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

my name is robert bosch medicare bob i own senior healthcare direct and i've helped over a hundred thousand people understand what medicare is how much it costs what does it cover one of my coverage options this video is designed for youtube although i will also post it to our facebook page so that the eighty thousand people that follow us can also see this video now in this video i'm gonna help you understand so there's a lot of other people online a lot of resources you have i promise you what i'm about to go over with you is how i've helped the over hundred thousand people with choosing the right medicare coverage for them alright so in this video we're gonna cover what is medicare how much does it cost how and when do i sign up what does medicare cover what are my coverage options a medicare advantage vs. medicare supplement drug coverage Part D and I'm going to cover all this in this video and I promise you if you follow along you'll never be sold a plan you'll actually choose the plan you want cuz you'll understand your options so let's first talk about what Medicare is who's eligible for it so Medicare everybody who turns 65 is eligible for Medicare as long as you've worked 40 quarters if you've been on disability so if you're under 65 and you've been on disability for at least two years you're also eligible for Medicare okay and also if you get awarded back to disability payments and it goes past two years you'll get Medicare right away as well so Medicare's for people when that turns 65 or older or someone who's been on disability for at least two years and is under 65 so that's Medicare Medicare is insurance but it doesn't cover everything so let's talk about how much is it when do I sign up what does it cover so how do you sign up if you're drawing Social Security benefit and you're turning 65 years old you'll automatically be enrolled in a Medicare a and B and you'll get your Medicare red white and blue card in the mail about three months before you turn 65 if you're turning 65 and you're not drawing your Social Security benefit you will not be automatically enrolled so you'll have to do something proactively to enroll into Medicare you have three ways to do that you can call Social Security you can go to Social Security's website I'll put the link in this video for you or you can go to the Social Security office the easy way to do it is if you're turning 65 I would go ahead and just do it online if you're taking Medicare later and you're not drawing Social Security I would go to the Social Security office because you'll have to give them a form proving that you were still working so you don't get a penalty so if you're turning 65 you're gonna be automatically enrolled and you'll get your card about three months before so what does it cover how much does it cost well there's two parts to Medicare there's Part A and there's Part B Part A is for your hospital bills and this is what you've been paying taxes into for your whole life so as long as you have paid into your 40 quarters or have you been married to somebody who's paid in for 40 quarters then you'll get Medicare Part A for free now Medicare Part B on the other hand is not free it's going to cost you for this year about a hundred and thirty five dollars a month now I'm going to use a lot of generalizations when it comes to cost not exact cost because these things do change plus or minus ten dollars throughout the years and this video will be useful for everyone over the next five to ten years on what medicare covers and what it costs so if you're drawing Social Security this 135 dollars a month will automatically start coming out of your Social Security check if you're not drawing Social Security then you'll get a bill quarterly from the government every three months for the 135 times three if it's quarter or comes out of your Social Security check now what's nice about Medicare is it's the largest network or no 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's no HMO no PPO is the point there all right now the problem with Medicare is it doesn't pay everything so you're gonna have a bill if you only have Medicare so if you go to the hospital every time you go to the hospital you're gonna have to pay around $1,400 now what's important here is that's not an annual deductible meaning when you go to the hospital you pay for $200 and then if you go back you don't have any more out-of-pocket cost when you go to the hospital that 1400 hour or the part a deductible is going to be every single time you go now it lasts for 60 days but if you go into the hospital for different reasons or outside of the 60 days you're going to pay that roughly 1400 dollars every time you go now if you're admitted in the hospital you're gonna have to pay starting day 61 you're gonna have to pay around 350 dollars a day again that's not the exact amount but it's over 300 hours a day and that's starting day 61 all right also with Medicare Part A you have skilled nursing facility benefit Medicare pays the first 20 days for free but then starting day 21 you'll have to pay around 180 dollars a day all right for the next 80 days so Medicare Part A very simple it's going to cover your hospital bills but you have to pay the first $1,400 roughly every time you go it also covers skilled nursing care and it's going to give you the first 20 days for free but then starting day 21 you have to pay around 180 dollars a day so that's Part A now Medicare Part B this is for all your medical and doctor bills so this is what you're going to use mostly on a you know monthly or quarterly basis if you use Medicare is going to be your medical doctor lab work imaging anything that's outside the hospital is going to be Medicare Part B your medical bills durable medical equipment stuff like that very simple Medicare has a very small annual deductible this year is a hundred and eighty five dollars so you have to pay the first hundred eighty-five dollars of your met of your Part B services your doctor bills before Medicare is going to pay anything after you pay that hundred eighty-five dollars Medicare is gonna step in and pay 80% and that means you have to pay the other 20% and the real scary part to that 20% is there's no limit so for those of you have had health insurance before you know typically you have a deductible you pay and then your plan steps in and then you have to pay a portion like 20% or 30% until you reach what's called a max out-of-pocket okay well with Medicare there is no max out-of-pocket so if once you know Medicare is only gonna pay eighty percent so you're twenty percent that you're responsible for is unlimited exposure so that's very important so there's no max out-of-pocket with Medicare all right so that's Medicare a and B give you a summary it's gonna cost you about a hundred and thirty-five dollars a month there's two parts a is for hospital B is for medical doctor imaging lab work everything that's out of the hospital it doesn't pay everything by itself so for Part A you have to pay roughly the first $1,400 and then starting day 61 you have a copay of like three hundred three hundred dollars a day and it also covers skilled nursing for the first 20 days but starting day 21 you'll have to pay around 180 dollars a day with Medicare Part B you have a very small annual so that's one time one hundred and eighty-five dollar deductible once you pay that very small deductible of 185 dollars Medicare is gonna step in and pay 80% and that means you have to pay the other 20% and the scary part is no limit to that 20% what's nice about Medicare no referrals no HMO PPO any doctor any hospital that accepts medicare so if you're traveling you can go there if there's a specialist if you live in Florida and there's a specialist in Houston you want to go to and they take Medicare you can go because Medicare is accepted nationwide all right so that's Medicare so we talked about what is Medicare insurance for people that are turning 65 or older or if you've been on disability two years you're eligible for Medicare how much it costs how do you sign up for most people it's 100 five dollars a month if you're drawing Social Security you'll automatically be enrolled if you're not drawing Social Security you have to register with Social Security office what does medicare cover a and B a hospital B medical you got a per occurrence deductible that's the big problem with Part A Part B you have the 20% with no limit but you can keep your doctor because there's no HMO or PPO all right now we're going to talk about what are my coverage options and this is where so many people online try to make this complicated or the carriers mail a bunch of stuff and it makes it complicated here's the biggest favor I'm going to do for you right now there's not a hundred different coverage options for Medicare there's not there's really only two because everything you're looking at everything you're getting in the mail all the phone calls you're getting the stuff you're seeing online okay everything fits into one of two categories there's nothing other than this so everything you're looking at so if you have a dining-room table and you're like my clients and you're getting bombarded with stuff in the mail okay then I'm gonna help you right now you're gonna be able to identify that everything will fit into one of two piles on your dining room table everything is either called a Medicare Advantage plan or a Medicare supplement another word for supplement is Medigap okay everything you're looking at it's either gonna be this or it's gonna be that okay so you're gonna put it in two piles so how do we identify this right how do I know if it's an advantage plan or a Medicare supplement well let's talk about it first we're going to talk about Medicare Advantage so the first thing you want to understand about a Medicare Advantage plan is it is not a supplement plan okay it's not gonna fill in the holes to Medicare it's not gonna pay the bills that Medicare would normally leave for you it does not work with Medicare but you're also not giving up Medicare either you're still a Medicare beneficiary the idea behind an Advantage plan is that private insurance companies go and can negotiate with Medicare the government and they tell the government listen we're a private company all we do is insurance so we can do it more cost-effective than you we can do this better than you or at least as good okay so it's it's just it's a private alternative kind of like your group insurance it'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'm not allowed to say you know a carrier has this plan in this area and here's the copay so I'm gonna give you generalize out-of-pocket costs that are associated with Advantage plans we offer Advantage plans they are for a certain type of client but again my goal is that you understand 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 advertised as zero premium plans but they're not free okay because they are getting remember that hundred and thirty five dollars a month that's coming out of your Social Security well instead of that going to Medicare it's going to go to a private insurance company instead so the money would you won't see the difference it's still just going to come right out of your Social Security but it's not going to go to Medicare necessarily it's it's going to go to Medicare the Medicare will forward it to whichever private company you choose all right now so you will not use your red white and blue Medicare card if you with an advantage plan instead they're gonna mail you a policy a summary of benefits and a card and the insurance plan will will override so it will work instead of Medicare so I'll give you a few examples that will make this make perfect sense remember when I shared with you about Medicare Part A how it has a fourteen hundred dollar deductible every time you go to the hospital roughly and I'm sure there's gonna be somebody commenting on the YouTube page with the exact part a deductible but the point is it's about fourteen hundred dollars so the way it works is if you have an advantage plan it's not gonna pay that fourteen hundred dollars every time you go to the hospital because again it's you're not technically using that benefit it's going to replace it with its own charge and a popular copay for the hospital again not exact benefit but a popular very very average would be if you go to the hospital it doesn't pay the fourteen hundred instead it's gonna charge you say three hundred and fifty dollars per day days one through seven so if you go to the hospital for two days it would be seven hundred dollars all right cool you know that's less than the 1,400 but if you go for seven days times 350 that's more than the $1400 so it's not better or worse there it's just different the point there though that I want you to understand is it doesn't pay that fourteen hundred it's going to replace it with its own charge all right another example let's say you go to the doctor okay well it's you won't have that one eighty five deductible and then twenty percent that you have to pay instead you'll have a copay you know maybe primary is ten dollars maybe a specialist is forty five again that could be five and fifty or 25 and 75 depending on where you live okay but or the plan you choose but the point is is it doesn't pay the twenty percent it's gonna have its own copay all right let's say you go get an MRI or a CT scan okay so let's say a scan well that might be again the point is it doesn't it's not like Medicare's paying a you pay 20 it's just kind of a copay of let's say a very average copay will be for it MRI or CT scan on some plans will be about four hundred and fifty dollars okay now what's nice about the Advantage plan compared to Medicare that's good is remember Medicare had no limit to the twenty percent well the Advantage plans they do have a max out-of-pocket which we call you know mo Opie now for HMOs it might be five thousand dollars depending on where you live PPOs they might be ten thousand dollars so why did I just use the term HMO PPO right that's because Medicare Advantage plans because the hundred and thirty five dollars is not going to Medicare it's going to that private company you're 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 room here apologize or a PPO what does that mean an HMO means you have a list of doctors that you can then you have one set of lists that you have to go to while you're on that plan with a PPO you have two sets of doctors or two sets of benefits basically in-network or out-of-network and these are based on the county you live in so if you choose an advantage plan they're gonna be low cost per month because depending on where you live you see some zero premium plans advertised but again remember that they're still getting that one thirty five you're paying Medicare but there's nothing extra okay but that's because it doesn't actually pay the bills that Medicare charges you're gonna have its own set of co-pays deductibles sometimes out-of-pocket costs the good news is it is gonna have a max out-of-pocket 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 okay because Medicare Advantage plans are very county specific if you live in one county and you move one county over that plan may not be available there and the big deal is you do you are limited on the doctors you can go to okay so gonna have a network it's either gonna be an HMO or PPO there's also something called a P ffs which is a private fee-for-service which are kind of rare but for the majority you the point is you're gonna have an HMO or PPO so if you have an HMO you have to get referrals to go to certain doctors you are that insurance companies controlling your health care so you know they're managing your care so if you need to get a procedure done you might have to get what's called prior authorization okay so to summarize an Advantage plan is it's not a supplement it's a private alternative or replacement to the Medicare your Medicare a and B benefits you're still paying one hundred thirty four dollars a month some plants have no extra per month charge but again you're going to go to certain doctors certain hospitals it's restrictive in your county and you have a copay for everything you do until you reach that max out-of-pocket okay so you know this is a health plan all right it's similar to what you've had probably your entire life okay but probably even a little stronger okay because normally these plans don't have like a big deductr one thing you have to meet so the point there is they're cheaper month you have to go to certain doctors but you're going to bill for a lot of the stuff you do okay till you reach the max out-of-pocket now let's talk about the only other option which is a Medicare supplement plan this is also called a Medigap kind of confusing a lot of the carrier's refer to supplement insurance but then in your Medicare a new book it's you know Medigap insurance here's how this works with a Medicare supplement you're gonna stay on your a and your B sorry a and B is your primary insurance so that means the 135 dollars a month you're paying still goes to Medicare that means you're going to use your red white and blue card why is that 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 where you want to go okay as long as they take Medicare they'll take your supplement because Medicare is your primary now here's how this works you will pay an extra premium for a supplement plan depending on your age and you live in the plan you choose probably around $85 a month to $140 a month depending on the plan you choose so you pay the 135 to Medicare so you keep Medicare as your premium as your primary then you'll pay an extra let's just call it a hundred and ten dollars a month more for the supplement for the Medigap but you're paying for it because it actually pays the bills that Medicare doesn't pay so if you go to the hospital instead of you paying the $1400 your supplement will pay that for you every single time if you go to the doctor instead of you paying the 20% the supplement will pay it for you every time you get a scan like an MRI a CT scan whatever it is Medicare is gonna pay eighty your supplement pays the other 20% there's max out-of-pocket essentially it's gonna be just your premium depending on the plan you choose so the point with a supplement plan is it's gonna cost more it's gonna cost more per month but it's gonna give you the best coverage you've ever had in your life because you know as long as you pay your your Medicare premium and your Medicare supplement or Medigap premium you're never really gonna have a bill you go to the hospital for a day you go for six weeks you pay nothing and you go to the hospital one time you pay zero you go four times next year you pay zero you get a knee replacement you'll pay zero you get physical therapy you pay zero because you're paying this premium you won't have any out-of-pocket costs medic mints all will pay the part a deductible and the 20% that Medicare doesn't pay the three supplements that we're going to talk about so you with a supplement you're gonna pay more per month okay no one's tricking you you're gonna pay more you keep your right to go to any doctor any hospital okay and in return you're not gonna have any bills either it's gonna pay the hospital and the 20% now what I do now is I typically ask somebody a question that's going to help you you're gonna get a gut feeling in your stomach are you a Medicare Advantage plan person or Medicare supplement person but before I do that I have to share with you the only time you're automatically approved for a Medicare supplement or Medigap is when you first turn 65 and/or get your Medicare Part B for the first time so let me let me explain when you first turn 65 you're in what's called your open enrollment or when you first start your Medicare Part B so it's really your Part B effective date that's the first time that's the only time in your life you're allowed to get a Medigap a supplement plan and you don't have to answer any health questions so if you start with a Medicare Advantage plan because you're thinking hey 65 is not what it used to be I'm active I'm playing tennis I'm riding my bike I'm help with my grandkids I travel all the time I do all this and that I'm in good shape I'm healthy so I'm gonna go with the cheaper plan and then when my health gets a little worse maybe then I'll upgrade to a supplement the problem with that logic is there's no guarantee that you're going to be healthy enough to upgrade your plan from the advantage to the supplement so if you choose an advantage plan that's the risk you take is that you may never be able to get a supplement because the only time you're automatically approved for this plan is when you first turn 65 or start your Part B the supplement so here's the question I always ask people you know to help them kind of pick which one are they are you an advantage plan person or a supplement person because there's no wrong answer it's a very health is personal choice health care is so you know what you might really like your twin brother or twin sister may not like okay what you might want your spouse may not want so it's very different but here's a question that people typically say helps them to figure it out let's say you choose a Medicare supplement plan and your premiums the hundred hours a month one hundred ten dollars a month call it a hundred hours a month to make this example easy and you are healthy and you choose the supplement plan and you go the whole year and nothing really happens you get your physical you know you go to the doctor a couple times maybe you need an antibiotic or something because you get a cold or whatever and so you don't really you know you don't use it a whole lot and you go the whole year you don't use it and we do annual reviews in our office with our clients as all brokers should so if if that happens and you talk to me or one of my support members and are you gonna say Bob I chose a supplement man and I didn't even get to use it I went to the doctor two times I'd have been better off just paying a little having no premium and in it not paying the 110 dollars a month because I didn't use the plan again when you choose this we don't know what the next 12 months holds right if we did if we had a crystal ball then obviously we'd all choose the cheaper plan and upgrade when we needed to but we don't know that so let's say you go all year and you don't use the plan a whole lot would you consider that hundred hours a month a waste of money like come on Bob I should have got that man I you know I should have just went with 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 the next five years then I did the past twenty okay so I'm 65 or older anything could happen my biggest unknown cost is my healthcare cost no matter how healthy I think I am I know and it makes sense that I make that a fixed cost so that's a cost of living for me so even though I didn't get to use it this year it's a cost of living and I'm happy I have it because I get to go where I want to go and if something does happen I'm not gonna have any surprises it's very simple if you answered that this would be a waste of money then choose this choose the advantage you are an Advantage plan person if you look at it as a cost of living then choose a supplement very simple because the only the worst case on a SUP I guess it's worst case is you pay the premium you don't use the plan I I would say let's go out for a drink and Cheers you had a good year health-wise but that's that's the difference so or again if you really don't have the hundred dollars a month okay if it comes down to you not paying your your rent or your electricity bill then you know you're probably an advantage meant person as well but if it comes down to cost of living or waste of money so waste of money you know you want to kind of gamble a bit go with the advantage if you would consider the cost of living it's a Medicare supplement all right so now you should have an idea if you're an Advantage plan person or a supplement person so I'm gonna go over with you if you're an Advantage plan person how to choose the right Medicare Advantage plan very few people talk about this but I've done this a lot so we're gonna talk about it so if you are an Advantage plan person meaning you really do not have the money for a supplement which is fine or you know you'd consider it a waste of money if you didn't really use it and you choose an advantage here's the best way so you would for you if you're an Advantage plan person on your dining or table you go through and you have the supplement and you have the advantage on two stacks so now that you know you're not a supplement person and you're an Advantage plan person you can get rid of the supplement material and now let's help you pick which Advantage plan is right for you the biggest decision you have to make because there's no perfect plan so the biggest decision you have to make is are you network focused or benefit focused this is the choice you have to make if you're gonna choose an advantage plan because there's no perfect plan so network focused what does that mean that means Bob I'm an Advantage plan person but I have a cardiologist that no matter what I have to have he saved my life or she saved my life ten years ago and I'm not seeing a different cardiologist no matter what okay so that's Network focused meaning there's not a doctor you're willing to give up all right so then we probably look at maybe we check the HMOs but we probably look at the PPO so you have that flexibility hopefully to go to that cardiologist or whatever doctor that you cannot live without so that's what Network focused means if your benefit focused this is probably someone that's super healthy never had any health issues and they don't foresee themselves even though again we can't predict but they don't foresee themselves using the plan a whole lot 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 which whatever is the richest plan the doctors it's I feel like a number in a ways maybe I don't I don't have a doctor I love so they can tell me which doctors to go to but I want all the bells and whistles on a plan in this scenario I just looked through the plans and we find you the one that has all the bells and whistles since you're flexible in the doctor's so you have to decide if a you network focus if you're choosing an advantage or you benefit focused once you do that it's easy to pick the right Advantage plan for you all right so that's the Advantage plans person now let's talk to the Medicare supplement person so you have your stack of papers and you would consider a supplement a cost-of-living remember supplements also Medigap okay so now I'm talking to supplement people all right so how do I choose the right Medicare supplement plan here's the good news really not a bad answer I'm going to go over the three most comprehensive there's not a bad answer out of any of these okay but I'll just share with you what they cover and then I'll tell you kind of which one I like and you know but there's no bad answer out of these three so you're a supplement person so which supplement do I choose well here's the three most comprehensive plan F plan G plan in now I call plan F full coverage and this is because it's the most expensive supplement but you'll pay your premium say this one's 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 plaintiff its full coverage so let's say that's 100 a month that plan fills in all the gaps to Medicare a and B so it's gonna pay the Part A deductible it's going to pay the skilled nursing copay up to an additional 80 days it's gonna pay that hundred $85 Part B deductible and it's gonna pay the 20% so you literally just pay your premium no co-pays no out-of-pocket costs because everything is in your premium you pay that premium no co-pays no deductibles keep your doctor go to any hospital plan gee I call greatest value let's say this plan if this was the example of probably about a hundred and ten dollars okay plan G is the same coverage as F it's gonna pay your hospital bills gonna pay the skilled nursing benefits got the foreign travel benefit paid the twenty percent for you every single time the only benefit difference is that the G plan doesn't pay the 185 annual deductible the Part B that Part B deductible 185 it's the absolute only difference okay so why do I call Plan G a greater value than f simple math the premiums typically at least thirty dollars difference so that's three hundred and sixty dollars a year and the only difference is you pay the first hundred eighty five dollars of your Part B bills so you'll come out and I'm not a not a finance major but you come out ahead cuz 360 is more than one eighty five so you can save some money with G compared to F so it's a greater value or greatest value so if I'm talking to somebody who's turning 65 I would tell them you know cross off F because why pay three hundred and sixty dollars more for a one hundred eighty five our benefit because it's the same so I would go with G over F but no bad choice there there's also some changes coming in 2020 to plan F you know I have some other videos on that but I'm not going to talk about the macro changes and stuff but I like G because it's a greater just for the pure math reasons a greater value than F now plan in I call not fixed it's a good plan I think it's a plan of the future for sure and I know Chris Westfall and Justin Brock to my other colleagues online are a really high on plan in and I am too it's not a bad plan but with plan in you have for out-of-pocket costs I think that's a four all right so the first one is this same 185 deductible the second one is you have up to a $20 copay for the doctor visit you have a $50 copay for the ER but if you're admitted that's waived and then it pays all your hospital bill and then the the fourth item is Part B excess charges so what's a Part B excess charge every doctor that accepts medicare has one of two contracts either they accept what Medicare says they can charge or they want to charge over it if you have G or F it doesn't really matter because it's going to pay Part B excess charges for you if you have plan in and you go to one of those doctors that charges more than Medicare allows then you would pay 15% of that difference all right so that's plan in again and plan in in this scenario might be ninety five dollars so me and and and for right now what I you know what I know about this and the market I would still choose G over here because it still guarantees my healthcare cost over in none of these are bad choices so this is not me I'm not anti plan in I've liked in for a long time and I think with some of the changes coming in is going to be in about four or five years become the what popular plan but G's been the most popular plan for the last five years because of some changes in the industry that are happening here next year but I would choose G over F because it's a greater value just pure math and then I choose G over in because it guarantees my healthcare cost because for me I would rather pay the ten to fifteen dollar difference just to not have the copay or the Part B excess charge you know if I've accepted that I'm a supplement person and I'm gonna pay for it then I'm gonna go with with the G plan pay the hundred ten dollars a month and not worry about it anymore so if you're a supplement person I would go with G now how do you choose the carrier you want very simple the letter of these plans dictates the coverage not the carrier and I'm a top producer with with all the carriers so they're all great to me and I'm great to them and they're the ones that do a good job they're great and they all do a good job because these are federally regulated okay but plan G is the same with every carrier so Mutual Omaha plan G's the same as GPM plan G AARP plan G is the same as Blue Cross Blue Shield plan G plan G is the same with every carrier the doctor gets paid the same your benefits are exactly the same okay the only difference there's one big difference okay one big difference so what G is a G are you with me BlueCross G AARP G same benefits Mutual Omaha Cigna G same benefits one huge difference price that's it the price of there G is the only difference so there's no difference of benefits so don't let a carrier talk you into paying a bunch more money because they have a cool logo or you've heard their brand name before alright now as a broker we only choose to represent a plus companies oka rated or higher are companies so just because of rate stability and the whole idea behind insurance is everybody pays a little so nobody pays a lot so we have our probably top ten a rated carriers that are big enough that if they have a bad claims year they're not coming after you for big rate increases so you know but in general when you got those ten major companies some of those numbers are membered I mentioned the only difference is price your doctor gets paid the same and your benefits are the same so the only difference is price the letter of the plan determines the coverage so once you know you want a G plan then I do my job you know right hopefully I helped you pick which plan you want and then my office and I will get you the best price for that plan all right so that's a supplement the last thing I think yep last thing we're going to talk about today see okay we did that we did that all right now we're going to talk about Part D all right I know you may not be able to see this board as well as I would like you to but this is more just to pace myself so that I know 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 all right now if you choose an advantage plan right that that option that was on the left if you choose an advantage plan right the met the private alternative you can choose an advantage plan that has the Part D included in it okay so it's gonna be included in that that Part D the Part D drug benefit will be usually included in that Advantage plan there's pros and cons to that the pro is there's not typically an additional premium for it because if you buy a zero premium Advantage plan the drug plan is included in it so all you're paying is the one thirty five a month for Medicare and it's got a drug benefit in it the downside of that is you're not able to choose a drug plan that covers your medications for the lowest cost you have to go with whatever drug plan is included there so if you choose an advantage plan you have less flexibility on which drug plan you get because you have to choose the one that's in their plan all right now if you go with a Medicare supplement plan you get what's called a standalone Medicare Part D plan and that is very I'm not gonna say customizable but very flexible because there's usually about 30 to 35 different Medicare Part D drug plans in every county because they're County specific and if you have a supplement and you choose your drug plan then or to choose a Part D plan you get a standalone so what you would do is you'd give your agent hopefully our office I would love to work with you and give us a list of your prescriptions and we put them in Medicare gov Medicare's website and it actually shows us which drug plan will save you the most amount of money so you know you give it so it's based on your prescriptions which is nice so a lot of times by getting a standalone drug plan yes you pay an additional premium of 10 to 35 dollars but you're gonna save money in your drug costs because it's covering your prescriptions for a better value then maybe the Advantage plan that you have to choose whatever drug plans with it so just so you know if you choose an advantage plan you probably got your drug benefit with it if you go to the supplement you get a standalone drug plan and and and that's how that works now there's I'm going to go over how the drug it's work real quick and I'll close with that most drug plans have four levels they have the deductible level they have the copay level they have the doughnut hole or the coverage gap still currently and then they have catastrophic okay so most plans nowadays have a deductible even if you have an advantage plan but they what's tricky is they have what's called a tiered deductible so what they're doing is they're encouraging you to go generic so you might have a four hundred and five dollar drug plan deductible for tier three and higher which we'll go over in a moment well let's talk about it now so every drug plan has what's called a formulary which is a list of covered drugs and within that formulary they put them into tiers like a category so tiers and there's five tiers tier one is going to be your preferred generic tier two is your non-preferred generic tier three is going to be your preferred brand name tier four is going to be your non-preferred brand name and tier five is going to be your specialty drugs so there's five tiers within a formulary of the covered drugs and the tier dictates the cost the higher the tier the more expensive the prescription is alright so if a lot of deductibles and the drug plans will say for tier three plus there's a deductible so if you take generics then the deductible doesn't apply all right after you meet your deductible say the four hundred and five dollar deductible if your plan has one then you go into what medicare calls the initial coverage level I just call it the copay level and this is what we're all kind of used to because this is what we pay a nice copay for our prescription so let's say you take Crestor which is wholesale say hundred eighty bucks but on your drug plan it's a forty dollar copay all right now once you and the drug company spent a certain amount of money call it forty seven hundred dollars and again it might be 48 50 this year or forty four or fifty I but it's roughly about 4700 ollars once you pay that you went to the donut hole once you and the insurance company pay that the insurance company is basically saying I listen you you take a lot of expensive prescriptions you know we've kind of given you a discounted price for long enough we need you to kind of 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 doughnut holes being phased out so it's going away so the numbers keep changing suppose about next year there'll be no doughnut hole we'll see in theory for right now let's say there is the doughnut hole 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 that amount is you're out of the doughnut hole and you enter what's called catastrophic coverage and then you essentially only have to pay five percent of your wholesale drug costs all right so that's that's a drug plan all right that's it's got a formulary is a list of covered drugs within that formulary each prescription is on a tier level between one to five one being the cheapest five being the most expensive and then you have four levels that you kind of graduate as you and your drug plan spend money all right okay so I don't know how long this videos been but I know it's been a little while and but I also I guarantee that if you've watched the whole thing you know more about Medicare and your coverage options in your neighbor that's a fact you probably have a good idea are you a Medicare Advantage or Medicare supplement person now you have a decent understanding of Health prescription drug plans work but you're not supposed to be an expert on this okay you're supposed to be familiar with it and so you can choose the right coverage for you the expert is us so the shameless plug here for those of you that do not know my name is Robert beige I got the corn a nickname Medicare Bob and that's because I've been helping people on Medicare for the last ten years and a couple my client started calling me Medicare Bob and it just kind of stuck and then people in the industry call me Medicare Bob as well and I know it's corny and it's laughable but I like it and I own it because I love helping people I love connecting the dots to Medicare for people because I get to help and sell a product to people that they thank me afterwards because now they they don't feel like they sold they got sold a plan they feel like they bought and shows their own plan and that's my goal for myself and all of my agents so I have licensed agents that are trained by me and work with me every day and if you'd like our help the phone number is gonna be listed on this video you can also go to Medicare bob.com which will direct you to senior health care direct comment already subscribed to this YouTube my youtube channel I have more videos than anyone else online about Medicare and and and I love it I love getting to help people across the whole country we're licensed in all 50 states we help people everywhere also I have over 80,000 followers on our Facebook page that's a great way to connect if you have a question you can send us a quick message so please go to Facebook and just search Medicare Bob and you'll be able to like our Facebook page so subscribe to the YouTube channel like the Facebook page and also I have a podcast so if you're on Spotify Apple music you know please feel free to to to subscribe to the podcast so if you have any questions about Medicare that I did not answer please leave a comment below but the best thing to do is just call our office and ask for one of our licensed agents and we'll be happy to help you

Channel: Robert Bache

Views: 120,159

Keywords: MedicareBob, Medicare, Medicare 101, part a, part b, part c, education, retirement, aarp, elderly, how to sign up for medicare part d, Medicare enrollment, how does medicare work, Medicare 101: what is medicare?

Id: 511VEwzFu50

Length: 45min 25sec (2725 seconds)

Published: Tue Jul 16 2019