Welcome to another edition of the Doctor’s Note, where we talk about what’s on our minds when it comes to your health.
This week on the podcast I had the opportunity to sit down and talk with Renee’ Thompson, who has helped guide me through the Medicare enrollment process. She changed my mind on a lot of things, and helped get me on a special plan that’s been great for me.
In this week’s Note, I want to share some of the insights I got from her.
But first, take a listen to the podcast episode I had with her. Her explanations of all things Medicare are so clear and understandable.
Medicare is important for all of us to understand. Most of our lives we’re paying into a Medicare fund. We might as well understand what’s available.
As you may know, I’m on Medicare now. Last year I turned 65. I’ve been in medicine a long time, and I didn’t realize how complex signing up for Medicare was. There are so many decisions, and making a mistake when signing up could end up costing you a lot of money.
If you’re around my age, it’s this time of year you’re getting inundated by people trying to get you to sign up for Medicare.
Typically, you will want to talk with a broker. Someone who doesn’t represent one company. They will be unbiased, and can explain Medicare as a whole. What it covers and what it doesn’t. And what your options are outside of original Medicare.
The big takeaway I got from my conversation with Renee’ is that everyone’s Medicare situation is unique. We all have different concerns and different health needs. You need to choose your Medicare plan based on your specific needs.
As we’ve covered here before, there are Advantage Plans, Supplemental Plans, and Drug Plans.
Depending on your health issues, one combination might work better than another. This is why you need to sit down with someone who can educate you on what’s out there, and what you may or may not need.
A lot of it comes down to the state of health you’re in, and what medications you might be taking.
Everybody needs medical coverage in my opinion, especially for disaster. That’s what insurance is actually for.
People expecting their insurance to cover everything is a huge problem. We have an insurance problem in my opinion. It overwhelms our medical system, and it drives the costs up.
Reasons Why I Chose “Plan G”
I realized that if I signed up with a Medicare Advantage Plan and I came down with some weird disease that couldn’t get handled where I live, there’s a chance that where I would need to go wouldn’t take the advantage plan I would be on. For example, if I needed to go to Vanderbilt for something and Vanderbilt doesn’t take my plan, then I can’t go there.
With a Supplemental, as long as the Physician or group takes original Medicare, then I can be seen. If they take Medicare, they are going to take a Supplemental.
Another thing for me was travelling. If it’s not deemed an emergency, you’re probably going to pay out of pocket if you’re out of state. If it’s an emergency they will cover it.
In either of these situations, if you have Plan G it will be covered. I don’t have to worry about it.
If you’re not careful you could find yourself in a situation where bills start rolling in and you’re not sure what you have to pay or not pay.
Because I’m on a Supplemental, they have to take me if they take Medicare. If I’m hospitalized, 100% of it is covered. Plan G Supplemental will cover your hospital stay from day 1.
Medicare alone doesn’t cover the first $1,410 (for 2020) of your hospital stay.
Everybody needs drug coverage. If you don’t have credible coverage through an employer, you need a drug plan. Mine is around $13 per month. If you don’t sign up for one initially, and end up needing medications covered you’re going to get penalized. The penalty is a percentage for every month you weren’t on a drug plan back to when you turned 65. This can get costly.
I have Medicare, the Plan G supplement, and a drug plan.
One thing that’s important to remember is that drug plans change every year.
This is why you need to get your plan reviewed every year or two. Plans change. And your health situation changes. You may pick up more medicines. Some drug plans may cover an expensive medication and some may not. Typically, drug plans and/or advantage plans have to cover one medication in the therapeutic category.
What surprised me the most when signing up was how much it costs if you still work. You’re finally reaching Medicare age, and you think you’re covered. You think that you’re just going to be given insurance now. This is not the case at all, especially if you’re still working.
There’s a specific price for Part B and Part D based on your income. You can check Medicare.gov to see those brackets and what you will have to pay based on your income if it’s above a certain level.
Medicare Part A: This is hospital coverage. If you’ve paid into Medicare for 10 years or more you don’t pay for this part.
Medicare Part B: This is everything else medical you would need to have done. This is typically what costs the most money.
Medicare Part D: This is your drug plan. You’ll need this regardless.
Everybody has different requirements, both medically and financially. In my opinion, insurance is just that. It’s insurance against disaster. Take the worst case scenario, and get the plan that will help you most in that situation.
Navigating Medicare shows you just how complex the medical world is. You have to know what you’re doing when you’re trying to navigate any insurance.
For those of us that are entering the Medicare system, it can be complex. You will be inundated with people trying to sell you a particular plan. The big thing is to know what you’re looking for.
Sometimes the “all inclusive” plans sound great, but when you look at the details they may be lacking certain things that you have not considered.
Get an independent Medicare broker that has all the different plans available to you, and isn’t working for a particular insurance company.