Medicare Part A-- Medicare part A is your basic hospital coverage. Medicare Part A covers certain medical services and supplies in hospitals, doctors offices, and other professional health care settings. Medicare Part A helps cover:
Inpatient care in hospitals
Skilled nursing facility care
Home health Care
Inpatient care in a Religious Non medical Health Care Institution
However, with Medicare Part A, it is important to keep in mind that you will only be 80% covered for all of these services. This will leave you having to pay the remaining 20% out of pocket.
How much Does Medicare Part A cost?
If you buy Medicare art A, you will usually pay up to $451.00 each month. However, most people get the premium-free Part A. You will be able to enroll in the premium-free Part A if you are 65 years or older and:
You receive retirement benefits from Social Security or the Railroad Retirement Board.
You are eligible to receive Social Security or Railroad benefits, but have yet to file for them.
You or your spouse had Medicare-covered government employment, meaning that you paid Medicare taxes
If you are under the age of 65, you can qualify for Premium-free Part A if:
You get social security or Railroad retirement Board of disability benefits for 24 months.
You have End-Stage Renal Disease (ESRD) and meet the requirement necessary.
Medicare Part B
Medicare Part B is your basic medical insurance. Medicare Part B helps cover:
Services from doctors and other health care providers
Home health care
Durable medical equipment
Some preventative services
Like Medicare Part A, Medicare Part B will only allow you to be 80% for the services mentioned above. You will be responsible to pay out of pocket for the leftover 20%.
How Much Does Medicare Part B Cost?
Generally, most people the Part B premium of $99.00 each month and you pay $140 per year for your Part B deductible. However, if you do not sign up for Medicare Part B when you are first eligible, you may be required to pay a late enrollment penalty as well. Also, if you are modified adjusted gross income as reported on your IRS tax return from two years ago, is above a certain amount, you may also be required to pay more. Usually if this applies to you, Social Security will contact you. Keep in mind however, that the amount you pay can change from year to year depending on your income.
If you disagree with the higher amount that you are paying for your Part B premium (For example: If your income decreases for whatever reason), you should contact Social Security.
Medicare Part C
Medicare Part C, also known as a Medicare Advantage Plan, is usually a combination between Medicare Part A, Medicare Part B, and Medicare Part D. Also, in many cases, extra benefits like: dental, hearing, and vision may be included for extra cost. Medicare Part C is run by Medicare-approved private insurance companies
How much Does Medicare Part C Cost?
If you are enrolled in Medicare Part C, or a Medicare Advantage Plan, you will usually have to pay a monthly premium to addition to your Part B premium.
Medicare Part D
Medicare Part D is your Medicare prescription drug coverage. Like Medicare Part C, Medicare Part D is also run by Medicare-approved private insurance companies. Medicare Part D helps cover the cost of prescription drugs and if you are like most seniors with many prescriptions, enrolling in a Medicare prescription drug coverage may be beneficial. Also, Medicare Part A may even help you lower your current prescription drug costs as well as help protect you against high costs in the future.
How much does Medicare Part D cost?
If you are enrolled with Medicare Part D, throughout the year you will be required to pay: A monthly premium, a yearly deductible, co payments of coinsurance, costs in the coverage gap, costs if you receive Extra Help, and costs if you pay a late enrollment penalty.
However, your actual drug plan costs will vary depending on: the prescription drugs that you use, the plan that you choose, whether the prescription drugs that you use are on your plan's forumlary, and whether you receive Extra Help paying for your Medicare Part D plan.
What is a Medicare Supplemental Plan?
A Medicare Supplemental Plan, also known as a Medigap Plan, will cover the gaps that Original Medicare does not cover. For example: With original Medicare, all of your costs will be 80% covered. Therefore, you will be responsible for paying the remaining 20% out of pocket. Now, most people will think that 20% is not much. However, if you are like many seniors who will undergo a knee replacement or his replacement surgery, 20% of your coverage can add up. To protect yourself, people often enroll in a Medicare Supplemental Insurance plan.
What are my Medicare coverage choices?
If you are looking into Medicare coverage, there are two main options available so that you are able to get the best Medicare insurance coverage that will fit all of your insurance needs. Those two ways are through: Original Medicare or through a Medicare Advantage Plan.
What is Original Medicare?
According to www.medicare.gov, Original Medicare is defined as " A fee-for-service coverage under which the government pays your health care providers directly for your Part A and/or Part B benefits."
What does this mean exactly? Well, for most of us, upon reaching the age of 65, you will automatically be enrolled in Original Medicare, sometimes known as traditional Medicare as well. As defined earlier, Original Medicare is usually a combination of Medicare Part A and Medicare Part B.
If you decided you do want the option of Original Medicare, you must next decide if you need a Part D prescription Drug Plan. Then, once your make that decision, you must decide if you need to enroll in a Medicare Supplemental plan.
Medicare Choices Continued...
Keep in mind that you do not necessarily NEED all of these plans. You must find the right plan that fits all of your insurance 'wants' and 'needs'.
On the other hand, if you decided to get with a Medicare Advantage Plan, also known as Medicare Part C, you mus next decide if you want a Prescription Drug coverage Plan to go with it. As I mentioned previously, this drug plan may be already included depending on the prescription drug plan that you choose. If it is not included, you may want to considering adding one if you have many prescriptions.
No mater what your Medicare choices are, it is important to do your research. That includes online research, speaking with friends and family, and even speaking with your doctors-this way, you can find the best plan for you!
Does Medicare Cover your Test or Service?
Medicare Part A: As we mentioned previously, Medicare Part A is your basic hospital insurance. Therefore, Part A covers: Inpatient care in hospitals, Skilled nursing facility care, Hospice care, Home health Care, and Inpatient care in a Religious Non medical Health Care Institution.
We know that this above list is nonspecific, so below we are going to get into more detail about the services Medicare Part A covers. However, keep in mind that you may have to pay the co payments, co insurances, or deductibles for the services mentioned below:
Part A Covered Services
Blood: Fortunately enough, if the hospital you are attending receives blood at no charge, you will not be responsible to pay for the blood or to replace it. However, if the hospital has to buy blood for you, you have two options: You must pay the hospital costs for the first three unites of blood that you receive in a calender year, or you must have the blood donated by you or someone else.
Home Health Services: Medicare will cover 'medically necessary' part time or periodic skilled nursing care and physical therapy, speech language pathology services, as well as services for people with a continuing need for occupational therapy.
However, a Medicare doctor or certain health care providers who work with that doctor, must diagnose that you do in fact, need home health services. Note: This diagnosis must occur during a face-to-face interview with your doctor.
Once the doctor diagnoses that you need home health services, he will then order you care and a Medicare certified home health agency will provide it. Other home health services consist of: medical social services, part time or periodic home health aid services, and medical supplies that you will potentially need at home. However, keep in mind that you must be home bound—This means that leaving home for you take major effort or you are not able to leave home at all.
You will not be required to pay for your covered home health care services, however, you will have to pay 20% of the Medicare approved amount for durable Medical equipment that was used during your home health care services.
Hospice Care: In order to qualify to hospice care, your doctor must certify that you are terminally ill and are expected to live six months of less. If you already enrolled with hospice care and have been receiving it for six months, a hospice doctor or nurse practitioner will need to see you again to certify that you are still terminally ill. You will continue to receive hospice care as long as the hospice medical director or hospice doctor continues to re certify that you are terminally ill. Hospice Care usually takes place where you live. For some people, that may be at there home and for others that may be at a nursing home. Regardless, hospice care will take place at what is considered your 'home'.
Hospice Care coverage includes:
Drugs for pain relief and symptom management
Medical nursing and social services
specific durable medical equipment
other covered services.
However, there are services that will be covered that Medicare usually does not cover, like: spiritual grief counseling.
Hospice care will not pay for your stay in facility, which is basically room and board, unless the hospice medical team finds that you need short term inpatient stays for pain and symptom management that can not be addressed at your home. If this is the case and the hospice medical team finds that you need short term inpatient stays, you must be stay in a Medicare approved facility (like a hospice facility), hospital, or a skilled nursing facility that is in contract with hospice.
Medicare will also cover inpatient respite care. This is the care you receive in a Medicare approved facility that your usually caregiver can rest. You can stay up to 5 days each time you receive inpatient respite care.
You will not be required to pay for hospice care. However you do pay a co payment of up to $5 per prescription for outpatient prescription drug pain and symptom management as well as 5% of the Medicare approved amount for the inpatient respite care., if you receive it.
Inpatient Hospital Care: Medicare will covered inpatient care in hospital. This includes care that you receive in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long term care hospitals, inpatient care for a clinical research study, and mental health care. Keep in mind that staying overnight in a hospital does not always mean that you are considered an inpatient. You are technically considered an inpatient the day a doctor formally admits you to a hospital with a doctors order. Therefore, be sure to ask if you are a inpatient or outpatient since it will affect what you pay and what will be covered under Medicare Part A.
Medicare will cover:
Semi private rooms
Other hospital services an supplies.
However, Medicare will not be responsible for covering:
Private duty nursing
A television in your room (if there is a separate charge)
A phone in your room (if there is a separate charge)
Personal care items: razors, or slipper socks
A private room (unless medically necessary)
Note: If you are enrolled in Medicare Part B, it will cover the doctor services that you receive during your hospital stay.
Religious Non medical Health Care Institution (Inpatient Care) : It is important to remember that Medicare is not in agreement with your religious beliefs. In fact, Medicare will not cover the religious portion of your care. Medicare will be responsible for covering the non-medical, non religious health care items and services in this type of facility if your quality for hospital or skilled nursing facility care. Medicare will cover things like: room and board, and other non-medical items and services that no do not require a doctor's order or prescription (EX: the use of a basic walker during your stay, or wound dressings).
Skilled Nursing Facility Care: Medicare will not cover long term care of custodial care, but they will cover semi private rooms, meals, skilled nursing and rehabilitative services, as well as other medically necessary services and supplies (After 3 days minimum). To qualify for skilled nursing facility care, a doctor must order that you need skilled nursing care daily, like in some cases where you would need physical therapy.
You are not required to pay anything for the first 20 days each benefit period. However, you will have to pay a co insurance per day for days 21-100 each benefit period. You will also pay all costs for each day after day 100 in a benefit period.
Related Medicare Supplemental Insurance and MEDIGAP NEWS
AARP Medicare Supplement- AARP Medicare Supplement is insurance by United Health Care. When deciding on a AARP Medicare Supplement Plan, it is imperative to consider all of your individual insurance needs to ensure that you receive the best health care coverage for the very best price.
Medicare Advantage Plan-Medicare Advantage Plans, oftern referred to Medicare Part C Plans, is very benefitial to be enrolled with. Medicare Advantage plans are general managed care plans, meaning that they usually operate through HMO (health maintenance organization) or PPO (preferred provider organization). Medicare Advantage Plans offer the same coverage as Medicare part A and Medicare part B. However, they also may offer additional coverage such as: Vision, hearing, deantal, etc.
Medicare Insurance Supplements-Medicare Insurance Supplemental are crucial if you want to save money! Medicare Insurance Supplemental help cover the gap that Medicare Part A and Medicare Part B do not cover. Medicare Part A and B only cover up to 80%, leaving you to pay the remaining 20%. Once you enroll in Medicare Insurance Supplements, you will be 100% covered!
Medicare Part D Comparison- Most people are aware of Medicare Part A and B, but most people do not know about the importance of Medicare Part D. Medicare Part D is your presciption drug plan, the plan helps you afford paying for all of your prescriptions. Once you complete yor Medicare Part D comparison, you will realize how benefiital Medicare Part D is.
Medicare Part D Plans-Medicare Part D plans is the prescription drug part of Medicare. Medicare Part D offer prescription drug coverage that Medicare A and B do not. If you find yourself with a lot of medications, consider a Medicare Part D plan to help save you money!
Medicare Supplement Cost- When considering a Medicare Supplement Plan, one may be concerned with the cost. In order to find the Medicare Supplement cost, you first have to find the company you wish to use. It is important to search for the best company to fit your individual needs. If the Medicare Supplement cost is a huge fact, you must find a company offering the best policiy for the most affordable prices.
Medicare Supplement Insurance Costs- If you are having difficuly deciding if you need a Medigap Policy, you should view your hospital bills within the last year. Depending on the amount of your bills, you may want to consider Medicare Supplement Insurance. Once you decide that a Medicare SUpplement Insurance Plan is something you are considering, you must look at different companies and different plans. Medicare Supplement Insurance Costs differ from company to company. Therefore, it is imperative that you do your research to find the best plan for you!
Medicare Supplement Insurance Premium-The Amount you will be spending on a Medicare Supplement insurance premium is important to most seniors. Medicare Supplement Insurance plans differ just as the the monlthly premiums do. Once you decide the a Medicare Supplement Insurance is something you are considering, you must do your research! Reasearch different companies as well as different plans.
Medicare Supplement N Medicare offers 14 different Plans named as Medicare Part A through Medicare Part N. Each plan specializing and offering different things. Specifically, Medicare part N, also known as Medigap N, pays the deductible for Medicare part A, but not for Medicare Part B. Plan N however, will be pay the coinsurance for Medicare Part B.
Medicare Supplement Plans Comparison-As you may know, there are many different Medicare Plans. All of these Medicare plans do not cover all health care costs and prescriptions. Keeping this in mind, Medicare Supplement plans do. They help cover the "gaps" that Medicare plans do not fully cover. Medicare Supplement Plans Comparison can show you what you may cover for the costs of your healthcare.
Medicare Supplement Plans-There are various Medicare plans indentified as Medicare A through Medicare N. All of these plans however, will not have you 100% covered. This is exactly why you need to consider Medicare Supplement Plans. Medicare Supplement plans cover the "gaps" in health insurance that are not covered. Once you enroll in a Medicare Supplement Plan, you will be 100% covered, saving you money in the long run.
Medicare Supplement Quote- There are several different types of Medicare supplement insurance plans. Each plan is labeled from A through N and they each cover a different sector of treatment. You have to take the time to study carefully what each plan covers; this way, you can make a more informed decision based on your needs. With each company you think about signing up with, always call the company first for a Medicare Supplement Quote. Once your receive the quotes, its important to compare so that you are able to find the Medicare Supplement Plan that fits all of your insurance needs.
Medicare Supplement Insurance Costs-Medicare Supplemental Insurance Costs differ depending on the company. Although Medicare A through N are usually standardized, the cost of Medicare upplemental Insurance cost various depending on the plan and company.
Medicare Supplements Are available for those 65 years or older. Sometimes, Medicare Supplements are available a few months prior to reaching the age of 65 as well. As you begin to look into Medicare, you may come accross Medicare Supplements too. Medicare Supplements fill the gaps in your Medicare coverage.
Medigap Insurance Plans- Although Mediare offeres coverage, they do not cover you 100%. In fact, they only cover you up to 80%, leaving you responsible to pay the remaining amout. This can add up to a large amount of money. Therefore, if you are looking to save money and be 100% covered, it is important that you find a Medigap Insurance Plan.
Medigap Insurance- Medicare Supplemental Insurance, often referred to Medigap Insurance, is available to qualified participants who are 65 years old or older. Medigap Insurance covers the "Gap" left by your Medicare coverage. When it comes to Medigap insurance, you pay a monthly premium and in return you will be 100% covered.
Medigap Plans- Unlike Medicare Plans, Medigap Plans allow you to 100% covered. There are various Medigap Plans so you can find the best Medigap Plan for you for the very best price.
Medigap-Policies- Are typically offered and enrolled in when you are 65 years old, or in some casts a few months prior to those who have researched and planned ahead of time.
Medigap- Medigap insurance is an insurance plan that will cover costs that Medicare may not cover. You could think of it as an insurance plan that will fill in the “gaps” in Medicare coverage. Medigap can also be referred to as a Medicare supplement plan.
Supplemental Medicare Plans - As we age, our health tends to decline. Therefore, you will be go to doctors and receiving more medications now than ever! If you only have Medicare, you will be required to pay 20% of healthcare expenses. Once you enroll in Supplemental Medicare plans, you will be 100% covered, leaving you to pay no healthcare expenses.
Senior Health Coverage- Senior Health coverage can be overwelming and confusing. To better understand the different types of senior health coverage, you must do your research. You can do your research on the computer, talk to a friend, or your can call an speak with a local agent. Regardless of what you may choose, it is important do you research so that you know the basics of senior health coverage.
- As you become older, you become more and more aware of Medicare. Sometimes though, we are not aware of the Supplemental Health Plans that are offered as well. There are so many great advantages to Medicare, but there are even more great advantages to Supplemental Health Plans.
Supplemental Insurance for Medicare- As mentioned previously, Supplemental insurance for Medicare fills the gaps that basic Medicare does not cover. Once enrolled with Supplemental Insurance for medicare, you will find that you will be saving yourself money.
Medigap Insurance: What Is It And How Can I Get It?
As the baby-boomer generation is approaching retirement age the word Medigap Insurance has become a very popular word.
The question is: What does it mean and how will it affect me? Turning 65 can be a very traumatic thing for some people, for others it is just a number. However you choose to look at it turning 65 will mean a lot of changes for you. 65 is the age when most people consider retirement so they can enjoy a slower pace of life and perhaps do things that they have never had time for. It can be a very confusing time as well, especially when it comes to senior health care coverage.
When you turn 65 it is important to know what your options are when in comes to senior health care coverage. On the first day of the month that you turn 65 you are automatically enrolled in Medicare. Medicare is a program that is designed to cover 80% of you medical care cost, leaving you with about a 20% portion. While this is a good program to have, if you have a serious illness and require a lot of care your 20% can add up fast leaving you with medical bills that total hundreds if not thousands of dollars. This is where a good Medigap plan or senior supplement plan comes into play. If you are enrolled in Medicare Part A then you can get a Medigap supplement plan. This plan will take up where traditional Medicare leaves off. For a small monthly premium payment you can have your 20% portion of your medical care covered 100%. That is great news for the baby-boomer generation, especially if you are on a fixed income. In addition, when you enroll during the open enrollment period you have guaranteed coverage regardless of the condition of your health without having to go through the underwriting process.
Don’t let this time of life become confusing for you. It is suppose to be a time where you can relax and enjoy yourself. The experts at 1-800-MEDIGAP can help you navigate your way through the senior health care insurance maze. With one phone call you can have your choice of coverage from some of the largest insurance carriers. Medigap Insurance agents waiting to help you take care of your Medigap insurance needs. Don’t hesitate call today.
Things you need to plan for when turning 65 !
Medicare Supplement Open Enrollment: “Things To Do”
Are you the type of person that has to plan everything out so that you feel like you are in control? Is your life, a long list of “things to do”? If you answered yes to either of those questions then there is one more thing you need to add to your list, especially if you are approaching retirement age and this will certainly make you feel that you are more in control that you ever have been. You must pick up the phone and call your medigap insurance agent and ask for information regarding Medicare supplement open enrollment. This bit of information could mean the difference of being financially secure in retirement to absolute destitution. Let me explain.
As you may be aware, once you reach 65 you are automatically enrolled in traditional Medicare. Medicare will cover approved procedures and service for items such as hospitalizations, emergency services, out patient services and medical equipment. It is divided into two parts, Part A and Part B. While Part A is essentially your hospitalization coverage, Part B is you medical coverage. Part B will require a monthly premium as well as deductibles and co-payments. It is great coverage and it will cover 80% of approved procedures and services leaving the remaining 20%, which is your responsibility. If you are in excellent health the remaining 20% may not be a big deal for you. However, if you have and kind of medical condition you may be setting yourself up for a financial disaster, especially if you are among the many who will be on a fixed income in your retirement years. This certainly will not figure into your plans and you will feel more out of control than ever before. With a Medicare supplement plan you can plan almost to the penny what you out go will be as far as expenses for health care is concerned.
As was stated above you will automatically be enrolled in Medicare at age 65, at that time you are eligible to enroll on a Medicare supplement plan. If you do enroll during the open enrollment phase you have guaranteed coverage regardless of the condition of your health. For one monthly premium payment your 20% responsibility will be covered 100%. So go ahead and make your list of “things to do”, but be sure that calling 1-800-MEDIGAP.
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