Hey Medicare Nation!
It’s January 2018!
I hope everyone made informed decisions regarding your Medicare Advantage Plans for 2018.
If you missed the last episode, go back and listen to it!
I discussed the Medicare Premiums, co-pays and co-insurance for 2018.
Many of you have sent me emails “asking me” if you can change your Medicare Advantage Plan in January.
The answer is……yes….with specific guidelines.
Currently, it is the Medicare Advantage Plan “Disenrollment Period.”
The current Disenrollment Period runs from January 1st through February 14th each year.
During this time, you can “drop” your Medicare Advantage Plan and go back onto Original Medicare.
You do this by contacting MEDICARE by phone 800-633-4227…..and telling the Medicare representative that you would like to “Disenroll from your Medicare Advantage Plan” to go back onto Original Medicare. Medicare may also help you with a Part D prescription Drug Plan if you’d like.
On Original Medicare, you are covered under Part A and Part B of Medicare.
Under Part A….you are covered for Medicare benefits where you would stay at a location as an “inpatient.”
The most common location is …..The Hospital. Another location where you stay overnight as an inpatient is….a Skilled Nursing Facility (SNF).
A SNF is NOT a Nursing Home. An SNF is a location where you are admitted as an inpatient to receive medical care and rehab 24hrs a day.
Also….. if you are diagnosed with a terminal illness, your doctor may suggest you enter Hospice as an inpatient.
All the services covered in the Hospital, SNF and Hospice are covered under Part A of Medicare.
There is a “Deductible” each time you are admitted to the Hospital. The Deductible cost for being admitted as an inpatient in the hospital is $1,340.00 in 2018. The Deductible is due EACH benefit period you are admitted.
Part B of Medicare is for “Outpatient Services.”
Benefits under Medicare for Outpatient Services covered under Part B include, but not limited to:
* Doctor Vists
* Laboratory Blood Draws
* Outpatient Same Day Surgery
* Oxygen in your home
There is an “Annual Deductible” for Part B of $183.00.
After you pay your $183.00 annual deductible, you will be responsible for the remaining 20% Medicare Allowable Charges for services under Part B.
What does that mean?
Let’s say you already visited your Cardiologist and had bloodwork drawn at Quest or Labcorp.
We’ll say your out-of-pocket costs for both cost a total of $183.00.
That takes care of your annual Part B deductible for 2018.
Now….let’s say three months later…..you need to have an MRI. We’ll say the Medicare allowable cost is $1,500.00.
Medicare Part B covers 80% of the $1,500.00, which is $1,200.00.
You will be responsible for the remaining 20%, which is $300.00.
You will pay 20% of ALL Part B Medicare Allowable Charges. There is NO Cap!
You may also need Prescription Drug Coverage.
Prescription Drugs are NOT covered under Part A or Part B in general. Prescription Drugs will be covered while you are admitted to one of the facilities under Part A.
If you want Prescription Drug coverage, you WILL need to enroll in a stand-alone-prescription-drug-plan.
You can find which Prescription Drug Plan (PDP) is available in your area, by going onto the Medicare.gov website and “hover” over the FIRST Blue Box named “Sign Up/Change Plans.”
A column will appear and go down to where it reads…”Find Health & Drug Plans.”
“Click” on that box and it will bring you to the Medicare Plan Finder site.
Type in your zipcode and follow the instructions.
If you are comfortable with the costs associated with Original Medicare Parts A & Part B…..then that’s all you need to do.
If you’d like to add additional coverage to protect you against the on-going out-of-pocket costs associated with Original Medicare, you can purchase a Medicare Supplement (a.k.a. Medi-Gap) Plan.
A Medicare Supplement Plan is an Insurance Policy, where you pay the insurance carrier a monthly premium and the plan will pay Medicare out-of-pocket costs that you have pre-determined.
Medicare Supplement Plans “VARY” in coverage and in premiums.
The “Medicare Benefits” they pay for you, are the SAME, no matter where you live in the U.S.
So…..if you chose a Supplement Plan “F,” which is the policy which pays ALL your out-of-pocket costs for Medically Necessary services under Medicare, and you live in Seattle, WA…….you will be covered for the EXACT SAME Medicare benefits as a person living in Tampa, FL.
What is different you ask?
The difference is in the PREMIUM you pay.
Insurance Carriers that offer Medicare Supplement Policies charge DIFFERENT Premiums!
You NEED to know what the difference in Premiums are by EACH Insurance Carrier for the SAME TYPE OF PLAN.
Here’s an example:
Mary is turning 65 in March of 2018. Mary has a history of heart problems and would like to remain on Original Medicare and purchase a Medicare Supplement Plan “F” so that she can see ANY Cardiologist that is contracted with Medicare…. in ANY State.
Mary also wants to have a budget for her out-of-pocket health costs and having a Medicare Supplement “F” plan will allow her to do that.
Mary lives in Miami, FL and calls her Medicare Specialist Diane.
Mary discusses purchasing a Medicare Supplement with Diane and asks for her expertise and guidance.
Diane tells Mary that the 3 lowest premiums in her zipcode have the following montly premiums:
1. $239.00 From Acme Insurance Co.
2. $250.00 From Beta Insurance Co.
3. $275.00 From Delta Insurance Co.
These premiums are for the EXACT same Plan with the SAME benefits!
Why would you pay Delta insurance company $275.00 a month, when you can pay Acme Insurance Company $36.00 a month less….for the SAME benefits!
That’s why it’s soooo important to speak with a Medicare Specialist or Medicare Consultant like myself.
I speak MEDICARE! I care about YOUR best interests! I have NO loyalties to ANY Insurance Company!
You can also STAY on the Medicare Advantage Plan you are enrolled in.
Do your Due Dilligenct to ensure you are doing what’s best for your health and out of pocket costs for 2018.
I’m hear to help you if you need me!
You can contact me by email at Support@TheMedicareNation.com
You can contact me by phone: 855-855-7266.
I will even answer your question by email if I can answer it in ONE paragraph!
If I have to do any kind of research, you need to hire me as your consultant.
My time is valuable and I want to do what’s best for you!
Thanks for listening Nation!
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Thank you and have a Happy, Peaceful & Prosperous Week!