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  • Bob Vineyard

How Does Medicare Work?

Bob Vineyard · January 29, 2020 · Leave a Comment

How does Medicare work when I turn 65? Am I enrolled automatically? When do I sign up? How much does it cost? Will my doctor take Medicare? GA Medicare expert Bob Vineyard explores what Medicare is, and how it works.

How Does Medicare Work?
How Does Medicare Work?

Ask questions of an expert who is enrolled in Medicare. Over 45 years health insurance experience. You have questions? He has answers. No selling, ever. Call or email.

Is Medicare Advantage Better Than Medicare?

What is Medicare Part C? Is Medicare Advantage better than Medicare supplement? What is original Medicare? What is the difference in Medicare supplement and Medigap? How can I find the best Medicare supplement rates?

How Does Medicare Work?

Do I have to pay for Medicare? Does it cost more than my group insurance plan? How does it compare to Obamacare? Can I get a subsidy?

What are the copay’s? What is the deductible? How much will it cost me to go to the doctor? Will I have to file a claim? How do I satisfy my deductible? Do I pay my doctor every time I go? What are my Medicare premiums? How much is Medicare Part A? How much is my Medicare Part B premium?

What are Medicare 2020 plans? Which Medigap plan is the best? Does Medicare cover prescription drugs? Is my doctor in network? Do I need a referral to see a specialist?

How to Find the BEST Medicare Plan?

Does Medicare Cover Everything?

Does Medicare cover dental work? Are hearing aids covered by Medicare? How about vision coverage?

How do you find answers to your Medicare questions WITHOUT getting a SALES PITCH?

Everyone wants to talk. No one wants to listen and answer . . . until you BUY SOMETHING.

Something you don’t want, don’t need and can’t afford.

Medicare explained using words you can understand. A Medicare 101 course if you will.

An Offer You Can’t Refuse

Give me 10 minutes by phone. Ask ANY question. How does Medicare work?

I can tell you.

What’s the difference in Medigap and Medicare supplement?

Like Kleenex and tissue, Medigap and Medicare supplement are two ways of saying the same thing.

How easy was that?

What is Medicare and how do I use it?

Medicare is health insurance designed primarily for folks age 65 and older. Those who are younger than 65 may qualify if they are disabled or have end stage kidney disease.

Medicare has 4 parts. Your red, white and blue card is broadly accepted by doctors and hospitals alike. No networks! Referrals not needed. Nor is 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.

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.

Medicare Part D covers outpatient prescription drugs.

Why is Medicare Part D 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.

#HowDoesMedicare2020Work #GAMedicareExpert #GeorgiaMedicareSupplementRates

Medicare Supplement Plans, Medicare ga medicare supplement rates, how does medicare work, medicare part a, medicare part b, medicare supplement, medicare supplement cost, medigap, medigap rates, original medicare

Your Medicare Questions Answered

Bob Vineyard · August 28, 2019 · Leave a Comment

Your Medicare questions answered by GA Medicare expert Bob Vineyard. Where do you go for answers? Why does no one want to help until you BUY something? Can anyone help?

How about the Georgia SHIP staffed by volunteers? Or calling Medicare direct? Who has all the answers when you want to know who has the best Medigap plan? Is there a Medicare for Dummies, or Medicare 101 site?

Medicare questions answered

Where is the best place to find answers to ALL my questions without getting a SALES PITCH?

Medicare Questions Answered

Why Search the Web When All Your Answers are Here?

Georgia Medicare expert Bob Vineyard spends hours every day searching so you don’t have to. Don’t you have something better to do with your time?

Even after working in health insurance for over 45 years Bob still is learning new things. He spends times reading information on Medicare, health and senior fitness so you don’t have to. Bob also participates in several consumer forums, answering the tough questions.

Bob is dedicated to helping YOU understand how Medicare works. He also makes sure you find the right plan that fits YOUR needs and budget.

Welcome to the NO SELLING ZONE!

Your Medicare Questions Answered by Volunteers

Why not talk to a SHIP counselor? They aren’t selling ANYTHING. It’s a non-profit organization. What could be wrong with that?

Counselors are volunteers with limited training. Kind of a Medicare 101 crash course for dummies. It would be rare to find someone who has had years of experience working with Medicare beneficiaries and insurance carriers.

The belief by some is, because they are volunteers working for a taxpayer funded, non-profit organization, their advice must be unbiased. Your Medicare questions answered by someone who truly wants to help . . . and that is true.

Motivation to help is good, but how accurate and useful is that advice? Will you have a counselor dedicated to help you . . . or will you be handed off to the first available person? Is personal service meaningful to you, or are you willing to accept advice from just anyone?

Going to the Source

Call 1-800-MEDICARE 24/7 except federal holidays. Operators are standing by . . . and most of them speak English.

When you ask questions about Medicare their computer “listens” to the conversation and an answer pops up on the rep’s screen. They will read the answer to you and assume you understand.

AI (Artificial Intelligence) is great but it is no substitute for the real thing. Remember HAL 9000 from Space Odyssey. “I’m sorry Dave. I’m afraid I can’t do that”.

While 800-MEDICARE is good, just like volunteer organizations, they don’t understand the insurance side of Medicare.

Medicare is easy.

Insurance is hard.

One Source for Answers to Your Medicare Questions.

Bob makes life simple. He explains how Medicare works using words that you understand.

For example. Many folks get confused about Medicare supplement and Medigap. What are they? How are they different.

Bob’s answer is this.

Medicare supplement and Medigap are interchangeable terms. Like Kleenex and tissue.

How easy is that?

Where can you get your Medicare questions answered?

Call or email. Give us 10 minutes. Ask any question. Never any pressure to buy. You decide if the information is helpful or not. No selling ever!

This is my offer you can’t refuse.

Medicare Supplement Plans, Medicare best medigap plan, medicare, medicare 101, medigap, senior fitness

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.

Medicare, Enroll in Medicare, Medicare Supplement Plans enrolling in Medicare, medicare advantage, medicare advice, medicare explained, medicare part d, medicare supplement, medigap, new to medicare, turning age 65

Do You Want Fries With That Medicare Plan?

Bob Vineyard · September 25, 2018 · Leave a Comment

Would you like fries with your Medicare plan? What do you know about those who offer advice about Medicare?

Picking a Medicare Plan is as Easy as Ordering Lunch

Picking a Medicare plan while blindfolded is what happens too often. Almost no one understands Advantage plans. Medicare drug plan deductibles? Who can explain that? Much easier to pick a plan without a deductible. You can’t go wrong there.

fries with your medicare plan

Medicare supplement plans are easy. All Medicare plans with the same letter are identical. Just go with the plan with the lowest premium. Right?

Maybe you will appreciate my Shop Like a Boss video, explaining how to search for Medicare plan information.

No need to ask an insurance agent. They cost too much.

Questions You Really Should Ask

How long has the agent or carrier rep worked the Medicare market? Maybe feel more comfortable talking with someone at Medicare.gov or a volunteer and a not-for-profit organization.

Surely they will be impartial?

Or will they?

Turning 65 Medicare Options

How does Medicare work?

Bob Vineyard explains in this Georgia Medicare Minute video

If you are turning 65 and enrolling in Medicare, this may be your only chance to purchase a Medigap plan. Here is your guide to understanding GA Medicare.

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

Senior healthcare insurance is commonly used to describe 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 has 4 parts.

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 Supplement or Medicare Advantage?

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.

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.

How Much Does Medicare Cost?

In 2018 most Advantage plans issued in Georgia limit your out of pocket for approved in network health care expenses to $6700.

The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.

Some cancer centers, such as Mayo Clinic, Sloan Kettering and MD Anderson may not participate in certain Medicare Advantage plans.

Medicare and Cancer

Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.

Chemotherapy drugs administered in a doctor’s office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.

This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.

We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.

According to the Mayo clinic, “new cancer treatments are routinely priced at over $100,000 per year of treatment.”

A study from the Medicare Rights discovered the number one reason for disenrolling from a Medicare Advantage plan was “provider access problems”. Number 4 on the list was “cost sharing too high”.

Who is giving you Medicare advice? An experienced agent who is enrolled in Medicare or someone that works in a fast food restaurant?

#WantFriesWithYourMedicarePlan

#GAMedicarePlans

#MedicareVideos

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Do I Need a Medicare Supplement Plan and Medicare Advantage?

Bob Vineyard · November 4, 2014 ·

AP20C7

Medicare supplement and Medicare Advantage. What’s the difference? Do I need both? What is the difference in Medigap and Medicare supplement? Do Advantage plans have more advantages? Can I change plans every year during open enrollment?

Which plan is better? Should I have an Advantage plan or Medigap?

That is a question only YOU can answer.  Consider the differences and then decide which plan fits your needs and budget.

Are you turning 65? Do you need help navigating the Medicare maze?

Call us. We can help.

Medicare supplement and Medicare Advantage

What is the difference?

A lot.

Do I need both a Medicare supplement plan and an Advantage plan?

Nope. Even if you wanted both, Medicare says you can’t have both.

So pick one or the other.

Medicare supplement plan F rates

What is the difference in Medicare supplement and Medicare Advantage?

Medicare supplement plans work with original Medicare.

  • No networks
  • Use any doctor, lab or hospital anywhere in the U.S.
  • Referrals not necessary to see a specialist
  • Keep your current doctor(s)
  • Your doctor cannot be dropped from the plan mid year
  • You can keep your plan every year.
  • Annual review not needed (for your supplement plan)
  • Out of pocket is clearly outlined and can be budgeted
  • Pick a drug plan that covers the drugs you need

Is Medicare Advantage Better?

The advantages of a Medicare Advantage plan are, the monthly premium is lower.
The disadvantages are:
  • you are limited in most cases to docs and hospitals in the network
  • the Rx is often paired with the plan and may not include the meds you need
  • your doctor can be drop out of the plan at any time
  • you may have to change your plan every year
  • you have to review the plan every year (participating network providers, meds, cost of health care, etc)
  • your out of pocket for in network only claims is almost always higher than Medigap
  • your out of pocket cap averages $6,700 (most 2018 plans) + out of network claims + Rx copay’s
  • you can find yourself out of network and incur penalties any time, anywhere
But other than that, the Advantage plans are great until you use them.

Can I change plans every year during open enrollment?

Medicare supplement plans do not have annual enrollment periods. When you first turn 65 you can purchase any Medigap plan with any carrier, no questions asked.
Medicare Advantage plan and Part D drug plans can be changed every year, but only during open enrollment. Most retirees will change their Advantage and
Medigap change
drug plan every year or so, whether they want to or not. Each year the plans change and you MUST review to make sure you are not going to pay more for your health care than you expected.
Never ever take the “automatic” renewal option. Always ask your agent to shop and compare plans for you every year.
One of my Part D clients was prepared to take the automatic renewal from Cigna. Their new rate was dropping a few dollars and other than the addition of a deductible, the plan seemed like a good buy.
What they did not know (until I reviewed it for them) was this.
The renewal plan did not include all of her medications.
The renewal offer was $7 less than the Cigna plan I suggested but the difference in her out of pocket costs was significant.
Her expected annual prescription drug cost for the renewal offer was $2880.
The projected drug premium for the plan that was $7 higher but her annual prescription cost was only $1530. That additional $7 monthly premium saved her more than $1300 in out of pocket drug costs.
Had she accepted the automatic renewal she would have saved $84 in premiums but would have paid out more than $1300 for her medications.

Comparing Medigap plans is easy

Kind of.
Benefits are standardized and assigned a letter of the alphabet from A through N.
But Medicare only uses 9 of the letters
Medicare supplement plan F is the most popular. Also the most expensive and most oversold.
Plans G and N offer exceptional value.
Some carriers don’t offer all the plans.
AARP/United Healthcare does not off plan G. Neither does Blue Cross of Georgia (BCBSGA). Nor does Humana.
Mutual of Omaha (Omaha Insurance Company in Georgia) does not offer plan N. They did at one time, but not any more. Makes you wonder why, doesn’t it?
We never recommend a plan that does not have at least a 5 year renewal rate history.  That is to protect you.
Manhattan Life and Omaha Insurance Company have only been offering Medigap for a little over a year. Same for Companion Life.
There are over 250 different Medigap plans in Georgia. We have Medigap rates you won’t see anywhere else, but you can start your online shopping experience by clicking this button.

Georgia Medigap plans & Prices
Georgia Medigap plans & Prices

Medicare, Medicare Advantage, Medicare Supplement Plans medicare advantage, medicare supplement, medigap, medigap rates, open enrollment, turning 65

Don’t Buy Something You Don’t Need

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