Essential Parts of Medicare & How to Check Your Coverage

Geriatrician Leslie Kernisan, MD, talks with social worker and Aging Life Care Professional Michelle Allen, LCSW, about the crucial updates and insights into Medicare coverage that everyone over 65 should be aware of. With Medicare Open Enrollment approaching, it's vital to understand your options and ensure you're getting the best value for your healthcare needs. They also explain what to do during this time to keep out-of-pocket costs lower for the coming year.

Learn about the different parts of Medicare, including Medicare Advantage and Part D, and discover important changes coming in Medicare 2025 that could impact your coverage. The discussion also highlights a cap on prescription drug costs and provides practical steps for navigating the enrollment process and resources for assistance.

Chapters:
00:00 Essential parts of Medicare
02:57 Why check your Medicare coverage in 2025
05:58 The basics of Medicare
07:08 Medicare Part A: Inpatient Services Explained
10:03 Medicare Part B: Outpatient Services Overview
11:24 Medicare Part C: Medicare Advantage Plans
15:22 Medicare Part D: Prescription Drug Coverage
17:04 How to initially enroll in Medicare
19:26 Medigap, Medicaid, and other options
25:30 Why does Medicare Open Enrollment matter?
31:02 Medicare Updates for 2025
36:54 Steps to Take During Open Enrollment
42:04 Resources for Medicare Assistance

#medicare #medicare2025 #medicarecoverage #medicareinsurance #medicareexplained #medicareexpert #insuranceusa #applyformedicare #medigap

WATCH NEXT:
Episode #1 – Aging Life Care (and Geriatric Care Managers) Explained: Who They Are & Why Your Parent Needs One:

Episode #2 – How to Pay for Senior Care?

Episode #3 – How to Get your Aging Parent to Accept Help in the Home

Episode #4 – Memory Improvement: Say No to These Medications

[BetterHealthWhileAging]

Chapters:
00:00 Essential parts of #Medicare
02:57 Why check your Medicare coverage in 2025
05:58 The basics of Medicare
07:08 Medicare Part A: Inpatient Services Explained
10:03 Medicare Part B: Outpatient Services Overview
11:24 Medicare Part C: Medicare Advantage Plans
15:22 Medicare Part D: Prescription Drug Coverage
17:04 How to initially enroll in Medicare
19:26 Medigap, Medicaid, and other options
25:30 Why does Medicare Open Enrollment matter?
31:02 Medicare Updates for 2025
36:54 Steps to Take During Open Enrollment
42:04 Resources for Medicare Assistance

[ChadSharkeyNursePractitioner]

Every time I think I've figured out insurance, specifically Medicare, I realize I haven't. Nothing worse than telling a senior what I think I know about their insurance, only to find out it has changed. I now rely on expert social workers like Michelle for my senior population.

[cdd]

You are so right about NOT setting and forgetting your coverage. My parents did that and really paid a price with both the out of pocket amounts paid and the quality of care from their Medicare advantage policy.

I would only add that as you age, the likelihood of staying healthy goes down. Better insurance becomes more of a necessity, because the chances of using it increase.

I would only add that there’s a lot of advertising of Medicare advantage plans that state “you’ll pay no premiums”. In my experience that’s not correct: they simply deduct the premium from your monthly social security payment so that you don’t have to write a check for the premium (or electronically transfer the payment). You’re still paying for it. You’re just less aware of the actual cost of that premium.

And please describe the formulary part d for what it is: a requirement that we gaze into our crystal ball, divine what drugs we will need for the year, and pick the best plan. It’s a joke, really. Congress expects elders to 1) know which drugs they’re taking 2) know the formulary of what might be prescribed for their illnesses (because drs can change their minds about what should be prescribed for patients) 3) know what they might need in the future.

Have these legislators ever met an elderly person? It’s way too complex for me and I don’t have any vision challenges or cognitive decline.

The rest of the western world is laughing at us.

[noof]

Overall, a decent job covering a complex issue. But I believe an important item was missed: the "in network" / "out of network" aspect of Medicare Advantage plans. Many people fail to realize that doctors they have gone to for years, doctors whose judgments they have learned to trust, may NO LONGER be available because they're not in a particular plan's "network." Nasty surprise.

[bettyestone]

Need to talk about the deductible you pay each year on each insurance.

[beanyhead]

We have found that "In Network/Out of Network" really matters when you live in our small state that has no major hospitals or medical schools/research. Having a supplemental (Medigap) policy gives you peace of mind, knowing you can access speciality care, surgery, etc. across state lines at a major city hospital (or anywhere in the country, for that matter).