Medicare 101 - What is Medicare? | Medicare basics | Medicare 101

My name is Robert Bosch Medicare Bob. I own Senior Healthcare Direct and have helped over a hundred thousand people understand

what

Medicare is, how much it costs,

what

it covers, one of my coverage options. This video is designed for YouTube, although I will post it as well. Upload to our Facebook page so that the eighty thousand people who follow us can also see this video. Now in this video I will help you understand that there are many other people online. Many resources you have. I promise you what I have. I'm about to go over with you how I've helped over a hundred thousand people choose the right Medicare coverage for them.

Well, in this video we will cover what Medicare is, how much it costs, how and when I sign up. top what does Medicare cover what are my coverage options one advantage of Medicare over Medicare Part D supplemental drug coverage and I'm going to cover all of this in this video and I promise you that if you follow through they will never sell you a plan that In fact , you will choose the plan you want because you will understand your options, so let's first talk about what Medicare is, who is eligible for it, so everyone who turns 65 is eligible for Medicare as long as you have worked 40 quarters if you have been disabled, so if you are under 65 and have been disabled for at least two years, you are also eligible for Medicare, and also if your disability payments are returned and they pass the two years, you will receive Medicare as well immediately, so Medicare is for people turning 65 or older or for someone who has been disabled for at least two years and is under 65, so Medicare is insurance, but it doesn't cover everything, so let's talk about how much it is. is, when do I sign up?

What does it cover? How do I sign up? If you are receiving Social Security benefits and turn age 65, you will automatically be enrolled in Medicare A and B and will get your red, white, and blue Medicare Card mailed approximately three months before you turn 65. If you turn 65 and don't receive your Social Security benefit, you won't be automatically enrolled, so you'll need to do something proactively to enroll. Medicare, you have three ways to do it, you can call Social Security, you can go to the Social Security website. I'll put the link in this video or you can go to the Social Security office.

The easiest way to do it is if you're turning 65, I would go ahead and do it online if you're going to take Medicare later and you're not collecting Social Security. I would go to the Social Security office because you will have to give them a form showing that you are still 65 years old. working so that you do not receive a fine, so if you turn 65, you will be automatically enrolled and will receive your card approximately three months early, so what does it cover? How much does it cost? Well, Medicare has two parts. there is Part A and Part B.

Part A is for your hospital bills and this is what you have been paying taxes on your entire life, as long as you have paid your 40 quarters or been married to someone who has paid . for 40 quarters you will get Medicare Part A for free, now Medicare Part B, on the other hand, is not free, it will cost you this year about one hundred and thirty-five dollars a month, now I'm going to use a lot. of generalizations when it comes to costs, not exact costs because these things change ten dollars or so over the years and this video will be useful to everyone for the next five to ten years on what Medicare covers and what it costs , so if you withdraw Social Security, this $135 a month will automatically start coming out of your Social Security check.

If you are not collecting Social Security you will receive a quarterly bill from the government every three months times 135 multiplied by three if it is a quarter or it comes out of your Social Security check now, the good thing about Medicare is that it is the largest network or it does not have network in the country because if you have Medicare A and B you can go to any doctor, any hospital in the country that accepts Medicare, so there is no HMO. PPO is the point right now, the problem with Medicare is that it doesn't pay for everything, so you will have a bill if you only have Medicare, so if you go to the hospital every time you go to the hospital, Now you have to pay about $1,400 , the important thing here is that it is not an annual deductible, which means that when you go to the hospital you pay $200 and then if you come back, you have no more out-of-pocket costs when you go to the hospital. hospital, those 1400 hours or the part of the deductible that will be each time you go, now lasts 60 days, but if you enter the hospital for different reasons or outside of the 60 days, you will pay approximately $1400. every time you go now, if you are admitted to the hospital, you will have to pay starting on day 61, you will have to pay around 350 dollars per day again, that is not the exact amount, but it is more than 300 hours per day and that is.

After day 61, okay, also with Medicare Part A you have the benefit of a skilled nursing facility. Medicare pays for the first 20 days free, but then starting on the 21st, you will have to pay about $180 per day for the next 80 days, so the Medicare Part is very simple, it will cover your hospital bills, but You'll have to pay the first $1,400 or so each time you go, it also covers skilled nursing care and will give you the first 20 days free, but then starting on the 21st you'll have to pay. about 180 dollars a day, so now it's Medicare Part A, Part B, this is for all of your medical and medical bills, so this is what you'll primarily use on a monthly or quarterly basis.

If you use Medicare, it will be your doctor lab work imaging anything outside the hospital will be Medicare Part B your medical bills durable medical equipment very simple things like that Medicare has a very small annual deductible this year it is one hundred eighty five dollars, so what you have to pay for The first one hundred eighty-five dollars of Part B-covered services your doctor bills before Medicare pays anything after you pay those one hundred eighty-five dollars. Medicare will step in and pay 80% and that means you will have to pay the other 20% and the really scary part about that 20% is that there is no limit, so for those of you who have had health insurance before you knew it , they usually have a deductible that they pay and then their plan steps in and then has to pay a portion like 20% or 30% until you reach what's called an out-of-pocket maximum.

Well, with Medicare there is no out-of-pocket maximum, so if once you know Medicare will only pay eighty percent, then you will have to pay twenty percent. We are responsible for unlimited exposure, so that is very important, so there is no out-of-pocket maximum with Medicare. Okay, Medicare A and B give you the rundown. It will cost you about one hundred and thirty-five dollars a month. There are two. part A is for the hospital B is for the doctor's imaging lab work. Everything that comes out of the hospital doesn't pay for itself, so for Part A you have to pay about the first $1,400 and then starting on day 61, you have a copay of like three hundred and three hundred dollars a day and it also covers skilled nursing for the first 20 days, but starting on day 21 you will have to pay about $180 a day with Medicare Part B, you have a very small annual fee, so it is one hundred deductible times eighty-five dollars once you pay that little $185 deductible, Medicare will step in and pay 80% and that means you'll have to pay the other 20% and the scary thing is there is no limit to that 20%.

What's so good about Medicare? no referrals, no HMO PPO, no doctor, no hospital that accepts Medicare, so if you travel you can go there, if there is a specialist, if you live in Florida and there is a specialist in Houston that you want to go to and they accept Medicare you can go because Medicare is accepted nationwide, okay, that's what Medicare is, so we talked about what is Medicare insurance for people who are turning 65 or older or if you've been disabled for two years, are you eligible for Medicare, how much does it cost? , how to register.

For most people it's 100 five dollars a month if you receive Social Security you will be automatically enrolled. If you do not receive Social Security, you must register at the Social Security office. What does Medicare cover? A and B. A hospital. B. Medical. I have a per occurrence deductible, that's the big problem with Part A. Part B has 20% without limit, but you can keep your doctor because there is no HMO or PPO. Now we're going to talk about what my coverage options are and this is where so many people online try to complicate things or providers mail in a bunch of stuff and make it complicated.

This is the biggest favor I am going to do you now. There aren't a hundred different coverage options for Medicare. There's really only two because everything you're seeing, everything you get in the mail, all the phone calls you get, the things you see online, okay, it all fits into one of two categories, there's nothing more than this, so everything I'm looking at, so if you have a dining room table and you're like my clients and you get bombarded with things in the mail, okay, so I'll help you right now, you'll be able to identify that. everything fits in one of the two piles on your dining room table everything is called a Medicare Advantage plan or Medicare supplement another word for supplement is Medigap okay everything you're looking at is going to be this or it's going to be like this so you're going to put it in two piles, so how do we identify this correctly?

How do I know if it is an Advantage plan or a Medicare Supplement? Well, let's talk about it first. Let's talk about Medicare Advantage. So the first thing you want to do is What you need to understand about a Medicare Advantage plan is that it is not a supplemental plan. Okay, it won't fill Medicare gaps. You won't pay the bills that Medicare would normally leave you. It doesn't work with Medicare, but it's not working for you either. go up Medicare or are you still a Medicare beneficiary the idea behind an Advantage plan is that private insurance companies can negotiate with Medicare, the government and they say to the government, listen, we are a private company, all we do is insure, so what we can do is more profitable than you, we can do it better than you or at least as good, so it's just a private alternative, kind of like your group insurance, that's how it's going to work, so now this is an educational video.

Advantage is very regulated so I have to tell you I can't say you know a provider has this plan in this area and here's the co-pay so I'm going to give you generalized out of pocket costs associated with the Advantage plans that we offer. Advantage plans are for a certain type of customer, but again my goal is for you to understand that so you can choose the right plan for you, so let's talk about it so the way it works is they're not free, okay, Dee, but you do see these. They're advertised as zero premium plans, but they're not free, okay, because you're remembering that one hundred and thirty-five dollars a month that comes out of your Social Security, instead of going to Medicare, it's going to a private insurance company. the money won't see the difference, it will still come directly out of your Social Security, but it won't necessarily go to Medicare, it will go to Medicare, Medicare will send it to whatever private company you choose. right now, so you won't use your red, white, and blue Medicare card if you have an advantage plan, instead, a policy, benefit summary, and card will be mailed to you and the insurance plan will will override, so it will work in place of Medicare. so I'll give you some examples that will make this make perfect sense.

Remember when I told you about Medicare Part A that it has a fourteen hundred dollar deductible every time you go to the hospital or so and I'm sure there will be someone commenting on the YouTube page with the exact part of the deductible, but the point is that It's about fourteen hundred dollars, so the way it works is if you have an advantage plan, you're not going to pay that fourteen hundred dollars every time you go to the hospital because, again, you're not technically using that benefit, so will replace with your own charge and a popular co-pay for the hospital again, not an exact benefit, but a very popular average would be that if you go to the hospital you don't pay the fourteen.

Instead, they will charge you one hundred dollars, let's say three hundred and fifty dollars per day, from day one to seven, so if you go to the hospital for two days, it will cost you seven hundred dollars. Okay, you know it's less than 1,400, but if you go for seven. days multiplied by 350, that's more than the $1,400, so it's not better or worse, it's just different. The point I want you to understand is that he does not pay that fourteen hundred, he will replace it with his own charge. Alright, another example. Let's say you go to the doctor, okay, you won't have that eighty-five deductible and then you'll have to pay twenty percent, instead you'll have a co-pay, you know, maybe the primary is ten dollars, maybe a specialist cost forty-five again. that could be five and fifty or 25 and 75 depending on where you live, okay, but or what plan you choose, but the point is that you don't pay twenty percent, you will have your own copay, okay, let's say you get a magnetic resonance. or a CT scan, okay, so let's say a scan, well, that couldbe again, the point isIsn't it like if Medicare pays you pay 20?

It's just a kind of co-pay, let's say a very average co-pay will be for it. The MRI or CT scan on some plans will cost around four hundred and fifty dollars. Well, what's good about the Advantage plan compared to Medicare, that's good, remember that Medicare had no limit at twenty percent. Well, Advantage plans have an out-of-pocket maximum that we call, you know, now, for HMOs, it might be five thousand dollars, depending on where. you live on PPO, it could be ten thousand dollars, so why did I use the term HMO PPO? That's because Medicare Advantage plans, because the one hundred and thirty-five dollars will not go to Medicare, but to that private company, you are giving up your right. to go to any doctor any hospital in the country that accepts

medicare

you will have a network you will have an HMO I'm running out of space here sorry or a PPO what does that mean an HMO means that you have a list of doctors that Can you then have a set of lists to Which ones should you go to while you are on that plan with a PPO?

You have two sets of doctors or two sets of benefits basically in or out of network and these are based on the county that you live in so if you choose an advantage plan you will have a low cost per month because depending on where hurrah you will see some zero premium plans advertised but remember again they still get the thirty five plan that Medicare is paying for but there is nothing extra ok but that is because it doesn't actually pay the bills that Medicare charges . You will have your own set of co-pays, deductibles, sometimes out-of-pocket costs.

The good news is that you will have an out-of-pocket maximum of five to ten thousand dollars again, that could be seven thousand to twelve thousand or three thousand to six thousand depending on where you live, that's okay because Medicare Advantage plans are very specific to each county if you live in a county and you move A county with that plan may not be available there and the big problem is that you have a limited number of doctors that you can go to so you will have a network that will be an HMO or a PPO. There's also something called Pffs, which is a private fee for service that's a little weird, but for most of you the point is that you're going to have an HMO or PPO, so if you have an HMO you have to get referrals to go to certain doctors, are the insurance companies. monitor your medical care so you know they are managing your care, so if you need to have a procedure done, you may need to get what is called prior authorization.

So, to summarize, an Advantage plan is not an add-on, it is a private alternative or replacement. Medicare, your Medicare A and B benefits, you're still paying a hundred and thirty-four dollars a month. Some plants don't have extra charges per month, but again you're going to go to certain doctors, certain hospitals, it's restrictive in your county and you have a co-pay for everything you do until you reach that out-of-pocket maximum, okay, so you know this is a health plan, okay, it's similar to what you've probably had all your life, okay, but probably even a little bit stronger, okay, because normally these plans don't have a big deductor, one thing you have to fulfill, well The point is that they are cheaper per month, you have to go to certain doctors, but you are going to bill for many of the things you do well until you reach the maximum out-of-pocket amount.

Now let's talk about the only other option, which is a complementary plan. Medicare, this is also called Medigap, kind of confusing, a lot of the providers refer to supplemental insurance, but then in your Medicare, there's a new book, you know that. Medigap insurance that's how it works with a Medicare supplement that will stay on your a and your B, sorry, a and B is your primary insurance, which means the $135 a month you pay still goes to Medicare, which means you are going to use your red, white and blue card, why is it important? Because that means you keep your right to go to any doctor, any hospital that accepts Medicare, you can travel with the plan, you can go wherever you want, that's fine as long as they accept.

Medicare will take your supplement because Medicare is your primary plan. Now this is how it works: you will pay an additional premium for a supplemental plan depending on your age and you will live on the plan you choose, probably around $85 per month to $140 per month depending on the plan you choose then you pay the 135 to Medicare so you keep Medicare as your premium as your main premium then you will pay an extra, let's just call it a hundred and ten dollars a month more for the supplement for Medigap but you are paying it because it actually pays the bills that Medicare doesn't pay, so if you go to the hospital Instead of paying the $1,400, your supplement will pay for it every time you go to the doctor instead of paying the 20%, your supplement will pay for you every time you have a scan, such as an MRI, CT scan, whichever I mean, Medicare will pay eighty, your supplement pays the other 20%, there is an out-of-pocket maximum, essentially, it will just be your premium, depending depends on which plan you choose, so the point with a supplemental plan is that it will cost more, it will cost more per month , but it will give you the best coverage you've ever had in your life because you know it, as long as you pay your Medicare. premium and your Medicare supplement or Medigap premium you will never have a bill you go to the hospital for one day you go for six weeks you pay nothing and you go to the hospital once you pay zero you go four times next year you pay zero, you get a knee replacement , you will pay zero, you will receive physical therapy, you will pay zero because you are paying this premium, you will have no out-of-pocket costs, medical mints, everyone will pay their part, a deductible and the 20% that Medicare does not pay for the three supplements that we are going to talk about then With a supplement you will pay more per month ok no one is deceiving you you will pay more you keep your right to go to any doctor, any hospital, that's fine and, in exchange, you will not have any bill, you will not pay for the hospital either and the 20 % now what I do is I usually ask someone a question that will help you, you'll have a gut.

Feeling in your stomach: Are you a Medicare Advantage or Medicare Supplement plan person? But before I do, I have to share with you that the only time you are automatically approved for a Medicare or Medigap supplement is when you turn 65 for the first time and/or receive your Medicare Part B for the first time, so let me explain. When you turn 65 for the first time, you are in what is called open enrollment or when you first start your Medicare Part B, so that is actually the effective date of your Part B, that is the first time the Only time in your life you can get a Medigap supplement plan and you don't have to answer any health questions, so if you start with a Medicare Advantage plan because you think 65 isn't what it used to be be active I play tennis I ride my bike I help with my grandkids I travel all the time I do all this and I'm in good shape I'm healthy so I'm going to go with the cheapest plan and then when my health gets a little worse maybe then I'll upgrade to a supplement, the problem with that logic is that there is no guarantee that you will be healthy enough to upgrade your advantage plan to a supplement so if you choose an advantage plan the risk you run is that you may never be able to get a supplement because the only time you are automatically approved for this plan is when you turn 65 for the first time or when you start your Part B supplement, so here is The question I always ask people you meet to help them choose which one it is: a person with benefits plan or a person on supplements because there is no wrong answer.

It is a very personal health choice. Medical care is so you know what you could really do. For example, your twin brother or your twin sister may not like it, okay, what you might want your spouse to not like, so it's very different, but here's a question that people often say helps them work it out. Let's say you choose a Medicare supplement plan and your premiums one hundred hours a month one hundred ten dollars a month call it one hundred hours a month to make this example easy and you're healthy and you choose the supplement plan and you go all year and nothing really happens, you get your physical, you know you go you go to the doctor a couple of times maybe you need an antibiotic or something because you get a cold or whatever and then you don't really know you don't use it much and you go all year without using it and we do annual reviews in our office with our clients like all runners should, so if that happens and you talk to me or one of my support members and you're going to say Bob, I chose a supplement and I didn't even get around to using it I went to the doctor twice it would have been better for me to just pay a little not to have a premium and in that case not to pay the 110 dollars a month because I did not use the plan again when you choose this we do not do it we know what the next 12 months will bring, if we did, if we had a crystal ball, obviously we would all choose the cheapest plan and upgrade when we needed to, but we don't know, so let's say you go all year and you wouldn't use the plan much.

Would you consider a hundred hours a month a waste of money? Come on, Bob. I should have hired that man. You know, I should have chosen a cheaper plan or would you consider the cost of living? meaning I'm 65 or older, statistically speaking I'm more likely to use my health insurance in the next five years than I am in the last twenty, so I'm 65 or older. Anything could happen. My biggest unknown cost is my healthcare cost, it doesn't matter. How healthy I think I am, I know and it makes sense for me to do it as a fixed cost, so it's a cost of living for me, so even though I couldn't use it this year, it's a cost of living and I'm happy.

I have it because I can go where I want to go and if something happens I won't have any surprises it's very simple if you answered this would be a waste of money then choose this choose the advantage you are an advantage person of the plan, if you look at it as a cost of living, then choose a very simple supplement because the only worst case on a SUP. I guess the worst case is that you pay the premium and don't use the plan. I'd say let's go out. for a drink and regards, you had a good year health-wise, but that's the difference, like this or again, if you really don't have the hundred dollars a month, that's fine, if it's about you not paying the rent or the electricity bill then you know you are probably an advantage person too but if it comes to cost of living or waste of money then you know you want to gamble a little go for the advantage if you consider the cost of living is an extra of Medicare, so now you should have an idea if you are an Advantage plan person or a supplement person, so if you are an Advantage plan person I will explain how to choose the right Medicare Advantage. very few people talk about this plan, but I've done it a lot, so let's talk about it, so if you're an Advantage plan person, that is, you don't really have the money for a supplement, which is fine or he knows.

I would consider it a waste of money if I didn't actually use it and choose a perk. This is the best way for you to do it if you are an Advantage plan person in your dining room or table you pass by and have the supplement. and you have the benefit of two stacks, so now that you know you're not a supplement person and you're an Advantage plan person, you can ditch the supplemental stuff and now we're going to help you choose which Advantage plan is right for you . The most important decision you must make because there is no perfect plan.

So the most important decision you need to make is whether you are network or profit focused. This is the choice you should make if you are going to choose a benefits plan, because there is no perfect plan. Network-centric, what does that mean? Bob. I'm an Advantage plan person, but I have a cardiologist that no matter what I have to do, he saved my life or she saved my life ten years ago and I'm not going to see a different cardiologist. no matter what, okay, so that's network focused, meaning there's no doctor you're willing to give up, so we'll probably look at HMOs, but we'll probably look at the PPO so you have that flexibility, hopefully, to go to that. cardiologist or any doctor you can't live without, that's what network focused means, if your benefit focused, you're probably someone who is super healthy, never had any health problems and doesn't foresee himself, although again we can't predict it, but it doesn't.

They don't anticipate using the plan much, so Bob I want the zero premium I want the plan that has zero premium I want dental I want vision I want hearing I want a gym membership I want whichever is the richest plan The doctors are me I feel like a number in a way, maybe not. I don't have a doctor I like so they can tell me which doctors to go to, but I want all the comforts of a plan in this scenario. I just looked at the plans and we found you the one that has all the bells and whistles because it's flexible at the doctor's office, so you have to decide if you focus on your network, if you choose a perk or if you focus on the benefits, a Once you do, it's easy to choose the right Advantage plan for you, then that's the personof Advantage plans, now let's talk to the Medicare supplement person so you have your stack of papers and consider a supplement as a cost of living, remember supplements too Medigap, okay, now I'm talking to supplement people, it's Okay, so how do I choose the right Medicare Supplement plan?

Here's the good news, it's really not a bad answer. I'm going to go over the three most comprehensive ones, there's no bad answer between any of these, okay, but I'll just share with you what they cover and then I'll tell you which one I like and you know, but there's no bad answer between these three, so You are a person who uses supplements, so which supplement do I choose well? Here you have the three most complete. plan F plan G plan now I call plan F full coverage and this is because it is the most expensive supplement, but you will pay your premium, let's say this is a hundred and forty dollars a month and again it could be 110, it could be 160.

It depends on where you live, but for the plaintiff their full coverage, so let's say it's 100 a month, that plan covers all of the Medicare A and B slots, so you'll pay the Part A deductible, you'll pay the skilled nursing copay up to an additional. 80 days you'll pay that $85 Part B deductible and you'll pay 20%, so you're literally just paying your premium, no co-pays, no out-of-pocket costs because it's all in your premium, you pay that premium, no co-pays. With no deductibles, keep your doctor on any hospital plan. I call it higher value, let's say this plan, if this were the example, probably about a hundred and ten dollars, okay, plan G has the same coverage as plan F, it will pay your hospital bills and it will pay for nursing benefits specialized I got the foreign travel benefit paid twenty percent by you each time the only benefit difference is that plan G does not pay the annual 185 Part B deductible that Part B 185 deductible is the only absolute difference is well then why?

Do I call Plan G a greater value than simple math? The premiums are usually at least thirty dollars apart, so it's three hundred and sixty dollars a year and the only difference is that you pay the first one hundred and eighty-five dollars of your Part B bills, so I'll get out and not I'm a finance student, but you'll get ahead because 360 ​​is more than one eighty five, so you can save some money with G compared to F, so it's a higher value or the higher value, so If I am Talking to someone who is turning 65, I would tell them to cross out F because why pay three hundred and sixty dollars more for one hundred and eighty-five?

Our benefit is the same. So I would choose G over F, but there is no bad choice. There will also be some changes in 2020 in plan F. You know, I have other videos on that, but I'm not going to talk about the macro changes and stuff, but I like G because it's greater just for purely mathematical reasons, a value greater than. F now I don't call the plan fixed, it is a good plan. I think it's a plan for the future for sure and I know that Chris Westfall and Justin Brock for my other colleagues online have a very high plan and so do I, it's not bad. plan, but with the plan included, you have out-of-pocket costs.

I think it's a four, so the first is the same deductible of 185. The second is that you have up to a $20 copay for the doctor visit. There is a $50 copay. for the ER, but if they admit you, that doesn't apply and then you pay your entire hospital bill and then the fourth item is Part B overcharges, so what is a Part B overcharge? Every doctor who accepts Medicare has one of two contracts they accept. What Medicare says they can charge or want to charge above if you have G or F, doesn't really matter because they will pay you the excess Part B charges if you have a plan and you go to one of those doctors that charges more than they allow Medicare, then you would pay 15% of that difference, okay, so planning again and planning in this scenario could cost ninety-five dollars, so for me and for now, what I know, what I know about this and In the market, I would still choose G here because it still ensures that the cost of my healthcare is higher.

Neither of these are bad options, so this is not me. I'm not against the plan. I've liked it for a long time and I think with some. One of the changes coming is going to become the popular plan in about four or five years, but G has been the most popular plan for the last five years due to some industry changes happening here next year, but I would choose G. over F because it is a higher value, pure math and then I choose G over because it guarantees my health care cost because for me I would rather pay the difference of ten to fifteen dollars just to not have the co-pay or excess charge of Part B, you know.

If I have accepted that I am a supplementary person and I am going to pay for it, then I will go with plan G, I will pay a hundred and ten dollars a month and I will not worry about it anymore, so if you are a supplementary person I would choose G now, how Do you choose the supplier you want? Very simply, the letter of these plans dictates the coverage, not the provider, and I am a top producer of all the providers, so they are all great for me and I am great with them and they are the ones who do a good job , they are great and they all do a good job because they are federally regulated, but plan G is the same with all companies, so Mutual Omaha's plan G is the same. as a GPM G plan, AARP plan G is the same as Blue Cross Blue Shield plan G, plan G is the same with all companies, the doctor gets paid the same, their benefits are exactly the same, okay , the only difference, there is a big difference, okay, a big difference, so what G is a G?

You are with me? BlueCross G AARP G same benefits Mutual Omaha Cigna G same benefits big price difference that's all the price there G is the only difference so no benefit difference so don't let a provider talk you into paying a lot more money because they have a cool logo or because you've heard their brand before. Now as a broker we only choose to represent companies with a positive rating or higher, so just for the stability of the rates and everything. The idea behind insurance is that everyone pays a little, so no one pays a lot, so that we probably have our top ten rated insurers that are big enough that if they have a bad claims year they're not going to chase you for big rate increases, so you know, but generally, when you got those top ten companies, some of those numbers are affiliated.

I mentioned the only difference is the price your doctor gets paid the same and your benefits are the same so the only difference is the price the letter of the plan determines the coverage so once you know you want a plan G, then I do my job, you know, I hope I've helped you choose the plan you want and then I'll go to the office and get you the best price for that plan, so that's an extra, the last thing I think. Yeah, the last thing we're going to talk about today look, okay, we did it, we did it.

Now let's talk about Part D, okay. I know you may not be able to see this board as well as I would like. but this is more to put my mind at ease so you know what we've talked about, what we have, so let's talk about Part D, so what is Part D? Part D is drug coverage right now if you choose an advantage plan. Well, that option that was on the left, if you choose a benefit plan, just if you meet the private alternative, you can choose a benefit plan that has Part D included. Okay, so it will be included in that Part D, the Part D drug.

The benefit will generally be included in that Advantage plan. There are pros and cons. The advantage is that there is usually no additional premium because if you buy a zero premium Advantage plan, the drug plan is included, so all you are paying is one thirty-five a month for Medicare and you have a benefit of medicines. The downside is that you can't choose a drug plan that covers your drugs at the lowest cost, you have to choose whatever drug plan is included there, so if you choose an Advantage plan, you have less flexibility over which drug plan you get because You have to choose the one that is in your plan right now.

If you choose a Medicare Supplement plan, you get what's called a standalone Medicare Part D plan and that. It's very, I'm not going to say, customizable, but it is very flexible because there are typically 30 to 35 different Medicare Part D drug plans in each county because they are county-specific and if you have a supplement and you choose your drug plan , then or to choose. With a Part D plan, you get an independent one, so what I would do is give your agent, hopefully, our office. I would love to work with you and give us a list of your prescriptions and we'll put them on the Medicare gov website and actually show us which drug plan is going to save you the most money so you know it gives you so It's based on your prescriptions, which is good, a lot of times when you get a stand-alone drug plan, yes, you pay an additional premium of $10 to $35. but you will save money on your drug costs because it covers your prescriptions at a better value than maybe the Advantage plan, so you will have to choose any drug plan that includes it, so to know, if you choose an Advantage plan, you probably get your medication benefit with it, if you go to supplement you get a standalone medication plan and that's how it works.

Now I'm going to go over how the medication works real quick and close with what most medication plans have. four levels, they have the deductible level, they have the copay level, they have the coverage gap or coverage gap still currently and then they have catastrophic status, so most plans today have a deductible, even if you have an advantage plan, but the complicated thing is that they have what's called a tiered deductible, then what they're doing is encouraging you to use generic drugs so that you can have a drug plan deductible of four hundred and five dollars for the tier three and above, which we will see in a moment, well, let's talk. about this now, so every drug plan has what is called a formulary, which is a list of covered medications and within that formulary they put them into tiers as a category, so there are five tiers, tier one will be your preferred generic.

Tier two is your non-preferred generics Tier three will be your preferred brand Tier four will be your non-preferred brand and Tier five will be your specialty drugs, so there are five tiers within the formulary of covered drugs and the tier dictates the cost the higher the tier the more expensive the prescription is okay so if there are a lot of deductibles and the drug plans will say for tier three plus there is a deductible so if you take generics the deductible doesn't apply afterwards To meet your deductible it says the four hundred five dollar deductible, if your plan has one, then you enter what Medicare calls the initial level of coverage.

I just call it the copay level and this is what we're all used to because this is what a good copay pays for our prescription, so let's say you take Crestor, which is wholesale, let's say a hundred and eighty dollars, but in your drug plan is a forty dollar copay now, once you and the drug company spent a certain amount of money, call it forty seven hundred. dollars and again it could be 48 50 this year or forty four or fifty me, but it's about 4700 dollars once you pay that you went into the coverage gap once you and the insurance company pay that the insurance company basically says: I hear you. take a lot of expensive prescriptions, you know we've given you a discounted price for long enough, we need you to step up and pay more and in that situation the drug company pays like 70 percent of the drug and then you pay 30 percent of the drug and the coverage gaps are being phased out, so it's going away, so the numbers keep changing.

Let's say next year there won't be any coverage gap, we'll look at it in theory for now, let's say the coverage gap exists and you're in it and then once you get out of it, once you spend, let's say you know fifty five hundred or whatever amount, you're out of the coverage gap and you go into what's called catastrophic coverage and then you essentially just have to pay. five percent of your wholesale drug costs okay, so that's a drug plan, okay, it has a formulary, it's a list of covered drugs within that formulary, every prescription is at a tier of one to five, one is the cheapest, five is the most expensive and then you have four levels that you graduate to as you and your drug plan spend money, okay, so I don't know how long these videos have been, but I know it's been a little while and I also guarantee that if you've seen everything, you know more about Medicare and your coverage options in your neighbor, that's a fact, probablyHave a good idea of ​​whether you are a Medicare Advantage or Medicare Supplement person.

Now you have a decent understanding of how prescription drug health plans work, but you're not supposed to be an expert at this, you're supposed to be familiar with it and therefore be able to choose the right coverage for you. We're the expert, so shameless plug here for those of you who don't know my name. It's Robert Beige. I gave corn a nickname Medicare Bob and that's because I've been helping people with Medicare for the last ten years and a couple of my clients started calling me Medicare Bob and it just stuck and then people in the industry called me .

Me too, Medicare Bob, and I know it's cheesy and ridiculous, but I like it and I own it because I love helping people. I love connecting the dots with Medicare for people because I can help and sell a product to people who thank me. then because now they don't feel like they sold, they were sold a plan, they feel like they bought and they show their own plan and that's my goal for me and all my agents so I have licensed agents that are trained by me and they work. with me every day and if you want our help, the phone number appears in this video, you can also go to Medicare bob.com which will direct you to senior health care.

Comment directly you are already subscribed to this YouTube, my YouTube channel. I have more videos than anyone else online about Medicare and I love it. We help people all over the country. We are licensed in all 50 states. We help people everywhere. Additionally, I have over 80,000 followers on our Facebook page. This is a great way to connect. If you have any questions you can send us a quick message so please. go to Facebook and just search for Medicare Bob and you can like our Facebook page so subscribe to the YouTube channel like the Facebook page and I also have a podcast so if you're on Spotify Apple Music, you know, no hesitate to do it. to subscribe to the podcast, so if you have any questions about Medicare that I didn't answer, leave a comment below, but the best thing you can do is call our office and ask for one of our licensed agents and we'll be happy to help you