012. Medicare 101

Medicare is a topic that’s often discussed – and often misunderstood. June Kim is a community relations specialist with Blue Cross Blue Shield of Texas that specializes in Medicare, and she’s here this week to separate the fact from fiction. 

Though it can be confusing at times, she’s passionate about making healthcare a more approachable, understandable topic for seniors. This week Lori and June will discuss key differences between the original Medicare plan and Medicare Advantage, the limitations of each, and who might benefit from each of the plans. There are also opportunities to switch the plan and inherent risks of doing so. For instance, seniors must be healthy to enroll in a Medicare supplement program, but they couldn’t get coverage for preexisting conditions such as cancer. Based on knowledge like this, June offers insights and tips to help seniors navigate their healthcare.

Takeaways from this episode:

- Seniors aged 65+ are eligible for Medicare, and there are 2 types: Original Medicare and Medicare Advantage.

- Medicare is strictly for medical insurance and doesn’t cover senior living facilities (assisted or independent). 

- Everyone should take advantage of Medicare Part A, which is free and covers hospital costs

- Medicare Part B covers doctor visits, X-rays, outpatient care, and more – which requires a monthly premium and increases each year.

- Original Medicare (consisting of Parts A and B) and does not cover everything, just 80%, so patients must pay the remaining 20% in addition to the normal Original Medicare monthly premium.

- Those who choose Original Medicare can supplement with “Medigap” coverage, which can cover the remaining 20% – but to be eligible, patients can’t have preexisting conditions.

- Those who still have medical insurance through their employer don’t need to sign up for Part B healthcare plan because it’s essentially double-paying.

- Medicare Advantage is Part C, which is a local plan that often requires co-pays, making it an attractive option for those who seldom visit doctors or don’t have the resources to pay larger monthly premiums.

- Part D helps cover the cost of prescription drugs, so they’re more affordable.

- Medicare Advantage is an “all-in-one” plan that often bundles in add-ons like drugs, transportation, hearing aids, and even basic vision and dental.

- Medicare Advantage is also very localized, so if you move, you’d need to enroll in a different Medicare Advantage plan. 

- There’s a risk involved with switching from Medicare Original to Advantage – if you want the Original plan again because you’ve become ill with a disease, you wouldn’t qualify for the supplement plan.  

Topics discussed:

- Medicare plans and supplements
- Prescription drug coverage
- Home health / rehab
- Hospital visits
- Preexisting conditions
- Medicare enrollment
- Switching Medicare plans (life changes)

For more information about plans and the brochure mentioned in this episode, please visit: 

www.Thinkbluetx.com
To contact June Kim:
June_kim@bcbstx.com
214-783- 7901

For more detailed and up to date information please go to:
www.medicare.gov  

And for social security:

www.ssa.gov

If you wish to suggest a topic, be a guest or want to support the podcast please email Lori@Loriwilliams-seniorservices.com or reach out online: https://www.facebook.com/LoriWilliamsSeniorServices/
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