How does a jet engine propel an airplane o? the ground? Or how does nano technology work? Unless you’re an expert in such matters, I don’t know and you don’t know. Heck, I can’t even figure out how to run my thermostat.
Here’s another thing to add to the list of ba?ers: Medicare. There are as many rules with Medicare as there are people in government making them. And, because the government likes changes, the rules are constantly, and often drastically, shifting.
After what I estimate is around 25,000 hours of my own life spent talking to my clients, running a healthcare agency, attending conferences and retraining each year, I like to think I am expert in Medicare. But still, just about every day something ba?es me and I need to go to other experts I that know to put our collective minds together.
Medicare is complex. And if there is one thing I have learned from talking to thousands of Medicare clients over the years, is that if you are confused about Medicare, your part of a very big club. The club includes doctors, lawyers, professors. Smart people who just don’t understand Medicare.
That said, I have also gotten pretty good at explaining Medicare. So, let’s go over the basics. Medicare has four parts, each with a letter. These four parts to Medicare are named with the word, “Parts”: Part A, Part B, Part C and Part D.
You get your Medicare card from the government, from the Center for Medicare Services, CMS. There is only one place to get it, from CMS. Amazon Prime does not o?er Medicare cards, at least not yet. We will discuss how to get your Medicare card in the next video.
Your Medicare card gives you both Part A and Part B. Part A is essentially hospital coverage but also includes a few other things such as skilled nursing care. Part B covers essentially everything medical that doesn’t take place in the hospital, including doctor appointments, labs, x-rays and other tests. Part B also covers outpatient drugs such as chemotherapy drugs or even Botox.
Part C is another name for Medicare Advantage. We will discuss that subject in a minute.
Part D is your prescription drugs.
When you get your red, white and blue Medicare card you have completed step one. It’s like going to the airport though. The airport is not your ?nal destination. You still have to get onto a plane.
There are two types of Medicare: The first type is Original Medicare, sometimes called Traditional Medicare. And the second type is Medicare Advantage, sometimes called Part C. Once you get your Medicare card you come to a fork in the road where you pick one or the other. You cannot choose both, any more than you can board two airplanes.
With Medicare Advantage, CMS pays a private insurance company such as United, Aetna or Humana to take over and manage all your medical needs. There are usually both HMOs and PPOs to choose from. Most plans include your drug coverage and often other bene?ts as well such as some dental coverage, thus making Medicare Advantage all inclusive. In essence, Part C is all you need.
With Original Medicare, Medicare itself stays in charge of your medical needs. Medicare pays the first 80%. The other 20% Medicare does not pay for under Original Medicare could cost someone an unlimited amount, maybe hundreds of thousands of dollars with bad luck. Because of this, people almost always get a Medigap supplement, most commonly Plan G, that covers the other 20% of costs, after a deductible that is set by the government each year. In 2026 it was $283. With Original Medicare, you will also need a stand-alone drug plan to cover your Part D.
I often describe Medicare Advantage as being like the Full-Meal-Deal at fast food restaurants> Medicare Advantage includes everything needed medically within one plan. Whereas Original Medicare is alla carte usually needing 2 or even 3 extra plan enrollments.
Which is the better choice? That depends on your own views. Medicare Advantage will often provide better cost value. Original Medicare will generally give you more freedom and ?exibility especially with your doctor choices. A question I often ask clients is, “Which is most important to you? Value or flexibility?”
We will discuss this further in the video on comparing the two.
It is vital, however. to know, that in the ?rst 6 months after you join Medicare with Part B, there is no underwriting to sign up for a Medigap supplement. No matter what your medical conditions are, carriers must issue any supplement to you charging you the normal premiums, and with no medical questions. Once those 6 months are up, in most circumstances you will have underwriting to pass to get a Medigap supplement. This being the case, you may never be able to change to Original Medicare in the future if you cannot pass underwriting. This is an important matter, for the future with your medical treatment options, to consider carefully.
