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Medicare has four parts:
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Part A (Hospital insurance)
- helps
pay for inpatient care in a hospital and some skilled nursing
facility care (following a three day hospital stay), some home
health and hospice care. For 2011 there is a $1,132 deductible
for a hospital stay or up to 60 days. Additional charges will be
incurred for longer stays. Physicians’ bills are not covered
under Part A.
-
Part B (Medical insurance) - helps
pay for physicians’ services and other medical services and
supplies that are not covered by hospital insurance. For 2011
there is a $162 annual deductible and then Medicare pays 80% of
approved services.
-
Part C (Medicare Advantage plans) -
People with Part A and B can select to receive their care
through one of private provider organizations.
-
Part D (Prescription drug coverage) –
Assists people who have Part A or Part B with the costs of
medications that are filled at your local pharmacy.
To be eligible for free Part A you
must be 65 and eligible to receive Social Security benefits or
railroad retirement benefits. If age 65 you may also qualify
through your spouse, if they are eligible. You may also be
eligible if disabled and meet the requirements of the Social
Security disability program.
Anyone who is
eligible for Part A can enroll in Part B by paying a monthly
premium. Most new enrollees in 2011 are paying $115.50, but
higher income individuals (greater than $170,000 on a joint return)
pay more.
You can enroll in Medicare during the
7 month period (3 month before, the month of, or 3 months after
the month of your birthday by contacting Social Security
(1-800-772-1213). Your coverage becomes effective the 1st day of
the month of your birthday unless your birthday is on the 1st.
and then it becomes effective the 1st of the previous month.
Medicare supplement plans (often
referred to as “Medigap”) are offered by private insurance
companies to supplement Medicare coverage (i.e. the $1,100
hospital deductible, the $155 Part B deductible and the 20% for
part B services). Medicare prescribes the benefits for each of
these 12 plans (a few states have some exceptions). An insurance
company does not have to offer all 12, but the plans they offer
must adhere to those benefits dictated by Medicare. Thus, the
benefits provided by a Plan F will be consistent for all
companies. Premiums vary by the plan’s benefits, the company and
region of the country. The monthly premium for a non-smoking
female for the most popular Medigap policy, Plan F, is
approximately $120.
Things to consider in selecting a
plan:
- The amount of premium you are
willing to pay.
- The benefits you want.
- The reputation and financial
stability of the company offering the plan.
- The acceptability of the plan by
your healthcare providers.
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