Upbeat music plays. Text appears beside an illustrated bubble labeled "Medicare basics"
ONSCREEN TEXT: Medicare Conversations
Text appears beside an illustrated card labeled "Medicare"
ONSCREEN TEXT: Medicare basics
Karol appears sitting in a chair.
ONSCREEN TEXT: Karol Carstensen Medicare Made Clear
Hi, my name is Carol Carstensen.
NARRATOR: I'm part of the Medicare Made Clear team. And I know from trying to learn about it myself, just how much there is to know about Medicare. It can be kind of overwhelming at times, even if you've been at it for years.
Medicare card and notepad appear.
NARRATOR: So today, I'm gonna go over the basics of Medicare
because a strong foundation in the basics is gonna help you understand your choices
Karol appears again.
NARRATOR: and make better Medicare decisions for yourself.
Text appears beside a question mark icon.
ONSCREEN TEXT: What are we discussing today?
NARRATOR: We'll start at the beginning
and talk a little bit about
Karol appears again.
NARRATOR: what Medicare is and who can get it.
A bed icon appears labeled "Part A", a stethoscope icon appears labeled "Part B", a hospital bed and stethoscope icon appear labeled "Part C", and a pill bottle icon appears labeled "Part D". A hand holding a Medicare card also appears.
NARRATOR: Then, we'll talk about the parts of Medicare, what they cover, what they cost,
The icons leave the screen and the hand holding the Medicare card is left Labeled "My coverage".
NARRATOR: and then we'll go into how to put those parts together to come up with coverage that works for you.
Karol appears again.
NARRATOR: So, let's get started.
A Medicare card appears beside text.
ONSCREEN TEXT: What is Medicare?
NARRATOR: Medicare is a federal health insurance program
A cake icon appears next to a wheelchair icon.
ONSCREEN TEXT: 65+ OR 18+
NARRATOR: for people 65 and older and others who have qualifying disabilities.
The cake and wheelchair icon move to the left and a united states icon and a document icon appear.
ONSCREEN TEXT: 65+ OR 18+ Citizen Or Legal Resident
NARRATOR: You also need to be a United States citizen or a legal resident.
A blue screen appears with a dotted timeline. The last dot being a document icon labeled "Legal Resident".
ONSCREEN TEXT: at least 5 years
NARRATOR: If you're a legal resident, you need to have lived in this country for at least five years in a row, including the five years just
before you enroll in Medicare.
Karol appears again.
NARRATOR: Another important thing about Medicare is its individual insurance.
A note pad appears beside text. The note pad has three checked marks labeled "Qualify", "Enroll", and "Choose coverage".
ONSCREEN TEXT: Each person must:
NARRATOR: Meaning every individual person needs to qualify for it
themselves, enroll in it and choose coverage for themselves.
Karol appears again.
NARRATOR: This can be different from what you're used to if you've had a family health plan through an employer, for example.
A bed icon, stethoscope icon, bed and stethoscope icon, and pill bottle icon appear beside text.
ONSCREEN TEXT: What are the parts of Medicare?
NARRATOR: Government-sponsored Medicare is made up of two parts,
Bed icon appears labeled "Part A" and stethoscope icon appears labeled "Part B".
ONSCREEN TEXT: Part A and Part B. Each part covers certain health care services.
Above the icons appears text.
ONSCREEN TEXT: Original Medicare.
NARRATOR: The two together are often called Original Medicare or sometimes traditional Medicare.
A hospital bed and stethoscope icon appear labeled "Part C", a pill bottle icon appears labeled "Part D", and an umbrella icon appears labeled Medicare Supplement insurance.
NARRATOR: There's also a Part C and a Part D, and Medicare supplement insurance. And we'll get to those in a little bit.
Hospital bed icon appears labeled "Part A".
NARRATOR: So, let's start with Part A.
ONSCREEN TEXT: Hospital Insurance
NARRATOR: Part A is hospital insurance. It covers inpatient care
when you're in the hospital or a skilled nursing facility.
Hospital icon labeled "Part A" moves to the left of the screen and a note pad appears on the right. The note pad has five check marks labeled "Rooms", "Meals", "Nursing services", "Equipment", and "Operating room".
NARRATOR: It covers your room, your meals, your nursing services when
you're in the hospital, any equipment or supplies that are used in your care, operating room, whatever the needs are that you have while you're in the hospital
Karol appears again.
NARRATOR: or in a skilled nursing facility.
Stethoscope icon labeled "Part B" appears.
ONSCREEN TEXT: Medical Insurance
NARRATOR: Medicare Part B is medical insurance. It covers your doctor visits or your doctor services, even when you're in the hospital.
Stethoscope icon labeled "Part B" moves to the left of the screen and a note pad appears to the right. The note pad has 7 check marks labeled "Doctors visits & services", "Out-patient care", "Clinic visits", "Emergency room", "Ambulance", "Preventive care", and "Medical devices".
NARRATOR: Other things covered by Part B include care when you're in an outpatient facility like the clinic or the emergency room, for example,
ambulance services if you need to go to the emergency room, preventive care services like flu shots, medical devices that you might use at home,
such as a wheelchair.
Three gold coins appear beside text.
ONSCREEN TEXT: What do I pay for Medicare?
NARRATOR: Original Medicare, again, has Part A and Part B,
Karol appears again.
NARRATOR: and it does come with some costs. Those costs can include
A dollar sign icon appears labeled "Premium", a dollar bill icon appears with a dollar sign on it labeled "Deductible", and a pie chart icon appears labeled "Copay or coinsurance".
NARRATOR: premiums, deductibles, copays, and coinsurance.
Hospital bed icon appears labeled "Part A". Beside the icon is a check mark labeled "Premium", and three gold coins.
NARRATOR: Now, let's start with Part A. Part A, in fact, is premium free for most people.
ONSCREEN TEXT: Premium-free after ten years of work
NARRATOR: If you've worked and pay taxes or your spouse has for at least 10 years, then you get Part A premium free,
Karol appears again.
NARRATOR: otherwise, you would have to pay a premium.
Hospital bed icon appears labeled "Part A". Beside the icon are four check marks labeled "Premium", "Deductible", "Copay", and "Coinsurance". There are also three gold coins.
NARRATOR: Other costs for Part A include a deductible and some copays and coinsurance.
ONSCREEN TEXT: You only pay while using Part A services
NARRATOR: But importantly, you only pay for Part A when you're actually
receiving Part A services,
Karol appears again.
NARRATOR: such as when you go in the hospital.
Stethoscope icon appears labeled "Part B". Beside the icon is a check mark labeled "Premium", and three gold coins.
NARRATOR: So, Medicare Part B does come with a premium.
ONSCREEN TEXT: Premium deducted from Social Security
NARRATOR: And that will be deducted out of your Social Security check
if you receive Social Security.
Karol appears again.
NARRATOR: Otherwise, you'll need to pay it directly to Medicare.
Stethoscope icon appears labeled "Part B". Beside the icon are four check marks labeled "Premium", "Copay", "Deductible", and "Coinsurance". There are also three gold coins.
NARRATOR: Other costs with Part B include some copays, a deductible
and some coinsurance.
A pie chart appears labeled "You pay 25%".
ONSCREEN TEXT: Coinsurance
NARRATOR: For most services, you pay 20% coinsurance, and that means you pay 20% of the Medicare-approved amount
ONSCREEN TEXT: Medicare pays 80%
NARRATOR: for that service and Medicare pays 80%.
Karol appears again.
NARRATOR: So, we've talked about Original Medicare Part A and Part B, what they cover and what they cost,
Hospital bed icon labeled "Part A" and stethoscope icon labeled "Part B" appear next to four squares. The squares include a pill bottle labeled "Prescription drugs", a toothbrush labeled "Dental", eyeglasses labeled "Vision", and an ear labeled "Hearing".
NARRATOR: but they don't cover everything. Neither Part A nor Part B
covers prescription drugs, for example, dental, or vision, or hearing care.
Hospital bed and stethoscope icon labeled "Part C" and pill bottle icon labeled "Part D" appear next to four squares. The squares include a pill bottle labeled "Prescription drugs", a toothbrush labeled "Dental", eyeglasses labeled "Vision", and an ear labeled "Hearing".
NARRATOR: This is where Part C, Part D and Medicare supplement insurance come in. They offer you more coverage options.
Hospital bed and stethoscope icon labeled "Part C", pill bottle icon labeled "Part D", and umbrella icon labeled "Medigap" appear beside text.
ONSCREEN TEXT: What are these additional options?
NARRATOR: Let's start with Part C.
Hospital bed and stethoscope icon labeled "Part C" appear next to an equal sign and text.
ONSCREEN TEXT: Medicare Advantage
NARRATOR: Part C is Medicare Advantage.
Text slides over and document appears labeled "Plan 1" with text below saying, "Offered by private insurance companies".
Medicare Advantage plans are offered by private insurance companies.
ONSCREEN TEXT: Medicare Advantage
Hospital bed icon labeled "Part A" and stethoscope icon labeled "Part B" appear.
NARRATOR: They cover everything that Original Medicare covers, all of your Part A benefits and Part B benefits.
Hospital bed icon labeled "Part A" and stethoscope icon labeled "Part B" appear next to four squares. The squares include a pill bottle labeled "Prescription drugs", a toothbrush labeled "Dental", eyeglasses labeled "Vision", and an ear labeled "Hearing".
NARRATOR: In addition, most plans will include prescription drug coverage and additional benefits like dental and vision coverage.
ONSCREEN TEXT: Medicare Advantage
Hospital bed and stethoscope icon appears labeled "Part C". On the other side of the screen, it says "$0 premium" with three gold coins.
NARRATOR: The costs for a Medicare Advantage plan might include a premium or it might not. There are some plans that have $0 premiums.
Hospital bed and stethoscope icon appears labeled "Part C". Beside the icon are four check marks labeled "Copay", "Coinsurance", and "Out-of-pocket limit". There are also three gold coins.
NARRATOR: Other costs would include copays for services you receive and sometimes the coinsurance.
NARRATOR: Another important thing to know about Medicare Advantage plans
is that they are required by Medicare to set an annual out-of-pocket limit.
ONSCREEN TEXT: Out-of-pocket limit
A timeline from Jan 1 to Dec31 appears. The first part has three-dollar signs, and the next part is labeled "Plan Coverage".
NARRATOR: This out-of-pocket limit is like built-in financial protection, because if you reach that limit, the plan would pay all of your costs for the rest of that year.
ONSCREEN TEXT: There may be many plans offered and coverage may vary
NARRATOR: There may be many Medicare Advantage plans offered in a region, or a state, or a county,
Karol appears again.
NARRATOR: and each one will have its own coverage and cost terms.
Pill bottle appears beside text.
ONSCREEN TEXT: How are prescription drugs covered.
NARRATOR: Now, let's talk about Medicare Part D.
Pill bottle icon labeled "Part D" appears next to an equal sign and text.
ONSCREEN TEXT: Prescription drug coverage
NARRATOR: Medicare Part D is prescription drug coverage.
Text slides over and two lines appear pointing to a hospital bed and stethoscope icon labeled "Medicare Advantage plan" and a pill bottle labeled "Stand-alone Part D plan".
NARRATOR: You can get prescription drug coverage in two ways, either through in the Medicare Advantage plan, like we just talked about, or through a stand-alone Part D plan.
Karol appears again.
NARRATOR: You can always remember prescription drug plans and Part D by thinking D is for drugs.
A circle with many types of pills appears. Then moves to the side and a list appears labeled "Rx" with a $.
ONSCREEN TEXT: Part D coverage
NARRATOR: Medicare requires that Part D plans cover all the types or classes of drugs that are normally used by Medicare beneficiaries. Every plan has a formulary or a list of covered drugs. So, when you're choosing a Medicare Part D plan, it's really important to look at those formularies and make sure that the drugs that you take are on those lists.
Three documents appear. One labeled "Plan 1" with $, one labeled "Plan 2" with $$, and one labeled "Plan 3" with $$$.
NARRATOR: Costs for a Medicare Part D plan vary from plan to plan.
Plan 2 appears to the side and two check marks appear labeled "Premium" and "Copay". There are also three gold coins.
NARRATOR: But it usually includes a premium, and you'll probably pay a copay when you fill a prescription.
Karol appears again.
NARRATOR: What you pay in copays, again, depends on the plan and also the formulary. Every plan places certain drugs on what they call tiers,
Three lines appear labeled "Tier 3", "Tier 2", and "Tier 1" and a pill moves beside each tier.
NARRATOR: or levels, of a formulary and the level determines what you pay at the pharmacy counter. Usually, the higher the level
or tier, the more you'll pay.
Karol appears again.
NARRATOR: Costs for Medicare Part D will vary from plan to plan,
Many location bubbles appear with a pill bottle in them.
ONSCREEN TEXT: Pharmacy network Out of network
NARRATOR: but most plans have a pharmacy network. And if you fill your
prescriptions within that network, you're going to get the best price for that prescription.
A check mark appears beside text.
ONSCREEN TEXT: Can I get additional coverage?
NARRATOR: Medicare supplement insurance
is also called Medigap,
Umbrella icon labeled "Medicare supplement insurance" appear next to an equal sign and text.
ONSCREEN TEXT: Medigap
NARRATOR: and it's just what it sounds like.
Karol appears again.
NARRATOR: It supplements Medicare.
A wallet appears with a gold coin sticking out is above text.
ONSCREEN TEXT: Out-of-pocket health costs
Medicare supplement plans help pay some of the out-of-pocket costs
Karol appears again.
NARRATOR: that come with the Original Medicare Part A and Part B.
Ten documents appear each labeled "Plan" then the letter A, B, C, D, F, G, K, L, M, or N. Below the documents is text.
ONSCREEN TEXT: Medicare supplement insurance plans
NARRATOR: Medicare supplement plans are standardized, they're labeled from A through N.
Karol appears again.
NARRATOR: There's 10 different plans with
varying levels of coverage. So, each Medicare supplement plan that has the same letter offers exactly the same coverage. However, plans may differ in what they charge.
United States appear with two documents each labeled "Plan 2", but each having different amounts of dollar signs.
NARRATOR: So, a Plan G, for example, in one state may be a different price from Plan G in another state.
A hearing icon and a toothbrush icon appear beside text.
ONSCREEN TEXT: Do Medicare supplement insurance plans cover other services?
NARRATOR: The main purpose of a Medicare supplement plan is to cover the costs that come with Original Medicare Part A and Part B.
Karol appears again.
NARRATOR: However, some Medicare supplement plan providers
A note pad appears with text on it.
ONSCREEN TEXT: Medigap insurers may make value-added services available either free or on a discounted basis. These services may come from the insurer or other companies.
NARRATOR: do offer additional programs that can provide discounted
services for dental, or hearing, or other health care services.
Hospital bed, hospital bed and stethoscope, stethoscope, umbrella, and pill bottle icons appear beside text.
ONSCREEN TEXT: How do these all work together?
NARRATOR: Medicare parts and plans
Karol appears again.
NARRATOR: can work together in different combinations to offer you the coverage you need. It really comes down to two scenarios.
A bed icon appears labeled "Part A", a stethoscope icon appears labeled "Part B" below text. A plus sign with a pill bottle labeled "Part D" appears and a plus sign with an umbrella labeled "Medicare Supplement" appears.
ONSCREEN TEXT: Original Medicare
NARRATOR: You can keep Original Medicare Part A and Part B and decide to add prescription drug coverage and/or a Medicare supplement plan
ONSCREEN TEXT: Medicare Advantage plan
NARRATOR: Or you can choose a Medicare Advantage plan instead,
Hospital bed, pill bottle, toothbrush, ear, eye, stethoscope icons all appear around text.
ONSCREEN TEXT: Medicare Advantage plan
NARRATOR: which encompasses all of the coverage in one plan.
Document appears labeled "Plan 1".
ONSCREEN TEXT: Which plan is right for me?
NARRATOR: People often ask, how do I know what's right for me?
Karol appears again.
NARRATOR: What Medicare plan should I choose?
Hospital bed and stethoscope icons appear beside "Original Medicare" on top. In the middle is "Original Medicare" + pill bottle icon "Part D" + umbrella icon "Medigap". On the bottom is stethoscope/hospital bed icon "Medicare Advantage plan".
NARRATOR: Well, that choice is personal because your health needs are personal and each person needs to make a decision for themselves.
Karol appears again.
NARRATOR: There are a few things to think about as you look at Medicare plans and coverage in general.
Text appears next to a note pad with check marks labeled "Dental" and "Vision"
ONSCREEN TEXT: Medicare Advantage
NARRATOR: One, would you like to have additional benefits like dental or vision? If so, then a Medicare Advantage plan
Karol appears again.
NARRATOR: might be a better choice because they offer these options whereas Original Medicare doesn't.
Piggy bank appears labeled "Premium" with a line connecting to a wallet with a gold coin sticking out labeled "Copay".
NARRATOR: Two, would you prefer to have lower monthly premiums and pay as you go, so to speak, when you go to the doctor with the copays. Or would you prefer to have higher premiums and fewer copays or out-of-pocket expenses?
Karol appears again.
NARRATOR: Number three, do you have specific doctors
A note pad appears with a location icon labeled "Specific providers" and a plane icon labeled "Travel frequently".
NARRATOR: or providers you'd like to see, or do you travel frequently? If you do, Original Medicare might be a good choice for you
A plane goes across the screen.
NARRATOR: because every provider in the United States is covered.
ONSCREEN TEXT: Medicare Advantage plans
NARRATOR: Medicare Advantage plans often have a provider network
Many doctor icons and pill bottle appear all connected by lines.
NARRATOR: and you need to choose providers from within the network to get the plan's best prices.
Light bulb icon appears next to text.
ONSCREEN TEXT: So, what is the takeaway?
NARRATOR: So, there you have it, that's the basics of Medicare.
Karol appears again.
NARRATOR: And if there's just one thing that you take away from today, I hope it's this: you get to choose. You get to choose Medicare coverage that fits your health needs, your budget and your lifestyle.
ONSCREEN TEXT: Visit MedicareMadeClear.com
NARRATOR: If you need more information about Medicare basics or other Medicare topics, please visit us at MedicarMadeClear.com,
Karol appears again.
NARRATOR: and follow us on Facebook for answers to your Medicare questions and regular updates on Medicare topics. Thanks so much for listening.
(upbeat music)
ONSCREEN TEXT: Medicare Made Clear brought to you by UnitedHealthcare
UnitedHealthcare logo appears.
©2024 United HealthCare Services, Inc. All rights reserved. Medicare Made Clear® by UnitedHealthcare®
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