Understanding the basics to Medicare:
- Medicare Part A, Hospital Insurance;
- Medicare Part B, Medical Insurance;
- Medicare Part C (Medicare Advantage), or
- Medigap Insurance (Medicare supplement insurance) and
- Medicare Part D, prescription drug coverage.
Generally, people who are over age
65 and getting Social Security automatically qualify for Medicare Parts A and
B. Some people with certain disabilities also may qualify for Medicare
that are under the age of 65.
Medicare Part A
is paid for by a portion of Social Security tax. It helps pay for
inpatient hospital care, skilled nursing care, hospice care and other services. Part A has coinsurance and a deductible of
$1,156 unless you have a Medicare supplement that covers that amount. This is not an annual deductible and can be
every 60 days in some cases.
Medicare Part B
is paid for by the monthly premiums of people enrolled and by general funds
from the U.S. Treasury. It helps pay for doctors' fees, outpatient
hospital visits, and other medical services and supplies that are not covered
by Part A. Part B has a deductible and
coinsurance unless you have a Medigap (Medicare supplement plan) that covers
it. It is important to get a Medicare
supplement policy within 6 months of your Part B effective date. This period is referred to as open enrollment
and you are not required to qualify with health questions.
Medigap Insurance (Medicare supplement insurance). Medicare Part A
& B covers about 80% of the costs. A
lot of people decide to get Medicare supplement insurance (Medigap Insurance)
to cover the gaps that Part A & B does not cover. These plans tend to cover deductibles,
coinsurance and sometimes copays. There
is no network so any doctor or hospital that accepts Medicare will accept a
Medigap plan because it’s the law. Also,
the benefits can’t change from year to year.
The plans are designated with a corresponding letter and currently are
Plan A through D, Plan F, Plan G and Plans K through N.
One of our Licensed Benefit Advisors
can help make Medicare seem much easier to understand than it appears. Click the link if you would like to Compare
Medicare Supplement Plans Instantly Online.
Part C (Medicare
Advantage) is optional if you decide not to get Medicare supplement insurance
(Medigap Insurance). Typically this type
of plan has a network and requires you to get a referral to see a
specialist. The benefits to this plan
can change from year to year and if you move you may need to change plans. If you decide you want one of these plans it
is very important to understand the “max out of pocket” expense section of the
plan. These plans may help lower your
costs of receiving medical services, or you may get extra benefits for an
additional monthly fee. You must have both Parts A and B to enroll in
Part C. You can’t get Medigap Insurance
(Medicare supplement insurance) if you have Part C.
Part D
(prescription drug coverage) is voluntary and the costs are paid for by the
monthly premiums of enrollees and Medicare. Unlike Part B in which you
are automatically enrolled and must opt out if you do not want it, with Part D
you have to opt in by filling out a form and enrolling in an approved plan.
Bill Loughead
We make Medicare seem easy!
1-888-40-Summit (888-407-8664)
info@summitmedigap.com
