Understanding Your Medicare EOB and MSN

If you are on Medicare and you go to the doctor, they build Medicare, their portion, or if you're on Medicare Advantage, they build the whole thing to the insurance company and everybody's buying, and then eventually you get something and it says you did this. What is that called? If you're on a government Medicare and a Medicare supplement, it's called a Medicare Summary Notice, an MSN. If you're on Medicare Advantage, which is private Medicare, it's called an Explanation of Benefits, an EOB. They both tell you the same thing. They're going to tell you, you get one every quarter, and they're going to say, okay, you went to these doctors, you had these procedures, the doctors charge Medicare or the insurance company this much, and this is how much you have to pay, patient responsibility. So they're not sending you a bill, they're just kind of having you check what the doctor filed to make sure the doctor's not scamming Medicare, right? So does that line up? Does that look good? If it doesn't, call Medicare. So with a Medicare supplement, let's say you have the most popular plan in America, which is Plan G. It will have a deductible, which is under $300. So you have to pay that first before the insurance company kicks in. So when you look at that Medicare Summary Notice, it might say patient balance due, that's because you haven't met your deductible yet. You'll pay that directly to the doctor's office. But once you're done with the Plan G, once you've paid your deductible for the year, you don't pay anything else. That's why Plan G is the most popular plan, the most attractive plan, which I will buy when I turn 65. I made my deductible and I'm done with it. I'm going to be nickel and dimed all year. Versus Medicare Advantage, where every time you get a service, see a doctor, have a surgery, go to the ER or anything, lab, x-ray, boom, you'll pay a copay or coinsurance every time. So a little bit more complicated, but most people, they want the money at the doctor's offices now. They used to say, I will bill you more and more like we want 20 bucks now. So if they don't, then your EOB, your Explanation of Benefits, will tell you what you did and what you have to pay. And with the Medicare Advantage, you're working towards that maximum out-of-pocket, which is the most you can be billed for the entire year. Most people don't hit that. But if you have a lot of chronic conditions, you're having some major things, expensive things like cancer treatment, dialysis, transplant, the big stuff, you're going to hit your maximum. Once you hit it, you don't pay any of those copays for the rest of the year. So if you know you're going to hit it, keeping track of that can give you some way to budget financially for what's going on medically for the year with your Medicare Advantage. If you need help, our team at the Medicare Family, we're licensed in all 50 states. Just book your own appointment. It's free. Go to MedicareFamily.com. We'd love to answer your questions. No obligation, no pressure. We're a family business, so we operate like family. We're not Wall Street. So if you need help, give us a call. If you like this video, you might really like this video. Check it out. And we'd appreciate if you subscribe to our channel so you never miss a great video. We put out one every week. Check in the description below this video for a link to our cheat sheet on Social Security and Medicare. And you can also give us a comment. If you have a specific question, always feel free to call us or email us at the Medicare Family.