Видео

Great!

Very good question. There are two things to look for: 1.) If it has a $0 deductible or a deductible only on certain drug tiers 2.) If you see the drug copays go to $0 after a certain amount of months and the total drug copays end up being less than $2,000

Thanks. That's the tough thing about some of our tutorial videos about SSA.gov and Medicare.gov...the websites are always changing.

That's definitely frustrating. Consider not using the authenticator apps, as they just complicate the process even more. You might need to contact login.gov or SSA for assistance with logging in.

Wonderful to hear this!

If the drug is on your plan's formulary, then you can confirm the pricing on Medicare.gov. If it's just a generic, then it's likely covered fine. But if it's a brand name drug, you can verify whether it's covered on your plan's formulary and get the pricing. If it's not covered at all, then ask your doctor for an alternative until you can find one that is covered. Additionally, you can ask your plan to provide a a "formulary exception" to see if they will cover the non-covered drug. But they don't have to allow this.

Sure, but make a copy before you do that. They commonly lose stuff mailed to them. Also, you don't need an appointment anyway to turn in these forms. Preferably, just walk-in and then when you're called up to the window you can give the forms to a human. They usually will process it right there for you. Every office is different, though.

My husband and Mom have been very happy with WellCare.

I have Wellcare for 2024 and have had no problems. For 2025 I will be changing only because I was recently prescribed a drug that is making them not the best plan for me for the new year. Other than that I woud stay with Wellcare.

Really any video editing software gives you the ability to hide/remove certain things from a video. It's just an editing option. :)

@@MedicareMindset does zoom have that option? I find it better than loom for my audio

@@victoriaho5170 Not sure, sorry.

Thanks. Other than "Do you want to apply for Medicare Part B?", I don't believe there are any sub-questions for that one. But there may be. I don't think it's anything too involved. Yes, similar questions. Yes, the application question actually mentions that stepchildren should be included.

If you don't see it in his account, he can go with one of the other options mentioned in the video.

Great to hear! Yes, we have a much newer video titled, "Enroll in Social Security & Medicare at the Same Time" here: ruclips.net/video/7luWHFVPq9s/видео.html | This would be for someone enrolling in Social Security and Part A only...or...Social Security and also Part B.

@@MedicareMindset great thank you!!!

Thanks! Yep, same rule is in place. Your spouse will need to setup a phone or in-person appointment to enroll through your work record...to get premium-free Part A. And you will need to be at least age 62 for your spouse to be able to do this.

Wait until tomorrow (10/15) and the ENROLL button will show up when you're viewing the plans.

Yes, she can still be on your health plan. Her having Part A does not impact her ability to be on your plan as a dependent. I assume your employer has 100+ employees? If not, then she needs Part B as A&B would be primary if the employee count is under 100. If you own the HSA, then your wife having Part A does NOT impact your ability to contribute to the family HSA max.

@MedicareMindset and she can use the hsa too? Thank you

Yes 100+ employees

@@Snaps_Provolone Yes

@@Snaps_Provolone Very good. She won't need Part B then.

If there is no deductible in the plan, correct...you start in the Initial Coverage phase. But if a drug is NOT on the plan's formulary list of drugs, having LIS Extra Help will NOT actually help you. The drug needs to be on the plan's formulary for the plan to provide any benefits or LIS to kick in.

@@MedicareMindset Thank you so much for your quick reply and expertise on the knowledge.

@@chocolatebutterfly9295 You're very welcome.

Glad you were able to find a plan that works well for you.

What state?

Sounds the same as me. I have an Aetna Silverscript plan in 2024 for $13/month which has been eliminated for 2025 and replaced by the next stepped up plan at Silverscript for $48/month. And the price of my 2 generic drugs will cost more. Amazing. However Wellcare Value Script is much cheaper. State is Florida.

@@mariaw593 Sounds like what I found in Ohio. Wellcare 0 premium 0 for 3 tier 1 scripts

Yes, you need to wait until 10/15 to submit the application (no later than 12/7). The new Part D plan will start 1/1/25 and automatically cancel the existing Part D plan.

Very glad to hear this!!

Yep, the employer who provides the health insurance currently (or provided in the last 8 months).

@@MedicareMindsetokay thanks

More than likely, there is a lower premium plan in 2025 you can switch to that covers your meds. Switch between 10/15-12/7.

Yeah, that's a common theme for many going into 2025. But not all Part D plans are increasing. Interestingly, some are actually decreasing in premium. Regardless, you'll be able to find an alternative Part D plan during AEP that likely has a low premium and still covers your medications well.

I will transfer most of my generic drugs to the VA Pharmacy plan as they are supplied to me at no cost. The one level 4 drug I take, I will continue to order from an overseas pharmacy at a substantial discount.

You will file the appeal after Part B is approved and after you get the IRMAA determination notice from Medicare.

If you haven't signed up for Part B (medical) or Part D (drug plan), then you can't get an IRMAA letter from Medicare. When you do sign up in the future, that's when you'll get the IRMAA letter...at which time you can file the appeal. You can't file the appeal before receiving the IRMAA letter.

Thank you. So will I have to pay a premium? Situation as follows. Very high income in 2023 (would be in highest IRMAA surcharge zone). Retired end of 2023. Income in 2024 and 2025 will not cause any surcharge. Will start Medicare mid 2025. If they use 2023 I will have an issue if I can’t appeal.

@@keithmachado-pp6fv You'll be fine. Yes, they will look at 2023 income when you start Part B in mid-2025, but you'll be able to use your 2024 income or 2025 estimated income to file the appeal. Since 2024 income will put you in the 1st range, I would just use the 2024 tax return info on the 2025 appeal. Because by mid-2025, you should have your 2024 tax return done. So you can easily show what income range the late 2023 retirement put you in starting with 2024. Then in 2026, you won't have to do an appeal since they will look at 2024 income automatically.

Switch to a different Part D plan during AEP that has a lower premium. Try not to get too invested in your Part D plan because you'll need to switch at some point. These changes happen all the time, which is why AEP exists (10/15-12/7).

@@MedicareMindset Would not all plans be similarly priced since now they all have to comply with the Inflation Reduction Act?

@@savmanhk Surprisingly, for 2025 there are some plans going up in premium and others going down. On 10/1, go to Medicare.gov and search standalone Part D plans. You'll see that there will be a couple plans with a low premium to choose from for your minimal medication needs. 😀

I'm glad to hear this cleared it up for you. Yep, call your local SSA office to schedule a phone appointment to sign up.

Wonderful to hear!

Awesome!

Glad to help!

I'm so happy to hear this! It saved you from having to setup a phone appointment with SSA, which likely would've been scheduled for 2-3 months from now...if you could even get through on their phone line. :) Take care.

So you're just trying to get your mother's Medicare number and/or Medicare card? If all online routes aren't working for you, then take her to her primary doc's office. They should have her Medicare number and card on file. Then with that information, you can create a Medicare.gov account for her since you just need her Medicare number and Part A start date. Once you're in the Medicare.gov account, you can print a copy of the card and order a new one to be mailed to her. If you want, you can communicate with me directly at info@medicaremindset.com

Great!!

Haven't heard of 1a or 1b for prescription tiers. But I suppose it's possible somewhere out there...not with Medicare plans.

On the application, they ask about your spouse. They will then determine if your benefit or the spousal benefit is higher. SSA may reach out to you to determine your intentions and give you options. I also noticed your other question from our Form L564 video, but the question seems to have disappeared...so I'll answer it here. On Form L564, Section B #2 is when YOU were covered on your wife's health insurance. Section B #5 is asking when YOUR WIFE worked for her employer. These dates need to go back to at least when you turned 65. If not, you'll need to get the same form completed by your previous employer to show that you had coverage dating back to when you turned 65.

@@MedicareMindset Thanks a lot for your quick reply. Well explained videos !

Wonderful!

It depends on the timing. If you're turning 65 and in your 7-month initial enrollment period, it won't matter. But if you're more than 8 months after separating from the employer, technically you can't submit a special enrollment period application for Part B. You would have to wait until the general enrollment period between 1/1 - 3/31 to sign up for Part B. You would likely have a late enrollment penalty in that situation. I guess it depends on how your employer would fill out form L564. If they show you as an active employee still, then you're okay. But if they show you separated more than 8 months ago, that's not good.

I got the approval of a client to screen record the submission of their application. And then we removed their information from our video to protect them.

Thanks for reaching out. The size of your employer will be the first factor. Because it's Medicare based on SS Disability... If the employer has 100+ employees, the employer health plan is primary and Medicare is secondary. So that means your spouse has the option to decline Part B, which saves having to pay $174.70/mo for Part B. They must keep Part A since receiving SS benefits. No big deal since Part A doesn't have a premium. If the employer has under 100 employees, Medicare is primary and the employer health plan is secondary. They must keep both Parts A & B in that scenario. In either case, you'll need to compare the premiums paid in both scenarios and the medical and drug coverage comparison. Depending on the specific medications taken and the employer plan's benefit design, it might be better to stick with the employer plan. It just depends on the medications. There is more to it, so let me know what state you live in. If you're in OH, KY, IN, IL, TN, GA, NC, SC, FL, or AR...we can help you. If you're outside of those states, I can refer you to a trusted Medicare insurance agency who is licensed in your state. If you want, email me directly at info@medicaremindset.com

@@andystamas thank you for responding. I don’t know exactly how many people but in one building there are over 2000 people. So overall, it’s thousands of employees

@@TobyMichaelPortableTechReview Then your spouse has the option to decline Part B when the Medicare card arrives...and just stay on the group plan. Part A hospital would be secondary. But they will have the option to leave the employer plan if you determine Medicare is more advantageous.

@@andystamas thank you. You have been so helpful. I felt that was probably the best option considering I know my coverage is very good but options to change later are so confusing!

@@TobyMichaelPortableTechReview Sure thing. Yeah, the easiest path would be for your spouse to just stay on the group plan. Then the only decision will be whether to drop Part B or keep Part B. If you want to save the $175/mo for Part B, then have them drop Part B. They can always add back Part B at anytime while covered on your employer plan based on your active employment. No penalty in that scenario. Take care.

Glad to hear this! And then in 2025, it gets so much easier with no more donut hole. 😀

@@MedicareMindset Excellent. I turned 65 last week and just signed up for Medicare A and B and a supplemental plan. D is next. I just discovered your channel, so I’ll have binge watch to make sure I’m doing things correctly!

@@anthonygardner400 Great! It sounds like you almost have everything wrapped up. Just make sure your medications are covered in your Part D plan in 2024...but also in 2025. You can confirm 2025 in October when the 2025 plans are announced. If necessary, you can change your Part D plan between 10/15-12/7 each year for a 1/1 start. With Part D changing quite a bit in 2025, we recommend you double check your plan's coverage of your drug list in October.

@@MedicareMindset​​⁠Excellent advice. I’ll definitely look at that in October. Thanks very much!

Are you referring to the "re-entry #" provided partway through the application for benefits? If so, that has no connection to logging into your SSA account. You will login to your SSA account using Login.gov or ID.me. Then you will get a text or email with a security code to access your account. You will do this each time you login. Once you're in, you should be able to see a partially completed application that hasn't submitted. Click on that to access and complete.

So glad to hear this!

???

Then that means you're not receiving either Social Security benefits or Medicare benefits. You can't change your address online with SSA unless you're receiving one or both of those benefits.

Our video was released 2yrs ago and it's about creating your account from scratch (via Login.gov). SSA just last week announced they are transitioning away from the old SSA username login, so everyone will need to login through Login.gov or ID.me. If you don't have a Login.gov or ID.me account already, create one right there on SSA.gov and then the system will ask you to give permission to connect that account to SSA.gov. Once the whole process is done, you will no longer need the old username route to login. Also, SSA mentioned in their recent email about this change that the next time you login with your old username, the system should prompt you to now set it up through one of the two other routes.

From what we've heard, setting up the account via ID.me works better for folks living abroad.

From what we understand, you have to create the account using the ID.me route when you live overseas. Give that a shot. And if you remember, please reply back here or send us an email at info@medicaremindset.com on whether ID.me works for you.

You moved to Europe?

@farzadjahangirl2... Hello. I do have the same problem. I live outside USA and my info. Is not acceptable as valid even though I tried the ID.me. It doesn't let me finish my account creation. I called the SS in the USA, and the lady had no idea of any transition ór why I try to create a new account. She kept me on the phone for more than an hour pretending she was helping me, but I believe she was eating and counting the flies pass by. She was useless. Today is the end of August and I am so upset and nervous they will cancel my Social Security account. 😢

@@strongbamboo5947 Sorry to hear you're still having this issue and not getting any help from SSA. The only thing I can think of is contacting the US Embassy or Consulate location in the country you reside.

@@MedicareMindset Thanks for your response. Yes, I already called my nearest consulate and they put me to a machine...after long minutes, I had a person who his only answer was to go to the website, but it is the website where my phone and address are not accepted as valid. Why do they make it so hard? Why don't they have a site for residing outside citizens?? Excuse me? Is it for real that they will cancel accounts??? I thank you in advance for your kind answer🙏