to protect your coverage and your wallet.
Confused about how Medicare works alongside your employer health insurance? This episode breaks down your enrollment options, highlights potential pitfalls, and shows you how to avoid costly penalties. Get clear, practical guidance to make informed decisions about your healthcare coverage.
Confused by Medicare jargon like step therapy or prior authorization? You’re not alone. In this episode, we break down exactly what these terms mean, which Medicare plans use them, and practical tips to get the care you need, without the headache. Whether you’re new to Medicare or just want to make smarter healthcare decisions, this guide will help you navigate the approval process with confidence.
Wondering how the 2025 Medicare drug price negotiations will impact your wallet? Join us as we break down which medications are on the list, exactly when prices will drop, and practical tips to help you save on your prescriptions. Don’t miss this essential guide to navigating the biggest changes in Medicare drug costs in years.
Life doesn’t always follow a schedule, and neither should your health coverage. In this episode, we break down Medicare Special Enrollment Periods (SEPs): what they are, which life events trigger them, and how you can use them to switch or update your health plan without penalties. Whether you’re retiring, moving, or experiencing other big life changes, this guide will help you make smart decisions for your healthcare.
Are you or a loved one managing a chronic health condition? Chronic Condition Special Needs Plans (C-SNPs) are specialized Medicare Advantage plans designed to provide personalized, coordinated care for specific health needs. In this episode, we break down who qualifies, explore the unique benefits of C-SNPs, and guide you step-by-step on how to enroll. Tune in to discover how these plans can make managing your health easier and more effective.
Confused about Medicare deductibles, coinsurance, and out-of-pocket costs? This podcast breaks down how Medigap (Medicare Supplement) plans can protect your wallet by covering gaps in your Medicare coverage. Learn how to compare plans, reduce financial risk, and make confident decisions for your healthcare.
Don’t navigate Medicare alone. Use our 2025 Annual Enrollment Period checklist to stay ahead of the game. Learn how to review your ANOC, compare plans effectively, and discover the coverage that’s right for you. Your best plan starts here!
Find out why some Medicare Advantage plans are being discontinued, what it means if yours is affected, and how to protect yourself with a stable Medicare Supplement plan. Don’t wait, know your options before it’s too late!
Relocating can throw your Medicare plans, Medicare Supplement, Advantage, and Part D into confusion. We break down exactly what changes, what stays the same, and how to make the transition seamless. Tune in and move with confidence!
Discover how to make the most of your Medicare benefits to stay strong, healthy, and vibrant as you age. From preventive care and wellness visits to essential screenings and practical tips, we break down everything you need to know to live your best life after 65. Your guide to aging well starts here!
Thinking about switching your Medigap plan to save money? In this episode, we break down when you can change your Medicare Supplement policy, how medical underwriting works, and the common mistakes to avoid, so you can make an informed choice without surprises.
Why do Medicare Supplement plan prices vary, and does paying more really mean better coverage? In this episode, we break down the factors behind Medigap costs and share tips on comparing quotes to find the best value for your healthcare needs.
Navigating Medicare enrollment can be confusing, but it doesn’t have to be. In this episode, we break down the Initial, Annual, and Special Enrollment Periods in simple terms, so you know exactly when to sign up for Medicare and Medicare Supplement, and avoid costly penalties.
Prepare with confidence! This episode walks you through a clear, step-by-step Medicare enrollment checklist, from key enrollment periods to choosing the coverage that fits your needs. Discover how a Medicare Supplement plan can help protect your savings and give you peace of mind.
Timing matters when it comes to Medicare! 🕒 Learn why enrolling in a Medicare Supplement (Medigap) plan during your Open Enrollment Period can save you money, protect your health, and give you guaranteed coverage—no matter your medical history. Don’t miss your window!
Navigating Medicare on a retirement budget can feel overwhelming—but it doesn’t have to be. In this episode, we break down how to choose a Medicare Supplement (Medigap) plan that protects your health without stretching your finances. From understanding plan types and coverage levels to comparing premiums and factoring in your personal healthcare needs, we guide you step by step to make an informed, budget-friendly choice. Whether you’re considering Plan G for comprehensive coverage or Plan N for lower monthly costs, this episode helps you balance protection and affordability with confidence.
Confused about your Medicare options? In this episode, we break down the essential differences between Medicare Supplement (Medigap) and Medicare Advantage (Part C) plans. From coverage and costs to provider networks, prescription drugs, and travel considerations, we’ll help you understand which plan fits your health needs, budget, and lifestyle. Tune in for a clear, side-by-side comparison that makes choosing your Medicare coverage simpler and less stressful.
Confused about Medicare Supplement (Medigap) plans? You’re not alone. Original Medicare doesn’t cover everything, and out-of-pocket costs can add up fast. In this episode, we walk you through 10 essential questions to ask before choosing a Medigap plan—from coverage details and costs to enrollment timing, discounts, and keeping your favorite doctors. Whether you’re new to Medicare or considering switching plans, this guide will help you make confident, informed decisions and protect your financial and healthcare peace of mind.
Medicare Supplement (Medigap) plans can protect you from unexpected medical costs, but paying too much is never part of the plan! In this episode, we share 8 proven strategies to lower your Medigap premiums without sacrificing coverage, including the best time to enroll, comparing carriers, exploring plan options, and even unlocking household discounts. Learn how to get the most value from your plan and keep more money in your pocket.
Confused about Medicare Supplement (Medigap) plans? We break down exactly what these plans cover, who truly needs one, and the smartest time to enroll, so you can avoid unexpected medical bills and protect your wallet. Don’t navigate Medicare alone, get the clarity you deserve!
Feeling lost in the maze of Medicare? We break down each part, hospital care, doctor visits, prescriptions, and reveal how a Supplement plan can fill the gaps. Clear, simple, and stress-free, because understanding Medicare shouldn’t be complicated.
Facing the loss of your employer health coverage? Don't worry, we've got you covered! Tune into our step-by-step guide to a smooth transition to Medicare. Discover everything you need to know about your Special Enrollment Period, enrolling in Part B, and the critical deadlines to avoid costly penalties. Take control of your health coverage and ensure a stress-free retirement!
Navigating Medicare prescription drug coverage can be overwhelming. In this episode, we break down what’s covered under Part B and Part D, highlight what's not included, and explain how to manage non-formulary drugs. Plus, discover strategies to help you lower your costs and make informed choices about your coverage options.
Are you a snowbird concerned about how your Medicare plan works across states? In this episode, we dive into the essential differences between Original Medicare, Medicare Advantage, and Medigap when it comes to seasonal travel. Discover how to secure nationwide healthcare coverage and avoid unexpected medical costs. Tune in to our expert guide and stay informed on the best options for your health while you roam!
Discover the ins and outs of Original Medicare, what it covers, what it doesn't, and the crucial gaps you need to know about! From dental and vision to long-term care, we'll break down the coverage you might be missing. Plus, we'll explore how Medicare Supplement and Medicare Advantage plans can fill in the gaps and provide the protection you deserve. Tune in to get the answers you need!
Navigating healthcare as a veteran or military retiree can be confusing, especially when it comes to understanding how TRICARE, VA benefits, and Medicare work together. Our expert guide breaks down the complexities, explaining how creditable coverage works and how Medicare Advantage and Medicare Supplement plans can expand your healthcare options. Tune in to get the clarity you need and make confident, informed choices about your health coverage!
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Turning 65 and feeling overwhelmed by Medicare? You’re not alone! In this podcast, we’ll break down everything you need to know, from eligibility and enrollment to costs, coverage options, and the critical services Medicare doesn’t cover. Whether you’re just starting to explore your options or preparing to make decisions, we’ll give you the clear, practical information you need to navigate Medicare with confidence. Tune in and make this important life transition easier to understand!
Are you confused about which vaccines Medicare covers? We've got you covered! In this episode, we break down how Medicare Part B and Part D protect you with essential vaccines like flu shots, shingles, and more. Discover where to get your immunizations, why they’re crucial for your health, and how to stay protected every step of the way! Tune in to learn more.
Introducing the 2025 Medicare Prescription Payment Plan! This innovative program allows you to pay your Part D drug costs in manageable monthly installments. Discover how it works, who’s eligible, and the simple steps to enroll. Say goodbye to unpredictable medication expenses and take control of your health care costs today!
Medicare Supplement isn’t just Plan F or Plan G. There’s so much more to explore! Dive into the details of Plan G’s comprehensive coverage, discover the cost-saving benefits of Plan N, and uncover the affordability of High-Deductible plans. Get the inside scoop on how to choose the perfect Medicare Supplement plan tailored to your needs and budget!
Learn all about Medicare late enrollment penalties and how to avoid them. We'll cover crucial deadlines, penalties for missing them, and offer tips for timely enrollment. Don't get caught off guard – watch now to navigate enrollment and avoid costly penalties. Subscribe for more Medicare info.
Please call us anytime for free quotes and answers to your questions at 844-945-2166 or visit our website to work with our Medicare Advisors today at https://rates.medicarefaq.com/
LateEnrollment #Penalties #AvoidPenalties #MedicareEnrollment
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The Medicare Part D Payment Plan is a monumental program beginning in 2025. Once in place, beneficiaries will be able to make monthly payments on their out-of-pocket drug costs rather than paying up front at the pharmacy.
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medicarepartd #partddrugcosts #medicarepaymentplan
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Social Security and Medicare go hand in hand. If you are retiring soon, it is important to know how to maximize your Social Security to make the most out of your retirement.
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socialsecurity #socialsecurityretirement #medicareandsocialsecurity
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For the first time ever, 51% of Medicare beneficiaries have switched to Medicare Advantage but WHY? With 31 million people already on board, it's time to explore if Medicare Advantage is your best choice! Check out our video for a breakdown and make an informed decision.
Please call us anytime for free quotes and answers to your questions at 888-382-1925 or visit our website to work with our Medicare Advisors today at https://rates.medicarefaq.com/.
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In 2023, more people opted for Medicare Advantage than ever before! 😳 Join Ashlee Zareczny in this quick, easy-to-follow video as she breaks down Medicare Advantage Plans for 2024. Explore coverage, pricing, and more so you can make an informed decision!
📞 Give us a call at 833-413-1685.
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🤯 Learn more about this topic HERE: https://www.medicarefaq.com/medicare-supplements/plan-g/
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Let's break down the cost of Medicare Supplement Plan G together! In this video, we show you an example of how much your monthly premium could look like if you enrolled in the popular plan.
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Big changes are coming to Medicare in 2024. As an enrollee, it is important to understand these changes and how you may be affected!
Changes to Medicare in 2024 (0:25)
2024 Medicare Costs (0:50)
Medicare Part A Cost Breakdown (1:14)
Medicare Part B Cost Breakdown (3:01)
Medicare Part C Cost Breakdown (3:42)
Medicare Part D Cost Breakdown (4:18)
Changes to Medicare Extra Help (5:00)
Changes to Medicare Part D Catastrophic Coverage Coinsurance (5:45)
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Medicare2024 #MedicareSupplementPlans #MedicareFAQ
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Medicare Private-Fee-for-Service plans offer you the ability to see any doctor at a pre-determined cost. These plans offer great benefits, but may not be available in all areas.
Private-Fee-For-Service Plans (0:26)
Private-Fee-For-Service Plans Networks (0:44)
Private-Fee-For-Service Plans Terms And Conditions (1:06)
Private-Fee-For-Service Plans Benefits (1:20)
Private-Fee-For-Service Plans Out-Of-Pocket Maximum Amount (1:33)
Private-Fee-For-Service Plans Costs (1:52)
Learn more about this topic HERE: https://www.medicarefaq.com/medicare-part-c/medicare-advantage-plan-pffs/
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The Medicare Annual Enrollment Period is an important time for all Medicare enrollees. During this time, you can make changes to your Medicare Advantage and Medicare Part D coverage for the upcoming year.
The Medicare Annual Enrollment Period (0:33)
Step 1: Assess Your Current Coverage (0:49)
Step 2: Determine Your Healthcare Needs (1:13)
Step 3: Review Changes to Your Current Plan (1:42)
Step 4: Compare Available Plans in Your Area (2:17)
Step 5: Work With A Licensed Insurance Agent (3:06)
Step 6: Enroll Before It’s Too Late (3:30)
Learn more about this topic HERE: https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/
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High Deductible Medicare Supplement Plan F offers the same great benefits as standard Plan F. However, the high deductible allows carriers to charge a much lower monthly premium. Learn more about High Deductible Plan F benefits and Eligibility.
Eligibility (0:23)
Medicare Supplement Plans Explained (0:49)
High Deductible Plan F (1:05)
High Deductible Plan F vs Standard Plan F (1:41)
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Medicare Supplement High Deductible Plan G offers coverage and benefits identical to the standard Plan G after you cover the high deductible.
Medicare Supplement Plans (0:22)
Medicare Supplement High Deductible Plan G (0:33)
Standard Plan G vs High Deductible Plan G Breakdown (1:07)
High Deductible Plan G Pros & Cons (1:57)
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MedicareSupplement #MedicareHighDeductibleG #MedicareFAQ
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Medicare Supplement Plan F, Plan G, and Plan N are the top three most popular Medicare Supplement plans available today. However, each plan has its own perks to bring to the table. Watch to learn the different benefits of Medicare Supplement Plan F vs Plan G vs Plan N.
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In this video, we compare Medicare Advantage and Medicare Supplement Plans side by side to allow you to choose the best plan for your needs.
Once you have enrolled in Medicare Part A and Medicare Part B, have two options. To enroll in a Medicare Supplement plan or a Medicare Advantage plan. Keep in mind, you cannot enroll in both.
Option one includes enrolling in a Medicare Supplement plan and a Medicare Part D plan. Original Medicare does not include prescription drug coverage. That's why you'll want to add a standalone Medicare Part D plan. In addition, you'll want to enroll in a Medicare Supplement Plan, also known as Medigap. This plan will cover additional out-of-pocket costs that you're responsible for paying. Medicare Supplement plans were specifically designed to fill in the gaps in coverage from original Medicare. This includes coinsurance and deductibles depending on the plan you enroll in. Medicare Supplement plans literally supplement your Original Medicare benefits.
Option two would be to enroll in a Medicare Advantage plan. Now, it's important to remember that Medicare Advantage is not the same as Original Medicare. These are managed health care plans that are offered through private insurance companies. Medicare Advantage plans do tend to have lower monthly premiums when compared to Medicare Supplement plans. In addition, some may come with ancillary benefits like dental and vision coverage. Most also include prescription drug coverage. Due to the low or zero-dollar monthly premium, you will have to pay more out-of-pocket as you use the benefits When compared to Original Medicare and a Medicare supplement plan, Medicare Advantage plans come with many limitations. These include a limited network of doctors, coverage that will not travel with you, and you need a referral to see a specialist.
Visit MedicareFAQ.com to learn more about Medicare Advantage vs Medicare Supplement plans.
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Medicare Supplement Plan N is one of the most popular Medicare Supplement plans available today. In this video we review we review Medicare Supplement Plan N benefits and how you can utilize the plan.
Medicare Supplement Plan N is ideal for those who prefer lower monthly premiums but still wish to have comprehensive coverage.
The most significant benefits of Medicare Supplement Plan N include Medicare Part A coinsurance coverage, Medicare Part A deductible coverage, foreign travel emergency benefits, and Medicare Part B coinsurance coverage
When you enroll in Medicare Supplement Plan N, the only out-of-pockets you are responsible for are, Medicare Supplement Plan N premium, Medicare Part B premium, Medicare Part B coinsurance, $20-$50 copayments, and Excess Charges (if applicable)
If you enroll in Medicare Supplement Plan N during your six-month Medicare Supplement Open Enrollment Period, you do not need to answer underwriting health questions. If you apply for coverage outside of this enrollment period, you may be subject to medical underwriting. This means a carrier may deny you coverage for any reason.
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Medicare Supplement plans cover the holes left by Original Medicare. If you became Medicare-eligible after January 1, 2020, Medicare Supplement Plan G is the most comprehensive plan available for you.
Medicare Supplement plans are standardized by the federal government. This means benefits are the same regardless of carrier. The only difference is the monthly premium.
Medicare Supplement Plan G coverage includes the Medicare Part A deductible, Hospice copayments and coinsurance, foreign travel emergency benefits, and Medicare Part B excess charges.
The only out-of-pocket costs you will pay when you enroll in Medicare Supplement Plan G are the Medicare Part B deductible and the Plan G premium.
If you are newly eligible for Medicare and are within your Medicare Supplement Open Enrollment Period, you can enroll in Medicare Supplement Plan G with no underwriting health questions. If you apply outside of this enrollment period, you may need to go through underwriting. This means a carrier may deny you for any reason.
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If you're eligible for both TRICARE and Medicare, it's important to know how the two programs work together. In this video, we explain what you need to know about your coverage options.
Original Medicare consists of a few different Parts – A through D. But, how does each part work with TRICARE?
When TRICARE-eligible beneficiaries sign up for Medicare Part A and Part B, they automatically enroll in TRICARE For Life. In this case, Medicare works as primary insurance, and TRICARE For Life is secondary.
TRICARE For Life helps cover costs Medicare doesn't. These include:
• Part A hospital deductible
• Part B coinsurance
Some TRICARE For Life beneficiaries may enroll in a Medicare Advantage plan to access benefits such as gym memberships, dental, vision, and hearing. Original Medicare (Parts A and B) do not cover these costs.
If you choose to enroll in an Advantage plan, it will be primary and TRICARE for Life will be secondary. When receiving care outside of your Advantage network, TRICARE For Life will cover the costs that your plan doesn't pay for.
When you have TRICARE For Life, there's generally no need to enroll in a Part D prescription drug plan. TRICARE For Life includes a prescription drug program and there is no additional cost to you.
If you have TRICARE For Life and later enroll in a Part D prescription drug plan, don't worry about penalties. Tricare For Life is considered creditable coverage.
It's possible to also enroll in a Medigap plan when you have Original Medicare and TRICARE For Life. But, it's not necessary. In this case, Original Medicare will be primary, your Medicare Supplement plan will be secondary, and TRICARE For Life will pay last.
As for how TRICARE Prime works with Medicare, when you're under the age of 65 and you have Medicare with TRICARE Prime, you don't need to disenroll. TRICARE For Life isn't mandatory. Those with disabilities on Medicare can remain on TRICARE Prime as long as they're eligible. When you do qualify, you'll get a waiver of Prime enrollment fees or a refund for the past enrollment fee.
In another scenario, TRICARE Plus offers the same primary care access as TRICARE Prime. It works the same as regular TRICARE in regards to Medicare because it's still primary coverage. The military clinic or hospital doesn't cover costs or beneficiaries who receive care from non-military health facilities. Before scheduling an appointment, beneficiaries should contact their local military hospitals to make sure they accept TRICARE Plus because each facility decides whether they accept it.
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Are you a Medicare beneficiary receiving Social Security benefits? Stay tuned to find out how the 2022 year will affect your cost!
In 2022, Social Security recipients will get an annual Cost-Of-Living Adjustment (COLA) of up to 5.9% – the largest increase since 1982. The COLA spike will boost retirees' monthly payments by up to $92 in 2022.
This Social Security increase is the first to have matched rising costs more closely. Yet, with the increase in inflation, Medicare's cost has gone up as well.
This brings us to the cost breakdown for 2022.
The Medicare Part A deductible increases to $1,556 for each benefit period. The standard Medicare Part B premium is now $170.10. Premiums for higher-income individuals are subject to increase. The new Part B deductible is $233, which is a $30 increase from 2021.
The good news is that in 2022, the average Social Security recipient will be better off for 2022.
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When you become Medicare-eligible, you may be wondering whether your existing coverage coordinates with Medicare. Whether Medicare will pay primary or secondary depends on the other type of coverage you have.
First, it's common for Medicare beneficiaries to work past the age of 65. Most will have employer coverage. So, the major questions are whether you should keep your Medicare coverage while you have employer coverage and, if you do, which will pay first? This depends on how many employees are at the company.
When your employer has 20 or more employees, your coverage is creditable for Medicare. However, with fewer, than 20 employees, the coverage isn't creditable. In the latter scenario, you'll want to enroll in Medicare Part B to avoid penalties in the future.
With creditable employer coverage, Medicare is secondary and the group plan is primary. Whereas, with a group plan that is not creditable, Medicare is primary and the group plan is secondary.
In the circumstance where you're Medicare-eligible due to disability and have employer coverage, possibly through your spouse, the number of employees must be 100 or more for coverage to be creditable.
Medicare Advantage plans are considered primary coverage because they pay for your care instead of Medicare.
Other scenarios where Medicare is primary:
• You have Medicare and a Medicare Supplement (Medigap) plan
• You're dual-eligible for and have Medicare and Medicaid
• You also have coverage through FEHB, TRICARE, COBRA, retiree insurance, or tribal self-insurance
Situations when Medicare pays secondary:
• When you have a worker's compensation, liability, or no-fault insurance policy
• Active duty with TRICARE
As for Veterans benefits and Medicare, the two don't coordinate together. Veterans benefits work at veteran-approved facilities and Medicare works at civilian facilities.
Medicare also does not work with the Marketplace (a.k.a. "Obamacare"). If you have this coverage and receive subsidies, unfortunately, you will no longer qualify for them when you become eligible for Medicare. Additionally, it's illegal for an agent to try to sell you a Marketplace policy when you already have Medicare.e
All this information can seem overwhelming, but we are here to simplify it for you so you can make the best health care decisions. If you found this video helpful, please subscribe to our YouTube channel and join our Facebook Community Group!
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Are you a Medicare beneficiary with a recent change in circumstance? If so, don't go anywhere! We're here with everything you need to know about Special Enrollment Periods for Medicare.
Medicare involves many different types of enrollment periods and Special Enrollment Periods apply to every part of Medicare. You're eligible for a Special Enrollment Period when you have a qualifying life event.
Depending on the type of life event that occurs, your Special Enrollment Period will come with its own rules and timeframe. We'll go over the most common ones next.
The most common qualifying event for Special Enrollment Periods is the loss of employer coverage. Many people continue to work past 65, so it isn't a surprise that this is the circumstance that happens most often. When you delay enrolling in Medicare under this circumstance, you're eligible for an eight-month Special Enrollment Period.
If you choose to delay Medicare while you continue to work past age 65, make sure your coverage is credible. To be creditable, the employer must have 20 or more employees. If your coverage isn't creditable and you delay enrollment, you'll be subject to a lifetime penalty on top of your Part B premium. This penalty goes up for every 12 months you delay. Your eight-month enrollment period begins when your group plan coverage ends.
The documents you'll need to enroll in Medicare when you previously had creditable group coverage are available 100% online. Most people enroll in Part A while they are still working (because it's premium-free). But you can later enroll in Part B and fill out and submit the form you need to do so, which you can obtain online. The form to prove that you had creditable coverage through your employer after becoming eligible for Medicare will need to be completed by both you and your employer.
Another qualifying event is relocation. Some circumstances that qualify you for a Special Enrollment Period for Medicare Advantage or Part D are:
• Moving out of your plan's current service area
• Entering or leaving a long-term care facility – this Special Enrollment Period lasts the duration of your stay at the institution plus two full months after you move out
• Release from incarceration
Additionally, if Medicare fails to renew or terminates your Advantage or Part D plan, you're eligible for a Special Enrollment Period.
The next circumstance is becoming eligible for Extra Help with Part D. This Special Enrollment Period is only available during the first nine months of the year because the Annual Enrollment Period runs from October through December.
If a New Advantage or Part D plan with a five-star rating is available in your location, you'll get a Special Enrollment Period to enroll in the plan.
Less common qualifying events:
• No longer eligible for Medicaid
• Eligible for a Medicare Advantage Special Needs Plan
• Losing another form of drug coverage
Now that you know about the different types of SEPs, here's how to be prepared:
• Notify your carrier of the changes ahead of time if possible (can extend timeframe)
• Know the window of opportunity you have for the SEP you qualify for
• Have the forms you need ready
• Shop around and become informed about plans
Thank you for taking the time to watch our video! We hope you found it educational. Please see the links below.
FAQ Article: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/
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Before you retire, it's important to explore all your options when you become eligible for Medicare. For federal retirees, this can be a bit tricky. In this video, we go over your options if you're eligible for both Medicare and Federal Employee Health Benefits.
Active government workers and retirees are enrolled in the Federal Employee Retirement Health Benefits (FEHB) program. This program covers both inpatient and outpatient services, just like Medicare. This is why some beneficiaries who are eligible for both are confused about whether they need to enroll in each program.
For the most part, those enrolled in FEHB don't need to enroll in a Medigap, Medicare Part D, or Medicare Advantage plan because their benefits already include this coverage. However, because FEHB benefits are expensive, those who are newly eligible for Medicare wonder how they can coordinate their coverage to reduce their out-of-pocket costs.
There are a few ways to do this. The first way is to enroll in Part A to supplement your FEHB benefits. More than likely, you worked 40 quarters or 10 years and paid into Medicare throughout those years, making you eligible for premium-free Part A. You can also become eligible in Medicare Part A through your spouse if they've worked for 10 years.
Enrolling in Part A will give you extra coverage for any inpatient medical expenses you incur. Your FEHB will be primary and Medicare Part A will be secondary. You'll save money by not paying the monthly Part B premium. The downside is you'll pay copays for your out-of-pocket services.
Compare the cost of the Part B premium to what you could be spending in copays to determine which option will save you the most money.
The other downside is if you delay enrolling in Part B, you'll incur late enrollment penalties since FEHB is not considered creditable coverage through Medicare. So, an additional 10% will be added to your premium for every 12 months you went without coverage.
Your other option is to enroll in Part A and Part B to supplement your FEHB benefits. With this combination, you're paying for both FEHB and Medicare. Medicare is your primary coverage, and FEHB is secondary coverage. Your FEHB acts as a supplement plan and covers deductibles, copays, and coinsurance. With this combination, you can see any doctor that accepts Medicare and you'll even have some additional benefits under Part B that FEHB does not cover. Also, since FEBH includes prescription drug coverage, you wouldn't need to enroll in Part D.
The third way to do this is to enroll in Part A and Part B with Medicare Advantage or a Medigap plan, suspending your FEHB coverage. The reason Medicare beneficiaries go with this coverage is that they determine this combination would cost less than keeping FEHB.
We go into some frequently asked questions in this video as well! Please go to 3:07 for the answers.
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Not sure how to pay your Medicare premium bill? Don't go anywhere! In today's video, we're going to talk about Medicare Easy Pay.
When you're enrolled in Medicare but aren't yet collecting Social Security benefits, you'll get a Medicare premium bill in the mail each quarter. Medicare Easy Pay is a free service through Medicare that makes it simple to pay your premiums.
Once you set up Medicare Easy Pay, Medicare automatically deducts your premiums from your checking or savings account. This deduction takes place around the 20th of each month.
There are two ways to sign up for Medicare Easy Pay. The first way is through the online form. First, you'll need to create an account on Medicare.gov or sign onto your existing account. Then, select "My Premiums," and finally click "Sign Up." The screen will then prompt you to complete a quick online form.
The second way to sign up for Medicare Easy Pay is through the mail-in form. Print out and complete the form from Medicare.gov, then mail it directly to Medicare.
It can take up to eight weeks to process your Easy Pay form. If you receive a Medicare premium bill after Medicare Easy Pay enrollment, your enrollment is not complete.
There are a few ways to pay your Medicare premium while you wait for processing. You can pay it online through your Medicare account, using a credit card, debit card, checking, or savings account.
You can also use your bank's online bill pay option to pay directly from your checking or savings account. The third way is to pay by mail to Medicare, via check, money order, credit card, or debit card. All you need to do is fill out the form and use the payment coupon that comes with your Medicare bill.
Once you receive a statement that states, "This is not a bill," you'll know your Medicare Easy Pay is processed and set up.
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If you're under 65 and collecting Social Security Disability Income (SSDI), this video is for you.
To be eligible for Medicare, you must be 65 OR collect SSDI benefits for 24 months. Once you collect for 24 months, you'll receive a Medicare card in the mail. This includes coverage for Part A and Part B.
Part A is premium-free for those who have worked at least ten years and have paid into Medicare for 40 quarters. Yet, Part B comes with a monthly premium. This premium will be automatically deducted from your Social Security check each month.
If you're still working, you may have the option to delay enrolling in Part B to avoid paying the premium. As long as Medicare considers your employer coverage creditable, you can delay Part B without incurring any penalties. As long as your employer has 20 or more employees, your coverage will be creditable.
Without creditable coverage, you'll be responsible for a penalty if you delay Part B. The good news is that when you age into Medicare at age 65, the penalty will reset.
Because Original Medicare comes with out-of-pocket costs, you'll want to enroll in a supplemental coverage option as well. Once your Part B is effective, your Medigap Open Enrollment Period begins. It lasts for six months and allows you to enroll in a plan without answering health questions and going through medical underwriting. That means a carrier can't deny you coverage due to your disability.
However, there are some downsides to enrolling in a Medigap plan when you're under 65. First, some states don't require carriers to offer Medigap to individuals under 65.
Still, carriers usually only provide one option to those younger than 65 in the states that require at least one Medigap plan offering to those who qualify due to disability. This option is Plan A, which only includes core policy benefits.
With Part A, you don't have coverage for many things that other policies include, like the Part A deductible or extended skilled nursing facility care.
Another downside of Medigap for those under 65 is that the premiums can be significantly higher than for those 65 or over. In fact, you could pay four times more for a Medigap plan than you would if you were 65.
This is because carriers know you have a disability, so they consider you high-risk financially. Meaning, they know they may pay more for your health care costs than they would for someone over 65.
Finally, even if you find a premium that fits into your monthly budget, it's common to see high rate increases through the years when you enroll in Medigap before 65.
An alternative form of supplemental insurance for those under 65 is a Medicare Advantage plan. For Advantage plans, everyone pays the same rates – regardless of age. Premiums for Advantage plans are low – sometimes even $0. Additionally, rate increases are low, including for individuals under 65.
No health questions are involved in the enrollment process for Advantage plans. These plans come with maximum out-of-pocket limits and extra benefits such as dental, vision, hearing, and transportation. Some even come with an over-the-counter pharmacy card that you can use to purchase items at your local pharmacy.
However, there are a few things to know before you enroll in a Medicare Advantage plan.
When you have one of these plans, you can expect to pay out-of-pocket costs as you use the benefits. These include copays and coinsurance when visiting the doctor's office. Before enrolling, you'll want to ensure that all of your doctors are in the plan's network.
As most Advantage plans come with prescription drug coverage, you should check ahead of time that the drug plan's formulary includes all of your prescriptions.
Having a Medicare Advantage plan is good in that the maximum out-of-pocket amount protects you from spending too much. Although an Advantage plan
Maybe you're not quite sure when to enroll in Part B, or you're unfamiliar with the coverage and costs involved in Medicare's outpatient insurance. If so, this video is a must-watch as we're unboxing everything you need to know about Medicare Part B.
You'll use your Part B at doctors' offices, as it's your outpatient coverage. Part B covers medically necessary services given by a provider. This includes preventive care, surgeries, and other treatments.
Some medically necessary services Part B will cover include mammograms, colonoscopies, lab testing, durable medical equipment, occupational therapy, transplants, home health services, medications administered at the doctor's office, outpatient mental health services, ambulance services, vaccines (such as for the flu or Hepatitis B), and some services you receive in the hospital.
Moving on to Medicare costs, Part B comes with a monthly premium. Each year, there is a standard premium amount that is adjusted if your income is higher. Each year, the Part B premium is subject to increase and the standard amount is announced each year in the late fall, as is the annual deductible for Part B.
In addition to the premium and deductible, Part B also involves coinsurance. Medicare pays 80% of the approved amount, leaving the beneficiary responsible for the remaining 20%. This means you'll need to pay 20% for all services received at the doctor's office.
Unfortunately, Part A and Part B don't have out-of-pocket maximums. So, the 20% you pay out-of-pocket can quickly add up. Luckily, this is where Medicare Supplement (Medigap) plans can help. They cover the 20% coinsurance, thus protecting you.
Last but not least, we're going to let you know when to enroll in Part B. The first enrollment window every Medicare beneficiary has to enroll in Part B is the initial enrollment period. It's unique to you and starts three months before your 65th birthday, ending three months after your 65th birthday. Thus, you have seven months to enroll in Part A and Part B. Keep in mind that if you don't enroll during the first three months of this period, your coverage could be delayed and won't become active until after you turn 65.
If you're collecting Social Security benefits, you'll automatically enroll in Original Medicare (Parts A and B), and your Part B premium will be deducted from your Social Security check each month. If you're not collecting Social Security, you'll have to enroll yourself. If you have another form of creditable coverage, like group medical insurance through a large employer, you can delay enrollment in Part B and avoid penalties.
Once you leave your employee group coverage when you retire, you'll get a Special Enrollment Period of eight months. Make sure to get the right documentation for proof of coverage.
Those who miss their Initial Enrollment Period and don't qualify for a Special Enrollment Period can use the General Enrollment Period to sign up for Part B. This enrollment period occurs annually, from January 1 through March 31. If you sign up during this time, your coverage will begin on July 1.
When you lack creditable coverage at the time of enrollment, you'll face a penalty of 10% for every 12 months you went without coverage. Unfortunately, this penalty will stick with you forever. This is why it's so important to be familiar with what constitutes creditable coverage and why you shouldn't just assume you don't need Part B yet.
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Are Medicare Advantage plans bad? If you've heard that they are, don't go anywhere. We're going to unbox the truth about Medicare Advantage plans.
Intro (0:19)
How Medicare Advantage Carriers Afford Low Premiums (1:26)
Giveback Benefit (2:53)
How Provider Networks Work With Medicare Advantage (3:59)
Prior Authorization (4:44)
Maximum Out-Of-Pocket Limit (5:19)
Annual Changes (6:24)
You've probably seen a few commercials for Medicare Advantage plans, especially during the fall Annual Enrollment Period. They usually start by asking if you're happy with your Medicare benefits, telling you Advantage has many more benefits. Some even throw a jab at Medicare Supplement plans, which come with monthly premiums. Others say there's no premium with an Advantage plan and that they could even return $140 or more to your Social Security check.
When something sounds too good to be true, that's usually the case. However, the issue is less with the plans and more with the advertisements. The commercials can be extremely misleading and create misconceptions. This is why doing your research is important.
So, how can Medicare Advantage carriers afford to offer such low-premium plans? It helps to understand how the plans work. When you enroll in an Advantage plan, the carrier is paid by Medicare to take on your risk. Because you're leaving Parts A and B, the private carrier manages your benefits instead of Medicare.
Medicare Advantage carriers also make their money through cost-sharing. Just because you don't have to pay a monthly premium doesn't mean the plan is free. You'll still have to pay out-of-pocket in the form of deductibles, copays, and coinsurance. Advantage plans must provide the same coverage as Parts A and B, but it's important to be aware that the carrier gets to choose how much of that service to cover and what you'll need to pay out-of-pocket.
Also, don't assume you won't have to pay your Part B premium anymore if you pick up an Advantage plan – this is not true. Regardless of whether your Advantage plan comes with a premium or not, you'll still need to pay your Part B premium.
This is where the giveback benefit comes into play. Some carriers in some ZIP Codes offer a Part B reduction, reducing the amount you pay for your premium – ranging from a few dollars to the full amount. However, it's not a reimbursement. Carriers can afford to do this because they get paid by Medicare. Keep in mind that the less you pay in monthly premiums, the more you'll pay out-of-pocket as you use your benefits. Thus, plans with the giveback benefit involve more cost-sharing. That's how the carrier recoups their money.
Benefits on an Advantage plan work differently from Original Medicare paired with a Medigap plan. First, Advantage plans come with doctor networks, so it's important to make sure your doctors are included. Advantage also doesn't travel with you – restrict coverage to your county. On the other hand, Original Medicare and a Medigap plan travel with you across all 50 states, as most doctors accept Medicare assignment.
When enrolling in an Advantage plan, it's important to understand prior authorization. Before you receive a service or treatment, the carrier may want to make sure it's medically necessary. So, you may be required to get prior authorization, which can take weeks. If the carrier doesn't think it's medically necessary, your request could face denial. On the other hand, Original Medicare paired with a Medigap plan doesn't require prior authorization so you won't be dealing with a wait.
Next, maximum out-of-pocket (MOOP) limits come with Advantage plans. They protect you from paying too much for services. Yet, the amount can be up to $7,500 and resets annually on the first of the year. So, unfortunately, if you're diagnosed with a serious illness or condition halfway through the year and end up getting close to or e
Medicare comes with many different parts and plans. We're going to break down Medicare Parts A through D in a simple way so that you know which parts to enroll in.
Medicare comes with 4 different parts, Part A, Part B, Part C, and Part D. Part A and B are both run by the Federal Government. Part C and D are offered through private insurance companies. When talking about Medicare plans, you're usually referring to supplemental Medicare options such as Medigap and Medicare Advantage.
Part A is your hospital coverage for inpatient care. This includes room and board, nursing care received while at the hospital, meals, and diagnostic tests. Part A also covers skilled nursing and hospice.
Part B is your coverage for outpatient care. This includes services at the doctors and other health care providers. Part B also covers preventive services, home healthcare, and items such as durable medical equipment. Basically, Part A will cover your services received at the hospital. Part B will cover any services received at the doctor's office. Part A and Part B is what makes up Original Medicare.
Now we're going to go over Part C. Also known as Medicare Advantage. Part C or Medicare Advantage is not part of Original Medicare. It's another way to get Part A and Part B coverage. It's Medicare coverage offered through private insurance companies. Since Part A and Part B don't cover 100% of your medical cost, most beneficiaries opt to enroll in additional supplemental coverage to fill in the gaps. This is done through either a Medicare Supplement Plan or Medicare Advantage plan.
Medicare Advantage plans are a form of managed care. With these plans, you opt to receive your Part A and Part B benefits through the carrier's network of providers instead of Original Medicare. To be eligible for Part C, you still must enroll in both Part A and Part B, as well as live in the plans service area. It's important to remember, Part C is optional. Not every Medicare beneficiary will choose to enroll in a Part C plan.
Last but not least, is Part D. Part D is your prescription drug coverage. Part D plans are also offered through private insurance companies. It covers the prescriptions you pick up at your local pharmacy. Part D is also optional. However, if you don't have another form of prescription coverage that's considered creditable under Medicare, you could face enrollment penalties if you choose to enroll later. Part D plans do change annually. That's why it's important to compare all the options in your area each year during the fall Annual Enrollment Period.
Resource Links:
https://www.medicarefaq.com/original-medicare/medicare-parts/
https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-a/
https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-b/
https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-c/
https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-d/
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If you're unsure what the differences are between Medicare and Medicaid, don't go anywhere. In today's video, we're going to explain the difference between the two, as well as additional Medicare Savings Programs you could be eligible for.
Medicare is a federally funded program for those who are over 65 as well as those who are under 65 with a disability. With Medicare, the benefits are the same across all 50 states, and your income is not an eligibility factor. With Medicaid, It's funded both on the federal level and the state level. You're eligible at any age and benefits and criteria do vary from state to state. With Medicaid, you must meet the low-income criteria within your state to become eligible.
If you meet the eligibility criteria for both Medicare and Medicaid, that means your dual-eligible. Those who are dual-eligible can qualify for a Medicare Savings Program. These programs help pay for your Medicare cost including deductibles, co-pays, and coinsurance. In addition, all of those who are eligible for Medicare Savings Program are also eligible for a program called Extra Help.
Extra Help provides assistance with your prescription drug cost under Part D. Also, if you delayed enrolling into Part D and incurred a late enrollment penalty because of it, that penalty will be waived if you're eligible for Extra Help. To qualify for Medicare Savings Program you must be already enrolled or at least eligible for Part A and your income and resources must meet the federal and state limits set for the program.
There are four different types of Medicare Savings Programs. The first type of Medicare Savings Program we're going to go over is called the Qualified Medicare Beneficiary Program, or QMB. With the Qualified Medicare Beneficiary Program, you will have coverage for the Part B premium. If by chance you were not eligible for premium-free Part A then the Qualified Medicare Beneficiary Program will also cover your Part A premium. Medicare will be your primary coverage and your QMB will be your secondary. This means you won't need any Medigap plan since your QMB will cover your premiums, co-pays, and deductibles. The Qualified Medicare Beneficiary Program is the highest level of Medicare Savings Program you can get.
The second type of Medicare Savings Program available is the Specified Low-Income Medicare Beneficiary or SLMB. The Specified Low-Income Medicare Beneficiary Program will pay for your Medicare Part B premium.
The next type of Medicare Savings Program is Qualified Individual or QI. The Qualifying Individual Program will also pay for your Medicare Part B premium. The only difference is that you must apply for this program each year. It's on a first come first serve basis.
The fourth and final type of Medicare Savings Program is the Qualified Disabled and Working Individual, or QDWI. If you're under 65, disabled, and working and you can qualify for the QDWI. This program will pay for the premium for your Part A. The most common question we get about the QDWI program is if you must be working? And the answer is yes, you must be under 65 disabled and still working to qualify.
Keep in mind, each state may have a different name for these types of Medicare Savings Program. So don't be confused if your local Medicaid office refers to them with a different name. You can apply for any of the Medicare Savings Programs at any time of the year at your local Medicaid office.
The list of what you need to apply can vary by state, but in general, you'll need to provide:
- Proof of residence
- Proof of age
- Other forms of insurance, like Medicare
- Checking and savings accounts
- Retirement accounts
- Stocks and bonds
- Mutual funds
Resources that aren't counted would include:
- Your primary residence
- Household items
- Any furniture
- One car
If you're a resident of Minnesota and eligible for Medicare, don't go anywhere! In this video, we discuss the Medigap plans available in your state.
Minnesota has two different types of Medigap plans, known as the Basic Plan and the Extended Basic Plan. Both of these plans include what are known as Basic Benefits.
The Basic Benefits both Minnesota Medigap plans include are:
• Coverage for any coinsurance that falls under Part A and Part B
• Coverage for the first three pints of blood per year
• Coverage for some hospice and home health services
Additionally, both Minnesota Medigap plans also include:
• 80% coverage for foreign travel emergencies
• 20% coverage for mental health care in an outpatient facility
• 20% coverage for physical therapy
Additionally, there are state-mandated benefits that come with both the Basic Plan and the Extended Basic Plan:
• Cancer screenings
• Reconstructive surgery
• Immunizations
• Diabetic equipment
The Basic plan includes the state-mandated benefits along with 100 days in a skilled nursing facility.
The Extended Basic plan comes with all of the previously mentioned benefits, plus some additional benefits as follows:
• Coverage for the deductibles that fall under Part A and Part B
• 20 extra days of skilled nursing facility care
• 80% coverage for usual and customary fees
• 80% coverage while in a foreign country
Additionally, on the Extended Basic Plan, once you spend $1k out-of-pocket, all benefits will be covered 100%.
With the Basic Plan (not the Extended Basic Plan), you can increase coverage by adding any of four riders. The four riders are as follows:
• Part A deductible rider
• Part B deductible rider – only available to those Medicare-eligible before 2020
• Usual and Customary Fees Rider
• Non-Medicare Preventive Care Rider
Good news for Minnesota residents: the state does not allow excess charges from doctors not accepting Medicare.
Although you can enroll in Medigap at any time, the best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period.
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If you're a Medicare beneficiary in Wisconsin, don't go anywhere! We're going to go over how Medigap plans in Wisconsin are different from the rest of the country.
Wisconsin is one of three states where Medicare Supplement plans are standardized differently. The state offers a Basic Plan along with additional riders you can pair it with for additional coverage.
The Basic Plan is excellent for covering what Medicare doesn't. Riders allow you to add additional benefits to a policy. They can help you with deductibles, copays, and other coverage gaps.
The Basic Benefits included in Wisconsin Medigap plans include:
• Coverage for the coinsurance under Part A and Part B for both inpatient and outpatient services
• Coverage for the first three pints of blood each calendar year
• Coverage for the Part A hospice coinsurance or copayment
• Coverage for the coinsurance at a skilled nursing facility
• Additionally, benefits for 40 home health care visits that are added to the amount already paid for by Medicare plus an extra 175 days of inpatient health care beyond Medicare
There are also state-mandated benefits that Wisconsin Medigap plans must include. Wisconsin requires insurance companies to offer specific mandated benefits that provide additional coverage to protect beneficiaries. These state-mandated benefits include:
• Extra coverage for skilled nursing facility care
• Kidney disease care
• Diabetic treatment
• And more
State-mandated skilled nursing facility care coverage:
• Must include coverage for 30 days of care at a skilled nursing facility with no prior hospital stay requirement
• The facility does not have to be certified by Medicare and the stay does not have to meet Medicare's definition
The state-mandated benefits also include extra coverage for kidney disease care:
• Coverage for both inpatient and outpatient dialysis treatment
• Coverage for transplants and donor-related expenses
• Up to $30,000 of coverage for kidney disease care in any calendar year
State-mandated diabetic treatment coverage includes diabetic supplies including self-management training and insulin infusion pumps. Lastly, the state mandates chiropractic care; Medigap policies cover the usual and customary expense for services provided by a chiropractor under the scope of a chiropractor's license. In Wisconsin, this benefit is available even if Medicare doesn't cover the claim. The care must also meet the insurance carrier's standards as medically necessary.
Some additional state-mandated benefits include:
• Breast reconstruction surgery
• Colorectal cancer screening
• Coverage of certain health care costs in cancer clinical trials
Please note that Medicare Advantage plans aren't required to provide coverage for the above-listed, state-mandated benefits. The seven additional benefits that you can pair with your Basic Benefits in Wisconsin are available à la carte and can be added to the Basic Plan to customize coverage. If you stick to the Basic Benefits, the plan is similar to Plan A.
The Wisconsin riders include:
• Coverage for the Part A deductible
• Coverage for 50% of the Part A deductible
• Additional home health care
• Coverage for the Part B deductible (available only to beneficiaries eligible prior to 2020)
• Coverage for Part B excess charges
• Additional coverage for foreign travel emergency
• Coverage for any copayments or coinsurance under Part B
You can add these riders to make your coverage equivalent to the most popular standardized Medigap plans. If you prefer a cost-sharing plan with a lower monthly premium, there are plan options that include 25% and 50% cost-sharing, similar to Plans K and L. A high deductible plan that is similar to High Deductible Plan G is also available in Wisconsin.
We hope you enjoyed this video and fo
You've likely seen commercials for the Medicare give back program, which is also known as the buyback benefit – some commercials even refer to it as a Medicare reimbursement plan. Yet, this benefit actually isn't a reimbursement at all, but a reduction. In this video, we'll explain what you need to know about the Part B premium reduction benefit that's available with some Medicare Advantage plans.
The Part B reduction plan is, well, just as it sounds. You enroll in a Medicare Advantage plan, and the carrier pays either part or your entire Part B premium. In the summary of benefits or evidence of coverage, you'll see a section that mentions the Part B premium buy-down. This is where you can see how much of a reduction you're going to get. This benefit is also referred to as the giveback benefit.
The giveback benefit has become very common across all states and is now available in the majority of areas. However, there are some ZIP Codes that do not offer this benefit in their Medicare Advantage plans.
Many carriers, both large and small, offer a Part B premium reduction plan. These include Humana, Cigna, Aetna, and many more. Carrier coverage depends on your county and ZIP Code. You should always consider the plan ratings before you enroll.
The Part B premium reduction plan only participates with Social Security. You won't receive any checks directly from the carrier. Anyone enrolled in Medicaid or another form of assistance helping to pay for their Part B premium will not be eligible to enroll in a Medicare Advantage plan with this benefit.
Most pay their Part B premium through their Social Security check. If your Part B premium currently comes out of your Social Security check, you'll see the reduced amount reimbursed in your check. If you're not paying your Part B premium through your Social Security, then you'll have to pay Medicare directly the reduced amount. If you pay Medicare directly anything over the benefit amount, your carrier will not send you a check to reimburse you; it is a reduction, not a reimbursement.
The amount you get back can range from 10¢ up to the entire Part B premium amount so you pay nothing. This amount depends on your area.
Part B Reduction Plan Eligibility
• You must be enrolled in both Part A and Part B of Original Medicare
• You must not be accepting any government assistance that currently helps you pay your Part B premium
• If you don't qualify for a Part B premium reduction plan, there are many other options available to you
It's important to know that a Medicare Advantage plan is not the best option for everyone. As great as it is to have your Part B premium reduced to save you money in your Social Security check, you might find that if you visit the doctor's office often, you could pay more out-of-pocket than you initially expected. Before you enroll in a plan, be sure to weigh out the pros and cons of Medicare Advantage and Medicare Supplements.
Thank you so much for taking the time to watch this video. If you have any questions, please leave them in the comments section below or give us a call.
Resources:
- https://www.medicarefaq.com/faqs/medicare-part-b-give-back-plan/
- https://www.medicarefaq.com/faqs/pre-enrollment-medicare-advantage-checklist/
- https://www.medicarefaq.com/faqs/medicare-advantage-open-enrollment-period/
- https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/
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Medicare Part D is the part of Medicare that covers your prescription drugs. This coverage is available either through a standalone prescription drug plan or a Medicare Advantage (Part C) plan. These plans renew and reset annually, on January 1.
So, what is this "donut hole" term you keep hearing being thrown around? The donut hole is one of the four phases of Medicare Part D. What many don't realize is that the Part D program is not funded by premiums. Instead, it is funded mostly through the Medicare program.
In order to keep the Part D program sustainable, Medicare had to find a way to convince beneficiaries to choose generic drugs over brand-name drugs. That's why Medicare created the donut hole, also known as the coverage gap.
When the donut hole (or coverage gap) was first created, beneficiaries had to pay 100% of the cost of their medication. In order to avoid the donut hole, beneficiaries would switch to the generic version of their brand-name medications.
Yet, there isn't a generic version available for all medications. Thus, beneficiaries who couldn't find a generic version could be put in a financial bind once they reached the donut hole. Thankfully, legislation has stepped in and reduced the amount that the beneficiary must cover from 100% to 25%.
Now that you know why the donut hole was created, let's go over the four phases of Medicare Part D.
Phase 1: Deductible Phase
• Part D plans come with an annual deductible
• You pay the full cost of medications until the annual deductible amount is reached
• It's possible that the deductible won't apply to you if you're taking generic medications or tier 1 and 2 medications
• However, if you take brand-name medications that are tier 3 or higher, you will likely have to pay the full cost of your medication until you reach the plan's deductible amount
Phase 2: Initial Coverage Phase
• You only have to pay a set coinsurance or copay set by your drug plan
• How much you pay in coinsurance and copays will depend on what tier your prescription fall within
• Tiers vary from one drug plan to another – you can find these tiers in your plan's drug formulary
• Most beneficiaries stay in this phase until their plan renews the following year (~85%)
Phase 3: Donut Hole (Coverage Gap) Phase
• Most people do not ever reach this phase
• You fall in the coverage gap (donut hole) after a certain spending amount reaches a set threshold
• The total amount includes both what you pay for your medication and what your insurance pays for the medication
• While in the donut hole, you will have to pay 25% of the full cost of your medications (both generic and brand-name)
• While in the donut hole, what counts towards your True Out-of-Pocket cost includes the amount paid towards your deductible, any copays/coinsurance paid while in the initial coverage phase, the full cost of brand name drugs while in the coverage gap, and the amount paid for generic drugs while in this phase
Phase 4: Catastrophic Coverage Phase
• When your True Out-of-Pocket cost (TROOP) reaches a certain amount, you reach this phase
• While in this phase, your costs for medications usually go down
• In the catastrophic coverage phase, you only pay around 5% of the cost of your medication
Now that you understand the four phases of Part D, it's important to know that these plans change annually. So, during the annual enrollment period (from October 15 through December 7), you'll want to compare all the plans in your area to make sure you're saving the most money possible.
Thank you for watching this video! We hope you found it educational. Please subscribe to our YouTube channel and join our Medicare Community on Facebook.
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Whether you're enrolling in a Medicare Advantage plan for the first time, switching your current coverage, or renewing your current coverage, it's important to know what to review before choosing a plan. In this video, we're going to go over our pre-enrollment Medicare Advantage checklist so that you can feel more confident in your decision.
Your pre-enrollment Medicare Advantage checklist will include:
• Which doctors are in your plan's network
• Your plan's coverage area
• Cost-sharing
• Summary of benefits
• Drug formulary (if the plan includes prescription drug coverage)
The first item on the checklist is doctor networks:
• Most Advantage plans are HMOs or PPOs with limited networks so it's important to make sure that all of your physicians are within the plan's network
• If you have multiple doctors, make sure each one accepts the plan you're choosing
• Also, consider that you'll need a referral from your primary care physician to see a specialist
The next item on the checklist is the coverage area:
• Advantage plans do not travel with you – thus, if you travel a lot, an Advantage plan might not be the best option for you because some restrict you to the doctors within your county
Next up is cost-sharing/out-of-pocket costs:
• Cost-sharing varies from plan to plan
• It includes deductibles, coinsurance, and copays
• Check how much copays are to see primary care physicians and specialists
• If you see doctors often, these amounts can add up quickly
• Check what the maximum out-of-pocket limit is, as these vary from plan to plan; plans with lower monthly premiums tend to have higher maximum out-of-pocket amounts
Next, check for extra benefits:
• Not all Advantage plans include dental, vision, and hearing, so make sure your plan includes the extra benefits you want
• Ask your agent if there is a Part B reduction plan available to you – this is when the plan reimburses some or all of your Part B premium (not available in all areas)
Finally, you'll want to go over all the important documents:
• Summary of Benefits – Check the benefits (including exclusions), deductible amounts, coinsurance and copay amounts, out-of-pocket limit, direct links to preferred provider directory and drug formulary, as well as any referral requirements
• Annual Notice of Coverage & Evidence of Coverage – What you'll receive if you're already enrolled in an Advantage plan; These notify you of any changes that will take effect in the plan in the following year
• Drug Formulary – If the plan includes prescription drug coverage, this will include all the medications your plan covers; check that all of your medications are included on the formulary – also, check the deductible for prescription drugs, which varies from $0 to $445
The enrollment periods you can use to make changes to your Advantage plan are:
• Initial Coverage Election Period
• Annual Enrollment Period
• Medicare Advantage Open Enrollment Period
Thank you for watching this video! We hope you found it educational. If you have any questions, feel free to leave them in the comments below. Please subscribe to our YouTube channel and join our Medicare Community on Facebook.
YouTube Channel: https://www.youtube.com/MedicareFAQ/
Facebook Community: https://www.facebook.com/groups/MedicareFAQ/
Resources:
- https://www.medicarefaq.com/faqs/pre-enrollment-medicare-advantage-checklist/
- https://www.medicarefaq.com/faqs/medicare-advantage-open-enrollment-period/
- https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/
- https://www.medicarefaq.com/faqs/medicare-advantage-vs-medicare-supplement/
- https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-c/
- https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-c/medicare-advantage-prescription-d
While there are many similarities between Original Medicare and Medicare Advantage, they're actually quite different. With Original Medicare, your benefits are administered by the federal government and include Part A and Part B. Part A is your hospital coverage and Part B is your medical coverage. You pay into both of these parts during your working career through Medicare taxes.
With Medicare Advantage, your benefits are managed through a private insurance company. Medicare pays the Medicare Advantage carrier to administer your benefits for both Part A and Part B. When Medicare Advantage is administering your benefits, it's known as Part C. These private insurance companies must follow the guidelines that the federal government sets in place.
Now that we've gone over the basic difference between the two, let's go over the pros and cons.
Original Medicare Pros:
• Benefits are identical from person to person
• There are no copays, no waiting periods, and no pre-existing condition limitations
• There are no networks, meaning you can see any doctor that accepts Medicare
• Any out-of-pocket costs will be the same regardless of the provider you choose
•Your coverage will also travel with you across the United States
Original Medicare Cons:
• Both Part A and Part B come with a deductible and coinsurance
• No maximum out-of-pocket
• No coverage for prescription drugs
Medicare Advantage Pros:
• Some areas have plans with $0 premiums
• Some plans have a Part B give-back option
• Plans have an out-of-pocket maximum limit
• Can come with additional perks like dental, vision, and hearing benefits, gym memberships, and long-term care
• Many plans include coverage for prescription medications
Medicare Advantage Cons:
• Benefits are different from plan to plan
• You still need to pay your Part B premium
• Limited doctor networks and need for a referral to see a specialist
• High cost per service
• Plans do not travel with you
• Maximum out-of-pocket limit could still break the bank
Now that we've discussed the pros and cons of both, let's go over how doctor visits, covered services, and costs work.
Doctor Visits on Original Medicare:
• When you have Original Medicare, you can see any doctor or specialist that accepts Medicare without needing a referral
• Plans don't change annually, so you don't have to worry about your doctor leaving the plan's network
Doctor Visits on Medicare Advantage:
• Most plans are HMOs or PPOs and you'll have a primary care physician to direct all your care – therefore, you'll need a referral to see a specialist
• Physicians can leave the plan's network at any time
Covered Services on Original Medicare:
• A wide range of services are covered
• Does not include coverage for routine dental, vision, or hearing care
Covered Services on Medicare Advantage:
• Includes coverage for the same services Original Medicare covers plus possible coverage for dental, vision, and hearing
Costs on Original Medicare:
• Part A and Part B both come with a deductible and coinsurance
• You will pay a monthly premium for Part B
• No maximum out-of-pocket limit
• The Part A deductible is per benefit period
Costs on Medicare Advantage:
• You still need to pay your Part B premium in order to be eligible for a Medicare Advantage Plan
So, which is better –Original Medicare or Medicare Advantage? This answer depends on your specific situation and your health care coverage goals. If you're looking to cover the gaps in Original Medicare, then the best option for you might be a Medigap plan in combination with a Part D prescription drug plan. If you can't enroll in a Medigap plan, then having Medicare Advantage is better than just having Original Medicare
Medicare changes every year. In this video, we go over what changes you can expect to see in 2021.
Part A is your inpatient coverage. Most beneficiaries don't need to pay a premium for Part A because they've paid in for at least 40 quarters. Yet, if you didn't pay in at all, your Part A premium is $471. If you paid in for at least 30 quarters, your Part A premium in 2021 will be $259.
Part A also comes with a deductible. For 2021, the Part A deductible is $1,484.
If you end up in the hospital for an extended period of time, Part A will pay 100% of the cost of your stay for the first 60 days. After the first 60 days, your daily coinsurance will be $371 and for days 91 through 150, it will be $742 per day.
Skilled nursing facility coverage also falls under Part A. For the first 20 days, Part A will cover 100% of the skilled nursing facility's cost. For days 21 through 100, you pay a daily coinsurance of $185.50. After 100 days, you're responsible for 100% of the cost.
Next, Part B is your outpatient coverage. This comes with a standard deductible of $148.50 for 2021. Higher-income earners are subject to higher premiums. The Part B annual deductible for 2021 is $203.
Medicare Advantage also comes with cost-sharing. The average monthly premium for an Advantage plan in 2021 is $21, which is the lowest it's been since 2007.
Advantage plans come with a maximum out-of-pocket limit. This limit for 2021 is $7,550 for in-network and $11,300 for out-of-network.
Another change for 2021 is Advantage plans now accepting patients with End-Stage Renal Disease (ESRD). Additionally, some Advantage carriers will start including long-term care benefits, such as personal care, transportation, meal delivery, and adult day care services. Yet, benefits will still not cover room and board or help with daily living activities.
For Part D, the average monthly premium for 2021 is $41. Premiums vary from state to state. The 2021 Part D deductible is $445.
The last thing we'll go over today is Medigap changes for 2021. Medigap includes two high-deductible plans. The high deductible for both High Deductible Plan G and High Deductible Plan F is $2,370 for 2021.
Medigap also includes two plans with maximum out-of-pocket limits. The maximum out-of-pocket for Plan L is $3,110, and the maximum out-of-pocket for Plan K is $6,220.
It's important to remember that most, if not all, of the cost-sharing for Parts A and B will be covered by a Medigap plan if you have one.
2021 Medicare Changes - https://www.medicarefaq.com/faqs/medicare-changes-in-2021/
Part A - https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-a/
Part B - https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-b/
If you find the different enrollment periods within Medicare confusing, don't go anywhere. In today's video, we'll go over every part of Medicare and the enrollment periods that come with each.
My name is Lindsay Engle, and I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com.
Medicare comes with many different parts and plans. Each one has a specific enrollment period, and some have multiple. In this video, I discuss which enrollment periods fall under each part.
First, we'll discuss Part A and Part B. Part A is your inpatient coverage, and Part B is your outpatient coverage. These parts come with two different enrollment periods:
• Initial Enrollment Period: When you can first enroll in Parts A and B. Begins 3 months before your 65th birthday, lasts the month of, and continues 3 months after your 65th birthday
• General Enrollment Period: If you miss your Initial Enrollment Period, this is the next time you can enroll in Parts A and B. It occurs annually between January 1 and March 31. Your coverage will start on July 1
– If you have a change of circumstance, you can qualify for a Special Election Period (example: having creditable group coverage through your employer)
Next, we'll discuss the different enrollment periods that come along with Medicare Advantage plans.
• Initial Coverage Election Period (ICEP): Begins three months before your 65th birthday and when it ends is dependent on when your Part B becomes effective
• Annual Enrollment Period: If you miss your ICEP, the next time you can enroll is during the Annual Enrollment Period (AEP), which occurs each year between October 15 and December 7
• Medicare Advantage Open Enrollment Period: If you're enrolled in an Advantage plan, and you want to make changes, you can do so annually between January 1 and March 31
– You could also qualify for a Special Election Period due to a change in circumstance
Part D prescription drug coverage also comes with similar enrollment periods.
• Initial Enrollment Period: During this time, you can also sign up for Part D
• Annual Enrollment Period: If you miss your Initial Enrollment Period, the next time you can enroll is during the Annual Enrollment Period
– You can also qualify for a Special Election Period, just like Parts A, B, and C (Advantage)
Now, let's go over when you can enroll in a Medigap plan.
• Medigap Enrollment Period: This is your only enrollment period for Medigap. It lasts six months and begins once you enroll in Part B – it isn't annual like the others
– Outside of the Open Enrollment Period, you can enroll in a Medigap plan at any time of the year as long as you have Part B – the only difference is you will have to answer health questions
A common misconception is that you can enroll in a Medigap plan during the Annual Enrollment Period without having to answer any health questions. This is not true unless it overlaps with your Medigap Open Enrollment Period.
The last enrollment period we'll go over today is for those eligible for Medicare due to a disability.
Initial Enrollment Period: You become eligible for Medicare once you collect Social Security Disability Income for 24 months. After 24 months, your Initial Enrollment Period will begin. This is the same 7-month window we discussed at the beginning of the video
Second Initial Enrollment Period: In addition to your Initial Enrollment Period, you get a second one when you age in at 65
Thank you so much for watching! If you'd like more information on the different enrollment periods mentioned, make sure to check out our enrollment period playlist.
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If you're aging into Medicare, don't go anywhere. In today's video, we're going to talk about your Initial Enrollment Period.
Medicare comes with many different enrollment periods. It's important to understand the difference between each one. Your Initial Enrollment Period is the first window of opportunity you have to enroll in Parts A and B, as well as Part D.
Your Initial Enrollment Period is a seven-month window. It begins three months before your 65th birthday, lasts the month of your birthday, and will continue three months after your birthday. If your birthday happens to fall on the first of the month then your IEP will begin the month before your 65th birthday. For example, if your birthday is on July 1, your IEP begins on March 1, and your coverage will become effective on June 1.
It's important to know that your Initial Enrollment Period only comes around once in your lifetime. The only exception is for those collecting Social Security Disability Income, in which case, your IEP comes around twice. Your first IEP will begin 24 months after you first collect SSDI. When you turn 65, you will have another IEP.
During this window, you can enroll in Original Medicare (Parts A and B) and Part D. When you enroll during your IEP, you can avoid the late penalties that come with Part B and Part D when you don't have creditable coverage. You can also enroll in a Medicare Advantage plan during this window because your Initial Coverage Election Period for Advantage is also a seven-month window beginning six months before your 65th birthday and ending the last month before you enroll in Part B or the last month of your Initial Enrollment Period.
When it comes to Medicare Supplements, your Initial Enrollment Period is important because it will activate your Medicare Supplement Open Enrolment Period once you enroll in Part B. When you enroll in Part B, your six-month window to enroll in a Medicare Supplement plan without having to answer any health questions will begin.
If you're collecting Social Security Income before turning 65, you'll be automatically enrolled in Part A and Part B when you age in. If you're not collecting Social Security by age 65, then you'll need to actively enroll in Parts A and B.
If you work for an employer with fewer than 20 employees, have retiree insurance, or TRICARE, you'll want to take advantage of your IEP and enroll in Parts A and B. This is because your Medicare becomes primary and your other coverage becomes secondary. If you don't enroll in Parts A and B when you're first eligible, you could be subject to paying 80% of your medical costs out-of-pocket.
If you work for an employer with more than 20 employees, your employer coverage becomes primary. At this time, you'll have the option to enroll in Part A or B without penalties if you delay coverage.
Since Part A is premium-free for most, the majority of people choose to enroll in it. You can choose to delay enrolling in Parts B and D since your employer group coverage is considered creditable and you'll get a Special Enrollment Period when you leave it.
Now, if you happen to miss your IEP, you will have to wait until the General Enrollment Period to enroll in Parts A and B. This occurs annually between January 1 and March 31. However, your coverage won't begin until July 1. This could leave you with a gap in coverage. If you went more than 12 months after your IEP, you could start incurring penalties if you didn't have creditable coverage.
If you didn't enroll in a Part D plan during your IEP, the next opportunity you have is the Annual Enrollment Period. This enrollment period occurs each year between October 15 and December 7.
Youtube Video : https://youtu.be/ez15SApv8aE
If you're a Medicare beneficiary living in Massachusetts, don't go anywhere. We're going to discuss how Medigap plans work in Massachusetts.
I'm Lindsay Engle, the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. Original Medicare comes with many out-of-pocket costs in the form of cost-sharing. Most people enroll in a Medigap plan to help with these gaps in coverage.
Medigap plans are standardized by the federal government. All 50 states – except for three – follow these standardized plans. Typically, you have 12 options to choose from, but in Massachusetts, you have three.
Your three options in Massachusetts are the Core Plan, Supplement1 Plan, and 1A Plan. The 12 plans that are standardized by the federal government are labeled Plans A through N.
The Core Plan in Massachusetts follows Medigap Plan A. The core plan will cover coinsurance that falls under Part A for an additional 365 days after your Original Medicare benefits have been exhausted. Also, it will cover any coinsurance under Part A for hospice care.
Additionally, the Core Plan will cover any coinsurance under Part B. It will also cover the first three pints of blood if needed at a hospital or doctor's office and an additional 60 days of inpatient mental health care.
Basically, the Core Plan covers your core benefits only.
The next plan option you have is Supplement1 Plan. This plan is in line with Plan F. It pretty much covers all of your monthly expenses outside your monthly premium.
Supplement1 Plan includes the same benefits as the Core Plan. It covers your Part A and Part B deductible, any coinsurance at a skilled nursing facility, foreign travel emergency care, and an additional 120 days of mental healthcare at an inpatient facility.
It's important to include that if you're eligible for Medicare after 2020, you won't be eligible for the Supplement1 Plan. This is because it covers the Part B deductible, which makes it a first-dollar coverage plan. As of 2020, all first-dollar coverage plans will be unavailable to newer Medicare beneficiaries.
If you're eligible after 2020, you can enroll in the Core Plan or the 1A Plan. If you're eligible for Medicare prior to 2020, you can enroll in any of the three options.
The last plan you have to choose from is the 1A Plan. This plan is very similar to Plan G. It covers the same benefits as the Core Plan, and the same benefits of the Supplment1 Plan, minus the Part B deductible.
To summarize, if you're a Massachusetts resident, you have only three Medicare Supplement options from which to choose. The Core Plan includes the core policy benefits that you'll see under Plan A. The Supplement1 Plan basically covers the same benefits as Plan F. Finally, the 1A Plan covers the same benefits as Plan G.
For more information on Massachusetts Medigap plans: https://www.medicarefaq.com/medicare-supplements/medigap-by-state/massachusetts-medigap-plans/
PDF documents of all 3 plans: https://www.medicarefaq.com/medicare-supplement-outline-of-coverages/ma-medicare-supplement-outline-of-coverage.pdf
I hope you found this video helpful! If you did, make sure to subscribe to our YouTube channel. Don't forget to turn notifications on, so you know as soon as we upload a new video. If you have any questions, make sure to leave them in the comments section below.
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Are you new to Medicare and considering delaying enrollment in Part D? Don't go anywhere – in this video, we explain how the Part D penalty works.
My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.
Part D works as prescription drug coverage alongside Parts A and B. The best time to enroll is when you're first eligible, during your Initial Enrollment Period.
Your Initial Enrollment Period begins three months before your 65th birthday. Will be the month of, and continues for three months after your 65th birthday. This gives you a seven-month window to enroll.
Like Parts A and B, Part D comes with a late penalty if you delay enrolling without creditable coverage. If you don't have creditable coverage, you may qualify for a Special Election Period to eliminate this penalty.
This penalty works differently from the Original Medicare penalties. With Part D, you'll be charged a penalty equal to 1% of the national average premium for every month you delayed enrolling without creditable coverage.
You'll pay this penalty every month as long as you have Part D coverage. If you're penalized, you can appeal the penalty by submitting a reconsideration request. This is available on CMS's website.
For example, say you waited 33 months after your Initial Enrollment Period to enroll in a Part D plan. Unless you had creditable coverage or qualify for a Special Election Period, you'd be charged 1% of the national average Part D premium for each of those 33 months.
Currently, the average premium for Part D is $33.06. The penalty is calculated by multiplying $33.06 by 0.33 (33 months), which equals $10.90. The Part D penalty is rounded to the nearest 10 cents. Therefore, your Part D premium would be somewhere around $43.97. Your premium would continue to increase, as the average premium does each year.
Each Part D carrier sets its premium and drug formulary. Even if you think you don't need Part D prescription drug coverage right now, many different carriers offer these plans nationally. The monthly premiums start at around $15.
When choosing between paying the premium now and paying the penalty for the rest of your life, it makes more sense to enroll sooner. This way, you'll avoid the penalty.
Part D plans change annually. Each September, you'll receive an Annual Notice of Change letter that will go over your drug formulary and notify you of any premium increases.
During the fall Annual Enrollment Period from October 15 through December 7, you'll have the opportunity to compare other plans in your area and make sure you have the lowest premium available.
As has been noted, the best time to enroll in a Part D plan, and avoid penalties, is during your Initial Enrollment Period.
Part D: https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-d/
Part D Late Enrollment Penalty: https://www.medicarefaq.com/faqs/medicare-part-d-late-enrollment-penalty/
Initial Enrollment Period: https://www.medicarefaq.com/faqs/medicare-initial-enrollment-period/
Special Election Period: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/
Annual Enrollment Period/Open Enrollment Period: https://www.medicarefaq.com/faqs/fall-medicare-open-enrollment-period/
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MedicarePartD #LateEnrollmentPenalty #PrescriptionDrugPlan
If you're considering delaying enrollment into Original Medicare Parts A and B, don't go anywhere. In this video, we'll go over what you need to know about Medicare's late enrollment penalties.
My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. When you first become eligible for Medicare, you may consider delaying enrollment. However, there are penalties associated with delaying enrollment in Medicare. We're here to explain what they are and how to avoid them.
Part A is your inpatient or hospital coverage. Most people are entitled to premium-free Part A, as long as they paid into enough quarters while still working. The late enrollment penalty for Part A is 10% of the current Part A premium. You'll pay this for twice the number of years you were eligible but didn't enroll.
For example, if you were eligible for two years but never signed up, you would have to pay 10% above the standard premium for four years.
Part B is your outpatient or doctor's coverage. The Part B penalty is 10% above the standard premium for every 12 months you went without coverage. Unlike Part A penalty, the Part B penalty is lifelong. The only way around it is if you're eligible for a Special Enrollment Period.
An example of the Part B penalty is if you were eligible for coverage in November 2013 but chose not to enroll until March 2017. This would mean you delayed enrolling for 40 months, or three years and five months. This time would count as three full 12-month periods, meaning you would have to pay a late enrollment penalty for 30% above the standard premium.
Now, how do you avoid both of these penalties? To avoid the Part A and Part B penalties, you'll want to enroll when you're first eligible; during your Initial Enrollment Period.
Your Initial Enrollment Period starts three months before the month of your birthday includes the month of your birthday, and continues three months after. Once you miss your seven-month IEP, you may begin to incur penalties, unless you're eligible for a Special Enrollment Period.
The majority of beneficiaries choose to enroll in Part A because it's premium-free for most. The most common reason for delaying Part B is if you have group employer coverage and your employer has more than 20 employees. In this case, the coverage is considered creditable, and you can delay enrollment into Part B with no penalty.
One of the most common questions we receive is if there's a cap on the Part B penalty. Unfortunately, at this time, there is no cap.
Another thing to note is if you're eligible for Medicare due to a disability and were paying penalties on your premiums, the premiums will be eliminated once you turn 65.
If you feel that the penalties you have incurred shouldn't have applied to you, you can submit a reconsideration request to Medicare. [LINK HERE]
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Are you aging into Medicare and still working? Don't go anywhere! In this video, we explain how your employer coverage works with Medicare. My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. The size of your employer will be a factor in your Medicare decision when you're 65 years old and still working.
If Your Employer Has 20+ Employees:
If your employer has more than 20 employees, your employer coverage becomes primary, and Medicare becomes secondary. In this scenario, most beneficiaries choose to enroll in Part A because Part A is usually premium-free as long as you have paid into Medicare for sufficient quarters. If you end up at the hospital, your Part A benefits will help keep your out-of-pocket cost lower.
Part B is your outpatient coverage, and Part D is your prescription drug coverage. As long as your employer has more than 20 employees, the coverage is considered creditable under Medicare. This allows you to delay enrolling in Part B and Part D without being penalized.
Because employer group coverage usually includes outpatient services and prescription drug coverage, most beneficiaries choose to delay enrolling since each comes with a monthly premium. Down the road, when you retire, you'll qualify for a Special Election Period. You'll be able to enroll in both Part B and Part D without incurring any penalties.
If Your Employer Has Fewer Than 20 Employees:
If your employer has fewer than 20 employees, your Medicare becomes primary, and employer coverage is secondary. In this scenario, you'll want to enroll in both Part A and Part B. If you don't, you could be responsible for paying 80% of your outpatient services as well as incur a late penalty.
An Exception:
If you have a high-deductible plan and health savings account, and you plan to continue contributing or accepting your employer's contributions, you shouldn't enroll in any parts of Medicare. This is because the IRS states that if you have any additional coverage, including Part A, you cannot continue contributing to your HSA.
Important Tips:
• It's important to make sure your employer notifies Medicare that you have retired to avoid rejection of any of your medical bills
• If you're currently collecting Social Security Income, you will automatically be enrolled in Part A. You cannot collect SSI without also enrolling in Part A.
If you plan to continue working past 65 and delay retirement, I hope you found this video helpful. If you did, make sure to subscribe to our YouTube Channel! Turn notifications on, so you know as soon as we upload a new video.
Medicare and Employer Coverage FAQ: https://www.medicarefaq.com/faqs/medicare-and-employer-coverage/
Medicare & HSA: https://www.medicarefaq.com/faqs/hsa-and-medicare/
Our Medicare Facebook Community: https://www.facebook.com/groups/MedicareFAQ/
Medicare #Turning65 #EmployerGroupCoverage
If you're a California resident who is eligible for Medicare, don't go anywhere! We're telling you what you need to know about Medicare Supplements in California and explain in detail how the Birthday Rule works.
Once you become eligible for Medicare, you'll have the option to enroll in supplemental coverage. This supplemental coverage comes in the form of either a Medicare Advantage plan or a Medigap plan with an additional Part D drug plan.
You can enroll in a Medicare Advantage plan during your Initial Coverage Election Period. If you missed your Initial Coverage Election Period, you could enroll during the Annual Election Period that comes around each October. If you enroll in a Medigap plan instead, your first opportunity to do so is during your Medicare Supplement Open Enrollment Period.
If you miss your Open Enrollment Period, you can still enroll in a Medigap plan at any time of the year. However, you'll have to go through medical underwriting and answer health questions.
Good news: if you're a California resident and want to change Medigap plans, you'll have an additional opportunity to do so without answering any health questions. The California Birthday Rule says that each year, 30 days before your birthday and 60 days after your birthday, you'll have the option to change your Medigap plan without answering health questions.
You're allowed to switch plan carriers, keeping the same plan with the same benefits, or switch to a plan with fewer benefits. For example, if you have Plan F, you can enroll in a different Plan F with another carrier. Alternatively, you can enroll in Plan G.
As another example, if you have Plan G, you can enroll in Plan G with a different carrier or enroll in Plan N. However, you won't be able to enroll in Plan F since Plan F has more benefits than Plan G.
Your premiums can increase year over year, so California residents benefit from the Birthday Rule. It allows you to shop other rates in your area to see if you can find one that's more affordable. If your health declines, you won't have to worry about that impacting your rates.
You can apply for Original Medicare (Parts A and B) in California, online, via telephone, or at your local Social Security office.
If you're ready to enroll in a Supplemental Medicare plan in California, give us a call! Once an agent collects some information from you, they'll be able to compare all your Medigap options for your area.
Medigap in California: https://www.medicarefaq.com/medicare-supplements/medigap-by-state/california-medigap-plans/
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If you're not sure which Medicare Supplement plan to enroll in, don't go anywhere! Today, we're going to review the top Medicare Supplement plans.
Hi everyone, my name is Lindsay Engle. I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com.
The top Medicare Supplement plans include Plan F, Plan G, and Plan N.
First, we'll talk about Plan F. Medicare Supplement Plan F is one of the most popular plans due to it leaving you with zero out-of-pocket costs outside of your monthly premium. Plan F is considered first-dollar coverage. This means that when you go to the doctor or the hospital, you'll never have to pay any copays, coinsurance, or deductibles. It's important to remember, though, that more benefits come with a higher monthly premium. So, Plan F is one of the more expensive plans because it includes the most benefits.
Plan F is only available to those eligible for Medicare prior to 2020. Regardless of if you have enrolled in Part B and a Medigap plan already, you are still eligible to enroll in Plan F. Those who were not eligible to enroll in Medicare before 2020 are not eligible to enroll in Plan F.
The runner-up plan to Plan F is Plan G. If you are not eligible for Medicare until after 2020, Plan G is the plan with the most benefits you are eligible for. Plan G covers all the same things as Plan F. The only difference is the Part B deductible. So, when you go to the doctor's office, you'll be responsible for paying the Part B deductible. Once you've met the Part B deductible, your benefits will kick in at 100% and you'll have no additional out-of-pocket costs.
Last but not least on our top Medigap plan list is Plan N. With Plan N, you'll still be responsible for the Part B deductible. In addition, you'll be responsible for a $20 copay at the doctor's office and a $50 copay at the emergency room. These copays keep your monthly premium lower. The only other out-of-pocket cost you'll be responsible for with Plan N is in the form of excess charges. The majority of beneficiaries don't need to worry about excess charges. To learn more about excess charges, read our article below.
That about wraps it up! We hope you found this video on the top Medigap plans helpful. If you did, make sure to subscribe to our YouTube channel. Don't forget to turn notifications on so that you're notified every time we upload a new video. We also have a fantastic Medicare Community on Facebook. Click the link below to join!
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Medicare beneficiaries have the option to obtain additional coverage that will supplement their original Medicare benefits. You can choose between a Medicare Advantage plan or a Medicare Supplement plan. Today, we will compare both side-by-side, so you can make the best decision for your health care coverage.
When you enroll in Medicare, you have the option to enroll in Part A and Part B. Part A is your hospital coverage and Part B is your doctor's coverage, or medical coverage.
There are still many out-of-pocket costs when it comes to Part A and Part B. This includes deductibles and coinsurance. In order to fill in the gaps of coverage that original Medicare doesn't include, you'll need to enroll in supplemental coverage. For this, you have two options. Option 1: a Part D plan with a Medigap plan, or Option 2: a Medicare Advantage plan.
If you are enrolling in a Medigap plan, it is recommended to add a stand-alone Part D plan because Original Medicare does not include prescription drug coverage. Medicare Supplement (Medigap) plans cover additional, out-of-pocket costs you are otherwise responsible for, such as coinsurance and deductibles.
The second option you have is to enroll in a Medicare Advantage plan. Medicare Advantage is not the same as Original Medicare. Medicare Advantage plans are managed healthcare plans offered through private insurance companies.
Medicare Advantage plans tend to have lower monthly premiums when compared to Medigap. Some Medicare Advantage plans come with ancillary benefits like dental and vision. Some also include prescription drug coverage. Due to the low or $0 monthly premium, beneficiaries need to pay more out-of-pocket as they use the benefits.
You may be wondering, how are Medicare Advantage plans free?! The Medicare Advantage carrier is paid around $1,000 per month by Medicare to take on your risk. That is how they are able to offer such low premiums, including some $0 monthly premiums.
In addition, Medicare Advantage carriers make money from cost-sharing. Unlike Medigap, you'll have copays every time you see a doctor. If you see multiple doctors within one visit, you could have just as many copays to pay in one exam.
It is also important to know that you still have to pay your monthly Part B premium with a Medicare Advantage Plan. A common misconception is that you don't have to pay the monthly Part B premium. This is not true and you will still be responsible for it.
You see many Medicare Advantage commercials throughout the year, especially during the Annual Enrollment Period. This is because carriers want these policies to seem more attractive to you with their $0 premiums and additional benefits. This makes them seem like all-inclusive plans. Keep in mind, however, that they are paid by Medicare to take on your risk and they will make their money between Medicare and cost-sharing you pay out of pocket when you use those benefits.
Medicare Advantage Plans need to cover the same benefits as Original Medicare. However, it is up to the carrier how much they will cover for that specific service. While Medicare may pay 80% for your doctor visit, Medicare Advantage might cover less than that as well as throw on additional cost-sharing in the form of copayments and coinsurance. All of this can quickly add up to more than the premium would have been for a Medigap plan.
So, is it better to have a Medicare Advantage plan or a Medigap plan? This depends on your specific situation. One may not be better than the other. However, one might be better than the other for you.
Three Things to Consider When Deciding Which Plan to Go With:
- Budget
- Medical Usage
- Travel Frequency
The last thing you should keep in mind is that if you enroll in a Medicare Advantage plan, you may not be able to enroll in a Medigap plan in the future.
There are many different enrollment periods for Medicare. Today, we will discuss one of the most important ones: the Medicare Annual Enrollment Period, which comes around every fall.
My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.
The Medicare Annual Enrollment Period is commonly referred to as the Annual Election Period or the Medicare Open Enrollment Period. It occurs annually, in the fall, between October 15th and December 7th.
This enrollment period is for beneficiaries who are already enrolled in Medicare to make changes to their coverage. This means that you must either be enrolled in Part A and Part B of Original Medicare, a Medicare Advantage Plan, or a stand-alone prescription drug plan under Part D.
If you're enrolled in Medicare Advantage, you can change from one carrier to another carrier or switch back to Original Medicare. When you switch back to Original Medicare, you can then choose to enroll in Medigap and Part D plans if you wish to do so.
If you're currently enrolled in Part D, you can choose to switch from one plan to another or drop your coverage altogether. You can also enroll in a Part D plan at this time if you only have Original Medicare without any prescription drug coverage.
A first key point to remember is if you're not already enrolled in Medicare, this is not the enrollment period for you. If you're looking to enroll in Part A and Part B for the first time and you're outside your Initial Enrollment Period, you'll have to wait until the General Enrollment Period, which runs annually between January 1st and March 31st.
Another key point to remember is that if you're choosing to enroll in a Medicare Supplement Plan at this time, you'll still have to answer health questions and go through medical underwriting. The only way around this is if your Medicare Open Enrollment Period is also happening during the Annual Enrollment Period or, due to a specific circumstance, you qualify for a Special Election Period.
The Annual Enrollment Period does not give you guaranteed issue rights. You can enroll in a Medigap plan at any time of the year. The only thing to remember is if you are outside of your Open Enrollment Period, which is the first six months after your Part B effective date, you will have to answer health questions. Any coverage changes you make during the Annual Enrollment Period will become effective January 1st of the following year.
Each September, your Medicare Advantage carrier or Part D carrier will send you a plan annual notice of change that will give you a brief summary of all your benefits.
Your notice of change will explain any plan coverage changes that will become effective the following year. You will want to pay attention to your premium. If you feel that the premium is increasing more than expected, it may be time to shop around for new plans.
If you have Medicare Advantage, you should also pay attention to the doctor network. Make sure your doctor is still within your plan's network.
Another important thing to check is your Part D drug formulary to ensure your current prescriptions will still be covered.
Thank you so much for watching! If you have any questions about the Medicare Annual Enrollment Period, make sure to leave them in the comments section below.
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Medicare Supplement premiums are unique for each beneficiary. Yours will definitely not be the same as your neighbor down the street. In today's video, we're going to explain the factors that determine your monthly premium.
Hi, I'm Lindsay Engle, and I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com. If you're like many Medicare beneficiaries, your first go-to to find Medigap quotes is online. You found a website, filled out a form, answered a few questions...only to find out that you actually can't get quotes without speaking to an agent.
You end up frustrated, wondering, "WHY CAN'T I SEE MY QUOTES ONLINE!?!?" Several factors impact your Medigap rates, and these are questions that you can't answer online. This is why you have to speak to a Medicare agent.
Now, we're going to go over which factors will determine your Medigap premium. Before we jump into these different factors, it's important to understand that all Medigap plans are standardized by the government. What this means is that each letter plan has a set of benefits that will stay the exact same regardless of the carrier with which you choose to enroll. The only difference will be the premium you pay.
(1) Your location: What you might pay in one state for the same benefits could be completely different than what you might pay in a different state.
(2) Your gender: Your gender could be a determining factor depending on the state where you live. Because females are mostly overall healthier than males, in some states they will find that they pay around $10-30 less in monthly premiums.
(3) Your age: If you enroll when you're first eligible at 65, you're going to pay less in monthly premiums than you would if you enroll at 75. Additionally, depending on the state where you live, if you're eligible for Medicare due to collecting Social Security Disability Income (SSDI) for 24 months, you can pay up to 3-4 times more in monthly premiums than those who age in at 65.
(4) Tobacco use: For those who smoke, chew, or use vaping products, you can expect to pay up to 10% more in monthly premiums. This is because those who use tobacco tend to have more medical conditions.
(5) Household discounts: Some carriers offer discounts to those who live in the same household, as long as they enroll in a plan with the same carrier.
(6) How you pay: Some carriers will charge you more if you choose to pay quarterly, semi-annually, or annually. Also, because it's more cost-effective for the carrier to process your payment electronically versus by check or credit card, some carriers will discount your premiums if you choose to pay electronically.
(7) The letter plan in which you choose to enroll: As expected when you want more benefits, you will pay a higher monthly premium.
(8) Rating method the carrier uses to determine your supplement policy premiums: There are three rating methods a carrier can use to set the rates for their Medigap policies: community, issue age, and attained age. Attained age rated is the most common model used by carriers today.
(9) Rate increase history of the carrier: You want to make sure they have at least an A or better financial rating and have been in the market for at least five years.
(10) The time you enroll: The best time to enroll is during your Open Enrollment Period.
(11) Some carriers offer a 12-month rate lock: Even if your effective date isn't for a few months, you want to enroll now to prevent any rate increases between now and your effective date.
Hopefully, this video helped you understand why it's impossible for us to give you accurate quotes without speaking to you over the phone to collect more information! Our agents will be able to compare any plan with any carrier that is available in your area to get you the most accurate quote based on your personal information.
MedicareFAQ: https://w
There are many different enrollment periods for Medicare. Today, we will discuss one of the most important ones: the Medicare Annual Enrollment Period, which comes around every fall.
My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.
The Medicare Annual Enrollment Period is commonly referred to as the Annual Election Period or the Medicare Open Enrollment Period. It occurs annually, in the fall, between October 15th and December 7th.
This enrollment period is for beneficiaries who are already enrolled in Medicare to make changes to their coverage. This means that you must either be enrolled in Part A and Part B of Original Medicare, a Medicare Advantage Plan, or a stand-alone prescription drug plan under Part D.
If you're enrolled in Medicare Advantage, you can change from one carrier to another carrier or switch back to Original Medicare. When you switch back to Original Medicare, you can then choose to enroll in Medigap and Part D plans if you wish to do so.
If you're currently enrolled in Part D, you can choose to switch from one plan to another or drop your coverage altogether. You can also enroll in a Part D plan at this time if you only have Original Medicare without any prescription drug coverage.
A first key point to remember is if you're not already enrolled in Medicare, this is not the enrollment period for you. If you're looking to enroll in Part A and Part B for the first time and you're outside your Initial Enrollment Period, you'll have to wait until the General Enrollment Period, which runs annually between January 1st and March 31st.
Another key point to remember is that if you're choosing to enroll in a Medicare Supplement Plan at this time, you'll still have to answer health questions and go through medical underwriting. The only way around this is if your Medicare Open Enrollment Period is also happening during the Annual Enrollment Period or, due to a specific circumstance, you qualify for a Special Election Period.
The Annual Enrollment Period does not give you guaranteed issue rights. You can enroll in a Medigap plan at any time of the year. The only thing to remember is if you are outside of your Open Enrollment Period, which is the first six months after your Part B effective date, you will have to answer health questions. Any coverage changes you make during the Annual Enrollment Period will become effective January 1st of the following year.
Each September, your Medicare Advantage carrier or Part D carrier will send you a plan annual notice of change that will give you a brief summary of all your benefits.
Your notice of change will explain any plan coverage changes that will become effective the following year. You will want to pay attention to your premium. If you feel that the premium is increasing more than expected, it may be time to shop around for new plans.
If you have Medicare Advantage, you should also pay attention to the doctor's network. Make sure your doctor is still within your plan's network.
Another important thing to check is your Part D drug formulary to ensure your current prescriptions will still be covered.
Annual Enrollment Period: https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/
Medicare Supplement Open Enrollment Period: https://www.medicarefaq.com/faqs/medicare-supplement-open-enrollment/
General Enrollment Period: https://www.medicarefaq.com/faqs/medicare-general-enrollment-period/
Medicare Advantage Open Enrollment Period: https://www.medicarefaq.com/faqs/medicare-advantage-open-enrollment-period/
Initial Enrollment Period: https://www.medicarefaq.com/faqs/medicare-initial-enrollment-period/
Special Enrollment Period: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/
Annual Notice of Change: https://www.medicarefaq.com/faqs/medicare-annual-no
You become eligible for Medicare, which is a federal health program, when you turn 65 years old. You're also eligible if you've been collecting Social Security Disability Income for 24 months or diagnosed with End-Stage Renal Disease. There are two main parts to Original Medicare. This includes Part A and Part B. Part A is your hospital coverage and Part B is your doctor and medical coverage.
When it comes to signing up for Medicare. Some are automatically enrolled in others will need to actively enroll. If you've been collecting Social Security benefits for at least 4 months, you'll be automatically enrolled into both Parts A and Part B. Your effective date will be the first day of the month you turn 65 years old. If your birthday happens to fall on the 1st of the month then your effective date will be the 1st of the month before your birthday. For example, if your birthday falls on July 1st, then your effective date will be June 1st.
You'll receive your Medicare card around 3 months before your birthday. If you're not collecting Social Security benefits, then you'll need to actively enroll into Part A and Part B. You'll want to enroll during your Initial Enrollment Period. Your Initial Enrollment window will be 7 months and starts 3 months before your birthday, will last the month of your birthday and will end 3 months after your birthday.
There are three ways you can enroll in Medicare. The 1st way is going down to your local Social Security Office. The 2nd way is to go ahead and give the Social Security office a call to enroll. The 3rd way and probably the most easy way is to do it online.
To begin the online application process you'll need to visit Social Security's web site. That's ssa.gov/benefits/Medicare. Then you'll scroll to the bottom of the page until you see the big blue button that says apply for Medicare only. If you recently have started an application and did not complete it, you can return to your saved application here also. It will bring you to the next page that talks a little bit about the online application and an option to start a new application. So go ahead and select start a new application. And then it will ask you if you're applying for yourself or someone who's not with you. So select applying for myself. Then it will ask if you have a My Social Security account. If you do not have one you will need to create one. If you do have one it will then ask you to sign in. So let's assume that I currently do not have a My Social Security account. You will need to have an address that's within the United States and US Territories to create the account. So select yes and hit next. At this point it will bring you to secure.ssa.gov to create an account. At this point it's going to ask you a few personal questions. The form will take about 15 to 20 minutes to fill out. If you would like you can save it and complete it later.
You will receive a letter from Social Security Administration once they made a decision about your enrollment.
Now, if you only have Part A and you delayed enrolling into Medicare Part B there are two additional forms that you'll need to complete to enroll in Part B.
So if you already have Part A and you're only enrolling in Part B, then you'll need to also complete 40B form. Which is application for enrollment in Part B. Once you complete this form, you'll want to include it in your online application or mail into the Social Security office. Now, if you delayed Part B due to having group employer coverage, you'll also need to complete the L564 form. Which is request for employment information.
MedicareFAQ: https://www.medicarefaq.com/faqs/applying-for-medicare/
Social Security Website: https://www.ssa.gov/benefits/medicare/
40B Form: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf
L564 Form: https://www.cms.gov/medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf
Before we go into the details on High Deductible Plan F. It's important to know your eligibility. If you are not eligible for Medicare until after 2020, you are not eligible to enroll in Plan F. If you are eligible for Medicare before 2020, then you are eligible to enroll in Plan F. If you aren't eligible for Medicare until after 2020 and you're looking for a high deductible plan, then High Deductible Plan G is the best option for you.
High Deductible Plan F is a good alternative for those who are interested in the standard Plan F, but the higher premium is a little bit out of their budget. With High Deductible Plan F, you get all the same benefits, leaving you with zero out-of-pocket costs outside your monthly premium. The only other out-of-pocket costs you'll be responsible for is the high deductible.
Now it's important to remember, that just because there's a high deductible that does not mean you're going to be paying 100% of your medical expenses out-of-pocket before coverage begins. All this means is that any coinsurance you pay will be applied towards the high deductible. Once you've met that deductible then your benefits will kick in 100%. Giving you the same benefits as standard Plan F. Therefore, if you're not able to afford the monthly premiums for the standard Plan F, the high deductible version of Plan F would be a great alternative for you.
While some beneficiaries may find that High Deductible Plan F when you add all the out-of-pocket cost together including the premium and deductible, is less than the standard Plan F. Others may find that the standard Plan F is actually cheaper in out-of-pocket total cost with premiums compared to the high deductible version of Plan F. That's why it's important to speak to an agent to help you compare rates in different areas on all different plans.
High Deductible Plan F - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-f-high-deductible/
High Deductible Plan G - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g-high-deductible/
Elimination of First-Dollar Coverage Plans - https://www.medicarefaq.com/faqs/medicare-changes-2020/
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High Deductible Plan G is a newer plan that was recently introduced in 2020. It's a great alternative for those who find the benefits on the standard Plan G attractive but are looking to pay a little bit less in monthly premiums. High Deductible Plan G has the same exact benefits as a standard Plan G. The only difference is that you must meet the plan's annual deductible before your benefits will kick in at 100%. Keep in mind that it does not mean that you're going to have to pay the full deductible before any of your benefits kick in. All that means is that any cost-sharing that you pay-out-of pocket once it adds up to that deductible, then your benefits will kick in at 100%. This high deductible is what keeps the monthly premium significantly lower when you compare it to the standard Plan G premiums.
So as long as you're comfortable with paying the high deductible out-of-pocket before coverage kicks in, then you'll end up saving quite a bit of money over the year in monthly premiums. For beneficiaries who don't want to have to worry about paying that high deductible out-of-pocket and are comfortable with paying higher monthly premiums than the standard Plan G is the right option for you.
The last thing to note is that if you are using your guaranteed-issue right to enroll in a high deductible plan, then you have to consider what year you became eligible for Medicare. If you were not eligible for Medicare until after 2020, then you can use guaranteed-issue right to enroll in High Deductible Plan G. However if you are eligible for Medicare prior to 2020 and you're using your guaranteed-issue rights, then you will not be eligible to use them with High Deductible Plan G. You'll be eligible to use them with High Deductible Plan F.
If you have any questions, make sure to post them in the comments section below.
High- Deductible Plan G - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g-high-deductible/
High- Deductible Plan F - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-f-high-deductible/
Standard Plan G - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g/
Standard Plan F - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-f/
All Medigap Plans - https://www.medicarefaq.com/medicare-supplements/medigap-plans/
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Hi there. I'm Lindsay Engle and I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com. And today's topic, we're going to talk all about Medicare Supplement Plan F.
Medicare Supplement Plan F, also known as Medigap Plan F, has been the number one choice among many Medicare beneficiaries do to leaving you with zero out-of-pocket cost. Medigap Plan F is considered a first-dollar coverage plan. This Is because outside of your monthly premium it will pay for any cost sharing that you may be responsible for after Medicare pays their portion.
Now the benefits may be very attractive to beneficiaries, however, with more benefits comes higher monthly premiums. Good news is if you find the monthly premiums for Plan F to be a little too high for your monthly budget, you do have some alternative options. The two alternative options you have are the high deductible version of Plan F as well as Plan G.
All Medigap plans are standardized by the government. This means that regardless of the letter plan you choose the benefits will be the same across all carriers. That's why it's important to work with the license agent. That way they can compare the same letter plan across all carriers to find you the lowest premium.
Now before you start comparing premiums for Plan F across all the carriers in your area. It's important to note if you're eligible to begin with. If you became medicare-eligible before 2020, then you are eligible to enroll in any first-dollar coverage plan. That includes planet F High Deductible Plan F and Plan C. However, if you were not eligible for Medicare until after 2020, you will not be eligible to enroll in Plan F. The best alternative would be Plan G.
Thank you so much for watching today. I hope you found this video on Plan F helpful. Until next time. Bye.
Plan F: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-f/
High Deductible Plan F: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-f-high-deductible/
Plan G: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g/
High Deductible Plan G: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g-high-deductible/
All Medigap Plans: https://www.medicarefaq.com/medicare-supplements/medigap-plans/\
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Hi everyone. I'm Lindsay Engle and I'm with Elite Insurance Partners and MedicareFAQ.com. Thank you so much for joining us. And in today's video, we're going to discuss and compare the differences between Medigap Plan F versus Plan G versus Plan N. But before we start comparing the plans, we need to address some important changes that have impacted all Medicare beneficiaries that were newly eligible as of 2020. The year that you became eligible for Medicare is what will determine which plans you are eligible to enroll in. So if you are eligible for Medicare before 2020, you can enroll at any of the top three plans being Plan F Plan G or Plan N. If you were not eligible for Medicare until this year or after 2020, you will not be eligible to enroll in Plan F. Your options will be Plan G and Plan N.
Plan F is considered a first-dollar coverage plan because it will leave beneficiaries with zero out-of-pocket costs outside of their monthly premium. With Plan F you'll have no cost-sharing. This includes deductibles, coinsurance, and co-pays.
Plan G has been the runner-up plan to Plan F due to it covering almost all of the same benefits. The only Benefit Plan G does not cover is the Part B deductible. The Part B deductible is $198. What this means is you'll have coverage for all of your out-of-pocket expenses, including co-pays coinsurance and deductibles. Once you've met that Part B deductible of $198, the only out-of-pocket costs will be what your monthly premium for Plan G.
Plan N has quickly become one of the most popular choices that our clients choose to enroll in. Plan N is considered a cost-sharing plan. This is because when you visit the doctor's office or the emergency room, you will have a small copay to pay. These co-pays are what keeps your monthly premium low. When you go to the doctor's office, you'll have a $20 copay. If you end up in the emergency room, you'll have a $50 copay. In addition to the co-pays, you’ll be responsible for the Part B deductible of $198 as well as any excess charges. However, most beneficiaries don't need to be concerned with excess charges. Some states do not even allow them and most doctors won't charge you with excess charges. Quick tip, If you can find an urgent care facility near you, then you won't have any copay to pay when you go to visit. This is important to take into consideration if you visit the doctor's office often. If you are not one to visit the doctor's office often then Plan N may be a good choice for you. It's important to remember that premiums vary from state to state.
For more information, please visit https://www.medicarefaq.com/faqs/plan-f-vs-plan-g-vs-plan-n/
For information on the 2020 changes visit https://www.medicarefaq.com/faqs/medicare-changes-2020/
Plan F - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-f/
Plan G - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g/
Plan N - https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-n/
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https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-c/
A Medicare Advantage plan is also known as Medicare Part C, it's offered by private insurance carriers and it's an alternative to a Medicare Supplement. Generally, Medicare Advantage plans are good for people who are healthy, because they don't have as many doctor visits and co-pays for specialists and it's also beneficial for someone who can't afford a Medigap policy because, in reality, some insurance is better than no insurance. These plans, you must have your Part A and B active in order to qualify to enroll. There is one health question, do you have end-stage renal disease. Now, if you do have end-stage renal disease, the standard Medicare Advantage plans won't be available. However, in some areas, there's what's called a Special Needs Plan.
Your Medicare Advantage plan will have a card for you, so when you go to your doctor, you will show your Medicare Advantage card instead of your Medicare card. This is because that private insurance carrier is now gonna handle your claims. Some of these plans include routine dental, vision, hearing and even gym memberships. It's important to remember that some of those services are only routine. So if you need dentures, fillings, root canals, you may want to purchase a separate, standalone policy.
Now, also with Medicare Advantage plans, you will have a one year trial right through your Guaranteed Issue, meaning that you will have 12 months to have your Medicare Advantage plan and within that time, you can either choose to stick with it or switch to a Medigap policy instead. You will also be protected if your Medicare Advantage plan leaves your service area through Guaranteed Issue, and you'll be able to switch at that point as well.
Well, the biggest pro that none of us can ignore is the zero dollar premium. And I know some of the plans do just have a lower premium, I've seen them between $20, all the way up to $100 bucks, depending on where you live. The downside to having a low premium is that you end up with higher out of pocket costs. The way you gotta look at it is either you're gonna pay for it upfront or you're gonna pay for it later.
Another thing to think about is when you have a Medicare Advantage plan, you have a more restricted network. As were with the Medigap policy, you can go anywhere where Medicare is accepted. That's not the case for Medicare advantage plans. Additionally, in most cases, referrals are needed to see specialists. So you will have to go to your primary care doctor, pay that copay to then go to the specialist and pay that copay. So all are very important things to think about when you're planning your year ahead. And if you throw in a hospital visit, a lot of them are $100 to $300 a day for the first 4 to 6 days.
One pro is that your Medicare Advantage premium can be deducted right from your social security, so it is one less bill you have to worry about manually paying. Another pro is there's national emergency coverage, so if you travel frequently and you have an emergency situation, you do have coverage with your Medicare Advantage plan, however, if you leave the country and have an emergency, you pay for that out of your own pocket.
So as you can see, there are a lot of pros to Medicare Advantage plans and there are a lot of cons that you would have to factor in. If you're someone who's confident with your health, who doesn't really frequent the doctors often, this might be a great plan for you.
Medicare Advantage vs Medicare Supplements: https://www.medicarefaq.com/faqs/medicare-advantage-vs-medicare-supplement/
Best Medicare Advantage Plans for 2020: https://www.medicarefaq.com/faqs/best-medicare-advantage-plans/
Join our Facebook group! It's a group dedicated to helping people become educated on Medicare. https://www.facebook.com/groups/MedicareFAQ/
Hi, I'm Lindsay Engle and I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com. Thank you so much for joining us on our Medicare Community YouTube channel. Today's topic is the Medicare Supplement Open Enrollment Period.
Medigap plans were created to help supplement your Original Medicare benefits. They cover out-of-pocket costs such as the 20% coinsurance that falls under Part B. The most important thing to remember about your Medicare Supplement Open Enrollment Period is that for the majority of beneficiaries it only comes around once in a lifetime.
Many beneficiaries may confuse the Medicare Supplement Open Enrollment Period with the Medicare Annual Enrollment Period that comes around every October. When in fact the Annual Enrollment Period is not for Medigap plans at all. The Annual Enrollment Period is for Medicare beneficiaries who are enrolled in Medicare Advantage or Part D plans. That is the time period that they can make changes. Now you can still enroll in a Medigap plan during the Annual Enrollment Period, you'll just have to go through medical underwriting and answer health questions.
Your Medicare Supplement Open Enrollment Period is a six-month window that begins with your Part B effective date. During this time frame, you can enroll in any Medigap plan with any carrier without having to answer any health questions. You're guaranteed to be accepted into the plan. Medigap plans are also guaranteed renewable. A carrier cannot cancel your policy due to health conditions.
The only time your Medigap policy can be canceled is if you don't pay your premiums. Now for some people, your Medicare Supplement Open Enrollment Period may happen more than once in your lifetime. There are two ways that your Medicare supplement open enrollment period can come around twice in your lifetime. One way is if you retire and go back to work. Then later on when you retire again, and you enroll in Part B, your Medicare Supplement Open Enrollment Period six-month window will begin again.
The other way your Medicare Supplement Open Enrollment Period may come around twice in your lifetime is if you're under 65 and collecting Social Security Disability Income. After collecting Social Security Disability Income benefits after 24 months you'll be eligible for Medicare. At that time, if you choose to enroll in Medicare Part B, your Medicare Supplement Open Enrollment Period six-month window will begin.
Now many beneficiaries and many states may not be able to afford the premiums for Medigap plans for those who are under 65. Or you may live in a state that doesn't offer plans to people on disability under 65. So in this case when you do turn 65, you'll have another Medicare Supplement Open Enrollment Period. At that time you can enroll in a Medigap plan with the premiums being the same as everyone else versus being more expensive because you're under 65.
Now some states have their own guaranteed-issue rules such as California, Connecticut, Washington, Maine, New York, Oregon, and Missouri. For example, California has a birthday rule. This allows you to enroll in any Medicare Supplement Plan without having to answer health questions around the month of your birthday each year. Connecticut has a year-round Open Enrollment period. This means that residence in Connecticut can change or enroll in a Medigap plan without answering health questions at any time of the year.
If you missed your once-in-a-lifetime Medicare Supplement Open Enrollment Period and don't live in one of the states that have their own guaranteed-issue rules. You can still enroll in a Medigap plan at any time of the year.
Hi everyone Lindsay here with Elite Insurance Partners and MedicareFAQ.com. Welcome. If it's your first time joining us, we're very happy to have you here. Now there are many different enrollment periods when it comes to Medicare. Today we're going to talk about the General Enrollment Period and what low-income beneficiaries should know.
The Medicare General Enrollment Period
The Medicare General Enrollment Period runs annually between January 1st and March 31st. It's the second opportunity you have to enroll in both Medicare Part A and B. When you enroll during the GEP your coverage will begin July 1st.
Most Medicare beneficiaries are unaware that if they delay enrolling in Part A and Part B without Credible Coverage, they're going to see some penalties.
There are two ways around these penalties. One of them is if you're low income and you qualify for Medicare Savings Program. And the other one is if you're collecting Social Security Disability Income and you were paying these penalties when you turn 65 those penalties will then be waived.
Medicare Savings Programs
If you're a low-income beneficiary you may have some other options. If you decline Part B because the premium is too expensive, there are three Medicare Savings Programs that you may qualify for.
These MSPs will pay your Part B premium and also protect you against any penalties. In addition, to qualify for a Medicare Savings Program you must be enrolled in Part A.
Now if you didn't work enough quarters, and you don't get Part A premium-free, so you declined it due to it being too expensive, you may qualify for a Qualified Medicare Beneficiary Program.
Qualified Medicare Beneficiary Programs
Now, I could go much more into detail about these Qualified Medicare Beneficiary Programs and these Medicare Savings Programs, but that would make this video over an hour long. So we'll make sure to include some links below to our MedicareFAQ.com to where it will go over these in more detail.
Part D Special Enrollment Period
For those looking for Prescription Drug Coverage, when you use the General Enrollment Period to enroll in Part A and B, you'll actually get a Part D Special Enrollment Period. This Special Enrollment Period for Part D will be between April 1st and June 30th. The effective date will be alongside your Part A and Part B, which is July 1st.
Hi everyone Lindsay here with Elite Insurance Partners and MedicareFAQ.com. Thank you so much for joining us today. If it's your first time welcome. Today, we're going to try and clarify some confusion around a specific enrollment period for Medicare, that's the Medicare Advantage Open Enrollment Period.
Previously you may have heard of this enrollment period referred to as the Medicare Advantage Disenrollment Period. Before, this enrollment period ran annually between January 1st and February 14th, and you could do exactly what it was said, which was disenroll from a Medicare Advantage plan. However, the legislation decided to discontinue this back in 2010.
Unfortunately, this was causing a lot of issues for Medicare Advantage beneficiaries. Normally if they had enrolled during the Annual Enrollment Period, which runs between October and December.
Then the New Year came in January, and they went to go use their new benefits and ended up finding out that there was a lot of unexpected out-of-pocket costs that they weren't prepared for, or maybe they went to go see their doctor, and the doctor was not in the plans Network. So, unfortunately, since there was no more Medicare Advantage Disenrollment Period, they were stuck in that plan until the next annual enrollment period.
Well, as of 2019, legislation decided to bring it back and rename it. It is now called the Medicare Advantage Open Enrollment Period, and it runs annually between January 1st and March 31st. Now, this enrollment period is only for Medicare Advantage beneficiaries. So if you are not currently enrolled in a Medicare Advantage plan, you cannot make any changes at this time.
Coverage will start the first day of the following month after you enroll. For example, if you enrolled February 10th, your coverage would start March 1st. Now an important difference between the Annual Enrollment Period and this Medicare Advantage Open Enrollment Period is that during this one, you can only make one change. During the Medicare Annual Enrollment Period, you can make multiple changes, and the last change is what would take effect. With this one, you can only make one change, so choose wisely.
Now, let's go over what you can and cannot do. You can switch from one Medicare Advantage plan to another. You can switch from one Medicare Advantage Prescription Drug plan to another. And you can disenroll from your current Medicare Advantage plan and go back to Original Medicare.
And at that point, if you choose to do so, you can enroll in a stand-alone Prescription Drug plan and a Medigap plan. What you cannot do. You cannot enroll in Part A and Part B, and you cannot switch from one Part D plan to another Part D plan at this time. It is only for making changes to your Medicare Advantage plan.
We know how confusing all of these enrollment periods can be. Today, I hope we helped clarify any confusion around the Medicare Advantage Open Enrollment Period. If you have any questions, please feel free to post them below.
If you haven't already joined our Medicare Facebook Community, make sure to do so. We post new videos and content regularly to keep you updated informed on all your Medicare benefits. You can also post questions to the community that other beneficiaries can help answer, and you can also read about their experiences. Until next time. Bye!
Medicare Supplement Plan G has been the runner-up plan when compared to Plan F. Plan F is known as the all-inclusive plan since it leaves you with zero out-of-pocket cost. You can think of Plan G as one level down. The only thing it does not cover is your Part B deductible. When you compare Plan G to Plan F regarding rate increases, you will see that over the past years Plan G has had a lower rate increase history compared to Plan F.
Plan G will cover the Part A deductible, any hospice co-pays, and coinsurance, foreign travel, it will also cover any excess charges that fall under Part B. For those who find that Plan F monthly premium is out of your budget Plan G is a good alternative.
It's important to compare what you'll spend out of pocket in monthly premiums when deciding between Plan F and Plan G. For example, if you multiply the monthly premium for Plan F x 12 as well as a monthly premium for Plan G x 12, you may find that what you spend on a monthly premium when comparing plan G and Plan F is actually more than what you would spend for the Part B deductible.
However, this may not be the case for all. That's why it's important to speak to a licensed agent who can compare these numbers to see which one makes the most sense financially and will save you the most money. Let's say Plan F costs you $120 per month. Over a 12-month period, you'd be paying $1,440 out-of-pocket for the year. When you compare Plan G monthly premium, Let's say it's $100. You'd be spending $1,200 over a 12-month period. That means your out-of-pocket difference between the two plan premiums is $240. It would have been more cost-effective to go with Plan G.
Another good alternative to Plan G is a newer High Deductible Plan that was introduced in 2020. That's High Deductible Plan G. As long as you're comfortable with paying the high deductible. Then the high deductible version of Plan G will save you a lot of money in monthly premiums when compared to the standard Plan G monthly premiums.
It's important to know that there have been some significant changes to Medicare. This includes MACRA, and the discontinuation of first-dollar coverage plans. Plan F High Deductible Plan F and Plan C are considered first-dollar coverage. So if you are not eligible for Medicare until after 2020. That means that you cannot enroll in Plan F. Therefore Plan G is no longer the runner-up plan, it is now the plan with the most coverage that you are eligible for.
Another important fact to know is that Plan G before 2020 was not a Guaranteed Issue plan. This means regardless of how you got guaranteed-issue rights, If you were using them to enroll in a Medigap plan you cannot enroll in Plan G. Plan F was the plan that would accept Guaranteed Issue.
To wrap it up Plan G is a great Medigap plan to enroll in. It has decent monthly premiums that aren't too high. Definitely not as high as Plan F. And pretty much check off every box under the benefits chart. The only thing it does not cover is your part B deductible.
Resource link: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g/
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MedicareSupplementPlanG #MedigapPlanG #PlanG
Hi everyone, Lindsay Engle here with Elite Insurance Partners in MedicareFAQ.com. Thank you so much for joining us. Today, we're going to go over Medicare Supplement Plan N. Medicare Supplement Plan N is an attractive alternative for newer beneficiaries, because it has the same benefits as Plan G. The only difference between Plan N and Plan G is that Plan N requires a small co-pay when visiting the doctors or the emergency room. There's a $20 copay when visiting your doctors and there is a $50 copay when visiting the emergency room.
Basically, in exchange for these small co-pays, you'll have a reduced monthly premium. Additionally, if you go visit an urgent care facility versus an emergency room, there will be no co-pay. So, as long as you're okay with paying co-pays Plan N is a good option for beneficiaries who are looking for a smaller monthly premium without losing benefits. In addition to paying these co-pays, the only out-of-pocket expense you're responsible for is the Part B deductible.
For example, we’ll compare the out-of-pocket cost you'll see with Plan N when compared to Plan G. Let's say you are not someone who frequently visits the doctor's office. If you went with Plan G. Your premium could be or somewhere around $100 per month. Over a 12-month period, you would spend $1,200 in annual premiums plus the Part B deductible.
Now, if you went with Plan N your monthly premium could be around $90 per month. If you visited the doctor's office twice during the year. Your out-of-pocket cost would be the annual premium of $1,080 plus the Part B deductible plus the $20 co-pay for both doctor visits. Giving you a grand total of $1,318. In this scenario, you would have saved around $80 annually if you went with Plan N.
However, if you did visit the doctor's office frequently, let's say once per month. Your total out-of-pocket cost for the year would be around $1,518. Therefore, you would have spent $120 more annually with Plan N then you would have with Plan G.
Medigap Plan N is one of the most recommended plans that we offer our clients. This is because most of our clients rather have to pay these small co-pays upfront versus a higher monthly premium. The only other benefits Plan N doesn't cover is excess charges under Part B. However, excess charges are not common in some states like Connecticut, Massachusetts, Ohio, Rhode Island, and a few others don't allow excess charges. As long as your doctor accepts Medicare Assignments, you won't have to worry about them.
So to wrap it up beneficiaries with Medicare Supplement Plan N will only be responsible for the Part B deductible as well as small co-pays when visiting the doctors and emergency room. Hopefully, after watching today's video, you have a good understanding of how Medicare Supplement Plan N works.
If you haven't already joined our Facebook Community, make sure to do so today. We’ll include a link in the description below. Also, don't forget about our YouTube channel. We post videos regularly to our Facebook Community as well as our YouTube channel to keep all of our beneficiaries up to date and informed on any Medicare changes. Until next time. Bye.
Like what you see? Join our Facebook group! It's a group dedicated to helping people become educated on Medicare. Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your Medicare resource center.