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Welcome to Medicare – What’s Covered?

Bob Vineyard · May 1, 2020 ·

Welcome to Medicare. What’s covered, what isn’t?  In the exam room I notice a sign. “Lab work is not covered by Medicare“. You owe $289. Do not pass go. Do not collect $200.

Welcome to Medicare physical exam? Covered. Lab work? Not covered.  Really? You turned 65 and signed up for Medicare. What happens next?

Here is a short introduction to Medicare. What’s covered, what isn’t,  and what to expect

  • Medicare’s definition of preventive care has surprises
  • Lab work may not be covered
  • Medical necessity is the rule
  • Free exams aren’t always free

Whether you have original Medicare and a supplement or you enrolled in an Advantage plan, the underlying rules of what is covered and what isn’t are the same. The difference is in how you pay for it.

You might want to view our Medicare Exam video on YouTube

Turning 65 – Welcome to Medicare 2019 – What’s Covered?

dr kildare

By the time you reach 65 and enroll in Medicare, most people have a doctor (or doctors) they like and trust. They want to continue that relationship and are not interested in picking a doctor from a list provided by an insurance company.

Georgia Medicare Plans specialize in helping you keep your doctor(s) and finding a Medicare supplement plan that fits your needs and budget. We have rates and information on more than 230 different Medigap plans and will provide a FREE REPORT on all plans based on your age, gender and zip.

You can start your research by comparing rates and benefits for roughly 30 plans by getting an INSTANT GA Medigap quote.

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I understand your confusion. Most people want information so they can understand what lies ahead. They want the time to read, make notes and ask questions.

Most of the insurance agents you will talk to are not old enough to enroll in Medicare and have not experienced it first hand. Bob Vineyard turned 65 in September, 2015 and enrolled in Medicare. In spite of 40 years in the health insurance business and over 400 Medicare clients, I am still learning things every day about how Medicare works.

Ask me anything. Others talk, we listen.

Welcome to Medicare Surprises

When I turned 65 and signed up for Medicare, one of the first things I did was schedule my Welcome to Medicare physical.

Because I chose original Medicare and a supplement plan, I was able to keep my doctor. My group insurance plan required me to have an annual exam and wellness interview so there should not have been any surprises with my Welcome to Medicare exam.

That was the wrong assumption.

While waiting in the exam room I saw a notice on the bulletin board.

Lab work is not covered by Medicare

Seriously? What’s that all about?

Preventive screenings are covered by Medicare in the following situations

  • Abdominal aortic aneurysm scan – Men only, if you smoked 100 cigarettes in your lifetime
  • Bone density – Mostly women, if you are estrogen deficient or have osteoporosis
  • Lab tests – Only if considered medically necessary by Medicare

What is considered medically necessary?

Medicare defines medically necessary as tests or treatment needed to diagnose or treat an illness, injury, condition, disease or symptoms that meet accepted standards of care.

Preventive lab work may not be covered by Medicare.

Congratulations! You are healthy. Your test is not covered!

not covered

I take no medications. For the last few years my doctor has run routine lab work to make sure my body is doing what it is supposed to. As much as it galls me to say, my Obamacare plan covered routine tests like CBC, Lipid Panel, CMP, etc. at no charge to me.

These tests were not free. The labs and technicians do not volunteer their time. The costs associated with the lab tests were absorbed by the health insurance carrier and baked into the premiums.

Not so with Medicare.

Those under age 65 pay nothing.

If you are 65 and older, there is no more free lunch.

When I asked about the sign on the wall. The one that said “Lab work is not covered by Medicare” her response took me aback.

Medicare generally doesn’t cover those tests if you are healthy. But if you were sick, they would pay for them.

Sign this ABN form. If Medicare denies the claim you will have to pay the cost of your lab work. You will owe $289.

So much for my “free” Welcome to Medicare exam.

Medicare physical exam.

Is it covered? Is it free? How much will I have to pay?

Original Medicare is quite good in most respects. No more doctor networks. Forget about balance billing (when you use Medicare providers that accept assignment).  Huge bills for health care are a thing of the past.

So exactly what is covered, and what isn’t? Check out this free Guide to Medicare Preventive Services. And yes, it really is free. Click to download.

More ways to save money.

Most of the retirees we talk to are paying too much for their Medicare supplement plan. Many are facing rate increases. One large Mutual company has increased rates 10 times since 2012!

Medigap plan F will be retired in 2020. Switch now if you can. Plan G is popular with over 90% of our clients. Some have not had a rate increase in two years.

Get a free GA Medigap quote.  FREE report listing rates for all plans based on your age, gender and zip code  sent by email once we confirm your information.

GA Medigap quote

You need to be informed. The more you know and understand the better it will be for your bank account.

#MedicareLab #WelcometoMedicare #GAMedicareExpert #GAMedigapRates

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Medicare Supplement or Advantage Age 65

Bob Vineyard · February 12, 2020 ·

You turn 65 and have to make a decision. Which is better? Medicare supplement or Advantage plans? Your initial enrollment in Medicare at age 65 can be frustrating and overwhelming. Did you get your FREE Medicare supplement quote yet?

  • Medicare supplement or Advantage? Which one costs less?
  • Are $0 premium Medicare Advantage plans a good deal?
  • Since I want to keep my own doctors, is Medicare supplement plan F right for me?
  • I am healthy and don’t see a doctor very often. It seems the $0 premium plans are good for me.
  • My spouse is always in the doctors office. Will they have to make a copay for every visit?

Can we talk? How will you pick the right plan that meets YOUR needs and YOUR budget for age 65 and beyond? Give me a call anytime.

GA Medigap Quotes

Medicare Supplement or Advantage. Which plan costs less?

As long as you are healthy, the $0 premium Medicare Advantage plan is great. But you might want to set aside an extra $300 per month or more in a “rainy day” fund. When your health changes the Medicare Advantage plans are like a leaky bathtub that loses water faster than it comes in.

Medicare supplement or Advantage - Which is better?

What if you are not be able to come up with enough money to pay all your bills because you were sold an Advantage plan? Is this really what you want in your golden years?

Advantage plans are great for healthy people who never go to the doctor or hospital.

If you are living on a fixed income and need to budget your monthly expenses, a Medigap plan is usually the better choice. Your Medicare supplement plan F means you will never have to worry about paying for hospital or doctor bills.

$0 Premium Advantage Plan Seems Like a Good Deal

Yes it does seem like a good deal, and that is often the way it is sold by agents looking for an “easy” sale. When choosing Medicare supplement or Advantage, most agents will push the Advantage plans, especially the ones with $0 premium.

Do you know why?

An agent will earn 2x as much when you buy an Advantage plan vs. what they are paid to offer a Medigap plan.

And that $0 premium is so easy to pitch to someone on a fixed income . . .

What is better than free?

Medicare supplement or Advantage? Which is better for you and which is better for the agents bank account?

If you are struggling to pay your bills now what will happen when you need to see a doctor or have some tests and the Advantage plan requires you to come up with $500 or more to get the care  you need?

A Medicare supplement plan makes it easy to stick to your budget without worrying about surprises.

Do You Like Your Doctors? Who Doesn’t?

If so, you probably want a Medicare supplement plan F or even G.

Almost every doctor, hospital, lab and clinic in the U.S. accepts Medicare patients. When you have a Medicare Advantage plan the insurance carrier tells you which doctors you can see.

Less than half the doctors in Georgia participate in ANY Medicare Advantage plan and the ones that do won’t participate in all plans. Your chances of finding a doctor that participates in your Advantage plan could be very slim.

Even if your doctors currently are “in network” for your Advantage plan they may drop out at any time. When that happens you find a new doctor.

If you don’t want to continually hunt for new doctors, then the answer to Medicare supplement or Advantage becomes an easy one.

Advantage Plans are Great if You Never Get Sick

But when your health changes, you will wish you had a Medicare supplement plan and by then it is probably too late to switch.

Advantage plans are “pay me later” plans. You pay little or nothing on a monthly basis but when you need to use your plan you pay and pay and pay. Oh sure, they have an out of pocket limit that in some cases is capped at $6700 (in 2018), but that is only for IN NETWORK expenses.

When you go out of network, and that is very easy to do, the out of pocket limit becomes meaningless.

Medicare supplement plans don’t have any networks so you pay the same regardless of the doctor, clinic or hospital you use. No penalties for seeing the wrong doctor or being admitted to the wrong hospital.

Medigap plans are great when you are on a shoestring budget.

So which is best for you? Medicare supplement or Advantage?

At Georgia Medicare Plans we explain all your options, including Medicare supplement or Advantage plans, and let you decide which one is best for your needs and your budget. We encourage you to get a free Medigap quote and review up to 40 different plans from a number of carriers. Click the banner above to shop and compare Medicare supplement plan costs.

#MedicareSupplementOrMedicareAdvantageAge65

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Going on Medicare Age 65

Bob Vineyard · July 18, 2019 · Leave a Comment

Going on Medicare at age 65. Can I sign up online? What if I am still working? When is the best time to enroll? How much does Medicare cost? Where can I get help?

Going on Medicare Age 65
Age 65 – Enroll in Medicare

If you are turning 65 you have a lot of going on Medicare questions. You will have a lot of people sending you information by mail, each piece claiming their plan is better. And your phone will ring off the hook. With people calling to SELL you something you don’t want, you don’t need and can’t afford.

Where do you turn?

Consider talking to a Georgia Medicare Expert.

Ready for Medicare?

When you are ready to sign up for Medicare the process is fairly easy. You can go online to sign up. Or maybe you would rather do it by phone. Another way is to visit your local Social Security office.

You can enroll in Medicare Part A and/or Medicare Part B online at www.SocialSecurity.gov. By calling Social Security at 1-800-772-1213 Monday through Friday, from 7AM to 7PM. Or In person at your local Social Security office.

How easy is that?

Where Can I Learn About Medicare?

You can waste a lot of time searching for Medicare information online. But it seems so easy. You just Google “How to go on Medicare”. Or “Where do I sign up for Medicare”. If you know how to enroll then you ask “Who has the BEST Medicare rates“.

Turning 65 – Enroll in Medicare

Those steps will give you a lot of results. Some information is readily available.

But if you just want to know how much Medicare costs. You only want to see Medicare supplement rates WITHOUT talking to a pushy agent. That is a bit more challenging.

About to enroll in Medicare? Every time you fill in your name, email address and phone this is what happens. Almost immediately your phone rings. Someone calling to SELL you something when all you want is INFORMATION.

And your email box will be flooded with offers. Just click this link and all your questions will be answered.

By now you know this is NOT how you want to learn about going on Medicare.

You are like Charlie Brown asking “Why won’t someone just help me?“!

Going on Medicare Age 65 1
Why Won’t Someone Help Me?

Medicare Help? Try This

Why search the web when all your going on Medicare questions can be answered here? Medigap rates. Advantage plan information. GA Medicare Expert Bob Vineyard can help.

When you are ready to sign up for Medicare, who would you rather talk to? A stranger on the phone whose last job was asking if you want fries with your meal? Or would you rather invest 10 minutes talking with someone who has over 45 years working in health insurance and is also on Medicare themselves?

You choose.

Here is my offer.

Give me a call. Invest 10 minutes by phone. Ask any question you want about Medicare. ANY question. Then you decide if my information is valuable or not.

If you like what you are getting, we move forward at your pace. If you don’t like what you hear, move on and we part as friends. It’s not personal, it’s just business.

I call this my offer you can’t refuse.

#GAMedicareExpert #GoingOnMedicare #Turning65

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New to Medicare – What Do I Need to Know?

Bob Vineyard · July 5, 2019 · Leave a Comment

When you are new to Medicare you will have questions. But you probably don’t know who can help. Even if you did, what questions will you ask?

You don’t know what you don’t know.

new to medicare
New to Medicare – What Questions to Ask?

About the time you think you have it all figured out they change the rules.

Turning 65?

If you are turning 65 and new to Medicare you are about to enter the state of confusion.

Medicare may SEEM simple, but it is not. It is easy until you have a claim. Then it becomes complicated. Where will you turn then? Will you go to the friend that told you to buy the plan they have? Maybe you will call the agent that SOLD you the plan? Good luck with that. They may not even be in the business by now.

You could call the carrier where you went direct to avoid talking to agents. You call an 800 number, press 1 for English then get routed to voice mail. Someone will call you back in a few days while you are in the shower.

How well does that work for you?

Maybe your best choice is to find a GA Medicare expert.

New to Medicare?

Enrolling in Medicare

If you are approaching age 65 and new to Medicare you know the drill. For the last year your phone has been ringing. Pushy insurance agents calling to SELL you a plan you don’t want, you don’t need and can’t afford.

Your mailman hates you because of all the junk mail that arrives at your door every day.

What do you keep? What do you throw away? Where do you turn for answers to your Medicare questions? Check out Medicare plans in Georgia.

Who Can Help Me?

There is nothing wrong with buying a Medicare plan online as long as you are prepared for a LOT of phone calls from agents wanting to SELL you something you don’t need, don’t want and can’t afford.

When you are new to Medicare how do you find the RIGHT plan?

All I ask is for you to give me 10 minutes by phone. Time to answer YOUR questions. You will NEVER be pressured to buy anything. This is your opportunity to ask ANY Medicare related question, then decide if you want to work with me or not.

It’s that simple.

It’s an offer you can’t refuse.

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Answers to Common Medicare Questions

boB Vineyard · June 23, 2018 · Leave a Comment

I have answers to your most common Medicare questions. Here are just a few examples of questions asked by people just like you who are turning 65.

  • How do I know which Medicare plan is right for me?
  • When should I enroll in Medicare?
  • Should I have the same plan as my spouse?
  • How much does Medicare cost?
  • Does Medicare cover (fill in the blank)?

Many of your questions can be answered by copying this into your Google search bar – site:http://www.georgia-medicareplans.com: 

Why is Medicare so confusing?

Why is Medicare Confusing?

Parts, plans, gaps, deductibles, copay’s, coinsurance . . .

It doesn’t take much before your head is swimming. Where do you go for answers  . . . but without the sales pitch?

Answers to Common Medicare Questions

Below are links that correspond to the questions shown above.

  • https://www.georgia-medicareplans.com/ufaqs/find-right-medicare-plan/
  • https://www.georgia-medicareplans.com/enroll-in-medicare-at-age-65/
  • https://www.georgia-medicareplans.com/medicare-traps-and-mistakes/
  • https://www.georgia-medicareplans.com/ufaqs/how-much-do-medicare-premiums-cost/
  • https://www.georgia-medicareplans.com/does-medicare-cover-my-cancer-treatment/

You have Medicare Questions.

I have answers.

Give me a call. I would love to help. (404) 252-5859

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