Essential Parts of Medicare & How to Check Your Coverage

[@BetterHealthWhileAging]

*Watch Next*: How to Pay for Senior Care? - kzbin.info/www/bejne/f3OuoHSFbr-gppY Chapters: 00:00 Essential parts of #Medicare 02:57 Why check your Medicare coverage in 2025 05:58 The basics of Medicare 07:08 Medicare Part A: Inpatient Services Explained 10:03 Medicare Part B: Outpatient Services Overview 11:24 Medicare Part C: Medicare Advantage Plans 15:22 Medicare Part D: Prescription Drug Coverage 17:04 How to initially enroll in Medicare 19:26 Medigap, Medicaid, and other options 25:30 Why does Medicare Open Enrollment matter? 31:02 Medicare Updates for 2025 36:54 Steps to Take During Open Enrollment 42:04 Resources for Medicare Assistance

[@cdd824]

You are so right about NOT setting and forgetting your coverage. My parents did that and really paid a price with both the out of pocket amounts paid and the quality of care from their Medicare advantage policy. I would only add that as you age, the likelihood of staying healthy goes down. Better insurance becomes more of a necessity, because the chances of using it increase. I would only add that there’s a lot of advertising of Medicare advantage plans that state “you’ll pay no premiums”. In my experience that’s not correct: they simply deduct the premium from your monthly social security payment so that you don’t have to write a check for the premium (or electronically transfer the payment). You’re still paying for it. You’re just less aware of the actual cost of that premium. And please describe the formulary part d for what it is: a requirement that we gaze into our crystal ball, divine what drugs we will need for the year, and pick the best plan. It’s a joke, really. Congress expects elders to 1) know which drugs they’re taking 2) know the formulary of what might be prescribed for their illnesses (because drs can change their minds about what should be prescribed for patients) 3) know what they might need in the future. Have these legislators ever met an elderly person? It’s way too complex for me and I don’t have any vision challenges or cognitive decline. The rest of the western world is laughing at us.

[@BetterHealthWhileAging]

It's important to know that if one chooses Medicare Advantage, one STILL has to pay the regular part B premium (which was $174.70/month in 2024). "No premium" means no additional premium on top of that. Re part D...well...it's better than nothing...but yes, still complicated and it's a shame we haven't yet figured out how to do better. As you probably know: the US has chosen in general to go with very market-based approaches to healthcare...personally I think this isn't so good for patients (there's a good reason most developed countries don't go this route)...but that's where we are for now.

[@no2of16]

I agree with Dr. Kernisan's panning of "market-based healthcare." And I'd go a step further: I think the term "for-profit healthcare" is an oxymoron.

[@no2of16]

Overall, a decent job covering a complex issue. But I believe an important item was missed: the "in network" / "out of network" aspect of Medicare Advantage plans. Many people fail to realize that doctors they have gone to for years, doctors whose judgments they have learned to trust, may NO LONGER be available because they're not in a particular plan's "network." Nasty surprise.

[@BetterHealthWhileAging]

Good point; it's certainly an important issue to consider

[@bettyestone70]

Need to talk about the deductible you pay each year on each insurance.

[@BetterHealthWhileAging]

Thanks for bringing up this important point: there are deductibles for Medicare Parts A & B, as well as for most Medicare Advantage (part C) and drug (part D) plans. The deductibles for Parts A & B can be found here: www.medicare.gov/basics/costs/medicare-costs

[@celesteaida48]

Thank you!

[@beanyhead1]

We have found that "In Network/Out of Network" really matters when you live in our small state that has no major hospitals or medical schools/research. Having a supplemental (Medigap) policy gives you peace of mind, knowing you can access speciality care, surgery, etc. across state lines at a major city hospital (or anywhere in the country, for that matter).

[@ChadSharkeyNursePractitioner]

Every time I think I've figured out insurance, specifically Medicare, I realize I haven't. Nothing worse than telling a senior what I think I know about their insurance, only to find out it has changed. I now rely on expert social workers like Michelle for my senior population.

[@merileemali5528]

What about self-administered meds when you go to the E!R

[@shelleybush8871]

I hate Medicare