Senior Advisors is a family-owned & operated agency with a focus on Medicare education & service. We don't just "talk the talk", we really focus on education with our workshops (30-40 per year) and online videos to help people understand the complexities of Medicare.
If you need help with setting up Medicare for the first time or you are just looking to save some money on your Medicare coverage, you should give us a call at our NJ Office- 908-272-1970 or Arizona Office- 602-935-8444
Something I've not heard anyone mention is that the Plan N copays are not indexed for inflation. The Medicare Part B premium is indexed for inflation. The part B annual deductible is indexed for inflation. The part A copay is indexed for inflation. The plan K & plan L max out of pocket amount is indexed for inflation. The plan N max copays of $20 & $50 isn't indexed for inflation. Years in the future the plan N copays will still be $20 & $50.
The comparison between Original Medicare vs Medicare Advantage is wonderful. It covered exactly what I needed to know to make an educated choice. Thank you so much.
Hello. I’m not sure I understand the question. If a doctor isn’t taking new patients, you would need to find another doctor that is taking new patients.
Excess charges are only charged by 2% of doctors in this country. Just ask if they accept Medicare assignment. If they don’t accept assignment, then Medicare allows 95% of the regular approved amount and the doctor can add on 15% of that amount. So if the approved amount was $100, they would allow $95 + 15%. Medicare would pay 80% of the $95 and your supplement plan would pay the difference up to $95. Then you would be responsible for the 15% of $95 which would be $14.25. There ARE situations where it could be a bit of money. If you have a specialist surgeon for your condition and his approved amount was $30,000 and he didn’t take assignment, then Medicare would allow him/her $28,500 and he could add on 15%. That would be $4275. But again, excess charges are a rare thing and not likely at all.
Yes we can certainly help you with your Medicare plans - you can give us a call today at 908-272-1970. My calendar tends to get booked out several weeks ; if you need something sooner , I have a stellar team of agents here that can assist - Rod, Bob, and Nick!
I start Medicare in my birth month of December 2024 along with a supplement and a Part D Plan. Will my Plan D rate change the first of the year or is it locked in for one year until December 2025 ?
Hello - Part D premiums are based on calendar year. So your Dec 2024 premium could very well differ from your 2025 Part D premiums. We will be happy to help you get setup for Dec 1 when you are ready. 908-272-1970
I sold an investment property and the capital gain made my MAGI increased in 2022. I received IRMMA letter in 2024. Now my income was lower in 2023 and 2024 too. My questions:) Can I file SSA 44 appeal form to adjust /lower my income tier (IRMMA effect) ? And When? What reason allows me to appeal for this capital gain as a non-reoccurring income now on the SSA 44 form?
Unfortunately this would not be a valid appeal reason. You can see the explanation of the appeal reasons on page 5 of the SSA-44 form: www.ssa.gov/forms/ssa-44.pdf
@@SeniorAdvisorsMedicare Thank you for the reply and explanation. Will this higher tier income premium for part B And D stay forever or just go on for 2 years ? Will Social security review my income every year and could adjust my premium ?
As always a clear and concise update of necessary financial needs related to the medical care for we seniors... Thank you continue the good work as I welcome more videos
FINALLY! We finally have a video on RU-vid from a person who is smart enough to know that Connecticut CAN charge excess charges, and that excess charges could be more common in the future! Bravo, sir.
Hello - if you give us a call , when can review your specific situation to get you the best premium/carrier options for Plan G and N based on your situation . Then we can try to help with your comparison :-) 866-751-2213
@@SeniorAdvisorsMedicare I know and I will. I am still a few months out. I turn 65 in December. I KNOW what I want to do, but the wild card is my rent. I feel like whatever I choose I will have to let go of in June 2025. It's a matter of good Healthcare or roof over my head. Difficult choice.
@@SeniorAdvisorsMedicare My rent in Ocean County NJ is 1700 a month My Sss is 1750 a month . I also pay 250 a month for my Medicare This July my rent will increase to 3000 a month in Ocean County NJ. I can not afford 16 dollars a year for AARP. I’ve call Senior Services on April 3, and continue to call them every week. I’m still waiting for a case worker .. So it’s very difficult time and impossible to have a nice day
Thank you for your feedback. This is a generalized and inaccurate comment. We work with thousands of seniors each year that are computer saavy enough to work with us over the phone / computer for their Medicare enrollment. According to AARP and Forbes about 80% are tech saavy --- www.forbes.com/sites/forbesbusinesscouncil/2021/09/10/how-tech-savvy-seniors-are-shaking-up-senior-living/?sh=580f7230389c
@@SeniorAdvisorsMedicare I’m 67 years old and I find the online system very difficult and confusing and I have called 3 times to get an appointment with a case worker in my country “ Ocean County “ and still have not received. a phone call back ,
@@SeniorAdvisorsMedicare It would be appropriate for you to ask me “how can I help you .? “. … Medicare can spend money on computers services. but not with helping senior ( me ) …
I agree with @robward155, I think it's important to discuss Biden's Inflation Reduction Act and how the out of pocket cap going forward is obviously being thwarted by these greedy insurance companies. This is a loop hole that needs to be closed!!!
Thank you for watching the video and providing your feedback. We have a different video which explains the Inflation Reduction Act. Inflation Reduction Act - Medicare Part D Impacts ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-DWE7tQSlw_w.html
Hello - thanks for your feedback. We would need the list of medications with dosage /frequency, to complete a part D analysis /recommendation. Generic drugs but fall into different tiers/costs, depending on drug. You can give us a call at 908-272-1970.
Good information, particularly about the prorating applied to HSA contributions when signing up for Medicare. No other Medicare video I've watched mentions this. Also, the backdating for Part A can get tricky. You have to plan ahead and stop HSA contributions well before enrolling in Medicare. If you get laid off, you can't plan ahead, so there's that complication.
Also - if you enroll in Medicare (or Social Security) after age 65, the government will back-date your Part A effective date by 6 months. This is explained in multiple scenarios in the second half of the video. This is something to plan for if you are contributing to an HSA , as explained in the scenarios.
One other question we get related to this... For people that have an HRA (Health Reimbursement Arrangement) and FSA (Flexible Spending Account), they do NOT have the same restrictions related to Medicare. There are no limitations for HRAs or FSAs related to Medicare enrollment.
Thank you! The best explanation video I’ve found (seen many). I retired 12/30/23, Pt B begins 02/01/24 and rec’d IRMAA increase letter. I went to drop off my SSA-44 at the local SS office today. The man said the life changing event had to happen during the year of the 2-year look back (tax yr 2022) and my form would be denied. I said that’s different than all my research and what my CFP told me so he said he could submit it but likely would be denied. I asked him to submit it. He was incorrect, right?
Thank you for the feedback. Yes, he was incorrect. The whole purpose of the form is to notify the government of new information that happened after the last tax year.
What if you are hit by 2 hurricanes declared national disasters and you take money out of your Ira to repair your home that insurance did not cover. Ie it caused income to go up and irmma to be incurred.
Hi Tanya- I am sorry to hear about your situation. I would recommend you bring all of your records to the Social Security office and see if there is any sort of exception that can be applied to reduce your IRMAA. If you are unsuccessful, you may also want to check with your Representatives to explain your station and see if they can assist with an exception to help reduce your IRMAAs.
Hello Dan - did you receive your letter from the government explaining your 2024 premium amounts? The figure in the letter should take effect in January.
@@SeniorAdvisorsMedicare No, never got a letter, but I think I’m enrolled in paperless communications. I’ll look on the gov website. Update: It turns out you have to go to SSA rather than Medicare to get this information. The reason I didn’t get the letter is that was sent to the wrong address, which I fixed. The SSA rep on the phone (only a 1-minute wait!) was helpful and professional.
What a Racket, my bp medication costs Less than the coverage I will be forced to buy to avoid penalities. My god you would hafto be a politician to think this is kosher.
@@SeniorAdvisorsMedicare Thanks, I'm not begging for things to be free but, to just make sense. My wife at 76 takes Nothing but I understand that I will need to sign her up to avoid penalities later if necessary, I expect to sign myself up just for my BP meds and then just pay cash as my scrip is only 35 dollars every 90 days. The system is a minefield and it seems the mines are undetectable until you encounter one.
I have earned a lot now. Thanks. What I am really interested in now is how does that affect the amounts that the insurance companies get from the Federal Government.
Thank you for watching and sharing your feedback. Here is an article that provides some info you requested: www.cms.gov/newsroom/fact-sheets/medicare-part-d-direct-and-indirect-remuneration-dir
Hi Donald - thank you for your feedback; although I don’t agree with your sentiment. Just want to make sure our viewers get accurate, non-partisan info. Trump actually led the way with the Senior Savings model capping covered insulin at $35/month on Medicare Part D. Biden extended the $35 /month cap on covered insulins in the Inflation Reduction Act, which also put a cap of $2,000 on Part D drug costs starting in 2025. So they both fought to reduce Rx costs for Seniors on Medicare. www.cms.gov/newsroom/press-releases/president-trump-announces-lower-out-pocket-insulin-costs-medicares-seniors
Thank you for doing this video explaining the way the 4 stages of part D work. I haven’t seen anyone else explain this so clearly. I’ve always been on tier 1 generics, so it’s never been an issue. But I will be starting a very expensive new drug and will be in stage 4 by March. The drug is not even in most formularies yet although FDA approved, so it is hard to use the Medicare plan finder tool to find the best plan for 2024. Otherwise, my current plan works the best for my other meds. Maybe the best option is to stick with the same plan since I will be in stage 4 regardless of the plan.
Hi Paul - thanks for watching and sharing your feedback. We recommend you confirm the new drug is covered on the Part D Plan. If so , you will likely reach the Catastrophic Phase after about $3,300-$3,500 of your spend on drugs. Then, you will be 100% covered the rest of the year. Best of luck with everything!
@@SeniorAdvisorsMedicare it was not covered, but it was added as a special add to my personal formulary. That’s why I may stick with my current plan for 2024. If I switch plans, it will have to be approved all over again and I don’t know how the other insurance companies are about approving these types of drugs. It’s all uncharted territory for me.
Hi John - there are numerous factors to consider when making this decision. In a short 15-20 minute call, we should be able to provide some general direction - you can give us a call at 909-272-1970
I found this really helpful. So much so that I’m going to print out the slides from the presentation. I am on an oral chemotherapy drug that costs $22,500 PER MONTH which means I will be in and out of the coverage and into catastrophic coverage in January, 2024. Five percent might sound like not very much but since July, 2023 I have been paying the 5% every month. Needless to say: the IRA is a god-send. Thanks for breaking it all down.
BILL BEEB I am about to start Medicare in Jan. I have been on full SSDI since Jan 2023. Can get a Medigap plan if I have Medi-cal with a share of cost (SOC) My share of cost is $1300.00 every month
If you have full benefits from Medi-Cal (California’s Medicaid Program), you do not need a Medigap policy. In fact, it is illegal for companies to sell you one. If you have Medi-Cal with share of cost (SOC), you can buy a Medigap policy to fill in the coverage gaps or to see medical providers that don’t accept Medi-Cal patients. You must apply for it, though, during a month before you meet your share of cost. More info below... cahealthadvocates.org/medigap/general-medigap-information/#:~:text=Medigap%20%26%20Medi%2DCal,-If%20you%20have&text=If%20you%20have%20Medi%2DCal,meet%20your%20share%20of%20cost.
This is really good info. I had heard some of these things before but hearing it from you in this video validates it. Now I can refer others to this video when the question about medicare advantage comes up, so that they have the facts. PS I have original medicare and a supplement through your brokerage and I'm glad I made that choice.
