Your Medicare Community - MedicareFAQ

Thinking about switching your Medigap plan to save money? In this episode, we break down when you can change your Medicare Supplement policy, how medical underwriting works, and the common mistakes to avoid, so you can make an informed choice without surprises.

Prepare with confidence! This episode walks you through a clear, step-by-step Medicare enrollment checklist, from key enrollment periods to choosing the coverage that fits your needs. Discover how a Medicare Supplement plan can help protect your savings and give you peace of mind.

Navigating Medicare enrollment can be confusing, but it doesn't have to be. In this episode, we break down the Initial, Annual, and Special Enrollment Periods in simple terms, so you know exactly when to sign up for Medicare and Medicare Supplement, and avoid costly penalties.

Why do Medicare Supplement plan prices vary, and does paying more really mean better coverage? In this episode, we break down the factors behind Medigap costs and share tips on comparing quotes to find the best value for your healthcare needs.

Confused about your Medicare options? In this episode, we break down the essential differences between Medicare Supplement (Medigap) and Medicare Advantage (Part C) plans. From coverage and costs to provider networks, prescription drugs, and travel considerations, we'll help you understand which plan fits your health needs, budget, and lifestyle. Tune in for a clear, side-by-side comparison that makes choosing your Medicare coverage simpler and less stressful.

Medicare Supplement (Medigap) plans can protect you from unexpected medical costs, but paying too much is never part of the plan! In this episode, we share 8 proven strategies to lower your Medigap premiums without sacrificing coverage, including the best time to enroll, comparing carriers, exploring plan options, and even unlocking household discounts. Learn how to get the most value from your plan and keep more money in your pocket.

Confused about Medicare Supplement (Medigap) plans? You're not alone. Original Medicare doesn't cover everything, and out-of-pocket costs can add up fast. In this episode, we walk you through 10 essential questions to ask before choosing a Medigap plan—from coverage details and costs to enrollment timing, discounts, and keeping your favorite doctors. Whether you're new to Medicare or considering switching plans, this guide will help you make confident, informed decisions and protect your financial and healthcare peace of mind.

Navigating Medicare on a retirement budget can feel overwhelming—but it doesn't have to be. In this episode, we break down how to choose a Medicare Supplement (Medigap) plan that protects your health without stretching your finances. From understanding plan types and coverage levels to comparing premiums and factoring in your personal healthcare needs, we guide you step by step to make an informed, budget-friendly choice. Whether you're considering Plan G for comprehensive coverage or Plan N for lower monthly costs, this episode helps you balance protection and affordability with confidence.

Timing matters when it comes to Medicare!

Feeling lost in the maze of Medicare? We break down each part, hospital care, doctor visits, prescriptions, and reveal how a Supplement plan can fill the gaps. Clear, simple, and stress-free, because understanding Medicare shouldn't be complicated.

Confused about Medicare Supplement (Medigap) plans? We break down exactly what these plans cover, who truly needs one, and the smartest time to enroll, so you can avoid unexpected medical bills and protect your wallet. Don't navigate Medicare alone, get the clarity you deserve!

Medicare Supplement isn't just Plan F or Plan G. There's so much more to explore! Dive into the details of Plan G's comprehensive coverage, discover the cost-saving benefits of Plan N, and uncover the affordability of High-Deductible plans. Get the inside scoop on how to choose the perfect Medicare Supplement plan tailored to your needs and budget!

Introducing the 2025 Medicare Prescription Payment Plan! This innovative program allows you to pay your Part D drug costs in manageable monthly installments. Discover how it works, who's eligible, and the simple steps to enroll. Say goodbye to unpredictable medication expenses and take control of your health care costs today!

Are you confused about which vaccines Medicare covers? We've got you covered! In this episode, we break down how Medicare Part B and Part D protect you with essential vaccines like flu shots, shingles, and more. Discover where to get your immunizations, why they're crucial for your health, and how to stay protected every step of the way! Tune in to learn more.

Facing the loss of your employer health coverage? Don't worry, we've got you covered! Tune into our step-by-step guide to a smooth transition to Medicare. Discover everything you need to know about your Special Enrollment Period, enrolling in Part B, and the critical deadlines to avoid costly penalties. Take control of your health coverage and ensure a stress-free retirement!

Turning 65 and feeling overwhelmed by Medicare? You're not alone! In this podcast, we'll break down everything you need to know, from eligibility and enrollment to costs, coverage options, and the critical services Medicare doesn't cover. Whether you're just starting to explore your options or preparing to make decisions, we'll give you the clear, practical information you need to navigate Medicare with confidence. Tune in and make this important life transition easier to understand!

Navigating healthcare as a veteran or military retiree can be confusing, especially when it comes to understanding how TRICARE, VA benefits, and Medicare work together. Our expert guide breaks down the complexities, explaining how creditable coverage works and how Medicare Advantage and Medicare Supplement plans can expand your healthcare options. Tune in to get the clarity you need and make confident, informed choices about your health coverage!Ask ChatGPT

Discover the ins and outs of Original Medicare, what it covers, what it doesn't, and the crucial gaps you need to know about! From dental and vision to long-term care, we'll break down the coverage you might be missing. Plus, we'll explore how Medicare Supplement and Medicare Advantage plans can fill in the gaps and provide the protection you deserve. Tune in to get the answers you need!

Are you a snowbird concerned about how your Medicare plan works across states? In this episode, we dive into the essential differences between Original Medicare, Medicare Advantage, and Medigap when it comes to seasonal travel. Discover how to secure nationwide healthcare coverage and avoid unexpected medical costs. Tune in to our expert guide and stay informed on the best options for your health while you roam!

Navigating Medicare prescription drug coverage can be overwhelming. In this episode, we break down what's covered under Part B and Part D, highlight what's not included, and explain how to manage non-formulary drugs. Plus, discover strategies to help you lower your costs and make informed choices about your coverage options.

Learn all about Medicare late enrollment penalties and how to avoid them. We'll cover crucial deadlines, penalties for missing them, and offer tips for timely enrollment. Don't get caught off guard – watch now to navigate enrollment and avoid costly penalties. Subscribe for more Medicare info. Please call us anytime for free quotes and answers to your questions at 844-945-2166 or visit our website to work with our Medicare Advisors today at https://rates.medicarefaq.com/#LateEnrollment #Penalties #AvoidPenalties #MedicareEnrollment SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video: https://www.youtube.com/@MedicarefaqCHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/ MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/MedicareFAQ LET'S CONNECT: https://www.facebook.com/MedicareFAQhttps://twitter.com/medicarefaq https://www.instagram.com/medicarefaq https://www.pinterest.com/medicarefaq https://www.tiktok.com/@medicarefaq

For the first time ever, 51% of Medicare beneficiaries have switched to Medicare Advantage but WHY? With 31 million people already on board, it's time to explore if Medicare Advantage is your best choice! Check out our video for a breakdown and make an informed decision. Please call us anytime for free quotes and answers to your questions at 888-382-1925 or visit our website to work with our Medicare Advisors today at https://rates.medicarefaq.com/.SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video: https://www.youtube.com/@MedicarefaqCHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/ MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/MedicareFAQ LET'S CONNECT: https://www.facebook.com/MedicareFAQhttps://twitter.com/medicarefaq https://www.instagram.com/medicarefaq https://www.pinterest.com/medicarefaq https://www.tiktok.com/@medicarefaq

In 2023, more people opted for Medicare Advantage than ever before!

Medicare Private-Fee-for-Service plans offer you the ability to see any doctor at a pre-determined cost. These plans offer great benefits, but may not be available in all areas. Private-Fee-For-Service Plans (0:26)Private-Fee-For-Service Plans Networks (0:44)Private-Fee-For-Service Plans Terms And Conditions (1:06)Private-Fee-For-Service Plans Benefits (1:20)Private-Fee-For-Service Plans Out-Of-Pocket Maximum Amount (1:33)Private-Fee-For-Service Plans Costs (1:52)Learn more about this topic HERE: https://www.medicarefaq.com/medicare-part-c/medicare-advantage-plan-pffs/WE CARE ABOUT YOUR MEDICARE #medicareadvantage #medicarepffsplans #medicarefaq SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video: https://www.youtube.com/@Medicarefaq CONTACT US: MedicareFAQ has helped over 50,000 Medicare clients save hundreds of dollars by comparing rates online. Get a quote today from 30+ carriers & plans in your area! Plus, our services are 100% FREE! Click this link to get started: https://rates.medicarefaq.com/ CHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/   MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/MedicareFAQ LET'S CONNECT: https://www.facebook.com/MedicareFAQhttps://twitter.com/medicarefaqhttps://www.instagram.com/medicarefaqhttps://www.pinterest.com/medicarefaq https://www.tiktok.com/@medicarefaq

The Medicare Annual Enrollment Period is an important time for all Medicare enrollees. During this time, you can make changes to your Medicare Advantage and Medicare Part D coverage for the upcoming year. The Medicare Annual Enrollment Period (0:33)Step 1: Assess Your Current Coverage (0:49)Step 2: Determine Your Healthcare Needs (1:13)Step 3: Review Changes to Your Current Plan (1:42)Step 4: Compare Available Plans in Your Area (2:17)Step 5: Work With A Licensed Insurance Agent (3:06)Step 6: Enroll Before It's Too Late (3:30)Learn more about this topic HERE: https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/WE CARE ABOUT YOUR MEDICARE #MedicareAEP #medicareannualenrollmentperiod #MedicareFAQ SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video: https://www.youtube.com/@Medicarefaq CONTACT US: MedicareFAQ has helped over 50,000 Medicare clients save hundreds of dollars by comparing rates online. Get a quote today from 30+ carriers & plans in your area! Plus, our services are 100% FREE! Click this link to get started: https://rates.medicarefaq.com/ CHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/   MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/MedicareFAQ LET'S CONNECT: https://www.facebook.com/MedicareFAQhttps://twitter.com/medicarefaqhttps://www.instagram.com/medicarefaqhttps://www.pinterest.com/medicarefaq https://www.tiktok.com/@medicarefaq

High Deductible Medicare Supplement Plan F offers the same great benefits as standard Plan F. However, the high deductible allows carriers to charge a much lower monthly premium. Learn more about High Deductible Plan F benefits and Eligibility. Eligibility (0:23)Medicare Supplement Plans Explained (0:49)High Deductible Plan F (1:05)High Deductible Plan F vs Standard Plan F (1:41)Learn more about this topic HERE: https://www.medicarefaq.com/medicare-supplements/high-deductible-plan-f/WE CARE ABOUT YOUR MEDICARE #medicaresupplement #MedicareFAQ #MedicareSupplementPlanF  SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video: https://www.youtube.com/@Medicarefaq CONTACT US: MedicareFAQ has helped over 50,000 Medicare clients save hundreds of dollars by comparing rates online. Get a quote today from 30+ carriers & plans in your area! Plus, our services are 100% FREE! Click this link to get started: https://rates.medicarefaq.com/ CHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/   MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/MedicareFAQ LET'S CONNECT: https://www.facebook.com/MedicareFAQhttps://twitter.com/medicarefaqhttps://www.instagram.com/medicarefaqhttps://www.pinterest.com/medicarefaq https://www.tiktok.com/@medicarefaq

Medicare Supplement High Deductible Plan G offers coverage and benefits identical to the standard Plan G after you cover the high deductible. Medicare Supplement Plans (0:22)Medicare Supplement High Deductible Plan G (0:33)Standard Plan G vs High Deductible Plan G Breakdown (1:07)High Deductible Plan G Pros & Cons (1:57)Learn more about this topic HERE: https://www.medicarefaq.com/medicare-...WE CARE ABOUT YOUR MEDICARE #MedicareSupplement #MedicareHighDeductibleG #MedicareFAQ SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video:    / @medicarefaq  CONTACT US: MedicareFAQ has helped over 50,000 Medicare clients save hundreds of dollars by comparing rates online. Get a quote today from 30+ carriers & plans in your area! Plus, our services are 100% FREE! Click this link to get started: https://rates.medicarefaq.com/ CHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/   MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/Medic... LET'S CONNECT: https://www.facebook.com/MedicareFAQ

Medicare Supplement Plan F, Plan G, and Plan N are the top three most popular Medicare Supplement plans available today. However, each plan has its own perks to bring to the table. Watch to learn the different benefits of Medicare Supplement Plan F vs Plan G vs Plan N. Learn more about this topic HERE: https://www.medicarefaq.com/faqs/medicare-supplement-plan-f-vs-plan-g-vs-plan-n/WE CARE ABOUT YOUR MEDICARE #MedicareSupplement #MedicareFAQ #MedicareSupplementPlans SUBSCRIBE: Did you find this video helpful? Subscribe to our channel for more informative Medicare videos! Be sure to hit the bell to be notified when we publish a new video: https://www.youtube.com/@Medicarefaq CONTACT US: MedicareFAQ has helped over 50,000 Medicare clients save hundreds of dollars by comparing rates online. Get a quote today from 30+ carriers & plans in your area! Plus, our services are 100% FREE! Click this link to get started: https://rates.medicarefaq.com/ CHECK OUT OUR WEBSITE: Our online resource center is built to give you unbiased information regarding your Medicare coverage choices: https://www.medicarefaq.com/   MEDICARE FACEBOOK COMMUNITY: Join our exclusive Medicare Facebook community! Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your sales-free Medicare resource center: https://www.facebook.com/groups/MedicareFAQ LET'S CONNECT: https://www.facebook.com/MedicareFAQhttps://twitter.com/medicarefaqhttps://www.instagram.com/medicarefaqhttps://www.pinterest.com/medicarefaq https://www.tiktok.com/@medicarefaq

In this video, we compare Medicare Advantage and  Medicare Supplement Plans side by side to allow you to choose the best plan for your needs. Once you have enrolled in Medicare Part A and Medicare Part B, have two options. To enroll in a Medicare Supplement plan or a Medicare Advantage plan. Keep in mind, you cannot enroll in both. Option one includes enrolling in a Medicare Supplement plan and a Medicare Part D plan. Original Medicare does not include prescription drug coverage. That's why you'll want to add a standalone Medicare Part D plan. In addition, you'll want to enroll in a Medicare Supplement Plan, also known as Medigap. This plan will cover additional out-of-pocket costs that you're responsible for paying.  Medicare Supplement plans were specifically designed to fill in the gaps in coverage from original Medicare. This includes coinsurance and deductibles depending on the plan you enroll in. Medicare Supplement plans literally supplement your Original Medicare benefits.  Option two would be to enroll in a Medicare Advantage plan. Now, it's important to remember that Medicare Advantage is not the same as Original Medicare. These are managed health care plans that are offered through private insurance companies. Medicare Advantage plans do tend to have lower monthly premiums when compared to Medicare Supplement plans. In addition, some may come with ancillary benefits like dental and vision coverage. Most also include prescription drug coverage. Due to the low or zero-dollar monthly premium, you will have to pay more out-of-pocket as you use the benefits When compared to Original Medicare and a Medicare supplement plan, Medicare Advantage plans come with many limitations. These include a limited network of doctors, coverage that will not travel with you, and you need a referral to see a specialist. Visit MedicareFAQ.com to learn more about Medicare Advantage vs Medicare Supplement plans.https://www.medicarefaq.com/faqs/medi...We CARE about your MedicareJoin Our Facebook Community: https://www.facebook.com/groups/Medic...Subscribe to our YouTube channel and turn notifications on!https://www.youtube.com/c/Medicarefaq

Medicare Supplement Plan N is one of the most popular Medicare Supplement plans available today. In this video we review we review Medicare Supplement Plan N benefits and how you can utilize the plan. Medicare Supplement Plan N is ideal for those who prefer lower monthly premiums but still wish to have comprehensive coverage. The most significant benefits of Medicare Supplement Plan N include Medicare Part A coinsurance coverage, Medicare Part A deductible coverage, foreign travel emergency benefits, and Medicare Part B coinsurance coverage When you enroll in Medicare Supplement Plan N, the only out-of-pockets you are responsible for are, Medicare Supplement Plan N premium, Medicare Part B premium, Medicare Part B coinsurance, $20-$50 copayments, and Excess Charges (if applicable) If you enroll in Medicare Supplement Plan N during your six-month Medicare Supplement Open Enrollment Period, you do not need to answer underwriting health questions. If you apply for coverage outside of this enrollment period, you may be subject to medical underwriting. This means a carrier may deny you coverage for any reason. We hope you find this video helpful.Resource link: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-n/ Subscribe to our YouTube Channel and join our Facebook Community.https://www.facebook.com/groups/MedicareFAQ/https://www.youtube.com/medicarefaq/

Medicare Supplement plans cover the holes left by Original Medicare. If you became Medicare-eligible after January 1, 2020, Medicare Supplement Plan G is the most comprehensive plan available for you. Medicare Supplement plans are standardized by the federal government. This means benefits are the same regardless of carrier. The only difference is the monthly premium. Medicare Supplement Plan G coverage includes the Medicare Part A deductible, Hospice copayments and coinsurance, foreign travel emergency benefits, and Medicare Part B excess charges. The only out-of-pocket costs you will pay when you enroll in Medicare Supplement Plan G are the Medicare Part B deductible and the Plan G premium. If you are newly eligible for Medicare and are within your Medicare Supplement Open Enrollment Period, you can enroll in Medicare Supplement Plan G with no underwriting health questions. If you apply outside of this enrollment period, you may need to go through underwriting. This means a carrier may deny you for any reason. We hope you find this video helpful!Resource link: https://www.medicarefaq.com/medicare-supplements/medigap-plans/medigap-plan-g/ Subscribe to our YouTube Channel and join our Facebook Community.

If you're eligible for both TRICARE and Medicare, it's important to know how the two programs work together. In this video, we explain what you need to know about your coverage options.Original Medicare consists of a few different Parts – A through D. But, how does each part work with TRICARE?When TRICARE-eligible beneficiaries sign up for Medicare Part A and Part B, they automatically enroll in TRICARE For Life. In this case, Medicare works as primary insurance, and TRICARE For Life is secondary.TRICARE For Life helps cover costs Medicare doesn't. These include:• Part A hospital deductible• Part B coinsuranceSome TRICARE For Life beneficiaries may enroll in a Medicare Advantage plan to access benefits such as gym memberships, dental, vision, and hearing. Original Medicare (Parts A and B) do not cover these costs.If you choose to enroll in an Advantage plan, it will be primary and TRICARE for Life will be secondary. When receiving care outside of your Advantage network, TRICARE For Life will cover the costs that your plan doesn't pay for.When you have TRICARE For Life, there's generally no need to enroll in a Part D prescription drug plan. TRICARE For Life includes a prescription drug program and there is no additional cost to you.If you have TRICARE For Life and later enroll in a Part D prescription drug plan, don't worry about penalties. Tricare For Life is considered creditable coverage.It's possible to also enroll in a Medigap plan when you have Original Medicare and TRICARE For Life. But, it's not necessary. In this case, Original Medicare will be primary, your Medicare Supplement plan will be secondary, and TRICARE For Life will pay last.As for how TRICARE Prime works with Medicare, when you're under the age of 65 and you have Medicare with TRICARE Prime, you don't need to disenroll. TRICARE For Life isn't mandatory. Those with disabilities on Medicare can remain on TRICARE Prime as long as they're eligible. When you do qualify, you'll get a waiver of Prime enrollment fees or a refund for the past enrollment fee.In another scenario, TRICARE Plus offers the same primary care access as TRICARE Prime. It works the same as regular TRICARE in regards to Medicare because it's still primary coverage. The military clinic or hospital doesn't cover costs or beneficiaries who receive care from non-military health facilities. Before scheduling an appointment, beneficiaries should contact their local military hospitals to make sure they accept TRICARE Plus because each facility decides whether they accept it.Thanks so much for watching! We hope you found this video helpful.Please subscribe to our YouTube channel: https://www.youtube.com/medicarefaqTurn on notifications so you're notified as soon as we upload a new video!Join our Facebook Community Group: https://www.facebook.com/groups/MedicareFAQ

Are you a Medicare beneficiary receiving Social Security benefits? Stay tuned to find out how the 2022 year will affect your cost!In 2022, Social Security recipients will get an annual Cost-Of-Living Adjustment (COLA) of up to 5.9% – the largest increase since 1982. The COLA spike will boost retirees' monthly payments by up to $92 in 2022.This Social Security increase is the first to have matched rising costs more closely. Yet, with the increase in inflation, Medicare's cost has gone up as well. This brings us to the cost breakdown for 2022. The Medicare Part A deductible increases to $1,556 for each benefit period. The standard Medicare Part B premium is now $170.10. Premiums for higher-income individuals are subject to increase. The new Part B deductible is $233, which is a $30 increase from 2021.The good news is that in 2022, the average Social Security recipient will be better off for 2022.Thank you so much for watching! We hope you find this video helpful.Please subscribe to our YouTube channel: https://www.youtube.com/medicarefaqTurn on notifications so you'll know as soon as we upload a new video!Join our Facebook Community Group: https://www.facebook.com/groups/medicarefaq

When you become Medicare-eligible, you may be wondering whether your existing coverage coordinates with Medicare. Whether Medicare will pay primary or secondary depends on the other type of coverage you have.First, it's common for Medicare beneficiaries to work past the age of 65. Most will have employer coverage. So, the major questions are whether you should keep your Medicare coverage while you have employer coverage and, if you do, which will pay first? This depends on how many employees are at the company.When your employer has 20 or more employees, your coverage is creditable for Medicare. However, with fewer, than 20 employees, the coverage isn't creditable. In the latter scenario, you'll want to enroll in Medicare Part B to avoid penalties in the future.With creditable employer coverage, Medicare is secondary and the group plan is primary. Whereas, with a group plan that is not creditable, Medicare is primary and the group plan is secondary.In the circumstance where you're Medicare-eligible due to disability and have employer coverage, possibly through your spouse, the number of employees must be 100 or more for coverage to be creditable.Medicare Advantage plans are considered primary coverage because they pay for your care instead of Medicare.Other scenarios where Medicare is primary:• You have Medicare and a Medicare Supplement (Medigap) plan• You're dual-eligible for and have Medicare and Medicaid• You also have coverage through FEHB, TRICARE, COBRA, retiree insurance, or tribal self-insuranceSituations when Medicare pays secondary:• When you have a worker's compensation, liability, or no-fault insurance policy• Active duty with TRICAREAs for Veterans benefits and Medicare, the two don't coordinate together. Veterans benefits work at veteran-approved facilities and Medicare works at civilian facilities.Medicare also does not work with the Marketplace (a.k.a. "Obamacare"). If you have this coverage and receive subsidies, unfortunately, you will no longer qualify for them when you become eligible for Medicare. Additionally, it's illegal for an agent to try to sell you a Marketplace policy when you already have Medicare.eAll this information can seem overwhelming, but we are here to simplify it for you so you can make the best health care decisions. If you found this video helpful, please subscribe to our YouTube channel and join our Facebook Community Group!FAQ Article: https://www.medicarefaq.com/faqs/when-is-medicare-primary/Our YouTube Channel: https://www.youtube.com/medicarefaqOur Facebook Community: https://www.facebook.com/groups/MedicareFAQ

Are you a Medicare beneficiary with a recent change in circumstance? If so, don't go anywhere! We're here with everything you need to know about Special Enrollment Periods for Medicare.Medicare involves many different types of enrollment periods and Special Enrollment Periods apply to every part of Medicare. You're eligible for a Special Enrollment Period when you have a qualifying life event.Depending on the type of life event that occurs, your Special Enrollment Period will come with its own rules and timeframe. We'll go over the most common ones next.The most common qualifying event for Special Enrollment Periods is the loss of employer coverage. Many people continue to work past 65, so it isn't a surprise that this is the circumstance that happens most often. When you delay enrolling in Medicare under this circumstance, you're eligible for an eight-month Special Enrollment Period.If you choose to delay Medicare while you continue to work past age 65, make sure your coverage is credible. To be creditable, the employer must have 20 or more employees. If your coverage isn't creditable and you delay enrollment, you'll be subject to a lifetime penalty on top of your Part B premium. This penalty goes up for every 12 months you delay. Your eight-month enrollment period begins when your group plan coverage ends.The documents you'll need to enroll in Medicare when you previously had creditable group coverage are available 100% online. Most people enroll in Part A while they are still working (because it's premium-free). But you can later enroll in Part B and fill out and submit the form you need to do so, which you can obtain online. The form to prove that you had creditable coverage through your employer after becoming eligible for Medicare will need to be completed by both you and your employer.Another qualifying event is relocation. Some circumstances that qualify you for a Special Enrollment Period for Medicare Advantage or Part D are:• Moving out of your plan's current service area• Entering or leaving a long-term care facility – this Special Enrollment Period lasts the duration of your stay at the institution plus two full months after you move out• Release from incarcerationAdditionally, if Medicare fails to renew or terminates your Advantage or Part D plan, you're eligible for a Special Enrollment Period.The next circumstance is becoming eligible for Extra Help with Part D. This Special Enrollment Period is only available during the first nine months of the year because the Annual Enrollment Period runs from October through December.If a New Advantage or Part D plan with a five-star rating is available in your location, you'll get a Special Enrollment Period to enroll in the plan.Less common qualifying events:• No longer eligible for Medicaid• Eligible for a Medicare Advantage Special Needs Plan• Losing another form of drug coverageNow that you know about the different types of SEPs, here's how to be prepared:• Notify your carrier of the changes ahead of time if possible (can extend timeframe)• Know the window of opportunity you have for the SEP you qualify for• Have the forms you need ready• Shop around and become informed about plansThank you for taking the time to watch our video! We hope you found it educational. Please see the links below.FAQ Article: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/Our YouTube Channel: https://www.youtube.com/medicarefaqOur Facebook Community: https://www.facebook.com/groups/medicarefaq

Before you retire, it's important to explore all your options when you become eligible for Medicare. For federal retirees, this can be a bit tricky.  In this video, we go over your options if you're eligible for both Medicare and Federal Employee Health Benefits.Active government workers and retirees are enrolled in the Federal Employee Retirement Health Benefits (FEHB) program. This program covers both inpatient and outpatient services, just like Medicare. This is why some beneficiaries who are eligible for both are confused about whether they need to enroll in each program.For the most part, those enrolled in FEHB don't need to enroll in a Medigap, Medicare Part D, or Medicare Advantage plan because their benefits already include this coverage. However, because FEHB benefits are expensive, those who are newly eligible for Medicare wonder how they can coordinate their coverage to reduce their out-of-pocket costs.There are a few ways to do this. The first way is to enroll in Part A to supplement your FEHB benefits. More than likely, you worked 40 quarters or 10 years and paid into Medicare throughout those years, making you eligible for premium-free Part A. You can also become eligible in Medicare Part A through your spouse if they've worked for 10 years.Enrolling in Part A will give you extra coverage for any inpatient medical expenses you incur. Your FEHB will be primary and Medicare Part A will be secondary. You'll save money by not paying the monthly Part B premium. The downside is you'll pay copays for your out-of-pocket services.Compare the cost of the Part B premium to what you could be spending in copays to determine which option will save you the most money.The other downside is if you delay enrolling in Part B, you'll incur late enrollment penalties since FEHB is not considered creditable coverage through Medicare. So, an additional 10% will be added to your premium for every 12 months you went without coverage.Your other option is to enroll in Part A and Part B to supplement your FEHB benefits. With this combination, you're paying for both FEHB and Medicare. Medicare is your primary coverage, and FEHB is secondary coverage. Your FEHB acts as a supplement plan and covers deductibles, copays, and coinsurance. With this combination, you can see any doctor that accepts Medicare and you'll even have some additional benefits under Part B that FEHB does not cover. Also, since FEBH includes prescription drug coverage, you wouldn't need to enroll in Part D.The third way to do this is to enroll in Part A and Part B with Medicare Advantage or a Medigap plan, suspending your FEHB coverage. The reason Medicare beneficiaries go with this coverage is that they determine this combination would cost less than keeping FEHB.We go into some frequently asked questions in this video as well! Please go to 3:07 for the answers.We hope you found this information helpful! Please subscribe to our channel, join our Facebook Community, and check out our article below.FAQ Article: https://www.medicarefaq.com/faqs/medicare-for-federal-retirees/Our YouTube Channel: https://www.youtube.com/medicarefaqOur Facebook Community: https://www.facebook.com/groups/MedicareFAQ

If you're under 65 and collecting Social Security Disability Income (SSDI),   this video is for you.To be eligible for Medicare, you must be 65 OR collect SSDI benefits for 24 months. Once you collect for 24 months, you'll receive a Medicare card in the mail. This includes coverage for Part A and Part B.Part A is premium-free for those who have worked at least ten years and have paid into Medicare for 40 quarters. Yet, Part B comes with a monthly premium. This premium will be automatically deducted from your Social Security check each month.If you're still working, you may have the option to delay enrolling in Part B to avoid paying the premium. As long as Medicare considers your employer coverage creditable, you can delay Part B without incurring any penalties. As long as your employer has 20 or more employees, your coverage will be creditable.Without creditable coverage, you'll be responsible for a penalty if you delay Part B. The good news is that when you age into Medicare at age 65, the penalty will reset.Because Original Medicare comes with out-of-pocket costs, you'll want to enroll in a supplemental coverage option as well. Once your Part B is effective, your Medigap Open Enrollment Period begins. It lasts for six months and allows you to enroll in a plan without answering health questions and going through medical underwriting. That means a carrier can't deny you coverage due to your disability.However, there are some downsides to enrolling in a Medigap plan when you're under 65. First, some states don't require carriers to offer Medigap to individuals under 65.Still, carriers usually only provide one option to those younger than 65 in the states that require at least one Medigap plan offering to those who qualify due to disability. This option is Plan A, which only includes core policy benefits.With Part A, you don't have coverage for many things that other policies include, like the Part A deductible or extended skilled nursing facility care.Another downside of Medigap for those under 65 is that the premiums can be significantly higher than for those 65 or over. In fact, you could pay four times more for a Medigap plan than you would if you were 65.This is because carriers know you have a disability, so they consider you high-risk financially. Meaning, they know they may pay more for your health care costs than they would for someone over 65.Finally, even if you find a premium that fits into your monthly budget, it's common to see high rate increases through the years when you enroll in Medigap before 65.An alternative form of supplemental insurance for those under 65 is a Medicare Advantage plan. For Advantage plans, everyone pays the same rates – regardless of age. Premiums for Advantage plans are low – sometimes even $0. Additionally, rate increases are low, including for individuals under 65.No health questions are involved in the enrollment process for Advantage plans. These plans come with maximum out-of-pocket limits and extra benefits such as dental, vision, hearing, and transportation. Some even come with an over-the-counter pharmacy card that you can use to purchase items at your local pharmacy.However, there are a few things to know before you enroll in a Medicare Advantage plan.When you have one of these plans, you can expect to pay out-of-pocket costs as you use the benefits. These include copays and coinsurance when visiting the doctor's office. Before enrolling, you'll want to ensure that all of your doctors are in the plan's network.As most Advantage plans come with prescription drug coverage, you should check ahead of time that the drug plan's formulary includes all of your prescriptions.Having a Medicare Advantage plan is good in that the maximum out-of-pocket amount protects you from spending too much. Although an Advantage plan

Maybe you're not quite sure when to enroll in Part B, or you're unfamiliar with the coverage and costs involved in Medicare's outpatient insurance. If so, this video is a must-watch as we're unboxing everything you need to know about Medicare Part B.You'll use your Part B at doctors' offices, as it's your outpatient coverage. Part B covers medically necessary services given by a provider. This includes preventive care, surgeries, and other treatments.Some medically necessary services Part B will cover include mammograms, colonoscopies, lab testing, durable medical equipment, occupational therapy, transplants, home health services, medications administered at the doctor's office, outpatient mental health services, ambulance services, vaccines (such as for the flu or Hepatitis B), and some services you receive in the hospital.Moving on to Medicare costs, Part B comes with a monthly premium.  Each year, there is a standard premium amount that is adjusted if your income is higher. Each year, the Part B premium is subject to increase and the standard amount is announced each year in the late fall, as is the annual deductible for Part B.In addition to the premium and deductible, Part B also involves coinsurance. Medicare pays 80% of the approved amount, leaving the beneficiary responsible for the remaining 20%. This means you'll need to pay 20% for all services received at the doctor's office.Unfortunately, Part A and Part B don't have out-of-pocket maximums. So, the 20% you pay out-of-pocket can quickly add up. Luckily, this is where Medicare Supplement (Medigap) plans can help. They cover the 20% coinsurance, thus protecting you.Last but not least, we're going to let you know when to enroll in Part B. The first enrollment window every Medicare beneficiary has to enroll in Part B is the initial enrollment period. It's unique to you and starts three months before your 65th birthday, ending three months after your 65th birthday. Thus, you have seven months to enroll in Part A and Part B. Keep in mind that if you don't enroll during the first three months of this period, your coverage could be delayed and won't become active until after you turn 65.If you're collecting Social Security benefits, you'll automatically enroll in Original Medicare (Parts A and B), and your Part B premium will be deducted from your Social Security check each month. If you're not collecting Social Security, you'll have to enroll yourself. If you have another form of creditable coverage, like group medical insurance through a large employer, you can delay enrollment in Part B and avoid penalties.Once you leave your employee group coverage when you retire, you'll get a Special Enrollment Period of eight months. Make sure to get the right documentation for proof of coverage.Those who miss their Initial Enrollment Period and don't qualify for a Special Enrollment Period can use the General Enrollment Period to sign up for Part B. This enrollment period occurs annually, from January 1 through March 31. If you sign up during this time, your coverage will begin on July 1.When you lack creditable coverage at the time of enrollment, you'll face a penalty of 10% for every 12 months you went without coverage. Unfortunately, this penalty will stick with you forever. This is why it's so important to be familiar with what constitutes creditable coverage and why you shouldn't just assume you don't need Part B yet.Resources: https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-b/Our YouTube Channel: https://www.youtube.com/medicarefaqOur Facebook Community: https://www.facebook.com/groups/medicarefaq

Not sure how to pay your Medicare premium bill? Don't go anywhere! In today's video, we're going to talk about Medicare Easy Pay.When you're enrolled in Medicare but aren't yet collecting Social Security benefits, you'll get a Medicare premium bill in the mail each quarter. Medicare Easy Pay is a free service through Medicare that makes it simple to pay your premiums.Once you set up Medicare Easy Pay, Medicare automatically deducts your premiums from your checking or savings account. This deduction takes place around the 20th of each month.There are two ways to sign up for Medicare Easy Pay. The first way is through the online form. First, you'll need to create an account on Medicare.gov or sign onto your existing account. Then, select "My Premiums," and finally click "Sign Up." The screen will then prompt you to complete a quick online form.The second way to sign up for Medicare Easy Pay is through the mail-in form. Print out and complete the form from Medicare.gov, then mail it directly to Medicare.It can take up to eight weeks to process your Easy Pay form. If you receive a Medicare premium bill after Medicare Easy Pay enrollment, your enrollment is not complete.There are a few ways to pay your Medicare premium while you wait for processing. You can pay it online through your Medicare account, using a credit card, debit card, checking, or savings account.You can also use your bank's online bill pay option to pay directly from your checking or savings account. The third way is to pay by mail to Medicare, via check, money order, credit card, or debit card. All you need to do is fill out the form and use the payment coupon that comes with your Medicare bill.Once you receive a statement that states, "This is not a bill," you'll know your Medicare Easy Pay is processed and set up.We hope you found this video helpful! Please subscribe to our channel, join our Facebook Community, and check out our resources below.FAQ Article: https://www.medicarefaq.com/faqs/medicare-easy-pay/Our YouTube Channel: https://www.youtube.com/medicarefaqOur Facebook Community: https://www.facebook.com/groups/medicarefaq

Are Medicare Advantage plans bad? If you've heard that they are, don't go anywhere. We're going to unbox the truth about Medicare Advantage plans.Intro (0:19)How Medicare Advantage Carriers Afford Low Premiums (1:26)Giveback Benefit (2:53)How Provider Networks Work With Medicare Advantage (3:59)Prior Authorization (4:44)Maximum Out-Of-Pocket Limit (5:19)Annual Changes (6:24)You've probably seen a few commercials for Medicare Advantage plans, especially during the fall Annual Enrollment Period. They usually start by asking if you're happy with your Medicare benefits, telling you Advantage has many more benefits. Some even throw a jab at Medicare Supplement plans, which come with monthly premiums. Others say there's no premium with an Advantage plan and that they could even return $140 or more to your Social Security check.When something sounds too good to be true, that's usually the case. However, the issue is less with the plans and more with the advertisements. The commercials can be extremely misleading and create misconceptions. This is why doing your research is important.So, how can Medicare Advantage carriers afford to offer such low-premium plans? It helps to understand how the plans work. When you enroll in an Advantage plan, the carrier is paid by Medicare to take on your risk. Because you're leaving Parts A and B, the private carrier manages your benefits instead of Medicare.Medicare Advantage carriers also make their money through cost-sharing. Just because you don't have to pay a monthly premium doesn't mean the plan is free. You'll still have to pay out-of-pocket in the form of deductibles, copays, and coinsurance. Advantage plans must provide the same coverage as Parts A and B, but it's important to be aware that the carrier gets to choose how much of that service to cover and what you'll need to pay out-of-pocket.Also, don't assume you won't have to pay your Part B premium anymore if you pick up an Advantage plan – this is not true. Regardless of whether your Advantage plan comes with a premium or not, you'll still need to pay your Part B premium.This is where the giveback benefit comes into play. Some carriers in some ZIP Codes offer a Part B reduction, reducing the amount you pay for your premium – ranging from a few dollars to the full amount. However, it's not a reimbursement. Carriers can afford to do this because they get paid by Medicare. Keep in mind that the less you pay in monthly premiums, the more you'll pay out-of-pocket as you use your benefits. Thus, plans with the giveback benefit involve more cost-sharing. That's how the carrier recoups their money.Benefits on an Advantage plan work differently from Original Medicare paired with a Medigap plan. First, Advantage plans come with doctor networks, so it's important to make sure your doctors are included. Advantage also doesn't travel with you – restrict coverage to your county. On the other hand, Original Medicare and a Medigap plan travel with you across all 50 states, as most doctors accept Medicare assignment.When enrolling in an Advantage plan, it's important to understand prior authorization. Before you receive a service or treatment, the carrier may want to make sure it's medically necessary. So, you may be required to get prior authorization, which can take weeks. If the carrier doesn't think it's medically necessary, your request could face denial. On the other hand, Original Medicare paired with a Medigap plan doesn't require prior authorization so you won't be dealing with a wait.Next, maximum out-of-pocket (MOOP) limits come with Advantage plans. They protect you from paying too much for services. Yet, the amount can be up to $7,500 and resets annually on the first of the year. So, unfortunately, if you're diagnosed with a serious illness or condition halfway through the year and end up getting close to or e

Medicare comes with many different parts and plans. We're going to break down Medicare Parts A through D in a simple way so that you know which parts to enroll in.Medicare comes with 4 different parts, Part A, Part B, Part C, and Part D. Part A and B are both run by the Federal Government. Part C and D are offered through private insurance companies. When talking about Medicare plans, you're usually referring to supplemental Medicare options such as Medigap and Medicare Advantage. Part A is your hospital coverage for inpatient care. This includes room and board, nursing care received while at the hospital, meals, and diagnostic tests. Part A also covers skilled nursing and hospice. Part B is your coverage for outpatient care. This includes services at the doctors and other health care providers. Part B also covers preventive services, home healthcare, and items such as durable medical equipment. Basically, Part A will cover your services received at the hospital. Part B will cover any services received at the doctor's office. Part A and Part B is what makes up Original Medicare.Now we're going to go over Part C. Also known as Medicare Advantage. Part C or Medicare Advantage is not part of Original Medicare. It's another way to get Part A and Part B coverage. It's Medicare coverage offered through private insurance companies. Since Part A and Part B don't cover 100% of your medical cost, most beneficiaries opt to enroll in additional supplemental coverage to fill in the gaps. This is done through either a Medicare Supplement Plan or Medicare Advantage plan. Medicare Advantage plans are a form of managed care. With these plans, you opt to receive your Part A and Part B benefits through the carrier's network of providers instead of Original Medicare. To be eligible for Part C, you still must enroll in both Part A and Part B, as well as live in the plans service area. It's important to remember, Part C is optional. Not every Medicare beneficiary will choose to enroll in a Part C plan.Last but not least, is Part D. Part D is your prescription drug coverage. Part D plans are also offered through private insurance companies. It covers the prescriptions you pick up at your local pharmacy. Part D is also optional. However, if you don't have another form of prescription coverage that's considered creditable under Medicare, you could face enrollment penalties if you choose to enroll later. Part D plans do change annually. That's why it's important to compare all the options in your area each year during the fall Annual Enrollment Period.Resource Links:https://www.medicarefaq.com/original-medicare/medicare-parts/https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-a/https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-b/https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-c/https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-d/Like what you see? Join our Facebook group! It's a group dedicated to helping people become educated on Medicare. Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your Medicare resource center.https://www.facebook.com/groups/MedicareFAQ/

If you're unsure what the differences are between Medicare and Medicaid, don't go anywhere. In today's video, we're going to explain the difference between the two, as well as additional Medicare Savings Programs you could be eligible for.Medicare is a federally funded program for those who are over 65 as well as those who are under 65 with a disability. With Medicare, the benefits are the same across all 50 states, and your income is not an eligibility factor.  With Medicaid, It's funded both on the federal level and the state level. You're eligible at any age and benefits and criteria do vary from state to state. With Medicaid, you must meet the low-income criteria within your state to become eligible.If you meet the eligibility criteria for both Medicare and Medicaid, that means your dual-eligible. Those who are dual-eligible can qualify for a Medicare Savings Program. These programs help pay for your Medicare cost including deductibles, co-pays, and coinsurance. In addition, all of those who are eligible for Medicare Savings Program are also eligible for a program called Extra Help.Extra Help provides assistance with your prescription drug cost under Part D. Also, if you delayed enrolling into Part D and incurred a late enrollment penalty because of it, that penalty will be waived if you're eligible for Extra Help. To qualify for Medicare Savings Program you must be already enrolled or at least eligible for Part A and your income and resources must meet the federal and state limits set for the program. There are four different types of Medicare Savings Programs. The first type of Medicare Savings Program we're going to go over is called the Qualified Medicare Beneficiary Program, or QMB. With the Qualified Medicare Beneficiary Program, you will have coverage for the Part B premium. If by chance you were not eligible for premium-free Part A then the Qualified Medicare Beneficiary Program will also cover your Part A premium. Medicare will be your primary coverage and your QMB will be your secondary. This means you won't need any Medigap plan since your QMB will cover your premiums, co-pays, and deductibles. The Qualified Medicare Beneficiary Program is the highest level of Medicare Savings Program you can get. The second type of Medicare Savings Program available is the Specified Low-Income Medicare Beneficiary or SLMB. The Specified Low-Income Medicare Beneficiary Program will pay for your Medicare Part B premium. The next type of Medicare Savings Program is Qualified Individual or QI. The Qualifying Individual Program will also pay for your Medicare Part B premium. The only difference is that you must apply for this program each year. It's on a first come first serve basis. The fourth and final type of Medicare Savings Program is the Qualified Disabled and Working Individual, or QDWI. If you're under 65, disabled, and working and you can qualify for the QDWI. This program will pay for the premium for your Part A. The most common question we get about the QDWI program is if you must be working? And the answer is yes, you must be under 65 disabled and still working to qualify.Keep in mind, each state may have a different name for these types of Medicare Savings Program. So don't be confused if your local Medicaid office refers to them with a different name. You can apply for any of the Medicare Savings Programs at any time of the year at your local Medicaid office. The list of what you need to apply can vary by state, but in general, you'll need to provide:- Proof of residence- Proof of age- Other forms of insurance, like Medicare- Checking and savings accounts- Retirement accounts- Stocks and bonds- Mutual fundsResources that aren't counted would include:- Your primary residence- Household items- Any furniture- One car

If you're a resident of Minnesota and eligible for Medicare, don't go anywhere! In this video, we discuss the Medigap plans available in your state.Minnesota has two different types of Medigap plans, known as the Basic Plan and the Extended Basic Plan. Both of these plans include what are known as Basic Benefits.The Basic Benefits both Minnesota Medigap plans include are:• Coverage for any coinsurance that falls under Part A and Part B• Coverage for the first three pints of blood per year• Coverage for some hospice and home health servicesAdditionally, both Minnesota Medigap plans also include:• 80% coverage for foreign travel emergencies• 20% coverage for mental health care in an outpatient facility• 20% coverage for physical therapyAdditionally, there are state-mandated benefits that come with both the Basic Plan and the Extended Basic Plan:• Cancer screenings• Reconstructive surgery• Immunizations• Diabetic equipmentThe Basic plan includes the state-mandated benefits along with 100 days in a skilled nursing facility.The Extended Basic plan comes with all of the previously mentioned benefits, plus some additional benefits as follows:• Coverage for the deductibles that fall under Part A and Part B• 20 extra days of skilled nursing facility care• 80% coverage for usual and customary fees• 80% coverage while in a foreign countryAdditionally, on the Extended Basic Plan, once you spend $1k out-of-pocket, all benefits will be covered 100%.With the Basic Plan (not the Extended Basic Plan), you can increase coverage by adding any of four riders. The four riders are as follows:• Part A deductible rider• Part B deductible rider – only available to those Medicare-eligible before 2020• Usual and Customary Fees Rider• Non-Medicare Preventive Care RiderGood news for Minnesota residents: the state does not allow excess charges from doctors not accepting Medicare.Although you can enroll in Medigap at any time, the best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period.We hope you enjoyed this video! Please feel free to ask any questions in the comment section below. Subscribe to our channel to see videos as soon as we upload them and join our Facebook Community!YouTube Channel: https://www.youtube.com/medicarefaqFacebook Community: https://www.facebook.com/groups/MedicareFAQ

If you're a Medicare beneficiary in Wisconsin, don't go anywhere! We're going to go over how Medigap plans in Wisconsin are different from the rest of the country.Wisconsin is one of three states where Medicare Supplement plans are standardized differently. The state offers a Basic Plan along with additional riders you can pair it with for additional coverage.The Basic Plan is excellent for covering what Medicare doesn't. Riders allow you to add additional benefits to a policy. They can help you with deductibles, copays, and other coverage gaps.The Basic Benefits included in Wisconsin Medigap plans include:• Coverage for the coinsurance under Part A and Part B for both inpatient and outpatient services• Coverage for the first three pints of blood each calendar year• Coverage for the Part A hospice coinsurance or copayment• Coverage for the coinsurance at a skilled nursing facility• Additionally, benefits for 40 home health care visits that are added to the amount already paid for by Medicare plus an extra 175 days of inpatient health care beyond MedicareThere are also state-mandated benefits that Wisconsin Medigap plans must include. Wisconsin requires insurance companies to offer specific mandated benefits that provide additional coverage to protect beneficiaries. These state-mandated benefits include:• Extra coverage for skilled nursing facility care• Kidney disease care• Diabetic treatment• And moreState-mandated skilled nursing facility care coverage:• Must include coverage for 30 days of care at a skilled nursing facility with no prior hospital stay requirement• The facility does not have to be certified by Medicare and the stay does not have to meet Medicare's definitionThe state-mandated benefits also include extra coverage for kidney disease care:• Coverage for both inpatient and outpatient dialysis treatment• Coverage for transplants and donor-related expenses• Up to $30,000 of coverage for kidney disease care in any calendar yearState-mandated diabetic treatment coverage includes diabetic supplies including self-management training and insulin infusion pumps. Lastly, the state mandates chiropractic care; Medigap policies cover the usual and customary expense for services provided by a chiropractor under the scope of a chiropractor's license. In Wisconsin, this benefit is available even if Medicare doesn't cover the claim. The care must also meet the insurance carrier's standards as medically necessary.Some additional state-mandated benefits include:• Breast reconstruction surgery• Colorectal cancer screening• Coverage of certain health care costs in cancer clinical trialsPlease note that Medicare Advantage plans aren't required to provide coverage for the above-listed, state-mandated benefits. The seven additional benefits that you can pair with your Basic Benefits in Wisconsin are available à la carte and can be added to the Basic Plan to customize coverage. If you stick to the Basic Benefits, the plan is similar to Plan A.The Wisconsin riders include:• Coverage for the Part A deductible• Coverage for 50% of the Part A deductible• Additional home health care• Coverage for the Part B deductible (available only to beneficiaries eligible prior to 2020)• Coverage for Part B excess charges• Additional coverage for foreign travel emergency• Coverage for any copayments or coinsurance under Part BYou can add these riders to make your coverage equivalent to the most popular standardized Medigap plans. If you prefer a cost-sharing plan with a lower monthly premium, there are plan options that include 25% and 50% cost-sharing, similar to Plans K and L. A high deductible plan that is similar to High Deductible Plan G is also available in Wisconsin.We hope you enjoyed this video and fo

You've likely seen commercials for the Medicare give back program, which is also known as the buyback benefit – some commercials even refer to it as a Medicare reimbursement plan. Yet, this benefit actually isn't a reimbursement at all, but a reduction. In this video, we'll explain what you need to know about the Part B premium reduction benefit that's available with some Medicare Advantage plans.The Part B reduction plan is, well, just as it sounds. You enroll in a Medicare Advantage plan, and the carrier pays either part or your entire Part B premium. In the summary of benefits or evidence of coverage, you'll see a section that mentions the Part B premium buy-down. This is where you can see how much of a reduction you're going to get. This benefit is also referred to as the giveback benefit.The giveback benefit has become very common across all states and is now available in the majority of areas. However, there are some ZIP Codes that do not offer this benefit in their Medicare Advantage plans.Many carriers, both large and small, offer a Part B premium reduction plan. These include Humana, Cigna, Aetna, and many more. Carrier coverage depends on your county and ZIP Code. You should always consider the plan ratings before you enroll.The Part B premium reduction plan only participates with Social Security. You won't receive any checks directly from the carrier. Anyone enrolled in Medicaid or another form of assistance helping to pay for their Part B premium will not be eligible to enroll in a Medicare Advantage plan with this benefit.Most pay their Part B premium through their Social Security check. If your Part B premium currently comes out of your Social Security check, you'll see the reduced amount reimbursed in your check. If you're not paying your Part B premium through your Social Security, then you'll have to pay Medicare directly the reduced amount. If you pay Medicare directly anything over the benefit amount, your carrier will not send you a check to reimburse you; it is a reduction, not a reimbursement.The amount you get back can range from 10¢ up to the entire Part B premium amount so you pay nothing. This amount depends on your area.Part B Reduction Plan Eligibility• You must be enrolled in both Part A and Part B of Original Medicare• You must not be accepting any government assistance that currently helps you pay your Part B premium• If you don't qualify for a Part B premium reduction plan, there are many other options available to youIt's important to know that a Medicare Advantage plan is not the best option for everyone. As great as it is to have your Part B premium reduced to save you money in your Social Security check, you might find that if you visit the doctor's office often, you could pay more out-of-pocket than you initially expected. Before you enroll in a plan, be sure to weigh out the pros and cons of Medicare Advantage and Medicare Supplements.Thank you so much for taking the time to watch this video. If you have any questions, please leave them in the comments section below or give us a call.Resources:- https://www.medicarefaq.com/faqs/medicare-part-b-give-back-plan/- https://www.medicarefaq.com/faqs/pre-enrollment-medicare-advantage-checklist/- https://www.medicarefaq.com/faqs/medicare-advantage-open-enrollment-period/- https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/Subscribe to our YouTube channel: https://www.youtube.com/medicarefaqFacebook Community: https://www.facebook.com/groups/MedicareFAQ/

Medicare Part D is the part of Medicare that covers your prescription drugs. This coverage is available either through a standalone prescription drug plan or a Medicare Advantage (Part C) plan. These plans renew and reset annually, on January 1.So, what is this "donut hole" term you keep hearing being thrown around? The donut hole is one of the four phases of Medicare Part D. What many don't realize is that the Part D program is not funded by premiums. Instead, it is funded mostly through the Medicare program.In order to keep the Part D program sustainable, Medicare had to find a way to convince beneficiaries to choose generic drugs over brand-name drugs. That's why Medicare created the donut hole, also known as the coverage gap.When the donut hole (or coverage gap) was first created, beneficiaries had to pay 100% of the cost of their medication. In order to avoid the donut hole, beneficiaries would switch to the generic version of their brand-name medications.Yet, there isn't a generic version available for all medications. Thus, beneficiaries who couldn't find a generic version could be put in a financial bind once they reached the donut hole. Thankfully, legislation has stepped in and reduced the amount that the beneficiary must cover from 100% to 25%.Now that you know why the donut hole was created, let's go over the four phases of Medicare Part D.Phase 1: Deductible Phase• Part D plans come with an annual deductible• You pay the full cost of medications until the annual deductible amount is reached• It's possible that the deductible won't apply to you if you're taking generic medications or tier 1 and 2 medications• However, if you take brand-name medications that are tier 3 or higher, you will likely have to pay the full cost of your medication until you reach the plan's deductible amountPhase 2: Initial Coverage Phase• You only have to pay a set coinsurance or copay set by your drug plan• How much you pay in coinsurance and copays will depend on what tier your prescription fall within• Tiers vary from one drug plan to another – you can find these tiers in your plan's drug formulary • Most beneficiaries stay in this phase until their plan renews the following year (~85%)Phase 3: Donut Hole (Coverage Gap) Phase• Most people do not ever reach this phase• You fall in the coverage gap (donut hole) after a certain spending amount reaches a set threshold• The total amount includes both what you pay for your medication and what your insurance pays for the medication• While in the donut hole, you will have to pay 25% of the full cost of your medications (both generic and brand-name)• While in the donut hole, what counts towards your True Out-of-Pocket cost includes the amount paid towards your deductible, any copays/coinsurance paid while in the initial coverage phase, the full cost of brand name drugs while in the coverage gap, and the amount paid for generic drugs while in this phasePhase 4: Catastrophic Coverage Phase• When your True Out-of-Pocket cost (TROOP) reaches a certain amount, you reach this phase• While in this phase, your costs for medications usually go down• In the catastrophic coverage phase, you only pay around 5% of the cost of your medicationNow that you understand the four phases of Part D, it's important to know that these plans change annually. So, during the annual enrollment period (from October 15 through December 7), you'll want to compare all the plans in your area to make sure you're saving the most money possible.Thank you for watching this video! We hope you found it educational. Please subscribe to our YouTube channel and join our Medicare Community on Facebook.YouTube Channel: https://www.youtube.com/MedicareFAQ/Facebook Community: https://www.facebook.com/groups/medicarefaq