For outpatient hospital procedures, do we need a separate authorizations for the physician frm Medicare B and for the facility from Medicare A

Aa a postal retiree, I'm using the SEP to enroll in Medicare's part B, PENALTY FREE. Then will SUSPEND my fehb & join a 0 premium medicare advantage plan this fall during open season. There's NO WAY any plans in the new PSHBP will offer any 0 premium plans. So in essence, medicare becomes primary payers & your pshb is second & pays very little after medicare pays its share. So they pocket most of your premium & you end up paying twice the premiums for the same coverage, and unless you have a catastrophic year they benefit & you loose. I don't trust the pshb plans & since MANY carriers are NOT participating, you are left with little to choose from. That certainly relates to higher premiums, less coverage and no real benefits.

Every time I go to the Doctor I have a high copay....I don't have the$....so I have no insurance

We had FEHB and Medicare when we retired.Since Medicare premiums are linked to your income in retirement, it is not beneficial to have both BCBS. If your premium is more than the catastrophic limit of FEHB, it is not financially better to subscribe to both FEHB and Medicare. I cancelled our medicare.

Thank you for posting this helpful video!

Yeh you get part of your part B back.but according to insurance underwriters. You get THE CRAPPIEST Coverage. And You will regert it .😢

@ 5:00 "when you return" from being away from the U.S.. ... How do you officially change your status from "away" to "returned"?

Regarding Medicare and FEHB, I have both Medicare A and B, and Federal Blue Cross Blue Shield. During last year’s FEHB Open Season, many federal retirees were automatically enrolled in a Medicare Part D Prescription plan, overriding their plan’s prescription drug benefit. I was one of those retirees. We did have the option to opt out, but since it was at no extra cost to me, I opted to be in it. However, I should add that your Part D cost is income driven. Meaning, it’s no cost if your modified adjusted income is $103,000 or less for singles, $206,000 or less for marrieds. If I was to go over the $103,000 income limit, I could opt out and my FEHB Prescription Plan would take over. My question is: Since prior to being enrolled in Part D, my BC/BS monthly premium included prescription drugs. However, now being in Medicare Part D, if it overrides my prior BC/BS prescription plan, why is my monthly BC/BS plan the same amount? It doesn’t reflect a reduction to my plan that is now not covering prescription drugs. So why am I paying a monthly BC/BS premium as if it still included a prescription drug plan?

I really wish there was some way Boomer Benefits could be involved with FEHB recipients, their help navigating through the morass of health insurance, claims and benefits would be invaluable.

Great video! How do manufacturer discounts factor in to the coverage gap?

Thanks for this video. It’s actually been really hard to find people covering this on KZfaq and when they do they don’t cover whether it might be preferable to go straight Medicare and not use the FEHB option. If you’re in the postal service you will have to sign up for Medicare A&B so the question after that is which route to take. I think people should be sure and read the policy of the FEHB plan they’re likely to take in detail and make sure they’re okay with the benefits and cost vs Medicare and a supplement. ( You have to drop FEHB completely if you want a supplement) Blue Cross Standard for example doesn’t coordinate with Medicare on part B drugs and only partially on skilled nursing. It does offer other coverage though such as hearing aid coverage. Its drug formulary is also a lot better than any part D plan in our area for 2024. It’s kind of a cross between a supplement and Medicare Advantage. Of course there are a lot of plans to choose from so you really want to do your research.

I am 63 and have FEHB and Tricare. I don't feel like I need part B but I guess I have to get it to get Tricare for Life.

Thank you 👍🏼💯

I'm already at a point where I can't get some tier 3 meds without paying something and I would love to go and Wegovy or Emgality, Trulicity etc... But the price is prohibitive for me especially when they demand that you get a 90-day supply. 2000 I'll have to do without.

We aren’t on Medicare yet so this won’t affect us right now but it is disappointing to hear. We have virtually appointments all the time. I have one doctor I see twice a year virtually and it’s worked out great. Fortunately our current insurance covers them with no problem but I foresee trouble when we switch to Medicare.

You can setup a monthly payment from your checking account to SS/ Medicare, same as you do with your supplement plan account.

The biggest nonsense I have ever heard in my life, very complicated for no reason but confuse people......................

Need to know how get rid part B

How do you get another provider I'll turn 65 in October you get so much in the mail and people call you and you're so confused

Thank you! Just researching my education before I need it this fall. This is some excellent information.

Mayo Clinic will have nothing to do with any medicare advantage plan. I personally have worked in the medical billing areas of hospitals and Dr offices. Medicare advantage plans are in a word nightmares, for the patients, the facilities, and the doctors. Go with traditional Medicare and obtain plan G in a medigap plan and pick up plan D for your scripts. That's the headache free way to go.

Plan G is the way to go if at all possible.

Yes concerned. That’s like charging me double at the grocery to cover the cost of people who buy more. Government needs to stop making everyone pay for everyone else. Another bite at the socialism apple.

I am disabled and very ill I have about 7 to 8 major hospital stays a year and 2 or 3 doctor appointments a week with about 12 specialist. With just Medicare I owed 20 % of everything. I have a Humana gold choice plus. I pay 12o a month more than standard medicare. My doctor visits to any in or out of network specialist or family doctor is free. No co pay. My meds teir 1 &2 are free, teir 3.. 4 bucks, teir 4 ..is 10 or 12 bucks, teir 5 is 20%. In hospital coverage cost me 0 per day in or out of net work, out paitent surgery $0, ER vist cost $95, Most test procedure cost 0 to 20 bucks to a few at 20 %. I just came out the hospital for a 5 day stay with a bad kidney infection on vancomycin 2 times a day one of the most expensive antibiotics made. My bill is zero except for the ER bill of 95bucks. I got a $7,200 set of hearing aids last year free of charge 100 % no cost to me. Rechargeable and will bluetooth with my phone stream music all that. I ger 2500 a year to spend on dental, I getabout $300 to spend on my eye glasses. Plus I get a $500 a year flex card to spend on any extra drugs hearing dental or vision.. Because of how sick I have been my insurance sends me 14 free never frozen moms meals a month to my house and they are great. I have gastroparesis and always in the hospital. My gastric doctor at the time wanted to do a feeding tube and just let me die a slow painful desk. I read about gastric pacemakers and talked to a human rep and we found a doctor 6hr from home that said it would help and could do. So I took a train to texas Humana approved it all fast I had it put in. I think I owed $250 humana paid $13000 and the hospital billed...... and thi make me laugh..... $455,000 and they wrote the rest off. I can and have physical therapy I did last year at zero cost following a hip replacement that only cost me a a couple hundred out of pocket. It is no doubt the best insurance I have ever had. I have central sleep apnea it has paid for 3 lab studies one auto cpap $1200 and now one ASV machine that cost over $4000. I have one script that is $1600 a month and only cost me a$12 a month. Several things take prior auths but they are fast often back with in the same day or 3 to 4 at max. I can not say enough good about my Humana Gold plus plan in oklahoma. I have had it going on 3 years and had another humana plan before that that had free monthly cost but it had more co pays but not outrageous. So yes there are some shit advantage plans and then them our some damn good and far better than standard medicare and a supplement plan. SO you can imagine when people just tear advantage plans a new one saying they are all full of hidden cost and blah blah. Just not True I love my plan it has out of network doctors and hospitals as well as great in plan ones. Like I said I have about 12 doctors. Sob far this year alone I have had about 5 weeks in the hospital and almost all of it was covered 100%. So please stop telling lies!

I will be selling a rental property this year for a profit. Will this affect my IRMAA for 2026 or 2027?

I currently work but am in ESRD. Do I qualify for any Medicare benefits?

Thank you a lot for this video. This is very interesting and informative. Keep posting like those amazing videos, this is awesome.

My understanding is that the prescription will be filled if you're primary at the VA Forward to the VA Pharmacy. The problem with the VA is that you always get the information too late. Nothing is up front in subject to change without notice. Right now you may qualify for community Care but it doesn't include transportation even if transportation is medically required . Incidentally community Care is not necessarily in your community.

Thank you.

What are the exceptions to have traditional medicare continue to pay for telahealth visits after December 2024. I read the information in the link you gave last video and it didn't say. Can you give us a clear answer to this question please. Much appreciated

Excellent. Easy to comprehend

I used telahealth, and it was of great benefit for me. I don't see any link??

Someone, somewhere sat down and figured it out so that it could ALL be stacked AGAINST the seniors. Never in our working years did we have to make insurance decisions to "last the remainder of our lives". This causes me to NOT want to play the game and to NEVER purchase insurance. I have to die sometime. Might as well be in my home whenever I get sick. SMH

"No providers within 50 miles." I don't remember discussing this when I signed on. Will not return my phone calls. I think maybe I've been taken advantage of.

unless your on a DSNP

They don't take Medicare in the Philippines

I have a telehealth appt scheduled in July.

Does this include advantage plans? And what about medical practices that send med techs to your house and do video calls with a nurse or doctor? Since I don’t drive when I found out about this medical place I became a patient. They do have a brick and mortar clinic tho. I have quite a few medical issues that need frequent care.

I don't see a link in comments?

Does the Part B premium get paid on the 1st of the month and is the giveback also applied on the 1st of the month?

Thank you for the info. I read recently that Humana and CVS/Aetna will be downsizing their MA plans.

Turning 65 in august.I'm still working full time am I required to apply for medicare. I have coverage from my employer.

Are you saying you can't apply for Medigap until your part B is in effect? Wouldn't this cause a gap period where you have medicare but no medigap?

Does plan N pay for physical therapy? Is there a copay?

I am a 59 yr. Old that was diagnosed with stage 2 breast cancer in 2020. I only have Medicaid for insurance, will be approved for medicare.

BOOMER is wonderful! They are very thorough and knowledgeable and not fraudulent 😊

It is a great video thanks for the great information and well delivered. This is exactly what I was looking for.