Understanding Medicare in 2020

If you prefer to listen while you are on the road, click below!


Zach – Hey everyone. Welcome to this weeks blog. My name is Zach Holcomb and as usual, unfortunately, Michael Reese is not joining us this morning as we’ve actually had the show be hijacked by his wife, Becky–  

Becky – Woo hoo!  

Zach – Mike’s actually at the door right now trying to get in, but we said there’s just not room for him on the program today, so unfortunately he will not be joining us. However, we do have a pretty exciting topic that Becky is gonna be sharing a lot of expertise on today. She’s our Medicare specialist on staff here. So, we’re gonna be talking about a lot of changes in Medicare for 2021 and do a little refresher on just all things Medicare. So Becky, ready to get started?  

Becky – I am.  

Zach – All right, fantastic. So first topic of the day, we’re just gonna do a quick refresher on Medicare Part A, B, and D. Now I, myself, I’m not very well versed in the field of Medicare. So Becky just kind of, let’s get everybody up to speed on Part A, B and D. Let’s just get a quick refresher.  

Becky – That’s right. Let’s see, I’m gonna share my screen so I can show you all a few slides.  

Zach – Okay.  

Becky – And I’m a rookie at this, so you gotta bear with me here.  

Zach – Yeah, no worries.  

Becky – So, we are gonna just start with, as everyone probably knows, October is the big month where it starts that enrollment period, but there’s so many enrollment periods, it’s crazy. You would think that the government would have it easy, but they don’t. There’s lots of different things going on, but right now, let’s just go over the basics. Your initial enrollment period is when you’re first eligible for Parts A and B. And that’s when you first turn 65 and how that works is, you’ve got this seven month window, and it’s three months before your birthday, the month of your birthday, and three months after. So, my birthday’s in October. So I would have had three months before the month of October and then three months after to sign up. And when you sign up during that time, if you decide to go like the Medicare supplement route, there’s absolutely no medical questions. So it’s the greatest time to sign up because it’s simple and easy. Now let’s say though, that you’re still working, you’d sign up for Part A, but you do not sign up for Part B until you’re done, you’re retired, and you’re off your company’s medical plan. So it’s kind of tricky when it gets into there, but you do want to sign up for Part A when you first turn 65.  

Zach – Okay.  

Becky – And again, this just goes up. The month you turn 65, the month after, you’ve got two months after, and it just goes through all the enrollment. So let’s say December, your birthday is like December 25th. You actually start your Part A December 1st. And that’s something that people forget. And especially with all COVID and everything going on, you really want to take advantage of the three months. No, I mean, at least two months ahead of your birthday. If you want to start your Medicare on December 1st, you need to be starting October 1st, getting everything submitted, sent in, because it just takes that long. And when you think of elections going on and a lot of people still aren’t back to work, the social security is not taking any in person appointments yet. So you have to do everything virtually online or phone calls. And if you call, be prepared to sit on hold for a while.  

Zach – Oh, we all love doing that, right?  

Becky – Yes we do. So just the quicker refresher here, just remember the Part A is your hospital insurance. So it’s your inpatient care, your skilled nursing care, your hospice, your home health care. And for 2020, which is, you know, where we’re at, it was $1,408 per benefit period. But remember it goes up every year, there’ll be an increase. You know, it may not be much, it might be five to 10 to $15, but there’s always an increase every year. And of course you do not pay a premium if you paid taxes for the past 10 years or 10 years working during your time. And then Part B is the medical part. So that’s all your physician services. That’s why, if you’re currently on your plan at work, you stay on your plan at work. ‘Cause this is all your, you know, your medical expenses, your durable medical expenses, your yearly checkups, your preventative shots, your flu shots, your– all that kind of stuff. And for 2020, the calendar deductible is $198. And again, we’re sure that it’s gonna go up. We just don’t know the numbers yet for 2021.  

Zach – Gotcha.  

Becky – And the average premium was $144.60, but remember, that’s all dependent upon your individual tax returns. So that number might be higher just depending on where your taxes fall.  

Zach – Right.  

Becky – And then of course, you know, you’ve got your Medicare supplement plans, but we’ll get back to that in a few minutes. I just want to go, some people, you have to have your Part D if you go a Medicare supplement route, and again, that’s the same seven month period. Unless, you know, if you’re on a Medicare disability, it’s a seven month period too. But some people, if they’re on a disability, they qualify a little bit earlier and we’ll get into this enrollment in just a few minutes. But, I also want to talk about Part C, what some people call the Medicare Advantage and that’s like a bundled plan. So it’s your Part D and your Medicare, kind of like your supplement, but it’s not a supplement. It’s your care and maybe dental, maybe a gym membership, stuff bundled together, but you pay copays with it. And you have, sometimes you have a premium, sometimes you don’t, but you have a deductible. So you might have to meet a $5,000 deductible every year or a $6,500 deductible. So there’s co-payments and deductibles.  

Zach – Gotcha. That’s a lot of information. I’m glad we have you.  

Becky – It is a lot and it’s very confusing. I’d love to say it’s not, but it is confusing.  

Zach – Right. Gotcha. Okay, so that’s kind of a quick refresher, you know, as we said on Part A, B, C, and D, now, Becky, we’re entering a pretty important period here. So what’s coming up here in the next few weeks that people need to be aware of?  

Becky – Well, what’s coming up is your annual open enrollment. And sometimes that gets confused with the open enrollment that I was just talking about when you turn 65, where you’ve got that three months, the month of, the three months after. But what this is, it’s from October 15th to December 7th, this year of 2020. And at that time, you can change your Part D if your premiums have gone up and you want to search for a different company, you can go to medicare.gov and kind of look at different companies and what, you know, you plug in what your drugs are, and it’ll spit out different programs that you can sign up for. You can only change during this time. Your effective date will be January 1, 2021, but for Part D this is a time where if you didn’t sign up, or if you want to change your plan, this is the only time that you can change it every year. Now for Medicare Advantage, if you don’t like your Medicare Advantage and you want to switch from a Medicare Advantage to a supplement, this is also the only time that you can disenroll and enroll into a plan. Again, it won’t be effective till January 1, 2021, but this is your time to search, see if you qualify, because you do have to do a medical exam. Well, not a medical exam. There’s medical questions asked and see if you can qualify to change. Or if you want to, say you want to switch from a Medicare Advantage to a new Medicare Advantage plan. This is your opportunity to go ahead and make that switch.  

Zach – Gotcha. Okay, understood. Anything else we need to know about this open enrollment period? That’s coming up here in October, correct?  

Becky – It’s coming up here October 15th through December 7th. And let me just share my screen again real quick with you.  

Zach – Okay.  

Becky – Because once you, if you do want to make a change, this is your time to make a change. And see, this is what you get. When you get me, I’m just not technology.  

Zach – No, you’re doing a good job.  

Becky – And then my kids in here, it’s like, where’s Sara to help me do this here. We’re gonna jump by these. So what happens is you’ve got these three periods. So you’ve got your annual enrollment from the 15th to the 7th. Your special enrollment, if you move out of the area, we’re gonna skip the 5 star special enrollment, but you also have that Medicare Advantage open enrollment. If you don’t like the plan you’re in, you can switch. But, that’s why it’s super important you absolutely have to make your first switch now, if you want to change to a supplement, because this is your only opportunity each year, otherwise you’ll have to wait till October 15th of 2021.  

Zach – Gotcha. Okay, understood. So speaking of 2021, are there any important changes to Medicare that are going to be going into effect next year that people need to be aware of?  

Becky – You know, there are a few changes and as we all know, coronavirus has changed everything. Particularly for when you think of 65 and older, it’s a lot, you have to be more careful when you go out. Obviously, as you know, there’s a lot of places that aren’t even letting you in the building yet.  

Zach – Right.  

Becky – So, what they’ve done is they’ve added telehealth and that’s a big deal because now you don’t necessarily have to go out to your, you know, around here, there’s a lot of ARCs. And I know I’m taking my dad, and they’re taking your temperature when you’re downstairs in the parking lot. And then they take your temperature before you walk inside, and then you have to have a sticker before you’re allowed to go to whichever room. It’s crazy when you go out there just to get a regular checkup.  

Zach – Right.  

Becky – So they have added the telehealth and other virtual services. They have also added lower out of pocket costs for insulin, which is a big deal. So you need to find a drug plan that participates in the senior savings model. And if you have any questions, that’s a great opportunity to give us a call and we can help you find those plans, but they have, they’re lowering this cost of insulin to everybody, which is fantastic. They also have added acupuncture for back pain, that wasn’t there before. They’ll cover up to 12 visits in 90 days for chronic low back pain. And of course, there’s all new COVID information. So if you, you know, their testing and all that is now covered and well I shouldn’t say covered, but there’s a lot more that they’re doing with the COVID. And then of course, you know, the biggest thing that they’re doing right now is they’re saying, get your shots up to date, get your flu shot, get your shingle shot, Shingrix.  

Zach – Right.  

Becky – I think it is the new one that’s coming out. They’re covering these, they’re covering your flu shots. They’re encouraging everybody to go out and get their flu shots, ’cause we all know that COVID’s not going away anytime soon. And you know, the flu season coming up, people are gonna be sick. So let’s get those flu shots, let’s not worry about it. Let’s stay healthy and let’s get through this 20-2021.  

Zach – Gotcha. Okay. Awesome, thanks for the refresher on next year. So something that you had mentioned to me before we jumped on the call here is you wanted to talk about kind of, give some examples of some of the rates that are offered through the different plans. You had mentioned a G versus N and then how that affects different age groups. I think like 65, 70 and 75. So, kind of give me, get us up to speed on that if you can.  

Becky – Well, that was something that they’re just coming out with. You know, everyone used to have F, F used to be the Cadillac of plans ’cause it would cover everything. And then there was G, which was, you know, your plan that covered everything but that one time $198 deductible on Part B. Well, now they’re saying, you know, N isn’t that bad, you may have a $20 copay, and it might be up to $50 if you have to go to the emergency room. However, that being said, as long as they do the Medicare assignments and let’s face it, most of the doctors do Medicare assignments, or if you’re not married to your doctor, you know, have to see that doctor, and you can go to a different doctor that takes the Medicare assignments, there are no excess fees. So now, N is looking more attractive because, so you might have that $20 deductible and it, you know, your costs might not be, you may only go a few times a year. You’re only maybe saying $1,600 out of pocket, but you might be saving up to $500 a year for a couple by switching. And, you know, especially now, when we aren’t going out as much, I think it’s important, that’s where I want to jump back to that chart real quick and let’s show you.  

Zach – Okay.  

Becky – And the reason I bring it up is because, here we go, all right, and this is where my technology is so good.  

Zach – There we go, third time’s the charm.  

Becky – You would think, right? Clearly it’s not, ugh. And I just had it.  

Zach – We’re getting there. No worries. This is when we need Mike, he’s trying to come in right now to help work on that–  

Becky – I know, he’s probably dying back there. So, when you look at the Medicare supplement, alright, Zach, can you see it in full screen Or am I just–  

Zach – Yeah, we can see this pretty clearly.  

Becky – Okay. So your foreign, the biggest thing that I always worried about was when people travel. I don’t want you stuck. Let’s say you go to Mexico or you go to Europe. I don’t want you stuck over there. Something happens, we want to get you home. And they both offer the same foreign travel emergency, which is 80% and $50,000 worth to get you back to the United States, which is what’s super important. And then when you look down it, when you look at G and you look at N, it’s the same, except for the excess fees. And again, the excess fees are only if your doctor does not take Medicare assignment, which most doctors do. That’s just, most doctors do that. They just take what Medicare says they’re gonna pay, that’s what they do. And then maybe a $20 copay. So it’s really not that much different, but I ran a few numbers this morning just to give you some idea.  

Zach – Okay.  

Becky – So, you know, if you’re an age 65 female, and I chose Etna, I chose a few household names. Let’s just go with Etna and Mutual of Omaha. So at 65, it’s not that much different. It’s $91 for plan G and $72 for plan N. So, you know, not too much different. And then you jump to 70 and it’s $96 and $80. But when you jump to 75, it jumps up to $113 and then $94. Right? And we all know Medicare costs are going up. So then let’s just look at a male here with Etna, $105 at age 65 for plan G, $83 for plan N. You know, again, not too much different, but when you jump up to 75, ’cause of course as women, we live longer than men.  

Zach – Right.  

Becky – It jumps dramatically, it’s up to $130. But only 107 with plan N. So you know, each month, it just, as you can see, as you get older, the savings grows. And I think what’s important is, yes, you may have to see more doctors and you may have to pay that deductible if you’re not admitted into the… I mean the deductibles, if you go to the emergency room, the $50 copay, I should say, not deductible, copay, but here’s the deal. I think we all know healthcare costs can only go up  

Zach – Right.  

Becky – So those numbers, we know that F has already gone away. You know, you can’t really get into F, so G is that new plan, everybody’s going into G. A lot of people are going into N ’cause not only cost savings, but long term, they know with the costs going up that this plan is still gonna be lower because you’re paying it. You’re doing the copays. And so long term, this might be the route to go for some people, if they’re concerned that they’re gonna have high medical care costs down the road. Because you aren’t covered for most things, other than those excess charges. And again, it’s not, you know, it’s very easy. You just pick up the phone, call your doctor’s office and say, “Hey, are you on Medicare assignment or do you charge excess fees,” and you’ll know right away if they’re gonna have excess fees for you.  

Zach – Gotcha. Okay, understood. So before we wrap up here, Becky, anything in particular that you feel we need to share with our audience? Maybe something that you’ve heard recently with somebody, one of our clients that you’ve spoken with about Medicare or something we haven’t touched on just yet?  

Becky – I think the big thing is everyone to, when it’s time for your renewals, if you’re in a Medicare supplement, check your renewal rate. If you go up by 10%, 15%, you need to give us a call and let us rerun. We work with about 30 different companies. It just takes a few minutes. We can, we also have Shubhi coming on. So we have a couple of us that can help run some quotes for you, and we can see if we can help you get a better rate. Same thing goes for your plan D, this is the best time. Check your plan D. Are you still getting that low rate? If you’re not, then let us help you run the rate, you know, on medicare.gov and see if we can find you a different program that’s better for you. This is your opportunity. Again, October 15th through December 7th, but don’t wait until December 7th. You know, you really gotta get in, October is the best month to get in and see what’s out there, what’s available. See if we can help you, because if you wait until the end, it’s really, there’s just so many people going in. It’s hard to get an answer. And then if you get an answer afterwards, and it’s not what you want to hear, we don’t have time to resubmit it to a different company. So I’d encourage you to call sooner than later is what I would say.  

Zach – Gotcha. Okay, understood. And like Becky said, if you have any questions or concerns about anything that we touched base on today, just give us a call at our office. Our number is 265-5000. Again, that number is 265-5000. You’ll be able to set up a time to speak with Becky to get any of these questions answered and we can get those concerns taken care of. All right, everyone, thanks so much for joining us today on the show. Mike’s gonna be back with us next week. I know he is dying to get back on the program.  

Becky – Yeah, he’s like, walking out in the hallway, pacing.  

Zach – I know he just doesn’t know what to do with himself when he’s not doing something. Becky, thanks so much for joining us today.  

Becky – Thank you.  

Zach – We really appreciate having you. 

Call Now Button