Medicare, explained out loud.

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If you are in Kentucky, or really anywhere in the country, and you are on Medicare, you will receive something in the mail by September 30th from the insurance company your plan is with. It's called an Annual Notice of Change. They are legally obligated to send this out to you by September 30th, and what this booklet is going to outline for you is what is changing on your plan from one year to the next.

So it's not spam. It's actually a pretty valuable document to read. It's probably the most important thing the insurance company will send you each year.

I've probably helped over a thousand Kentuckians look through their Annual Notice of Change. It's confusing, it's full of insurance jargon. But that's what we're here for. It doesn't cost you a penny to come sit with us. What we can do is go over your Annual Notice of Change with you, just to make sure that plan is still the best fit for you going into the next year.

So what I suggest is, don't just discard it, don't throw it away. Your health insurance for the next year, in my opinion, is a very important topic, and you should know what is on it and what has changed.

What we don't want you to do is show up at the pharmacy in early January, or show up at the dentist thinking you had a certain amount of money for a procedure, and then it turns out you had less, meaning you have to pay more out of pocket. Or that prescription at the pharmacy has increased. Those are the things we want to prevent for everybody on Medicare here in Kentucky.

So when you get that document, feel free to bring it up to the office or give us a call. We're happy to help.

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You could go out and search all the plans on the market, find out which drugs they take, and then what doctors they accept. I'm certain you're smart enough to do it. It might take you a full weekend. It's going to take me 25 or 30 minutes, because we do it every day.

A Medicare advisor doesn't cost you anything. It never costs you a penny to come see us. We're professionals when it comes to everything Medicare, meaning you don't have to be. I tell all my clients this: this is my job. I do this all day, every day. Let me take that off your plate. You have worked your whole life. You should go enjoy it. Hand this off to me.

And we do it all year round. If you have a question, you give us a call. We're your advocate. If we enroll you, you have access to our line all year. You can call us and we'll help you with your Medicare.

Come October 15th, during the open enrollment, we will review your plan every single year, because a lot of Medicare plans do change every year. I sometimes wish that wasn't the case, but we have systems and processes in place where we can quickly get to our clients who need to hear from us first, and we always will go over their plan changes.

Why wouldn't you want somebody in your corner advocating for you year-round, so you can go do whatever retirement calls you to do and you don't have to stress about all the mail you get, all the phone calls you get, worrying if you're in the right plan?

Hand that over to us. Myself and my team do it all day, every day, and we want to be in your corner and we want to take care of you.

If you would like a Medicare advisor, or you'd just like to come in, meet us, and understand a bit more how the process works, we would love for you to do that. My direct line is (859) 618-6443. Come in, speak with me. Hope to hear from you soon.

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If you're turning 65 in the next year, there are a few things you're going to want to know.

The first question you need to ask yourself: do I need to go ahead and take my Medicare, or can I delay it? A general rule of thumb is that if you're still working and you have qualifying coverage, or if your spouse is still working and you're on their coverage, then typically you can delay your Medicare.

Next, if you decide you do need to enroll, when do you enroll and how do you enroll? You have a seven-month window. It is three months before your 65th birth month, your 65th birth month, and three months after. So you have a seven-month window to enroll in your Medicare with no penalty.

I tell all my clients it pays to be proactive. Go ahead and enroll in your Medicare three months before, so it will start the first day of your 65th birth month.

How do you enroll? There are a few different options. You can call Social Security, you can go into the local Social Security office, or my favorite personally is doing it online. That's the simplest route. It takes most of our clients about 15 to 20 minutes.

Next, you need to know that Original Medicare is made up of two parts, Part A and Part B. Part A: think about anything inside the hospital. It's your hospital coverage. Typically Part A doesn't cost you a penny each month over the age of 65, and the reason is that you paid for it through your working life, whether you knew it or not.

Part B is your medical coverage. Think about anything outside of the hospital, it's going to fall under your Part B. Going to your primary care doctor, your specialist. Part B is $202.90 in 2026. If you're a higher income earner, it could be more. And if you're drawing Social Security, that $202.90 will typically come out of your Social Security check, out of sight, out of mind.

The next thing you need to know is these two terms: Medicare Advantage and Medicare Supplement. On our website there's a link where you can do a deeper dive into these key differences. There are pros and cons to both, so definitely do your research. And if you choose not to do a Medicare Supplement or a Medicare Advantage, one thing I would recommend is to certainly go get a prescription drug plan.

I wrote the full Turning 65 guide in plain English so everyone can understand it. I'm going to link that below, so if you want to keep doing some research as you approach 65, I highly recommend you do that. Or if you'd rather have myself or one of my team members look over your situation, you can always call us here directly at (859) 618-6443.

My name is Austin with Tyler Insurance Group. We're right here in Lexington. Our office is in the Beaumont Circle. So if you're turning 65, we'd be happy to help you out. Have a great rest of the day.

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What is the difference between a Medicare Advantage plan and a Medicare Supplement plan? Most individuals on Medicare had to choose between one or the other, whether they knew it or not.

First off, a Medicare Supplement and a Medicare Advantage plan are really trying to do the same thing. They're trying to cover gaps in Original Medicare. I'm going to explain those gaps very quickly, and hopefully in plain English.

Medicare, as simple as this, will cover 80% of your medical bills, leaving you on the hook for 20%. Let's do a quick scenario. Let's say we have a $100 medical bill. Medicare is going to say, okay, we'll pay 80% of that. You, on the other hand, are left with the additional $20.

That sounds great and all, except on Original Medicare there's no maximum out-of-pocket. Like most employer plans, and especially Affordable Care Act plans, they all have a maximum out-of-pocket. Think of a maximum out-of-pocket like a safety net, an amount at which the insurance company or Medicare would stop billing you. Medicare does not have that.

So let's go back to the 80/20 scenario. A $100 bill, we can cover that. Medicare's going to pay 80, you're going to pay 20. Now let's say we're diagnosed with cancer, heaven forbid. Ongoing treatments, and we all know in today's world medical bills and medical treatments are skyrocketing through the roof. Let's say we get caught with a $100,000 bill. Medicare's still going to say, okay, we're going to cover 80, we'll cover $80,000. But with no maximum out-of-pocket in place, you're on the hook for $20,000. And I don't know about you, but I don't know many people who have $20,000 lying around for medical expenses.

So a Medicare Advantage plan and a Medicare Supplement at the end of the day are really trying to solve the same problem. They just do it a bit differently. I tell all my clients that one is not better than the other. It really depends on your preferences, your lifestyle, your current health, your doctors and your prescriptions. We do all that in-house.

Now let's dive into a Medicare Supplement plan. A Medicare Supplement plan, also known as a Medigap plan, in simplest terms is this: you cut a check each month to an insurance company, and in return that insurance company is obligated to cover your 20% for you.

There are no networks when it comes to a Medicare Supplement, so you can go anywhere in the country, to any doctor that accepts Medicare, and that's about 99% of doctors. So if you like flexibility, if you might travel a lot, a Medicare Supplement might be a good option. There are generally no referrals.

Quick recap: a Supplement plan means you're going to pay a premium every month, a dollar amount premium every month, to an insurance company for them to cover your 20%. There are a few different types of Medicare Supplement plans, which we'll get into in another video, but that's the general gist of it.

Think of a Medicare Supplement as pay regardless. If you enroll when you turn 65 and you sign up for a Medicare Supplement, you're going to pay for that plan every month whether you use it or not. No matter if you're the healthiest person in the world, you're still going to pay for that Medicare Supplement.

The next thing on a Medicare Supplement: they do not cover prescription drugs, or dental, vision and hearing coverage. So if that's something you need, and prescription drug coverage is a must, you need to go out and get a prescription drug plan. We do all that in-house. But a prescription drug plan would need to go along with your Medicare Supplement.

All right, shifting gears. Now let's talk about a Medicare Advantage plan. These are the ones you see all over TV. They get advertised quite a bit today. Medicare Advantage plans are also known as Part C plans. Think of Part C as C for complete, and the reason for that is it really wraps everything into one plan. So your medical, your drugs, your dental, vision and hearing, all wrapped into that same plan. You can use that same card whether at the pharmacy, whether at the dentist, whether you're getting your eyes checked. One card, same plan.

I like to think of them as pay as you go. When something comes up, we're going to have what's called a copay. Think of a copay as just a flat dollar amount for that service. So let's say you get an X-ray. On a Medicare Advantage plan we would pay a flat dollar amount for that X-ray. Each Medicare Advantage plan does have a maximum out-of-pocket, meaning there is a safety net in place, the most you can pay in a given year on a Medicare Advantage plan.

There are some drawbacks to a Medicare Advantage plan. On a Supplement there's no network: you're going to pay each month, but you're going to have the flexibility to go anywhere in the country. Medicare Advantage plans are a little different. You are going to be tied to that plan's network, meaning that Medicare Advantage plan's insurance company can tell you what doctors you're able to go see and what doctors they're willing to pay for you to go see. So it's very important to realize that Medicare Advantage plans can tell you what doctor you can and cannot see. A lot of times you need referrals on a Medicare Advantage plan. Some carriers are doing away with that, some still have it, but keep that in mind.

If you still have some questions, reach out to the office. You can sit down with me or another advisor here in the office, and we would happily walk you through the differences as they pertain to your situation.

My name is Austin Tyler. I'm with Tyler Insurance Group here in Lexington, Kentucky. We're a local Medicare advisory firm that does this all day, every day. We help seniors and people turning 65 navigate their Medicare coverage. You can reach us at (859) 618-6443. Hope to hear from you soon, and as always, have a great rest of the day.

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The question is: what does it cost to sit with a Medicare advisor, to sit with me or to sit with another advisor on our team? The simple answer is that it doesn't cost you a penny. We will never ask you to pull out your checkbook, and we will never send you a bill.

We are compensated by the insurance companies, so we're contracted with most large carriers in the state of Kentucky and really the nation as a whole. Our job is to be as unbiased as possible. Think of us as an advocate between you and the insurance company.

We'll sit with you, we'll go over your current situation, and we'll point you in the right direction on the plan that fits your needs the best, in the most unbiased way possible.

So to answer your question, what does it cost to sit with a Medicare advisor? The answer is that it never costs you a penny.