medicare workshop
TRANSCRIPT
“To Do” List for People New to Medicare
Make sure you get your “Welcome Kit” from Medicare 3-4 months prior to
turning 65 or if under 65, when you are approved for Medicare
2
Make sure you have Medicare “Part B” (Medical Care) on your Medicare
Red, White and Blue Card
When enrolling in Part B you have an initial 7 month window, 3 months before you are eligible for Part B, the month of, and 3 months after. If you do not enroll in Part B when you are eligible and want to enroll later you will be penalized 10% each year
you could have been on B but did not enroll. 3 year wait=3x10% or 30% each month forever…
Currently Part B premium is $104.90 so that would be $104.90 plus 30% each month of that year!!!
Rules For Enrolling in Medicare
Medicare Parts A
4
Part A (Hospital Insurance) $ deductible
6 times a year 60 day benefit
Pays Nothing for….. Long Term Care….. Out Patient Services
Pays .…. the Hospital
….. Some cost of Skilled Nursing….. Hospice……Home Health Care
Work 10 yearsOr 40 quarters
For $0 premium
What Part B pays for: … Medically necessary services
… Doctors, tests, … Outpatient care and
… Preventative services
MEDICARE Part B
(Medical Insurance) $ deductible once a year (1 time)
Medicare pays 80% You pay 20%
MonthlyPremium
$
6
How Long Has It BeenSince You Have Had A
Medicare Review?
Why Do You Need A
Medicare Review?$$$$$
Medicare Supplement or Medigap Policies
• You must have Part A and Part B• Enroll at the right time to get Guaranteed Issue!• Works only with Original Medicare (your Red, White and Blue Card)• The cost goes up each year!• A supplement does not have Part D Medicare Prescription Drug Plan• Must enroll in a Medicare Prescription Drug Plan to have drug coverage
$
$
$ $
$
$$ $$
Medicare Supplement is the best there is!Medicare Supplement is the best there is!
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KNOW YOUR ENROLLMENT DATES
October 15 – December 7th this year!!
Anyone can enroll into a Medicare Advantage Plan OR make changes to
another Medicare Advantage Plan.
Anyone with a Medicare Prescription Drug Plan CAN ONLY change
during this period
October 15 – December 7th this year!!
Annual Election Period
8
Medicare Part C
A way to have your Part A and Part B deductiblesand Co-pays paid.
But you must obey the RULES
Rule – OBEY THEIR RULES
Part C (Medicare Advantage Plans)
(covers the headaches caused by Parts A, B, D
RULESRule – You must stay in network
and use their doctors RULE
Rule – DO NOT use your Red, White and BlueMedicare card
RULE
RULES
9
Medicare Part D(Prescription Drug Plans)
Helps cover prescription drug costs
Has Co-pays and most important
the DONUT HOLE!!
Must enroll at the RIGHT time or you will be PENALIZED
10
What is the “Donut Hole”????
DONUT HOLE
The “Donut Hole” starts at $_____.00 and you must spend
$______.00 out of your pocket to get back into your plan!
Confusing … I know!!!Monthly Copay Insurance Company Pays Total Drug what Mary paid Cost
January $104.00 $416.00 $520.00
February $208.00 $832.00 $1,040.00
March $312.00 $1,248.00 $1,560.00
April $416.00 $1,664.00 $2,080.00
May $520.00 $2,080.00 $2,600.00
June $654.00 plus $2,186.00 $2,970.00Mary gets in the donut hole
July $1,174.00
August $1,694.00
September $2,214.00
October $2,734.00
November $3,254.00
December $3,774.00
Mary will never get into catastrophic coverage.
Mary nevergets out of the hole!
Donut Hole
Mary never gets out ofthe HOLE!
Mary never gets out ofthe HOLE!
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of CERTAIN brand name drugs until you reach
YOU PAY DRUG CO. PAYS
$______12
% %
Just Released!!Confused
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