Understandng Medicare through videos. Bob Vineyard is your #GAMedicareExpert. Over 40 years in the health insurance business. Enrolled in Medicare 2015.
GA Medicare expert Bob Vineyard explains how Medicare works in this Georgia Medicare Minute video. Call (404)252.5859. Review the BEST Medicare plans based on YOUR needs and budget.
If you are turning 65 and enrolling in Medicare, this may be your only chance to purchase a GA Medicare supplement plan. Full report with Medicare supplement rates for ALL Georgia Medigap carriers. Anthem GA Medigap rates include Silver Sneakers
Enroll in Medicare
You don’t have to receive Social Security to enroll in Medicare insurance. CMS is the agency that oversees Medicare.
How to enroll in Medicare? You may sign up for Medicare 3 months before your 65th birthday, the month you turn 65, and 3 months following your 65th birthday. You may enroll online (highly recommended), by mail or by visiting a Social Security office.
Original Medicare has 4 parts. Your red, white and blue card is broadly accepted by doctors and hospitals alike. No networks!
Medicare Part A covers hospital inpatient charges and has a per admission deductible
Medicare Part B is for outpatient health care treatment. Doctor visits, labs, X-rays, MRI, CT scan (CAT scan), ambulance, ER, outpatient clinics, etc. Essentially any Medicare approved health care received outside the hospital setting. Treatment considered medically necessary under Medicare guidelines. Medicare Part B has a calendar year deductible. Once satisfied, Medicare pays 80% of the approved charge, you are responsible for the remaining 20%.
Most seniors worry about hospital stays, but your major expenses will more than likely fall under Medicare Part B outpatient expenses. Original Medicare stand alone has no cap on your out of pocket expenses.
You pay until you run out of money, get well or die.
Medicare Part C is now referred to as Medicare Advantage. More on that later.
Medicare Part D covers outpatient prescription drugs. Some Advantage plans have drug coverage built into the plan
Understanding Medicare Part D
Medicare Part D is confusing . Seniors will almost always buy the wrong drug plan and spend too much every year. Average spending on prescription medication is $1 for every $6 spent on health care. If you spend $60 per month on doctor bills you can expect to spend another $10 on medicine.
Lower your medication bill by only using your drug card when necessary. The right drug plan will save a lot on brand names but you will almost always pay MORE for generics.
Original Medicare vs Medicare Advantage
Did you know that some doctors and hospitals do not accept ANY Medicare Advantage plans? What happens if your claim is DENIED?
Medigap and Advantage plans cover the same things, but what you pay out of pocket for your care, and where you receive your care, is very different.
Original Medicare does not have networks. You can use any doctor or hospital anywhere in the US. Another plus is the ABN form which is only used with Original Medicare.
Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO. How are Medicare Advantage plans like a store credit card?
If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.
Non-emergency out of network care charges may be denied if you have an HMO.
Understanding Medicare and Cancer
Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.
Chemotherapy drugs administered in a doctor’s office or clinic normally fall under Medicare Part B. Medication from a retail pharmacy or by mail fall under your PDP.
This is why most of us chose a Medicare supplement plan in 2019. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.
We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.
According to the Mayo clinic, “new cancer treatments are routinely priced at over $100,000 per year of treatment.”
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