So let me tell you how Medicare works. They actually say it’s called ‘The ABC’s of Medicare’, but it’s actually A, B, C, D, F and so on. There’s many, many letters of Medicare. So let me explain what this means. When you start working in this country, and you pay on your pay stub where it says Medicare and they take a little bit out of your check every week or month, that is basically your contribution to qualifying for Medicare, and you have to do it for at least ten years. If you do that, when you become 65 you become eligible for Medicare. Medicare is basically health care for seniors, and if you’ve paid into it for that ten years and you’ve lived here and you’re a citizen in the United States, then you now are qualified for Part A. Remember, these are the ‘ABC’s of Medicare’. Part A is hospitalization only, and it has a deductible that you need to meet, and like I said, you have to pay into it, and if you don’t, and you want Part A, you’ll have to pay for it. It’s not free. So Part A, if you’ve worked and are a citizen, you can qualify; it doesn’t cost you anything (inaudible).
Part B is all outpatient services. Outpatient services are things like going to the doctor, you need an MRI, a blood test, anything else related to your health that you’re not hospitalized and you’re not taking drugs. So that would be all outpatient services is Part B.
Part D, hence D for drugs, would be you’re choosing a drug plan so that you can have your prescriptions covered. So that’s A, B and D. Now there’s also Part C. What’s Part C? Well, Part C is what they call ‘Medicare Advantage’.
Basically, it takes Medicare Part A and B and it puts them together. So it takes hospitalization and outpatient services, which is Part B, and Part D, and it puts them together as one plan and they call that Medicare Advantage and that’s a Part C.
I’ve had the opportunity to serve many of you in here, and many of you have this Medicare Advantage-type Plan. Medicare Advantage Plans typically are your HMO’s you see in the marketplace today. Some of the familiar names you’ve heard probably, the Blue Shield 65 Plus, Kaiser HMO, the Blue Cross HMO, SCAN, Secure Horizons, AARP, these are all your HMO products, and they’re called Medicare Replacements or Advantage Plans. There’s also Medicare Supplement plans. Those are different, because what they do is they allow you to keep your Medicare, and then you purchase a supplemental plan and they work together.
So what I tell people is if you think of it like a puzzle, Medicare doesn’t cover everything. That’s why most people don’t stay just on Medicare. You’ve got deductibles, and then when you purchase your Part B through Medicare, it costs around $100 a month, those are the two basic things that you must have before you can purchase a Medicare supplement or an Advantage Plan. Once you’ve purchased those or you have Part A and Part B in place, then you can go out into the marketplace and talk to someone like me, and I can show you what’s available in the marketplace.
These Medicare supplements or Medicare Advantage. So what’s the difference between a Medicare Supplement and a Medicare Advantage? Because there’s always a lot of confusion for people. They’re like, ‘What’s the difference?’ Medicare supplements are basically, you keep your Medicare intact, you have your Part A and your Part B. Part A is hospitalization, Part B is all outpatient services. Then you purchase a supplement, and on the average, when you age into 65, it’s around $160 a month. And then you must purchase a Part D, which is the drug plan. And all those things, then you have the Medicare, your Medicare supplement, your Part D, they come together and it’s like a puzzle. And that will cover your health care services.
Now the most common plan in California for Medicare supplement is the F Plan. The F Plan is what many of you who are on supplements have in this room, because it’s what I consider the best plan option out there for value because it covers everything. You’ll never see a bill. They coordinate your benefits and take care of everything. The cost on that, when you’re paying your premium through Medicare and you buy a supplement with a Part D on the average is about $300 a month, and that’s really, really good coverage, and all you’ll ever pay then is your prescription drug co-pays. So great coverage for about $300 a month when you’re 65. Of course the rates will go up as you age in and get older. But that’s really good coverage. And if you’re used to paying $700 or $800 a month, you’re like ‘Wow. That’s pretty good!’
Now, there’s always the question of, ‘Should I pay that much if I’m a healthy person? Do I really need to pre-pay for coverage every month if I’m not using it?’ So then you go into the Medicare Advantage arena and these are different products. These are called Replacements. They’re not Supplements. And those Replacements, essentially then what it says is that the government is willing to pay, and let’s use Blue Cross as an example, $X a month to take care of you, and they’re going to pay them, and these are typically all your HMO Plans. They’re responsible for paying all of the bills, and all of the billing goes through them and none of the billing goes through Medicare. The tension there is that it costs less, but in HMO’s, what are you giving up? You’re giving up the freedom to self-refer, right? Because on the Supplements, you have control. You can self-refer, do whatever you want.
When you have an HMO, you are a captive client to that plan, to that group that you choose, and the doctors that are part of that group and that hospital. That’s how HMO’s and managed care work. So you can’t just go and do whatever you want to do. It works for many people and for others, it doesn’t work at all. So it’s purely a matter or what is best for you.
So when you go into the Medicare arena, there are many, many variables, many plan choices, many drug plans available, it’s about taking a puzzle, all of that information, looking at doctors, what hospital is important to you. What are the key doctors that you must have? What are the drugs that you’re taking? What are the costs involved in those drugs? It takes me a fair amount of time to do an assessment on each individual. I take my knowledge and put it through my system or how I work the system to make sure I’m giving you the best possible products that suit you. Because every one of you is different. One of you will say ‘Well, this HMO will work fine for me.’ Someone else will say, ‘I don’t want an HMO at all. I want a PPO. I want the freedom to self-refer and to choose. I can afford to pay a little bit more.’ Or, ‘I can’t afford to pay two nickels.’ Everybody is extremely different, different scenario, passionate about what they want. Everybody has an opinion. Husbands and wives often don’t agree, because they have their opinion about what they want for them. It’s true.
So that’s my two-minute warning, obviously. As you can see, there’s a lot of information related to Medicare, and I want to be able to give you the best service that I can. It usually take about an hour and a half of time, sometimes up to two hours to get through everything, fill out an application, make sure you have all your questions answered. It helps me, again, a great lead for me is someone who is aging into Medicare. Another time I’m very busy is during Open Enrollment. Open Enrollment occurs every October 15th through December 7th. What that means is that you’re able to make a change if you’re already in Medicare and you’re not sure about what you have, and you’re thinking, ‘Maybe I need to look into something else.’ Or maybe ‘It’s gotten too expensive, I’m on a Supplement and I can’t afford to pay for that premium anymore and I need to see if there is something else available.’
You’re welcome to ask me any question any time, and I will give you the most up-to-date information that I have. Is Medicare going to be changing? Probably. Is the whole industry changing? Yes it is. I don’t believe that they’ll take these plans off the market any too soon, but there’s going to be sweeping over the next, probably five years. But I’m here to stay on top of those changes and answer your questions. It is what it is. We have to deal with one day at a time, and we can’t worry about tomorrow. We just have to live in the day. People get anxious, especially seniors, they get anxious about their future, I understand that. But don’t worry about tomorrow.
We don’t know what tomorrow will bring, because the contract goes through the end of the year. They’re not going to change anything this year, and they’ll let you know ahead of time, and then we’ll address it at that time, right? It’s wasted energy to worry about these things. I’m committed to keeping on top of what’s going on in the marketplace. You live in the moment. You should be grateful for what you have. It’s still one of the best systems out there when you look across the board globally, we do have a great system here. It’s not perfect, but I’ll tell you, where do you get free Medicare when you’re 65 by just paying in ten years? That’s incredible. You have the freedom to choose your doctor. So please refer me your people. I will educate them, that’s very important to me. Education is extremely important, because with knowledge comes power to make the best decision for you. And I’m done. I’ve passed out this paper that says the questions to ask when you’re purchasing Medicare. These are just a helpful tool for you to use, or if you know somebody who is aging into Medicare, give this to them, and then have them call me, and I’ll make an appointment. Yes?
How far ahead would you suggest somebody takes a look at it?
You should be getting your Medicare card about 90 days before you turn 65. I can’t actually help them until they actually get that Medicare card and they qualify for Part A and they’re signed up for Part B. Once they have that in place then I’m able to come in and help them choose a plan that suits them. OK? Guaranteed Issue is only the three months before the month of your birthday and three months after. So if they have any health issues at all, they need to do it in that time period or they lose that opportunity. Yes, question?
You helped sign me up for Blue Cross, and assigned my Medicare for me. I’m finding now that some doctors are not taking Medicare anymore (inaudible) of Blue Cross coverage?
For supplements, if they do not take Medicare, then that plan will not work, exactly. However, there’s another option available to you. When Open Enrollment comes up next time, we can talk about that and see if it’s a better fit for you. OK? OK, that’s it. I have a gift to give out. Can I do it? No? Real quick, I have a question, and I’m giving away mini-tickets. One question is: What are the four parts of Medicare?
You can’t just shout it out! You got to raise your hand, and Jean actually raised her hand first. You want to answer the question? You have to tell me what they are, the four parts, and what they are. Shh, be quiet please!
A is for hospitalization only, B is outpatient services, D is drugs and prescriptions, C is the Medicare Advantage that puts the A,B,and C together.
I have one last question, and that is: There are two different arenas in Medicare. What are they? Raise your hand do not shout it out. What are the two different arenas in Medicare, I don’t know whether you guys caught this or not. There are two different types of products. HMO?
No. Raise your hand if anyone knows. Well, there’s Medicare Supplements and Medicare Advantage. Those are the two different types. OK, I’m over.
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