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 but there are a few common myths and misconceptions when it comes to Medicare coverage before getting a Medicare plan. So to help us clear it all up, I have Jack Arnett with me, a manager over at Sanford Health Plan to help do that. Hi, Jack.
Jack Arnett:
Hi Courtney. Thank you for having me today.
Courtney Collen (Host):
Okay. Let's dive into the first myth. Medicare is free healthcare and costs do not change.
Jack Arnett:
Absolutely not true. And I'm not sure if the old Myth Busters TV show is, is still on, but there should just be some crescendo of music here.
Myth busted.
Number one, Medicare is not free. First of all for individuals actually let me just take a step back. The two main parts of original Medicare Part A and B, Medicare Part A, which is primarily the hospital side, limited benefit for skilled nursing care and hospice care. Medicare Part A is provided to Medicare beneficiaries and that's based on them working in what we call a Medicare covered employment. Those Medicare taxes are those FICA taxes that come out of our paycheck. If an individual has worked 40 quarters or 10 years, or their spouse has, then they qualify for Medicare Part A without a premium. But I never count that as free as all Medicare beneficiaries have worked and paid those taxes, it certainly, you know, it doesn't come free. Additionally, Medicare comes with copays, deductibles, and cost shares. And so individuals will normally shake out some additional type of Medicare coverage, be it a Medicare supplement or a Medigap policy. And many Medicare beneficiaries today are going, are choosing the route of a Medicare Advantage Plan.
Courtney Collen (Host):
All right. Number two, everyone pays the same amount for Medicare. Is that true?
Jack Arnett:
That is not true. Courtney. A lot of changes and a lot of different ways people could pay different amounts when it comes to their Medicare coverage. First of all when it comes to Medicare Part B, we just addressed Medicare Part A. Part B comes with a monthly premium and that premium in 2022 is $170.10. Last year, it was $144. So it went up sizably here in 2022 and every Medicare beneficiary in the country pays that Part B premium. And generally that will come out of their social security check. Now, that $170.10 premium will go up based on one's income, but for the vast majority of Medicare beneficiaries, they fall into that $170.10 range. Additionally, that, that supplemental coverage that a Medicare beneficiary chooses - be it a Medicare supplement plan or a Medicare Advantage Plan - those all come with premiums and deductibles and copays and cost shares. So definitely, Medicare is not free and definitely, not everybody pays the same amount.
Courtney Collen (Host):
What if somebody claims that they cannot keep their doctor or pharmacy when they move to a Medicare advantage plan? Is that true?
Jack Arnett:
It isn't it, I can't say it just blanket ‘It's not true’, it may be. But plan directories, provider directories is the true source of truth before enrolling into any Medicare Advantage Plan. An individual needs to seek out that, that provider directory and make sure their doctor, their specialist, their clinic, their hospital, is indeed part of that Medicare Advantage Plan. And if it's not, there are generally options where if they really find that Medicare Advantage Plan is advantageous to them, they may want to choose a different primary care physician or a different specialist. Or if that plan may offer out of network benefits as well. There's nothing more important to a Medicare beneficiary than their doctor. That's the way it is here. And I think most of us agree how important our, our primary care docs are to us. So we want people to make sure that that doctor, that person that's been with him probably for many, many years and, and helping them through all their healthcare needs are definitely part of that Medicare Advantage network.
Courtney Collen (Host):
And our last myth. Jack. Coverage is automatic.
Jack Arnett:
In one part, it is, but in most parts, it’s not. When someone turns age 65, they will be automatically enrolled into Medicare, you know, Part A, but they have to choose to enroll into Medicare Part B and why somebody wouldn't do that automatically when they turn 65, if they are continuing to work or their spouse is continuing to work and they have access to healthcare through that spouse or through their own, employer plan and then choosing some additional coverage, be it a Medicare supplement plan or a Medicare Advantage Plan, that does not happen automatically. The individual needs to research plans, get with a trusted advisor: somebody that is trained, certified, and licensed to help navigate all the options that they made, what they may choose. So, Courtney, no, coverage is not automatic when it comes to Medicare.
Courtney Collen (Host):
All right, Jack, thank you again for helping us sort through these common myths and misconceptions and for sharing your expert insights. If you'd like to learn 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_ 739-810-894PODCASTArticleMAMyths-PY2022-ND-SD_C, H3186_739-810-894PODCASTArticleMAMyths-PY2022-MN_C
Last Updated On: 6.01.22 at 10:30 AM
