There are many different Medicare plans available, including Advantage plans and
drug plans, and Part A and Part B.
There's a lot of different time periods involved when you need to enroll in some
of these.
A lot of people ask me, "Do Medigap plans include prescription drugs?"
Well, they don't.
And I'm going to explain why. And when you compare the two together, and how to
enroll.
Starting with the basics of Medicare.
And I'll go fast, promise you, I won't bore you to death.
But you've got various parts of Medicare.
This is sort of the hub of your coverage, the base of your Medicare
coverage.
That includes Part A and Part B Medicare.
Now, around that, you can enroll in a separat Part D drug plan, and a Medigap
Plan.
However, some people choose to opt out of Medicare Part A and B and enroll in a
Medicare Advantage Plan, and often those contain prescription coverage built in.
So that poses the question to people who want to keep A and B Medicare and a
Medigap Plan.
Probably because they don't want any network and they want to make sure that
bills are paid.
But that's a whole nother video which you can find about Medicare Advantage
plans.
They want to know well, do Medigap plans also include prescription drug coverage?
Well, they don't.
For years, there was what was called a Plan J.
And this goes way back when it did include prescription drug coverage.
That's the only time a Medigap Plan also included prescription Part D drug
coverage.
So, what do you do?
Well, you've got A and A.
A is hospitalization. B is your doctor services.
Those have gaps or expenses in them that a Medigap Plan comes in and pays.
Well, drug coverage is not a gap.
This is just for your medical.
You would have to enroll in a separate Part D drug plan.
Now, we can help with that.
Who am I, by the way?
Well, my name is Russell Noga. I'm the founder of Medisupps.com.
We're an online insurance agency for Medicare Supplement Insurance, licensed
in 47 states.
So wherever you're watching from, chances are we're in your state.
If it's one or the other three, don't worry, we can still help you.
Now, we specialize in finding people the best Medigap insurance in their states
for the lowest premiums now and for years to come, because you will get rate
increases on that.
No, they don't cover prescription drug coverage.
There are about 30 to, I'll say 50--it's hard to keep up with them all--different
drug plans available in your state.
And these are put out by private insurance companies, not Medicare.
Medicare oversees the process.
But these private insurance carriers offer these Medicare Part D drug plans.
And they all have different premiums, they all have what are called different
formularies.
Formularies are what they can get certain drugs for, what price, and even
what they even cover.
One company might carry a drug and the other one might not.
So, these companies are available in your state private insurance carriers
that are not combined with Medigap plans to offer these drug plans.
The exception to this in terms of if Medigap plans cover prescription drugs
plans.
And it wouldn't even fall under the Medigap Plan coverage, per se,
is the fact that if you get some drugs administered at the doctor's office, in
which case you're not filling a prescription, the doctor is
administering them.
Many of those are covered under Part B Medicare because it's happening.
The administration of the medication is actually happening at the doctor's
office.
And again, your Medigap Plan probably won't come in and cover it, although
we'll pay the 20% depending on which Plan letter you get that Medicare
doesn't pay.
So that would be the exception, not prescription that you go to the pharmacy
and get filled.
But something that is administered in the doctor's office, many of those drugs
are covered under Part D Medicare.
Now, how do you know which ones?
Well, talk to he or she who's staring you in the face at the office, because
they want to get paid too, and you could ask them, is this covered under Part B
Medicare?
They will know, or they can look it up.
In regards to a Part D drug plan, there are only certain times during the year
that you can change that.
Coming on to Medicare, there's only certain times that you can enroll in one
to start with.
So I'll start with that.
For anybody turning 65 or just coming on to Medicare, I'll start with the people
turning 65.
You are eligible for Medicare the first day of the month, you turn 65.
If your birthday is on the 15th, your Medicare started 15 days earlier, the
first day of the month, you turn 65.
Now, you have that month, as well as three months before and three months
after.
So seven months total to enroll, not just in Medicare, but also a Part D drug
plan.
So, you can do three months prior, that's fine.
But let's just say you're in that month, we you know, you only have three months
to enroll in that drug plan.
Otherwise, you have to wait until the annual election period each year to
enroll in the drug plan.
Now some people say, "Well, Russell, I don't take anything. Why should I enroll
in a drug plan?"
Well, you don't have to.
However, if you don't enroll during that time period, this is also of taking part
B Medicare.
So let's say you're not turning 65 and you're just--you're worth a couple extra
years and you're retiring.
Maybe you're 67, 69, you're coming on to Part B Medicare for the first time
because you delayed it, because you didn't want to have employer coverage
and Medicare and pay for both.
Then, you have three months after that to enroll in a Part D drug plan.
If you're tr yingto say, "Well, I want to save some money, and I'm going to
wait."
Just know you could do that, you don't have to get a Part D drug plan.
But just know if you're beyond that three months, you have to wait until
October 15 to enroll in a drug plan.
Then your coverage won't even begin until January 1 of the following year.
So that is called the Annual Election Period.
But that's also the period each year when you can change your drug plan.
So you may or may not be happy with your coverage.
Drug plan companies can change your formulary anytime during the year, which
means you literally could be covered for a drug and then they could change the
price or stop covering it, unfortunately.
I know, it's not fair, but that's the rules.
So, how does that apply to you?
Well, you know, next October, you need to look at your drug plan every year or
allow a company like us to help.
We don't sell them, but we help all of our clients get on the right one.
At that point, you can change your drug plan October 15 through December 7, and
the new coverage will go into effect January 1 of the following year.
But on that note, if you've got a Medigap Plan, that could be changed
anytime during the year.
You do not have to wait until that annual election period in October.
Let's say you get a rate increase, which is why we get a lot of phone calls.
People say, "My rate went up 30 bucks a month. What do you got?"
Well, we can do that anytime during the year.
So if you're watching this, regardless of what month it is, call us, we can
shop your rate.
The drug plan, however, has to be changed during that time of year.
So that about wraps it up; the times you can enroll in the drug plan when you
first come on Medicare, as well as when you can change your drug plan.
Do Medigap plans include prescription drug coverage?
Unfortunately, not.
However, the only way we can deal with this is to match you up with the perfect
Medigap plan, as well as help you out with that drug plan to get you the best
coverage to fit your needs.
You are different than your neighbor. You're different than your sister, or
brother, or friend.
So whatever drug drugs they take, they'll match it up against the drug
plan specifically based on what they're taking.
So you never want to just take somebody's recommendation of drug plan
out of thin air.
It could be entirely different for you.
And you could end up overpaying quite a bit.
To get help on all of this or to ask any questions away.
That's what we're here for. Our services free.
Just give us a call. You could talk to myself, or one of my top agents at
1-888-891-0229.
We are here to help you to get you with the best coverage now, and for years to
come.
Again, my name is Russell Noga with edisupps.com.
Thank you for watching, and I look forward to speaking with you soon.