Medicare Part D |How Does it Work?

How does Medicare Part D work? Almost no one understands it. The few that do know can’t explain it. 800-MEDICARE can’t help, neither can your friends. Most agents have no clue and neither do volunteer counselors.

Medicare Part D is confusing

GA Medicare plan expert Bob Vineyard looks at the most confusing part of Medicare.

How Does Medicare Part D Work?

Who Can Explain Medicare Part D?

The folks in Congress who designed the PDP program don’t understand it and they will never use the plan. Most carrier service reps who answer the phone MIGHT be able to explain their plan but they won’t have a clue about their competitors.

Why is Part D so difficult?

Consider this . . .

The program was designed by folks in Congress who know nothing about health insurance and they turned it over to insurance carriers to manage. What could possibly go wrong?

If you believe they know what they are doing just witness how they messed up Obamacare. And don’t overlook the misnomer for the law . . . the AFFORDABLE Care Act.

WHO thinks Obamacare is AFFORDABLE? How many got to keep their plan no matter how much they liked it? Which of you were able to keep their doctor?

So why do you think they got Medicare Part D right?

Almost no one Understands Part D.

Medicare prescription drug insurance plans have moving parts. Some have a deductible, others do not. All have copay’s. Some copay’s are a flat dollar amount, others are a percent of the retail price. All plans have the donut hole. All plans have preferred pharmacy’s and drug formulary’s.

Some drug plans have a mail order option, others do not. Some mail order refills will save you money, others will not and some will even cost you MORE than filling at a pharmacy. The preferred pharmacy you use this year may not be favored next year.

Am I Required to Use my Drug Plan?

Will you pay less for your medications if you pay cash or use a discount like GoodRx vs running everything through your drug plan? Are you better off running ALL your drugs through the Medicare Drug Plan Finder or only checking prices on some of your med’s? Why will I pay a higher copay by using my drug plan vs a discount card?

Why should I buy a drug insurance plan if I don’t need it? What is the penalty for not having a drug plan? Is it the same every month? How long will I have to pay the penalty? Can I pay the penalty from my HSA?

Can I save money by ordering from Canada? Why is it less expensive to pay cash, use a discount card or order from Canada?

Can I enroll in Medicare Part D at any time? Can I switch drug plans whenever I want? Do I need to review my prescription plan every year or can I just let it renew?

Who Will Help me Find a Medicare Drug Plan?

Why do some agents help with Medicare Part D and others don’t? How much are agents paid to help with Part D? Are agents required to show me ALL the drug plans in my area? Why do agents only sell one or two plans? How many drug plans are offered in Georgia?

What is wrong with picking the plan with the lowest premium? Aren’t all drug plans the same? Why do I have to buy my drug plan from an insurance carrier? Many of the policies are from carriers I have never heard of. Why shouldn’t I just buy from the same company that sold me the Medicare supplement plan? Don’t I get a discount for buying Medicare Part D and Medigap from the same carrier? Is there a reason why I shouldn’t enroll in the same drug plan as my spouse?

My best friend says her plan is the best. What is wrong with buying the same plan she has? Can I use my PDP with any drug store? Can I continue to fill my prescriptions at the same pharmacy I have always used?

Where Can I Get Help With Medigap Coverage?

Shameless plug follows . . .

Georgia Medigap rates. Best GA Medicare supplement prices. GA Medigap rates. GA Medicare 2020. Medigap 2020 plans. 2020 Medicare premiums. Plan G. Georgia Medicare agent. Medicare 101. Georgia Medicare Minute. Medicare explained. Medicare Part D. Silver Sneakers. How does Medicare work?

Bob Vineyard has over 40 years experience in the health insurance field. All your questions will be answered. People love to buy but they hate to be sold.

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.

I call it “An offer you can’t refuse

Why is Medicare Part D So Confusing?

Seniors often buy the wrong drug plan and spend too much on their prescription plan. Seniors on Medicare spend an average of $263 per month on prescription medications.

Lower your medication bill by only using your drug card when necessary. The right drug plan will save a lot on brand names but you will almost always pay MORE for generics.

Consider paying cash or using GoodRx instead for maximum savings. Also look for drug plans that have a deductible.

#HowDoesMedicarePartDWork #GAMedicarePlans

Pick a Drug Plan

Pick a drug plan, Medicare 101. Finding the RIGHT Part D plan is the most challenging part of Medicare. Experienced agents often get it wrong.

Medicare 101 - Picking a drug plan

Medicare Part D has a lot of moving parts. Formulary’s. Deductibles. Copay’s. Coinsurance. Preferred pharmacy’s. Brand name drugs. Generics. Which drugs are less expensive if you pay CASH.

It usually takes me anywhere from 5 to 20 minutes to run a drug report. Add another 10 to 30 minutes to explain to my Medigap client how to properly use the plan.

Very few people, including agents, understand drug plan deductibles.

Choosing Part D Isn’t Easy

Many think choosing a Part D plan is simple. Look for the plan that does not have a deductible and pick the one with the lowest premium.

That is the WRONG way to pick a drug plan . . . unless you enjoy OVERPAYING for your drug coverage.

Whether you pick a drug plan or you allow someone to help , at least make sure you get it right.

Do you want to DIY? Here is where you start.

Let me know how this works for you.

I have been running Medicare drug plan reports since 2010. The first few years I had no idea what I was doing. I made mistakes but fortunately they weren’t costly.

Showing clients how their copay changed once the plan deductible was satisfied was impossible. A few years ago Medicare reworked their software so now they can see month to month how their OOP changes.

When you use these new reports it is very obvious why a deductible plan produces lower OOP costs.

Why is Medicare Part D so Confusing?

Seniors often buy the wrong drug plan and spend too much on their prescription plan. Seniors on Medicare spend an average of $263 per month on prescription medications.

Lower your medication bill by only using your drug card when necessary. The right drug plan will save a lot on brand names but you will almost always pay MORE for generics.

Consider paying cash or using GoodRx instead for maximum savings. Also pick a drug plan that has a deductible.

This report compares a $17 plan with a deductible vs a $79 plan with no deductible. Not only is the premium for the no deductible plan considerably higher but so are the copay’s.

This is not an aberration. No deductible drug plans are more difficult to find. Also the premiums AND copay’s are noticeably higher than plans with a deductible.

Why not let my Pharmacist Help me Pick a Plan?

Your druggist probably has no idea how to run a Medicare drug plan report. Even if they do know how, they will not have the time. He or she will simply recommend a plan they see most often.

That means you may not know how much you could have saved compared to the other 2019 Medicare Part D plans.

Have you bought something recommended by a friend then later discovered you PAID TOO MUCH?

Sometimes you can return the item for a refund.

Medicare drug plans don’t work that way.

Your copay can range dramatically from one plan to the next. Copay’s are even further impacted by using the wrong pharmacy.

Last year I ran a report for a client. Had he kept his existing plan and pharmacy his total annual out of pocket (premiums + copay’s) would have been $13,000. By switching plans AND pharmacy’s he cut his OOP to $6,000.

You Can Pick Your Own Drug Plan

Some folks don’t want help with Part D. They have done it for their parents or other relatives. The plan they found worked so no need to make a change.

As one who runs hundreds of Medicare Part D reports every year I can tell you this. Picking a drug plan is not easy.

Sometimes I will run the report several times to find the lowest possible combination of premiums and copay’s.

Most folks who take the DIY approach only run the report once.

I tell my clients to run their own report, then let me generate a report. Almost without exception my total out of pocket is less.

This is all about saving money by picking the best drug plan. And that is the way it should be.

How to Get the Most Out of Medicare

How to get the most out of Medicare? Shop plans every year? How often should I change Medicare plans? Can I keep my doctor? Who can help me? GA Medicare expert Bob Vineyard helps.

How to get the MOST out of Medicare
How to Get the Most Out of Medicare

Get the Most for Your Medicare Dollars

How to get the most from your Medicare dollar is a popular question with close to 100 million responses from a Google search.

My clients say “Why didn’t I call you first? You answered all my questions. Never pressured me to buy.”

Turning 65 Medicare Options

Do you really want to spend time searching the internet for answers? Or allowing strangers in your home. Agents who will try to SELL you something you don’t want, don’t need and can’t afford.

Here is my “pitch”. Call. Give me 10 minutes to answer your questions. Any question. Then decided if you want my help or not.

I call this “an offer you can’t refuse“.

How to Get the BEST Medicare Plan in Georgia

GA Medicare expert Bob Vineyard reviews the BEST Georgia Medicare plans, news and options. Review our videos. Bob will help you find the RIGHT plan that fits YOUR needs and budget. Call (404)252.5859 or email [email protected] Watch our Medicare videos on YouTube.

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.

If you are turning 65 and enrolling in Medicare, this may be your only chance to purchase a Medicare supplement plan in Georgia. Full report with Medicare supplement rates for ALL Georgia Medigap carriers. Anthem GA Medigap rates include Silver Sneakers

You don’t have to receive Social Security to enroll in Medicare insurance. CMS is the agency that oversees Medicare.

How to enroll in Medicare? You may sign up for Medicare 3 months before your 65th birthday, the month you turn 65, and 3 months following your 65th birthday. You may enroll online (highly recommended), by mail or by visiting a Social Security office.

Shop and compare Georgia Medigap rates online. Instant quote. Up to 30 plans.

FREE REPORT for over 240 different GA Medigap carriers available on request. We quote Medicare supplement rates by phone and email your custom report. No obligation.

Comprehensive Part D Medicare drug plan review for new and existing clients. Learn the secret to saving hundreds on prescription drug costs. A drug plan deductible is your friend

How Does Medicare Work?

Medicare has 4 parts. Your red, white and blue card is broadly accepted by doctors and hospitals alike. No networks! No referrals. No prior authorization.

Medicare Part A covers hospital inpatient charges and has a per admission deductible

Medicare Part B is for outpatient health care treatment. Doctor visits, labs, X-rays, MRI, CT scan (CAT scan), ambulance, ER, outpatient clinics, etc. Essentially any Medicare approved health care received outside the hospital setting. Treatment considered medically necessary under Medicare guidelines. Medicare Part B has a calendar year deductible. Once satisfied, Medicare pays 80% of the approved charge, you are responsible for the remaining 20%.

When you have original Medicare, YOUR DOCTOR AND YOU decide on the care you need. You don’t need approval by an insurance carrier before can receive testing or treatment.

Many seniors worry about hospital stays. But your major expenses will more than likely fall under Medicare Part B outpatient expenses. Original Medicare stand alone has no cap on your out of pocket expenses.

Here is what I tell folks Without a supplement plan you pay until you run out of money, get well or die.

Medicare Part C is now referred to as Medicare Advantage. More on that later.

Medicare Part D covers outpatient prescription drugs. Some Advantage plans have drug coverage built into the plan.

Do All Doctors Take Medicare Advantage Plans?

How to get information on doctors that take Advantage policies? Did you know that some doctors and hospitals do not accept ANY Medicare Advantage plans? What happens if your claim is DENIED?

Did you know that Medigap and Advantage plans cover the same things? But what you pay out of pocket for your care, and where you receive your care, is very different.

Original Medicare does not have networks. You can use any doctor or hospital anywhere in the US. Referrals are not required.

All Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO. How are Medicare Advantage plans like a store credit card?
https://youtu.be/p0j41FsfHbA

If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Most importantly, your max OOP may also be higher. Some plans do not cap out of network charges.

Non-emergency out of network care charges may be denied if you have an HMO.

Is Cancer Treatment Covered by Medicare?

Medicare DOES cover your cancer treatments. However, Advantage plans issued in Georgia have a LOT of out of pocket expenses. In other words, you will pay a lot more for treatment under an Advantage plan.

Also, many Advantage plans often require prior authorization BEFORE you can be treated for cancer. Your doctor does not decide your care, the insurance company makes those decisions for you.

ORIGINAL Medicare does not have networks. Prior approval is NOT needed for cancer treatment or any other care. Medicare and a Medigap plan have minimal out of pocket costs.

Mayo Clinic, Sloan Kettering and MD Anderson may not participate in certain Medicare Advantage plans.

#BESTMedicarePlansGeorgia #GAMedicareExpert #GAMedicareVideos

How to Find the BEST Medicare Plan?

How do you find the BEST Medicare plan in Georgia? The one that is right for you AND your budget? GA Medicare expert Bob Vineyard explains.I did not say look for the lowest PREMIUM. I said BEST plan. Something that fits and is just right for you. Fits you like a glove . . .

find the medicare plan that is right for you
The One That is Right For You

Which is a better FIT for you? Original Medicare and a supplement plan, or an Advantage plan? Don’t let ANYONE try and SELL you something you don’t need, don’t want and can’t afford.

How do I find the RIGHT Medicare plan?

BEST Medicare Plans in Georgia

Where do you find the BEST GA Medicare plans?

Lucky you. We have a video that explains what you need to look for, what you need to avoid, and how to escape the pushy insurance agent.

Find the BEST Medicare Plan – An Offer You Can’t Refuse

Original Medicare and a supplement plan, or an Advantage plan? Don’t let ANYONE try and SELL you something you don’t need, don’t want and can’t afford.

How to Find the BEST Georgia Medicare Plan

GA Medicare expert Bob Vineyard reviews Georgia Medicare plans, news and options. Review our videos. Bob will help you find the RIGHT plan that fits YOUR needs and budget. The best Medicare plan in Georgia. Call (404)252.5859 or email.

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.

Turning 65?

If you are turning 65 and enrolling in Medicare, this may be your only chance to purchase a GA Medicare supplement plan. Full report with Medicare supplement rates for ALL Georgia Medigap carriers. Anthem GA Medigap rates include Silver Sneakers

You don’t have to receive Social Security to enroll in Medicare insurance. CMS is the agency that oversees Medicare.

How to Enroll in Medicare?

You may sign up for Medicare 3 months before your 65th birthday, the month you turn 65, and 3 months following your 65th birthday. You may enroll online (highly recommended), by mail or by visiting a Social Security office.

Original Medicare Explained

Original Medicare has 4 parts. Your red, white and blue card is broadly accepted by doctors and hospitals alike. No networks!

Medicare Part A covers hospital inpatient charges and has a per admission deductible

Medicare Part B is for outpatient health care treatment. Doctor visits, labs, X-rays, MRI, CT scan (CAT scan), ambulance, ER, outpatient clinics, etc. Essentially any Medicare approved health care received outside the hospital setting. Treatment considered medically necessary under Medicare guidelines. Medicare Part B has a calendar year deductible. Once satisfied, Medicare pays 80% of the approved charge, you are responsible for the remaining 20%.

Most seniors worry about hospital stays, but your major expenses will more than likely fall under Medicare Part B outpatient expenses. Original Medicare stand alone has no cap on your out of pocket expenses.

You pay until you run out of money, get well or die.

Medicare Part C is now referred to as Medicare Advantage. More on that later.

Medicare Part D covers outpatient prescription drugs. Some Advantage plans have drug coverage built into the plan.

Medicare is Confusing

Seniors will almost always buy the wrong drug plan and will spend too much every year. Average spending on prescription medication is $1 for every $6 spent on health care. If you spend $60 per month on doctor bills you can expect to spend another $10 on medicine.

Lower your medication bill by only using your drug card when necessary. The right drug plan will save a lot on brand names but you will almost always pay MORE for generics.

Consider paying cash or using GoodRx instead for maximum savings. Also look for drug plans that have a deductible.
https://youtu.be/LaA9NnFeBXI

Do All Doctors Take Medicare Advantage Plans?

Did you know that some doctors and hospitals do not accept ANY Medicare Advantage plans? What happens if your claim is DENIED? Maybe you don’t have the best Medicare plan after all.

Medigap and Advantage plans cover the same things, but what you pay out of pocket for your care, and where you receive your care, is very different.

Original Medicare does not have networks. You can use any doctor or hospital anywhere in the US. Another plus is the ABN form which is only used with Original Medicare.

Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO. How are Medicare Advantage plans like a store credit card?

If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.

Non-emergency out of network care charges may be denied if you have an HMO.

Shop and compare Georgia Medigap rates online. Instant quote. Up to 30 plans
https://gamedigaprates.com

Where Can I Find the BEST Medigap Rates?


FREE REPORT for over 240 different GA Medigap carriers available on request. We quote Medicare supplement plan rates by phone and email your custom report. No obligation.

Georgia Medicare – Plans, Rates, Instant Quotes

Comprehensive Part D Medicare drug plan review for new and existing clients. Learn the secret to saving hundreds on prescription drug costs. A drug plan deductible is your friend.

How long will it take you to find the RIGHT plan, the BEST Medicare plan? You can look for weeks . . . or make just one 10 minute phone call. Your choice

#BestGAMedicarePlans #GAMedicareExpert #GAMedigapRates