Medicare

Medicare is administered by the Centers for Medicare and Medicaid Services. Since there are no Medicare offices available to answer questions in a face to face interview, Medicare provides the following three methods to obtain information: from the website (www.medicare.gov), by contacting a Medicare representative at 1-800-MEDICARE (1-800-633-4227), or by visiting an insurance counselor at your state health insurance and assistance program (SHIP). The Medicare website is certainly the fastest, and for many, the best way to access Medicare information.

Medicare consists of four parts:

PART A - Hospital Insurance. Helps pay for hospital services, skilled nursing services (up to 100 days), some limited home health services and hospice care.

PART B - Supplemental Medical Insurance. Helps pay for doctor fees, outpatient hospital care and durable medical equipment. Part B is voluntary and has a premium of $110.50 per month (2010). However, most people already receiving Social Security will pay the same as they did in 2009 ($96.50) if their annual income is $85,000 or less (or $170,000 or less for married couple).

PART C - Medicare Advantage. Medicare managed care plans that cover everything that traditional Medicare covers and most plans cover additional services. Part C is voluntary and fees may include the Part B premium or more, depending on the services.

PART D - Prescription Drug Coverage. Medicare beneficiaries have the option to enroll in the Medicare Prescription Drug Plan. Part D is voluntary and includes a monthly premium which varies according to the plan.

Deductibles (2010)

PART A - $1,100 for Hospital for first 60 days.

PART B - First $155 per calendar year.

PART C - (You do not need to buy a Medigap policy if you in a Medicare Advantage plan.)

PART D - First $310 for drug costs.

Co-Payments (2010)

PART A - $275 per day for hospital days 61-90 and $550 for days 91-150 (2005).

PART B - $137.50 per day for skilled nursing days 21-100.

PART C - 20% of Medicare approved charges.

PART D - 25% for drug costs from $310-$2,830. There is no additional Medicare coverage until the beneficiary spends $4,550 out of their own pocket. This gap has been referred to as the ?Donut Hole.? Once a beneficiary spends $4,550 out of their own pocket they pay a co-payment of 5% for prescription drug costs for that year.

Medicare Supplemental Insurance Plans (Medigap)

The ten NAIC-Approved Plans from A-J

Every state is different (check with the department of insurance).

Premiums vary widely, check strength of company.

Open Enrollment Requirement. NAIC Medicare Model for Medicare Supplement Insurance-there is an open enrollment for the first six month period when a beneficiary (age 65 and older) enrolls in Medicare Part B.

Medicare Does Not Usually Cover

Medicaid