Lenore-Khoubesserian Mizenko and I’m one of the cofounders of medicare plan discounts dot com. And today I’d like to give you an overview of Medicare. Go over the A,B,C, & D’s of Medicare. What we’ll talk about today specifically is: What is Medicare…Who is eligible for Medicare…How enrollment works…The four parts of Medicare – which include Part A (hospital or facilities) Part B (doctor or services) Part C (Medicare Advantage) Part D (prescription drug plans) – we’ll also talk about Medicare supplemental plans or Medigap plans. And then finally we’ll summarize it all. So what is medicare? Well, in 1965 President Lyndon B. Johnson signed into law the Medicare program. And, in January 1966 the first participants began enrolling in Medicare. Today over 50 million Americans actually participate in Medicare. So, who is eligible for Medicare? Well Medicare is health insurance for people aged 65 or older or people under the age of 65 with certain disabilities. Is enrollment automatically? Well not exactly. If you’re currently collecting disability or social security benefits. You’ll automatically be enrolled. If you’re automatically enrolled in Medicare you’ll typically get your red, white, and blue card in the mail about three months before your 65th birthday or if you’re on disability you’ll get your red, white, and blue card about 25 months that you’re on Social Security disability benefits. Now, if you’re not on Social Security or Disability…don’t freak out. You can actually enroll by contacting the social security office at 1 (800) 772 – 1213 You can also go down to the social security office in person or do this online at Medicare.gov. Now there are specific enrollment times for Medicare. There’s a seven-month period when you can actually enroll in Medicare. It begins three months before your 65th birthday, it includes the month you turn 65, and it includes the three months after you turn 65. You need to make sure you enroll during that time-frame. Otherwise, you could possibly have some penalties associated with not enrolling. So there are four parts of Medicare Part A most people are familiar with that is hospital. There’s no cost to enroll in Part A if you’ve worked 40 quarters or 10 years or if your spouse is work 40 quarters of 10 years throughout their working career. Part A – which includes hospital coverage, semi-private room and board. Also, includes nursing services, it includes hospice, it includes skilled nursing, and some home health care. There are copayments associated with Part A. There’s co-insurance associated with Part A, and there is a deductible for each time you actually enter the hospital of $1288.00 ($1316.00 in 2017). Part B is your medical coverage. This is voluntary. So, Part B will cover typically your doctor’s – in and out of the hospital. It will also include testing (diagnostic tests), physical therapy, surgery, laboratory services, durable medical equipment, and outpatient services. There is a one-time annual deductible of one hundred and sixty-six dollars in 2016 ($166.00), and services are generally covered at eighty percent (80%). The cost to enroll in Part B starts at $121.80 – in 2016 – ($134.00 in 2017). first-time enrollment. So, if you’re currently covered through a group’s plan – like your employer or your spouse’s employer – you can actually delay starting Part B without penalty. As long as, you have – what’s called – credible coverage. Once you come off that credible coverage, that’s when you want to pick up Medicare Part B. Part C is known as Medicare Advantage. Now Medicare Advantage is a little bit different than traditional Medicare, it is an alternative to Medicare. It’s administered by private insurance companies and funded by Medicare. The plan design is very similar to that of group health plans. So what you’ll see in Medicare Advantage plans are HMO’s, PPO’s, POS (Point Of Service ) type plans. There’s an annual contract with Medicare Advantage. So, it’s not guaranteed to renew every year. Typically, Medicare Advantage plans are lower in cost. Most of them include some type of drug plan and may include some type of additional plans like dental and vision plans. There are co-pays associated with Medicare Advantage. There are geographical restrictions, typically associated with Medicare Advantage and there also are networks and referrals with Medicare Advantage. So, the fourth and final part of Medicare is Part D – known as prescription coverage. And this is similar to medicare advantage in that the federal government outsources or the plans are ministered by private insurance companies. You will have to enroll in a prescription drug plan if you’re not enrolled in a Medicare Advantage plan with drug coverage bundled into it. If you are not on medications and you think that you don’t have to enroll you might actually have a penalty if you delay enrollment in Part D. So, how do you enroll in Part D prescription drug plan? I would recommend that you seek out a licensed insurance broker, such as our company, or one close to your home. Or, you can go to Medicare.gov they actually have a rate tool to help you determine which plan is best for you. There are formula is associated with the plan and depending upon the types of medications and drugs you’re taking you could actually fall into what’s called a coverage gap – which can be quite costly. That’s why it’s best to go seek out an expert to help you with Part D. So, in addition to the four parts of Medicare most people actually look to pick up a Medicare Supplement – known as Medigap coverage. Why do they do this? Well, Medicare, as we talked about before, Parts A and B don’t cover everything. There’s no cap or ceiling on these. Part A hospital has a $1288.00 ($1316.00 in 2017) deductible associated with it. There are co-pays. Part B has a deductible and basically only covers eighty percent (80%) of services. So, you’re on the hook for the remaining twenty percent (20%). That’s why most people choose to have a Medigap or Supplemental plan to cover these costs that Medicare doesn’t pick up. So, Medigap plans or Supplemental plans are highly regulated by the government. There are 11 standardized plans lettered A thru N. Some are available in every state – they can vary by zip code – but regardless of the type of plan that you choose their standardized. The government standardizes every letter – every plan lettered A – every letter plan through F – G – all these plans are standardized the only difference is the actual premium. So if you’re looking for a Medicare Supplement plan I would highly recommend, again, that you seek outside assistance for these. So they can review specifically what each plan covers. Medigap insurance or Medicare Supplement plans have a couple of plus’s. They include that they’re portable. So if you actually travel a lot or have two residences this plan can be a better option then a Medicare Advantage plan. For instance…they’re also guaranteed renewable…so you don’t have to worry about them going away. They come back year-after-year or month-after- month as long as you’re actually paying your premium. They offer freedom of choice. So, typicaly you’re not constrained to a specific geographic area or network. So, that’s the advantage or the plus of a Medicare or Medicare Supplement or Medigap plan. So in summary, there are four parts of Medicare they are Medicare Part A – which is generally your hospital – there’s no cost for this. If you’ve worked the 10 years and 40 quarters. There is a deductible for each time you’re hospitalized of $1288.00 ($1316.00 in 2017). There’s co-pays co-insurance with Part A and keep in mind that there’s no cap or out-of-pocket maximums. Part B is general doctor and services there is a cost that starts at $121.80 a month. It does increase based on your income. There is a deductible of $166.00 ($184.00 in 2017) one-time annually. And typically, Part B will cover eighty percent (80%) of expenses. Medicare Part C is known as Medicare Advantage And this is an alternative to traditional Medicare. The price for this varies based on zip code and the plan design. You will have co-pays and deductibles, and there’s cost-sharing in a lot of these type plans as well as typically a network of doctors and restrictive geographic areas that you can go to. And finally, Medicare Part D is your prescription drug plan. These costs vary by zip code and the plan you select. I hope that gives you a basic understanding of Medicare. If you have additional questions? I encourage you to look at our other videos or contact us directly at Medicareplandiscounts.com. Have a good Day!