Medicare You Choose … Sort Of (Medicare Part B)

09/09/20 • 27 min

Some of the highlights of the show include:

What Medicare Part B is and what it covers
What the government considers “credible coverage”
What happens when you have credible coverage and what happens when you don’t
How much Medicare Part B costs on average
How Medicare Part B costs vary on a person-to-person basis
How chiropractic care can lead to a healthier lifestyle
The impact stress can have on your spine and your organs
What the Torque Release Technique is in chiropractic medicine
How it’s never too late to begin treatment with a chiropractor
Some of Dr. Sara’s tips for staying in shape and living a healthy life as we age
A brief primer on hospital indemnity plans and what they’re designed to cover
How Nick and Zach help clients build hospital indemnity plans that meet their unique needs
A few case studies on how hospital indemnity plans have helped Nick and Zach’s clients save money
And more!

Quotes

“Think of Part B as covering everything outside of being admitted to the hospital. Medicare has no referrals. Lab work, physical therapy, CAT scans, MRIs, ambulance rides, emergency room visits if not admitted to the hospital, and homecare in a limited basis, are all covered under Part B.” — Nick

“Medicare Part B has an 80/20 coinsurance, meaning Medicare pays the first 80% and you're responsible for the remaining 20%. The coinsurance takes effect after you have paid an annual deductible of $198 per year. Once the deductible is paid in full, you're responsible for 20% of all remaining charges.” — Nick

“Part B of Medicare pays for diabetic testing supplies. Insulin, pills, diabetic medications are covered under Medicare Part D, but the testing supplies themselves, folks, are covered under Medicare Part B.” — Nick

“Medicare is actually a pretty favorable insurance when it comes to chiropractic coverage. Typically, the only thing that is not covered within Medicare is examinations and/or X-rays if those are taken.” — Dr. Sara

“The cool part is we are removing that pressure, and putting those bones back in the proper place. It allows your brain and your body to connect and actually function optimally, and as that happens, for one, a person gets out of discomfort while at the same time that means that the organ system is also thriving and starting to optimally function.” — Dr. Sara

“The goal of our podcast is helping people prepare for retirement, whether that be 65, 70, 75 whenever that is.” — Zach

“If you get up into retirement age, and you have all the money in the world, and you want to travel, you want to do all the things you want to do, yet you don't have your health, what do you have?” — Dr. Sara

“I call it a Build-A-Bear plan, just because it is a very flexible plan. It's got a couple of different base parts of the policy you pick, and then it's got several riders that you can add on.” — Zach

Links:

Transcript

Announcer: Welcome to our fireside chat with Seniors Living Healthy, the podcast that helps prepare and educate you as you enter and live out your golden years. With over 10 years of experience, Nick and Zach are experts in the senior market and are here to help you live a healthy, full life. And now fireside with your hosts Nick and Zach.

Zach: Hello, and welcome to episode two of our inaugural season of Seniors Living Healthy. Again, I'm your host Zach, and here with me is my co-host, Nick.

Nick: Hello. Hi folks.

Zach: This episode, we're going to go over Part B of Medicare which covers your outpatient care. So again, as I'm sure that you've guessed, this episode’s ABC of Medicare is going to be Part B, medical. So, once you turn 65, you're going to be able to elect to take this Part B as long as you don't have credible coverage, Nick, tell them what the government considers credible coverage.

Nick: Credible coverage is determined by the level of coverage offered under the plan, and the number of employees covered by that plan. Among other things, if you are turning 65, or intend to retire soon, reach out to your HR benefits department to see if you will have credible coverage when the time comes.

Zach: That's great, Nick. And so if they don't have that credible coverage though, and they don't take their Part B, and pass on it, why don’t you tell them what they're going to win by not having that credible coverage?

Nick: Yeah, absolutely. Okay. So, once an individual goes eight months after they stop working, or employer coverage ends, whichever is first. They will be p...

Some of the highlights of the show include:

What Medicare Part B is and what it covers
What the government considers “credible coverage”
What happens when you have credible coverage and what happens when you don’t
How much Medicare Part B costs on average
How Medicare Part B costs vary on a person-to-person basis
How chiropractic care can lead to a healthier lifestyle
The impact stress can have on your spine and your organs
What the Torque Release Technique is in chiropractic medicine
How it’s never too late to begin treatment with a chiropractor
Some of Dr. Sara’s tips for staying in shape and living a healthy life as we age
A brief primer on hospital indemnity plans and what they’re designed to cover
How Nick and Zach help clients build hospital indemnity plans that meet their unique needs
A few case studies on how hospital indemnity plans have helped Nick and Zach’s clients save money
And more!

Quotes

“The goal of our podcast is helping people prepare for retirement, whether that be 65, 70, 75 whenever that is.” — Zach

Links:

Transcript

Zach: Hello, and welcome to episode two of our inaugural season of Seniors Living Healthy. Again, I'm your host Zach, and here with me is my co-host, Nick.

Nick: Hello. Hi folks.

Nick: Yeah, absolutely. Okay. So, once an individual goes eight months after they stop working, or employer coverage ends, whichever is first. They will be p...

Previous Episode

Medicare You've Worked For (Part A of Medicare)

Have a listen to learn:

What Medicare Part A is
The three different groups that qualify for Medicare Part A
What Medicare Part A covers and what it doesn’t cover
How much Medicare Part A costs
How Medicare doesn’t have any networks or referrals for any physicians or medical facilities and what that means for Medicare patients
How Medicare Part A covers 60 days of hospitalization and what happens on day 61 and beyond
What happens when you keep working after age 65 and the associated insurance implications
The options individuals who don’t qualify for Medicare still have
The services BenchMark Physical Therapy offers for Medicare patients
The most common kinds of ailments BenchMark sees in Medicare patients
The kinds of clients Parkwest Physical Therapy sees each day
Tips for how seniors can succeed with physical therapy activities
What “wrinkles on the inside” means
How recovery care is the favorite product that Nick offers and why
And more!

Quotes

“If an individual has worked 40 quarters or 10 years and paid into Medicare, traditionally via payroll taxes, then they will automatically qualify for Part A. They will receive Medicare Part A on the first day of the month of their 65th birthday with one exception: if their birthday is the first day of the month, they get it the month prior.” — Nick

“In a nutshell, Part A of Medicare is hospitalization insurance for individuals on Medicare.” —Nick

“Keep in mind that Medicare is a nationwide program. So, Medicare beneficiaries, whether from California, North Carolina, Michigan, to Florida all have the same program.” —Nick

“As we get older, our system just doesn't do what we tell it to do. Our brains try to tell our body what to do, and it doesn’t react the way it did when we were in our teens.” —Matt

“Physical therapy is a commitment. It's a time commitment. It's a financial commitment. It’s a lifestyle commitment.” —Matt

“I think the biggest hurdle for a lot of people is that it's so new. You're doing things that you've never done before. Everybody's gotten their routine, and some of the older population, they've been in that routine for 50, 60, 70 years. And so, turning things in a different direction is a little bit more challenging.” —Matt

“You always want to wear loose clothing because you're going to be doing things physical.” —Kaitlin

“Statistics say the average cost in a nursing facility of some sort is $72,000 per year. I would say there's a good chunk of people out there, especially in the market we deal in, that if you're retired, that $72,000 is probably pretty tough to come up with.” —Zach

Links

Transcript

Zach: Hello, and welcome to episode one of our inaugural season of Seniors Living Healthy. I'm your host, Zach, and here with me is our co-host, Nick.

Nick: Hello, folks.

Zach: This month's episode, we will go over Part A of Medicare, which is hospitalization. So, as I'm sure you've guessed, this episode’s ABC of Medicare is going to be Part A, hospitalization. Most people are going to get that the month they turn 65 with a few exceptions, so we're going to jump right in. And Nick, why don't you tell us how an individual gets that once they turn 65.

Nick: So, if an individual has worked 40 quarters or 10 years and paid into Medicare, traditionally via payroll taxes, then they will automatically qualify for Part A. They will receive Medicare Part A on the first day of the month of their 65th birthday with one exception: if their birthday is the first day of the month, they get it the month prior.

Zach: Thanks, Nick. So, with that one exception, is there any other kinds of exceptions out there to Part A, how somebody can receive it, and when they can receive it?

Nick: Absolutely, Zach, great question. So, if an individual doesn't qualify themselves for Medicare at age 65, they can qualify off a spouse, whether alive or deceased. Also, if an individual is under 65, ...

Next Episode

Everything You Need to Know about Medicare Part D

Some of the highlights of the show include:

The two most common times Medicare beneficiaries are able to make changes to their prescription drug coverage
The downfalls of not selecting drug coverage
What Zach and Nick do to ensure their clients get the right prescription coverage
The differences between the four different tiers of Medicare Part D prescriptions
The four different stages of prescription drug plans
What the maximum deductible is for 2020
How prescription drug plans operate a lot like car insurance
What the Medicare doughnut hole is and why it’s a bear for so many people
Why beneficiaries are most likely to complain about Medicare Part D vs. other types of Medicare
What patients should do if they are prescribed a drug that isn’t on their plans
Why it’s important for Medicare beneficiaries to choose a national drug chain as their pharmacy
What Aetna has in store for 2021
What the process of enrolling in a prescription drug plan looks like
And more!

Quotes

“These drug plans are regulated by the government and Medicare, and there's only certain election periods throughout the year that people can make changes or elect different coverage, so we get complaints about these plans non-stop throughout the year.” — Nick

“Your Tier 1 drugs are typically going to be the most inexpensive in most cases. Lots of drug plans offer these drugs free of cost. Tier 2 are going to be preferred generics in a lot of cases or non-preferred generics that are a little more expensive but still relatively inexpensive; Tier 3 are going to be your brand name drugs, and Tier 4 are going to be your specialty drugs, like cancer drugs.” — Nick

“You're going to pay the full cost of your prescriptions until you get through the deductible phase of your prescription drug plan.” — Nick

“The reason the doughnut hole can be such a bear is for people that have higher, more expensive medications, their cost-sharing within this period goes up pretty substantially.” — Nick

“We're going to be able to tell you when to expect to hit that doughnut hole, or if you're going to hit it at all, or when you hit that catastrophic phase moving forward there.” — Zach

“We always try to make sure when we're running PDPs for our clients, you know, making sure—a lot of them like those little local drugstores; we try to get them to at least check the big chains out there in case they do travel.” — Zach

“The key is always to choose a preferred pharmacy for lower drug costs. That's always the key.” — Tausha

“CVS is now allowing patrons to use PayPal, which I think is pretty cool. And then possibly in the future, they might be able to use Venmo as well.” — Tausha

“I just really wanted to just highlight the support that CVS Aetna has given around COVID-19. We waived all COVID related copayments, and I think what's probably stands out the most for me is that we opened multiple COVID-19 testing sites throughout the United States where we kind of had those hotspots. And CVS acted quickly and implemented those hotspots to help with testing.” — Tausha

Links:

Aetna: https://www.aetna.com/

Transcript

Zach: Hello, and welcome to episode three of our inaugural season of Seniors Living Healthy. I'm your host Zach, and here with me, as always, is Nick.

Nick: Hey, folks.

Zach: So, this month's episode, we're going to talk about Part D of Medicare, which is your prescription coverage. Nick, what is our number one complaint?

Nick: Prescription drug plans, no doubt, Zach. For whatever reason, these drug plans are regulated by the government and Medicare, and there's only certain election periods throughout the year that people can make changes or elect different coverage, so we get complaints about these plans non-stop throughout the year.

Zach: That's right. With our hands being so tied, it's really, really hard. We can't tell the future. So, we can't see what people are going to be doing, taking prescription-wise down the road; really, all we can do is what's working for them there in October when those annual enrollment period comes. So, I know we've touched there briefly on enrollment period but, Nick, what are the two most common times people can enroll in drug coverage?

Nick: So, the two most common times people can make changes to their prescription drug coverage is going to be their initial enro...