Courtney Collen (Host):
Welcome to Medicare Simplified, a podcast by Sanford Health Plan to help you decide which Medicare options are right for you. I'm your host, Courtney Collen. When choosing a Medicare plan, it's important to remember that Medicare isn't one-size-fits-all. There are many ways to have Medicare coverage and each person should choose the option that best fits needs and lifestyle. To explain the different parts of Medicare and break down what you need to know today, we're joined by Jack Arnett, a manager at Sanford Health Plan.
Jack, welcome.
Jack Arnett:
Thank you. Thank you for having me.
Host:
Good to have you. Let's start with this: the basics. What is Medicare?
Jack Arnett:
Medicare is the federal government's health insurance program for people that are 65 and above some people that are younger than 65 with certain disabilities. And those that have been diagnosed with end stage renal disease. One fun fact about Medicare Courtney. And if you ever win a trivia contest, please keep my name in mind. But the very first two Medicare beneficiaries were actually President Truman and his wife. President Johnson enacted Medicare in the late 1960s and as a symbolic gesture, he had invited President Truman and his wife, who actually began us thinking as a country in the 1930s about Medicare, to actually become the very first two Medicare beneficiaries. Today there's over 63 million Americans on Medicare.
Host:
I learn something new every day. Thanks for the fun fact. Jack, what are the different parts of Medicare?
Jack Arnett:
Sure. Medicare has four different parts, each covering different health care services. So Medicare Part A, which is commonly referred to the hospital side, of course, that covers inpatient hospital care, skilled nursing services. Hospital care is also a benefit under Medicare Part A and, in some limited circumstances, an individual can access home health care under Medicare Part A. Under Medicare Part B, also commonly referred to as the doctor side or the physician side of Medicare, it's going to include outpatient services for medically necessary services from a doctor and other health care providers, some preventative labs and x-rays and certain medical equipment and devices are also benefits under Medicare Part B. Medicare Part C is called Medicare Advantage and these are privately run plans by insurance companies that have a contract directly with Medicare, and then Medicare part D, which is the prescription drug side of Medicare.
Host:
What is Medicare supplement insurance?
Jack Arnett:
Sure. A Medicare supplement insurance plan also known as a Medigap Plan is an insurance plan to help pay for those out of pocket costs such as deductibles, copays, and co-insurance some Medigap plans or Medicare supplement insurance will provide as benefits that are not covered under original Medicare and the most common being travel internationally.
Host:
What’s the difference between a Medigap Plan and Medicare Advantage?
Jack Arnett:
One of the most commonly asked questions today, Courtney. A Medicare supplement insurance plan is operated by a private insurance company, and that provides additional coverage to help cover original Medicare's co-pays, deductibles and co-insurance. Now Medicare supplements do not provide coverage for items like hearing dental and vision, nor is there any Part D, Medicare's prescription drug coverage, offered with a Medicare supplement plan. Now a Medicare Advantage Plan is kind of an all-in-one insurance plan and it's an alternative for Medicare beneficiaries to receive the benefits under original Medicare Part A and B, and part D, in one plan. In most cases, Medicare Advantage Plan will cover additional benefits like hearing dental and vision. Some plans may even cover more benefits than that. We've seen Medicare Advantage Plans offer meal benefits and transportation and gym memberships. So quite a bit different. Today, almost one third of all Medicare beneficiaries have chosen a Medicare plan to help them with their additional Medicare costs.
Host:
So, when you choose a Medicare Advantage Plan, what happens to your original Medicare?
Jack Arnett:
Great question. A big myth is that people dis-enroll from Medicare when you choose to enroll into a Medicare Advantage Plan. And that's just not the case. Medicare beneficiaries that do enroll in a Medicare Advantage Plan, stay enrolled in Medicare. They don't dis-enroll, they don't turn in their red, white, and blue Medicare ID cards. They just choose to receive their Medicare benefits Part A and B, along with extra benefits through that Medicare Advantage organization.
Host:
Now, for anybody who might be getting ready to enroll in Medicare, or who would like to make some changes to their current plan, Jack, what's your advice?
Jack Arnett:
Keyword is research. Do their due diligence and seek out professional help from that. There is a myriad of options between North and South Dakota and Minnesota, our primary service area with Sanford Health Plan. There are dozens and dozens of plans to choose from. Each one can kind of tailor design to fit the needs and the lifestyle of that individual. Also, they need to be keenly aware of the different enrollment periods Medicare has. Traditionally for Medicare Advantage Plan, that enrollment period is October 15th through December 7th. And the election changes that time, take effect in January 1st. People that are new to Medicare, they can enroll into Medicare, which we call their initial enrollment period. That's a seven-month window Courtney. It's the three months before they turn 65, the month that they turn 65 and then three months after. But we're also seeing, not only in our service area, but around the country, more and more Medicare beneficiaries choosing to work beyond age and not retiring when that time comes for them to retire. And they no longer have access to that group insurance plan that they may be on or whatever credible coverage they have. Medicare allows them a special enrollment period to initially roll into Medicare and if both that initial enrollment period is missed or that special enrollment period is missed, Medicare has what's called a general enrollment period. I know a lot of enrollment periods here, and that's why it's so important to, to seek out help when it comes to that. But Medicare’s general enrollment period runs January 1st through March 31st. And then the effective date is until July. Now, there are changes coming to that general enrollment period, but as of the date of this broadcast and this podcast, those are the rules when it comes to the general enrollment period.
Host:
Okay, Jack all great information. Thank you for helping us sort out the basics of Medicare for sharing your expert insights. If you'd like to learn more, more about Medicare Advantage plan options from Sanford Health Plan, visit align.SanfordHealthPlan.com or find more information in our episode show notes. Jack, thank you.
Jack Arnett:
Thank you, Courtney.
Align powered by Sanford Health Plan is a PPO with a Medicare contract. Enrollment in Align powered by Sanford Health Plan depends on contract renewal. Sanford Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex, or any other classification protected under the law. This information is not a complete list of benefits. Call (888) 605-9277 ( TTY: 711) for more information. If you need language services or information given in a different format please call (888) 278-6485 (TTY: (888) 279-1549). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 888) 278-6485 (TTY: (888) 279-1549). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電888) 278-6485 (TTY: (888) 279-1549). Our customer service lines are available 8 a.m. to 8 p.m. CST, 7 days a week, October 1-March 31 except on Christmas and Thanksgiving, and Monday through Friday all other dates except on federal holidays.
CMS ID Number: H8385_901-334-856PODArticleUnderstandMedi-PY2022-ND-SD_C, H3186_901-334-856PODArticleUnderstandMedi-PY2022-MN_C
Last Updated On: 6.01.22 at 10:30 AM
