Medicare Basics - Medicare Changes Explained

If you're new to Medicare this year or interested in the

changes

coming to Medicare by 2023, this is the video for you today. I'm diving into Medicare Explained for 2023 so stay tuned so when we talk about Medicare we explain Medicare 101. we want to go over the parts of Medicare when to sign up for Medicare how to sign up for Medicare we're also going to talk about Medicare costs in 2023 and how to find the best Medicare plan and review the parts of Medicare we have A, which is your hospital insurance, you have Part B, which is your or your doctor's health insurance, you have part C, this is an optional part of Medicare, too known as Medicare Advantage and we'll get into that in a moment and Part D is the part of Medicare that covers your prescriptions, the medications you pick up at the pharmacy, Medicare enrollment, so your initial enrollment period when you turn Age 65 and are first eligible for Medicare is a seven-month period that begins three months before the month you turn 65, includes your 65th birth month, and lasts until three months after the month you turn 65. , which is the period in which you can enroll in Medicare, also known as the initial enrollment period, as long as you enroll before that month.

If you turn 65 in those first three months, your Medicare effective date will be the first day of the month in which you turn 65. So, if I turn 65 on June 15 and sign up for Medicare before June, my effective date Medicare will be on June 1. The trick here is that if you are born on the first of the month, the rules are a little different, so if my birthday is June 1st, then I am eligible for Medicare as of May 1st from the previous month, so that that's kind of an exception to that. rule if you are collecting Social Security benefits at least four months before you turn 65, then the government automatically enrolls you in Medicare Parts A and B.

You don't have to do anything. You will receive your Medicare card in the mail. No further action is required. but if you are not receiving Social Security benefits before you turn 65, then in most cases you have to enroll in Medicare to avoid a penalty and you can do this by enrolling online, which is the easiest way at ssa.gov slash Medicare You can also call Social Security or contact your local Social Security office to enroll in Medicare. The two main parts of Medicare, what we call traditional Medicare or original Medicare, are made up of Parts A and B and, as we've reviewed before, Part A is your hospital insurance Part B is your health insurance Part A is usually free and this is the part of Medicare that covers your inpatient hospital care, skilled nursing home care, some home health care, and hospice care are covered under Medicare Part A.

Part B is your outpatient health insurance. and this part of Medicare is not free, many people are surprised to find out that you have to pay a premium for Medicare Part B and in 2023 that premium is 164.90 per month and again this is the part of Medicare that covers doctor visits and outpatient services. tests and many other medical services. While most people pay $164.90 per month for Medicare Part B, you could pay more if you are considered a high-income person, so this is for full Part B coverage for people in 2023 , as seen by your income again. most people pay this, but if your adjusted gross household income from two years ago are going to look at your 2021 adjusted gross household income, if you fall into one of these higher income categories, then you'll pay a higher premium for your Medicare.

Part B coverage and we have another video that I'll link above that explains how to appeal these Irma charges if your current income is maybe a little different than it was two years ago, so be sure to check that out if you fall into one of these groups higher income, so when you have Medicare Part A and Part B, what are your out-of-pocket costs associated with that? Let's dig into that a little bit, for my Part A services, let's say if I get sick, I need to go. In the hospital, what am I responsible for paying well?

There is a sixteen hundred dollar inpatient hospital deductible associated with Medicare Part A. This is not an annual deductible, it is per 60-day benefit period, so you could potentially meet that deductible several times in a year if you have more than one hospital stay in a calendar year and after that, Medicare will cover your stay in the hospital until day 60. For days 61 to 90, if you stay in the hospital for that long, you will have to start paying four hundred dollars. per day, that is your coinsurance amount associated with Medicare Part A and if you use your extra lifetime reserve days after 90 days in the hospital, that coinsurance goes up to eight hundred dollars per day, additionally for nursing facilities specialized, Medicare will cover your first 20 days. in a skilled nursing facility, but after that you are responsible for paying 200 per day for days 21 through 100.

What are your out-of-pocket costs associated with Part B now? Medicare Part B your health insurance has an annual deductible of two hundred and twenty-six dollars per year and after you have met that deductible again, you must pay it first before your coverage takes effect. After you have met that Medicare will pay 80 percent of the Medicare-approved amount, you pay the other now important 20. knowing that there's no cap on that, so if you have very large outpatient medical bills, you have to pay the full 20 of the cost, there's no kind of cap or cap associated with that because of those potential out-of-pocket costs.

Most people will want to look into some type of supplemental coverage to help limit that out-of-pocket exposure and typically do so in the form of a Medigap or Medicare Supplement Plan or look into Medicare Part C, also known as a Medicare Advantage plan, I wanted to see. this little box here today to talk about what those main options are and how they work. There are two main ways that you can get your coverage when you're on Medicare and really all the different plans, you see the different ads, they all fall into one of these two paths, so the first path is to stay with original Medicare, the Parts Traditional Medicare A and B, you are receiving those benefits through the government Medicare program, from here you decide if you want to add Part D prescription drug coverage, which is purchased separately through private insurance companies that have contract with Medicare and offer Medicare Part D-approved drug plans, and Part D drug plans can cost anywhere from five dollars a month in most states to more than $50 a month. month, so it depends on what type of drug plan you want or need and I have another video that talks all about Medicare Part D.

It's linked below. It also talks about the penalties associated with Part D if you run out of a Part D drug plan, so it's important to be aware of them, be sure to watch that video, plus many people will want to add a Medicare supplement or a Medigap policy and what this does is fill in those 20 that Medicare doesn't pay and also helps pay the hospital deductibles and coinsurance amounts that Medicare doesn't pay, so Medicare supplement insurance policies are supplemental or secondary to your original Medicare benefits. One of the reasons people like them is because they are their secondary insurance.

Medicare is still your primary insurance you can turn to. to any Medicare doctor anywhere in the country, so there are no networks associated with these plans and because they fill gaps in traditional Medicare Parts A and B, you have very little out-of-pocket exposure, so you have very low deductibles and coinsurance amounts you can afford. You are responsible for when to take this route, so again, by taking this route, you can choose your own doctors. Any Medicare doctor in the country you can go to. You also have a very low out-of-pocket risk if you add a Medicare Supplement plan. the other route, the other route you can choose is to do a Medicare Advantage plan, also known as Medicare Part C.

Now these are managed care plans like HMO or PPO type plans and Medicare Advantage Part C plans combine Part A. B benefits, usually also include Part D prescription drug coverage directly into the plan and What these plans do is that they essentially replace your original Medicare benefits, so you must be enrolled in Parts A and B to be eligible for Medicare. Advantage plan, but if you sign up for a Medicare Advantage plan, say with Humana, when you go to the doctor, the hospital, that doctor and the hospital no longer bill Medicare, they bill Humana, so your Medicare Advantage plan is your primary insurance. using your red, white, and blue Medicare card at the doctor and hospital, even if you are still enrolled in Medicare Parts A and B, so Medicare Advantage plans have many different pros and cons.

I have a few different videos and I'll link them below that talk about the pros and cons of Medicare Advantage plans and who they are ideal for and who they may not be ideal for, so be sure to check them out before choosing Medicare Advantage plans for the most part. from the country. Start with zero dollars a month, you'll still have to pay your Medicare Part B premium in most cases, but the plans don't have an additional monthly premium and many of these plans include additional benefits like dental or vision coverage that are not necessarily included in the traditional Medicare Parts.

Additionally, Medicare Advantage Plans A and B have their own fixed copays and coinsurance that you will be responsible for for most covered services, so if you are admitted to the hospital or have outpatient surgery, you will have a fixed plan. copay or a fixed dollar amount you must pay that is set by your Medicare Advantage plan, something really important to keep in mind if you are new to Medicare in 2023 and are trying to decide which of these paths you want The bad thing is that plans Medicare supplement insurance plans do not have an annual open enrollment period in most states, so if you want to purchase one of these Medigap plans that fills the gap in Medicare Parts A and B, you usually only get one open enrollment where you can choose any plan you want and there is no medical underwriting, there are no health questions, you don't have to qualify for health and that is when you turn 65 for the first time or when you are new to Medicare Part B, so that's usually your only chance.

Choose any Medicare Supplement plan without any medical underwriting or health qualifications. Medicare Advantage plans, on the other hand, have an annual open enrollment period and you never have to medically qualify for a Medicare Advantage plan as long as you are enrolled in Medicare and If you live in the Advantage plan's service area, then you will be eligible for that plan, which is why many people ask me about how to alternate between these two paths. You know, if I start here, can I go here? If I start here, can I go? there and it's important to know that if you start here with a Medicare Supplement plan when you turn 65 for the first time with traditional Medicare, yes, you can always go to a Medicare Advantage plan during the fall annual enrollment period which, however, will be an option for you.

If you start here with a Medicare Advantage plan and then want to go here and buy a Medicare Supplement plan or a Medigap plan, you may or may not be able to do that, it depends on your health because you will be medically insured in most states. There are some states that have different rules and I will include more information about that below so that when it comes to deciding what type of Medicare plan and what insurance company is best for your needs, that is where we can help, so that my team and I am a licensed independent insurance broker, we work with Medicare Advantage plans and Medicare Supplement plans so we represent most major insurance companies in almost every state and we are here to help you with our services completely free and we can perform a needs analysis to help you determine what type of Medicare plan will be best for your needs and budget, and if you work with an independent broker, we can also offer you policy services for the life of your policy, so if you ever If you need help with claims or billing issues, we are here to help and again our service is completely free to you, so don't hesitate to give us a call, we will be happy to help.

Thank you very much for watching today. I hope this little public Medicare 101 course helped you get the information you were looking for. Check out the other videos on our channel. We have a ton of information about Medicare and almost every question you have will probably be answered somewhereplace of one of these. videos and you can also leave me any questions and comments below and reach out to us if you have any questions so thanks again for watching and we'll see you soon.