the five dumbest medicare rules i'm gonna go through all five right now so that you can
understand some of the things that you might come across in medicare that's really pretty dumb so
number five on the list is medicare excess charges and if you don't know what excess charges are
you absolutely want to understand this there's two ways that medicare contracts with doctors one
is medicare assignment and the other one is just medicare so if a doctor takes medicare assignment
it means that they agree to take what medicare pays them in full if the doctor does not take
assignment then they have the ability to bill you an excess charge which can be up to 15 percent
more than what medicare pays them so the good news here most doctors do take assignment but
certainly not all and most medicare supplement plans cover medicare excess charges but not all
so you want to understand that and make sure that you know what that's about and that's what
we do if you're new here i'm keith arnbrecht founder of medicare on video and i help people
across the country make the right medicare choices and i can absolutely help you as well
if you stay to the end of the video i'll show you how to download my book medicare made clear
free and something you can keep on your ipad or keep on your computer it's a great resource
for now in the future number four on the list of medicare dumb rules is knowing how many employees
your employer has so medicare is separated two ways when it comes to where you work
whether you work for somebody with more than 20 employees or whether you work for somebody with
less than 20 employees and for those that work for a company that has hundreds or thousands
of employees no big deal but if you work for a company that's 10 or 15 or 20 or 30 how are you
supposed to know how many employees and how your employer categorizes employees to count towards
medicare's requirements so it's important to understand that as well if you work for
a smaller company make sure if you're turning 65 give me a call send me an email we will make sure
that we figure that out ahead of time and that's a question i have right now do you currently work
for a company that is in that gray area say less than 50 employees where you don't really know
if you do comment below let me know so that way we can kind of figure things out from a percentage
standpoint how many people work for a small company how many people work for a big company
so that leads us right into dumb rule number three how medicare treats people
with an employer of less than 20 people so the way it works is if you work for a company that
has 20 of your employees and you turn 65 medicare is your primary insurance
if you work for a company larger than that and you turn 65 and you're going to stay at work
then your company plan is your primary insurance and there's a big difference there so especially
with a smaller company so what generally will happen is if you're going to work past age 65
which a lot of people do these days and you're going to stay on your company plan you're not
going to come into medicare sometimes you might have a spouse that is less than 65
that's not eligible for medicare and has to stay on your plan in order for them to stay on your
plan you have to stay on your plan as well if you work for a company less than 20 what's going to
happen you're going to start your medicare part a and part b and it's going to be primary to you
and then likely use your employer coverage as secondary coverage to cover what a and b do not
the problem with that is when it is then time to retire and truly come into medicare your
part b has already started so they're gonna in essence penalize you for doing what you were
supposed to do by the rules and i've had this happen before where when you come in since your
part b has started you have lost your freedom of choice of medicare supplement plan so you
have a limited choice of what is considered guaranteed issue so again it's a little
complicated but it's a dumb rule and make sure just give me a call send me an email let me know
what the scenario is and we'll make sure we walk you right through one of the great thing is
there's no cost to let me help you so hopefully you will allow me to help you
we'll make sure we get all your pieces in the right places medicare dumb rule number two
observation versus inpatient this is one that i guarantee you nobody understands and it makes
very little difference so medicare typically does not pay for a skilled nursing facility
so it doesn't cover long-term care however if you're in the hospital and then you're released
to a skilled nursing facility for rehab in other words you're going to get better and then go home
generally medicare is going to pay for but what they don't tell you
is that they only pay for skilled nursing in that scenario if you were impatient in the
hospital for three or more days so where this comes into play and i've had it happen before
is somebody's in the hospital i had a woman whose mother broke her arm and was in the hospital for
three days and then they released her to a skilled nursing facility for rehab however the hospital
admitted her as observation not as inpatient and because it was observation it did not count
towards medicare's coverage of skilled nursing facility so she had to pay somewhere around three
hundred dollars per day for however long her mother needed in that skilled nursing facility
because she was in the hospital under observation even though she was there for three days
instead of inpatient so i don't know that you can really control how they're going to admit you but
it's certainly important to understand so ask that question am i being admitted as observation
or am i being admitted for inpatient and if you've had this happen to you let me know
please comment below if you've had a scenario like this let me know because that's how we learn how
to help other people figure things out okay the number one dumbest medicare rule is not counting
retiree coverage or cobra coverage as creditable coverage and it's creditable coverage not credible
it's it's a confusing term but it means credit so will they give you credit for having coverage
in your health plan coming into medicare so if you're working past 65 or if you're coming into
medicare after age 65 generally if you stay at work you'll stay on your group health insurance
and then when you retire at age 70 75 whatever it may be you come off your group health insurance
you come into medicare it's just like you're turning 65 but there are certain scenarios where
people retire and the company says we'll pay for cobra coverage for six months on us thank
you for working for us the problem with that is if you take that cobra coverage then when
you come into medicare you're gonna be penalized you're gonna be penalized on your medicare part b
premium because they look at it as if you waited six months before starting medicare
when you should have started six months ago when in all reality of course you want free health
insurance from your employer same thing with retiree coverage even though it's real insurance
and you know some people stay on their retiree coverage the rest of their life
and never come into medicare but some stay on for a period of time and then come into medicare
and you're going to face a penalty it's going to be on your part b premium also on your part d
premium where it's going to cost you more than what it would have if you'd come in
under normal circumstances i've also seen it where an employer has retiree coverage and the group is
on that retiree coverage for 10 years then all of a sudden that employer either disappears goes away
doesn't know you another union contract and gets rid of that retiree coverage and then everybody
has to come into medicare and guess what penalties on part b and part d so again these are some of
the dumbest rules that medicare has that really don't make a lot of sense in the real world but
that's what we do we help figure it all out make sure you get in the right place i'm going to give
you a minute to take a look at how to download my book make sure you do that because it's free
and then give me a call send me an email when you're ready to come into medicare we'll make
sure we get all your pieces in the right places hope you found this helpful stay tuned to download
my book thank you for taking the time to watch my video hope you found it helpful something you will
absolutely find helpful if you're coming into medicare or even if you're already in medicare
is download a copy of my book medicare made clear i've spent a lot of time and a lot of effort on
this book and i give it away for free you'll find that i covered just about every piece of medicare
in this book and it's easy to read and easy to understand i've also put videos throughout the
book where i explain everything to you so if you don't want to read through all the information
just watch the videos and i'll walk you right through everything you need to know about medicare
you also find all the links and the guides that you need now either to sign up or in the future
for things that come along so take just a minute visit medicareonvideo.com forward slash free book
you can download it right now and it's yours to keep i hope you find it helpful have a great day
hey don't go anywhere these are some of my most recent videos right here you can also find the
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