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.
 
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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.
 
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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 coinsurance

Some 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.

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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.

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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-insurance

Situations when Medicare pays secondary:
• When you have a worker's compensation, liability, or no-fault insurance policy
• Active duty with TRICARE

As 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.e

All 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!

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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 incarceration

Additionally, 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 coverage

Now 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 plans

Thank you for taking the time to watch our video! We hope you found it educational. Please see the links below.

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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.

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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.

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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.

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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