Get educated on Medicare and your coverage options with Jeffrey Riego and Diane Gaswirth from United Healthcare Medicare Solutions in this webinar, presented by Pure Financial Advisors. Download the slide presentation. Learn:
- The A’s, B’s, C’s and D’s of Medicare: coverage and costs of each part
- Coverage options in addition to Original Medicare
- Enrollment timelines and delayed enrollment penalties
- Cost-saving tips
- Resources
Schedule a Free Financial Assessment with Pure Financial Advisors and learn how your decisions about Medicare, Social Security, taxes, and your investment portfolio impact your retirement plan:
Transcript:
Andi: Today’s presenters are Jeffrey Riego and Diane Gaswirth. Jeff is the independent agent who works directly with clients at no cost to help educate them on Medicare and UnitedHealthCare’s products to help find a plan that best meets your individual needs. Diane Gaswirth is the overseer and sales and retention person for UnitedHealthCare in San Diego, and she will be supporting Jeff by answering questions throughout the course of the presentation. Now, please welcome your presenters, Jeffrey and Diane. Hello, how are you today?
Jeff: Very good. Thank you, Andi.
Diane: Doing well, Andi.
Andi: Excellent. I know that there is a lot to cover today, and I know that people are going to have a great deal of questions. So at this point, I’m going to turn it over to the two of you and I will be here if anybody has any questions or needs any assistance. So thank you both very much for making yourselves available and for giving us this presentation on Medicare.
Jeff: Well, hello, everyone. My name is Jeffrey Riego, and thank you for the opportunity to talk with you today about the basics of Medicare. For many, Medicare is like a new language. It starts with learning words and putting them together into sentences, and then gradually you become more fluent. At UnitedHealthCare, we try to simplify this process through our Medicare Made Clear program. We hope you’ll walk away today with new vocabulary and a clear understanding about what Medicare is, how it works, and most importantly, how it could work for you.
So these are the top 10 Medicare questions we hear from people around the country. In fact, during this time of the year, I’m out in various restaurants giving community meetings, and I always come across someone that has one of these questions. First of all, define what Medicare is and who is eligible for it. Next, we’ll talk about Medicare. If you plan to work past 65, which is quite common, it’s quite OK. Then we’ll look at different Medicare coverage options and costs. After that, we’ll touch on how to choose coverage and explain the different enrollment periods. And lastly, we’ll talk about how you’ll be able to save money and where you can find more information. So let’s get started.
These are some common misconceptions about Medicare. So let’s go over a few basic facts about what Medicare is and what it’s not. Medicare is a health insurance for older and disabled Americans, and currently serves more than 61.4 million people in the United States. It’s funded by federal payroll taxes that you and your employers pay. The tax is labeled FICA, so if you look at your payroll stubs, your paychecks, you’ll see FICA on there. You’ve been paying that for a while. Medicare is not free. You’ll have some cost to pay, which we’ll cover in a bit. And Medicare is also not a family health plan. Each person must meet Medicare eligibility requirements as an individual. And finally, Medicare is different from Social Security. It’s also different from Medicaid, which is health insurance for people with limited incomes and resources. We’ll talk more about that next.
Let’s quickly touch on Medicaid. Medicaid is a state government program that helps pay health care costs for individuals, families, and children with limited income. Programs vary state to state but do follow federal guidelines for benefits. However, eligibility varies from state to state. Medicare and Medicaid can work together. In fact, some people can have both Medicare and Medicaid, and these are people that we call “dual eligible”. We’ll talk about this more later.
We said that Medicare is individual insurance, but who can get it? As you might guess, there are eligibility requirements for Medicare. First, Medicare is for U.S. citizens and for legal residents living in the United States for at least the previous 5 years. You must also meet one of the following requirements:
● be age 65
● younger than 65 with qualifying disability and have received disability benefits for 24 months
● any age with a diagnosis of end stage renal disease, or ALS.
To the right, you’ll see the red, white and blue card. This is an example of the Medicare cards that you’ll be receiving when you get Medicare.
We mentioned the term dual eligibility, so let’s delve into that a little more. People who are dual eligible can have both Medicare and Medicaid, and yes, the two programs can work together. If you have both Medicare and Medicaid, the two will work together and they cover most of your health care costs. Additionally, dual eligible individuals may be eligible for special private Medicare plans. They’re called dual special needs plans.
We’ve covered who can get Medicare, but before we look at what Medicare covers, let’s talk about a situation that I come across all the time: people working past 65. If you plan to work past age 65, your Medicare decisions may be different. In fact, you may be able to delay Medicare enrollment altogether, which is quite relieving for some people. This is generally an option for people who work for an employer with 20 or more employees and have employer health coverage that is considered creditable by Medicare. Specifically, your plan’s prescription drug plan must be as good or better than Medicare Part D. People who have health coverage from an employer with fewer than 20 employees must enroll at age 65 or they could face enrollment penalties. But what if your health insurance is through your spouse? Well, in this case, you may be able to delay, or you may still need to enroll at age 65, even if the spouse’s employer has 20 or more employees. This is because employers can have their own rules for covered dependents. Some employers require covered dependents or Medicare age 65 to enroll in Medicare in order to remain covered by the employer plan. Just ask your employer benefits administrator and learn about your options.
There are some important things to know about getting Medicare when you continue to work. First, Medicare and your employer insurance can work together. Medicare will typically be secondary to your employer insurance until you leave your employer or lose the employer insurance, whichever happens first. Then Medicare will become primary. Second, if you take part of any Medicare you will no longer be able to contribute to a health savings account. And finally, Medicare will not cover your spouse or children. So if you decide to take Medicare, you want to talk to your employer benefits administrator about that.
Let’s move on to what Medicare covers. First up is original Medicare, and it has two parts: Part A hospital insurance, and Part B medical insurance. Let’s look at both of these, starting with Part A.
Part A hospital insurance covers services provided during an inpatient hospital stay. Most covered services are listed here. This includes your room, your meals, nursing, and other services. One important thing you may notice missing from this list is doctor visits or doctor services while you’re inpatient. That’s because doctor services are covered by Part B, even when you’re in the hospital. Now, here are some additional important facts about Part A. Part A has a premium, but very few people pay it. Remember the FICA payroll tax that I discussed earlier? If you or your spouse paid that for 10 or more years, you get part A for free. You can’t be denied Part A coverage regardless of your health or financial status, and you’re covered at any hospital in the country that accepts Medicare.
Finally, you need to know a few terms to understand Part A benefits. Part A coverage and costs are based on benefit periods. A benefit period begins the day you were admitted into the hospital and ends after you’ve been out for 60 days in a row. And then there’s observation status, which is another important term. Part A covers hospital stays when you are admitted in an inpatient hospital, not if you’re there for observation, even if you stay overnight. But Part B would pay for some of these costs. And then there’s lifetime reserve days. These are extra days covered in the hospital if you’re staying in a hospital longer than 90 days. The maximum length of stay covered in the benefit period is 90 days. You get an additional 60 days called lifetime reserve days, which can be used only once, but they can be applied to different benefit periods. We’ll come back to these terms in a bit.
Now, let’s look at Part B medical insurance. The main covered services are listed here, including doctor visits, the test, the exams your doctor may order, and other outpatient services. Also, as we just discussed, Part B covers doctor services when you’re in a hospital as well. There are a couple of things to point out here. First, the annual Medicare Wellness visit, which is covered, is an opportunity to meet with your doctor to discuss your health status and goals. The second thing to point out here is durable medical equipment. To be covered, the equipment needs to be medically necessary and prescribed by a doctor. It also needs to come from a supplier approved by Medicare.
Here are some additional important facts about Part B. Part B has a monthly premium. If you’re receiving Social Security, the amount will be deducted from your checks every month. Just as with Part A, you can’t be denied Part B coverage regardless of your health or financial status, and you may see any provider in the country that accepts Medicare. Finally, Part B charges a premium penalty for late enrollment unless you qualify for a special election period. We’ll cover enrollment later in the presentation, but some people, including those that work past 65, may delay Part B enrollment without penalty.
We’ve gone over what Medicare Part A and B covers, now let’s look at what it doesn’t cover. Many people are surprised to learn that they’ll have out-of-pocket costs, which could be significant depending on individual health care needs. Further, there’s no out-of-pocket maximum, no financial protection with original Medicare. Another big surprise is that original Medicare does not cover prescription drugs. Other non-covered services include dental, vision, and hearing care, long term care, nursing homes, custodial care, care received outside the US. The good news is there are some options that will help with these non-covered items, so let’s explore those now.
Even from these simple examples, you can see that original Medicare doesn’t cover everything. The good news is that you have options for coverage that can cover other key things like prescription drugs. On that note, we’re now ready to talk about Medicare Part C, Part D and Medicare Supplement Insurance.
Now we’re going to see how Part C or Medicare Advantage, Part D, and Medicare Supplement Plan insurance fit into this picture. You have two options for more coverage. Option one is to add Medicare Supplement Insurance or a Part D prescription drug plan to original Medicare. Medicare Supplement Insurance will help pay some of the out-of-pocket costs not paid by Medicare Part A and B. Part D will cover prescription drugs. Option two, is to choose a Medicare Advantage Plan. Most Medicare Advantage Plans include drug coverage and additional benefits, such as dental and vision.
Part C is Medicare Advantage. It’s an alternative to original Medicare and offers another way to get Medicare A and B, plus more benefits. You’ll also continue to pay your Part B premium directly to Medicare. Plans are offered regionally by private insurance carriers. Most people also include other benefits like prescription drugs, dental and vision. The most important thing? All your benefits are covered under one plan. By law, Medicare Advantage Plans must provide all the benefits that original Medicare does. So plans combine part A and Part B coverage into one package. One exception is hospice care, which is covered by Part A, even when you have Medicare Advantage Plans. Most Medicare Advantage Plans also include built in prescription drug coverage, or Part D, as in drugs, which we’ll discuss next. Finally, Medicare Advantage Plans may also offer benefits, including coverage for dental, vision, hearing care, as well as wellness and fitness programs.
There are different types of Medicare Advantage Plans. Most are coordinated care plans, where care is delivered through a provider network. Most coordinated care plans are either HMO or PPO plans. PPO plans generally offer more coverage for out-of-network than HMO plans do. Then we have special needs plans that are designed specifically for people who have certain health issues, chronic conditions such as diabetes, or low income/dual eligible-that term that we went over earlier. There’s an institutional special needs plan as well for people that live in skilled nursing facilities. Point of service plans are a sort of hybrid in which networks are covered, like an HMO, and care outside of in-network is covered for certain services. Then we have private fees for service plans which typically offer more flexibility in choosing providers than other types of plans do. In general, you can get care from any Medicare approved provider who accepts the plan’s terms and conditions. Medicare savings account plans combine a high deductible health plan with a medical savings account. They generally offer more choice with more financial risk.
Here are some additional things to know about Part C. You must be enrolled in both Part A and B to be eligible for Medicare Advantage Plan. You must also live in the planned service area, and you can’t be denied coverage. It’s really easy to get confused by this. The plan provides Part A and B coverage, but you still need to enroll in Part A and B; it’s a prerequisite. To qualify for these, you need to have both Part A and Part B. Importantly, unlike original Medicare, every Medicare Advantage Plan has an annual out-of-pocket maximum for Part A and Part B services. Once you’ve paid this amount, the plan covers the entire cost for these services for the rest of the year.
Now, let’s move to Part D prescription drug coverage. Remember, drugs are not covered by original Medicare, except in select circumstances. You can get drug coverage in two ways: through a separate standalone Part D or through a Medicare Advantage Plan like we just discussed. Each Part D plan or Medicare Advantage Plan that includes drug coverage creates a list of specific drugs that it will cover. This is what is called a formulary. Each plan has its own list of drugs. Plans also cover all vaccines, like the shingles shots, that aren’t covered by Part B. Part B covers things like flu shots and pneumonia shots. Many Part D plans group their drugs into tiers. So the higher the tier, the more the cost of the drug becomes.
Now, let’s take a minute to talk about the different Part D cost stages, especially the Part D coverage gap commonly known as the doughnut hole, since it may be confusing for some people. There are four Part D coverage stages. The stage you’re in determines the amount you pay when you fill a prescription. So you begin in the deductible stage, if your plan has one, where you would pay the full cost of your drug, or in the initial coverage stage where you usually pay a copay. If your drug costs reach the limit for the initial coverage stage, then you would enter the coverage gap where you pay a greater share for the cost of your drugs. Typically, 25% for generics and 25% for brand name drugs in 2021. Now, not everyone enters the coverage gap. If you do, and your drug costs reach the limit, then you enter what’s called the catastrophic coverage stage and you pay reduced co-pays for the rest of the year.
Then in January, the cycle starts all over again.
A few final points about Part D: you are eligible to join a Part D plan once you are enrolled in Part A, Part B, or both. Plans often have pharmacy networks that you need to use to get the plans’ pricing, and plans may vary quite a bit in terms of what specific drugs they cover and what your costs may be. A final key point is that you could be charged a premium penalty if you’re late enrolling in Part D, unless you qualify for a special election period. Let’s talk about this in a few minutes.
Now we come to Medicare Supplement Insurance, or something called Medigap. Medicare Supplement Insurance plans, which are also offered by private insurance companies, are different from the plans we’ve discussed so far. As the name says, the supplement is a supplement to Medicare. So Medicare Supplement Plans help pay for the out-of-pocket costs that Medicare doesn’t cover, like the deductibles and the coinsurances that you would have to pay. It can only be used with original Medicare, not with Medicare Advantage. What that means is you cannot have both. Plans are standardized by the federal government. There are 10 plans labeled with letters A, B, C, F, L, D, N, and are out of order, and different states have different letters. It’s also important to note that Plan C and Plan F, which were very popular plans, are now only available to individuals who are eligible for Part A or turn 65 prior to January 1, 2020.
So those plans are no longer offered to people that are turning 65 today.
Here’s some of the costs that Medicare supplement plans may help with. Medigap plans can help with Part A deductibles, original Medicare co-pays, coinsurance and provider excess charges. You could also pay for foreign travel coverage. Medigap plans don’t fill in for what original Medicare doesn’t cover, such as prescription drugs or dental or vision.
This table will help you visualize the different types of plans and what they cover, and what costs different Medicare plans cover, from A through N.
Now for some fast facts. You must be enrolled in both Part A and Part B to be eligible for a Medicare Supplement Insurance plan, and you must choose from the plans offered in your state. Also, there’s a set enrollment period when you can’t be denied coverage or charged more based on your health history. So let’s talk about that in a minute when we cover enrollment. Medicare Supplement Insurance coverage is nationwide and goes with you wherever original Medicare does. Each plan sets its own premium. The amount can vary, even for the same coverage. In general, the broader the coverage the plan gives you, the higher the premium. And finally, just like the other plans we’ve discussed, you must continue to pay the Part B premium to Medicare.
Let’s talk about cost and start off with some simple definitions. Most people are familiar with premiums, deductibles and copays, which are defined here in this slide. Coinsurance may be a less familiar term. It’s an amount you pay when the cost of a covered service is split with you. It’s determined by percentage. For example, the cost of a service is covered 80% and you pay the remaining 20%, and that’s how original Medicare works. It’s an 80/20 type of plan. Finally, if you choose a Medicare Advantage Plan, Part D or Medicare Supplement Insurance plan, there are costs you pay for. Cost will vary by plan and by provider.
So let’s start with Medicare Advantage or Part C plans. With Medicare Advantage, some plans have low, $0 premiums. Some plans have deductibles and others don’t. With Part D prescription drug plans, you may have a monthly premium, deductibles, copays and coinsurance amounts. Part D plan costs will vary by plan provider. And finally, Medicare Supplement Insurance plans or Medigap plans may charge a monthly premium and also have a deductible and copay amounts.
We have covered a lot of information. Hopefully, you now have a basic understanding of the different parts of Medicare, Medicare Supplement Insurance, and the costs you could pay. Now what? Here are the seven combinations of the ways that you can utilize your Medicare. A lot of different illustrations here, seven different ways.
Now that we’ve covered the coverage option, let’s go back to the graphics we looked at earlier.
Step one is to enroll into the Medicare program, which consists of Part A and Part B and is provided by the federal government. Step two is where it gets interesting. Here you decide if you want more coverage than original Medicare. If you do, you have two options: option one, add plans to original Medicare, or option two, choose a Medicare plan instead. You can get a Part D drug plan coverage with either option. So the choice when looking at additional coverage is really between Medicare Supplement Insurance and Medicare Advantage. Let’s look closely into that and think about the choice in terms of coverage, costs, and convenience.
Coverage: Provider choice is one of the main considerations between these two coverage options. Medicare Supplement Insurance helps pay for care from providers nationwide. Medicare Advantage Plans, however, generally have provider networks and have a general geographic area where they provide services, specifically by county.
Cost: Both options help manage costs, but in a different way. With Medigap plans, you pay higher premiums than with Medicare Advantage Plans, but other costs may be lower. With Medicare Advantage Plans, you pay co-pays, but the premium may be low and you’re protected by an out-of-pocket maximum.
Then we have convenience. Many people who opt for Medigap plans also buy a Part D, D as in Drugs. With original Medicare, that’s three different plans. Medicare combines it all into one, which is more convenient. So once you decide on your coverage, you’re ready to enroll. Let’s explore those different enrollment periods.
Most people first enroll in Medicare during their initial enrollment period, also known as IEP. Your IEP is a 7 month long window which includes your 65th birthday month, plus the 3 months before and the 3 months after. You are enrolled in Medicare Part A and B automatically if you’re receiving Social Security. So if you are receiving Social Security, you’ll get that red, white, and blue card 3 to 4 months prior to turning 65. Otherwise, you need to sign up yourself online at medicare.gov, by phone, or just a simple call to the Social Security office. During your initial enrollment period you can also enroll into additional coverage, you can go into a Medicare Advantage Plan or prescription drug plan, or a Medicare Supplement Plan.
A final note: you may refuse or delay Part B enrollment and take just premium free Part A. This is a good idea for people who continue to work and have creditable employer coverage. It’s important to pay attention to the timing of enrollment to avoid late penalties, which we’re going to talk about in just a second.
If you miss your IEP, your Initial Enrollment Period, don’t panic. You have another chance to enroll called the general enrollment period, and this period goes from January 1 through March 31 every year. You can enroll into Part A, you can enroll into Part B, or you can do both of them at this time. However, late enrollment penalties may apply. So it depends on the timing of when you do this. So again, it’s very critical to pay attention to the timeline.
You must be enrolled in both Part A and B to be eligible for a Medicare Supplement Insurance plan. You are not subject to medical underwriting for 6 months after you enroll into Part B at age 65 or older. You can still apply for a Medicare Supplement Insurance plan after this time period, but you may be denied coverage or charged more based on your health history. So it’s very critical. Within the first six months of obtaining your Part B, that’s the best time to enroll into this Medicare supplement.
We talked about working past 65 a bit earlier and how you may be able to delay it. If you qualify for Medicare special election period, for people who work and have employee coverage past age 65, you have 8 months to enroll in Part B, and Part A, if you haven’t done so already. You may also want to enroll into a Medicare Advantage Plan or Part D prescription drug plan within the first two months. Now, it’s important to pay attention to this timing. As we’ve mentioned, both Part B and Part D charge late enrollment penalties. The Part D enrollment deadline is especially important since it happens quickly and can sneak up on you. One more thing: make sure your employer provides you with proof of creditable drug coverage. Otherwise, you can be penalized for that.
We’ve mentioned penalties a number of times, so let’s take a look closer at those penalties. Part A, Part B and D charge late enrollment penalties. The Part A penalty doesn’t apply to many people since most of us get Part A premiums for free. But for those that have to pay, the penalty is an additional 10% of the premium amount. The Part B penalty is also an additional 10% of the premium for each full 12 month period you could have had Part B, but didn’t. Unless you qualify for a special election period, you pay the penalty for as long as you have Part B. So it’s a lingering penalty that doesn’t stop with a one time payment, it goes on as long as you live. And that also applies to the Part D penalty, which is a smaller amount. It’s an additional 1% of the current average plan premium for each month you’re late. Currently, the national average cost of a Part B is about $35. So it’s about $0.35 a month. So hopefully, you enroll on time and with no penalties.
Medicare is not a one and done decision. Things may change in your life, in your health, and in your finances, so it’s important to review your coverage every year. And that’s why I have a job. Every open enrollment period or annual enrollment period is the busiest time of the year. All my clients start calling me and asking questions on what is the perfect plan for them for next year. And so it’s a good practice to have. You can change your coverage choices if you decide to during Medicare’s annual enrollment period, which is from October 15th through December 7th every year. The new coverage goes into effect January 1.
The Medicare Advantage open enrollment period is specifically for Medicare Advantage Plan members and runs from January 1 to March 31. You must be a member of a Medicare Advantage Plan on January 1 to be eligible for this enrollment period. During this time, you may switch to a different Medicare Advantage Plan, or drop a plan, or go back to original Medicare Part A and B. If you return back to original Medicare, you can also enroll into a Part D and a Medicare Supplement Plan as well. So you may only make one coverage change during this enrollment period. The next opportunity is next fall, annual enrollment period, unless you qualify for a special election period.
Medicare offers a special election period for qualifying life events. Certain situations such as moving to a new home or certain changes in your health care coverage or health can qualify for a special election or enrollment period. In most cases, you have 2 months from the date of the qualifying event to make coverage changes. During a special election period, you may switch or drop a Medicare Advantage Plan or prescription drug plan, but you can’t switch from original Medicare to Medicare Advantage.
We’ve talked about Medicare coverage options, the cost you may have in enrolling, now let’s talk a little bit about ways to save money. Medicare covers a range of preventive services, many at no additional cost to you. You may also be able to save money by choosing a provider from within your plans network. If not, make sure that your provider accepts Medicare _assigments_ and won’t charge you beyond what Medicare allows. Also, ask your doctor or pharmacist about ways to save. You may be able to switch to generic or other low tier drugs or get better prices by using different pharmacies. And always if you are in the hospital, ask whether you are an inpatient or there for observation. It makes a big difference in costs.
If you need it and you qualify, you may be able to get help paying for health care costs. A good place to start is with your state health insurance assistance program called SHIP. You can find the number at shiptacenter.org, or by calling Medicare at the number shown.
So where can I go for help? We’re here with you today at UnitedHealthCare. We’re very passionate about helping people have everything they need to make informed Medicare decisions. You can find us online and get regular updates by signing up for our newsletters and following us on social media. You can also find helpful information at Medicare.gov, the official government website for Medicare, or you can call Medicare at the number listed here.
And that’s it, folks. Thank you so much for your attention, we’ve covered a lot today. And I want to transfer this back to Andi, and any of your questions, we are here for you.
Andi: Let’s open it up to questions. We had a number of people that asked whether or not it’s possible to get a copy of the video presentation after the fact. And yes, we will be making that available on the Pure Financial website and on our YouTube channel within the next couple of days. So if you already are on our mailing list, you will receive an email when that replay is ready. I also saw a number of people that asked whether or not it was possible to get copies of the slides.
Diane: Yes, it’s fine, we’re happy to share the slides.
Andi: Excellent. So we’ll be able to send that out in that replay email. We will send a link to the slides as well as to the video presentation when it’s available. “Would it be possible to get a PDF version?” Yes, we can. And Diane will put Jeff’s information into the chat so that you can contact him for more information and to get your questions answered. I know we had almost 300 people on the call today, so there are probably a number of questions that we missed. Let’s answer a couple of the questions now publicly.
“Does Medicare and Advantage plans exclude people with preexisting conditions?” That one was from Glen.
Jeff: No, it doesn’t. As long as you have both Part A and B and reside in the service area, anybody can get a Medicare Advantage Plan.
Andi: “Do Medicare Advantage Plans cover out of U.S. services?”
Jeff: Absolutely.
Andi: Excellent. “Does this only apply to people in California or is this nationwide?”
Jeff: This is a national type of plan. Fortunately, I do have my licenses in seven other states, so I understand that this is a national broadcast. I would be able to pull out the different plans and the areas everyone lives in and kind of discuss what their specific plans would look like.
Andi: Jim says, “you use the term creditable when describing a current plan. What does that mean?”
Jeff: It means that their Part D plan specifically, which is the drug plan through your employer, has to be at least to what Medicare provides or better.
Andi: Vincent says, “do you have a plan for those with VA coverage?”
Jeff: Yes, we do. We have one called the Patriot.
Andi: Excellent. Diane, did you see any questions that you wanted to answer publicly that might be applicable to everybody that’s on the call?
Diane: I’ll just start at the top here. So, “Advantage plans cover outside of the US?” Yes, they do for emergencies and urgent care. Then the second part of that question is, “can I live part time in another country and be covered?” You would always be covered for urgent and emergency care, but in that situation you may want to look at what other coverage is available in the country that you’re going to be in. Medicare Supplement Plans are the type of plans that we recommend if people are going to spend 6 months in the U.S. in one area and then maybe 6 months in another area. That’s what we would recommend if it’s within the United States, but traveling abroad for several months is a little bit different. So I would look at what that particular country has to offer, if anything. You may need to be a resident there to tap into any type of coverage.
Andi: I see there’s also a question from Georgia, “I will be eligible for Medicare in a few months. My family members are advising to use Obamacare instead of Medicare. What is the difference between Obamacare and Medicare?” Which I guess would be the Affordable Care Act, officially.
Diane: That’s a really easy one to answer because Obamacare does not cover Medicare plans. So Medicare is entirely separate from that.
Andi: Patricia said, “if you are advantaged one year and change for supplement next year, can you be denied based on health issues?”
Jeff: There is what’s called a trial period for people that first enroll into a supplement plan. Upon turning 65 and obtaining their Part B, they have a trial period where they can go into a Medicare Advantage Plan for up to one year, and if they don’t like it, they can go back to their supplement plan with a guarantee. But those people have to go into the supplement plan first. So Medicare basically allows them to try out their other option, which is Medicare Advantage Plan, and if they don’t like it, they can go back into their plan that they originally had.
Diane: Without going through underwriting.
Andi: Diane has put Jeffrey’s information in the chat. She will be able to post that again for you to have all of your questions answered regarding your specific Medicare situation. Diane, do you see any others that are relevant to a number of our listeners today or attendees?
Diane: There are quite a few. “Am I required to enroll in any specific Medicare coverage or can I use my own choice of insurance?” Part A is automatic for most people, if you lived and worked in the United States for 10 years or for three quarters. But Part B, you must elect to have it and you must pay to have it. And so it really depends. If you have no other coverage, then yes, I would strongly recommend purchasing Part B and just know that that is means tested. Meaning, the more you make, the more you will pay. There is a baseline Part B premium, but if you are a high wage earner, chances are you will pay more than that. So important to factor those costs into retirement planning, because some people could pay up to $300 a month more for Part B coverage.
Jeff: Also feel free to contact me directly at my email, I can also give you specific plan information, which I can’t give out in this broadcast. But if you reach out to me and email me or text me or call me, I can give you more information about your specific situation.
Andi: And I just put Jeffrey’s link to his _UHC_ page, as well as his phone number into the chat so that you can contact him directly with your specific Medicare questions. And Diane and Jeff, I want to thank you so much for this wealth of information about Medicare today. It has been incredibly helpful for all the folks that have been on this call, and I know that a number of you still have questions. Please reach out to Jeff for more on that and realize that the costs related to Medicare, as well as your Social Security, your investments, your tax situation, all of these things play a part in your retirement plan. So if you would like to get a deeper look at how you can take advantage of all of these things and how all of this works in your retirement plan, I’ve also published an offer where you can schedule a free financial assessment with one of the CERTIFIED FINANCIAL PLANNERS™ at Pure Financial Advisors who can talk to you about your overall plan. It is a free assessment. It doesn’t cost anything and there’s no obligation, but you can find out how all of the costs involved in retirement go into the plan that you need for your retirement. So please give us a call. Let us know if there is anything that we can do to help. Call Jeffrey for your specific questions regarding Medicare. If you are already a client of Pure Financial Advisors and you have any questions related to how this all fits into your financial plan, contact your financial advisor directly.
Jeffrey, Diane, thank you so much again. We really appreciate the time that you’ve spent today with us thinking about Medicare. Thank you all. Have a great day.
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• Opinions expressed are subject to change without notice and are not intended as investment advice or to predict future performance.
• Investing involves risk including the potential loss of principal. No investment strategy can guarantee a profit or protect against loss in periods of declining values.
• All information is believed to be from reliable sources; however, we make no representation as to its completeness or accuracy.
• Intended for educational purposes only and are not intended as individualized advice or a guarantee that you will achieve a desired result. Before implementing any strategies discussed you should consult your tax and financial advisors.
• Pure Financial Advisors is not affiliated with any government agency, including, but not limited to Medicare. This material is provided for educational purposes only and does not constitute as advice. The information contained within this presentation is based on current Medicare laws and rules, which may change in the future.
• References in this material to United Healthcare does not constitute or imply endorsement, recommendation, or favoring by Pure Financial Advisors nor its employees.
