Sunday, October 14, 2012

How does Medicare & Medigap insurance work?



Understanding the basics to Medicare:

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

Sunday, October 7, 2012

Medicare Premiums- The cost of Part B

Medicare Premiums- What does Medicare Part B cost?



You pay a premium each month for Medicare Part B (Medical Insurance). Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.

How much does Medicare Part B cost?

Most people pay the Part B premium of $99.90 each month. You pay $140 per year for your Part B deductible and also co-insurance unless you have Medicare supplement insurance.  Some people automatically get Part B.  If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty.  If you’re modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount, you may pay more. 

Social Security will contact some people who have to pay more depending on their income. The amount you pay can change each year depending on your income. If you have to pay a higher amount for your Part B premium and you disagree (for example, if your income goes down), you should contact Social Security.

Part B premiums by income
If your yearly income in from 2 years ago was:

File Individual tax return                       File joint tax return               You pay


$85,000 or less                                       $170,000 or less                   $99.90
$85,000 to $107,000                              $170,000 to $214,000            $139.90
$107,000 to $160,000                            $214,000 to $320,000            $199.80
$160,000 to $214,000                            $320,000 to $428,000            $259.70


In contrast, 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 A & B does not cover everything.  It is recommended to get a Medicare Supplement Insurance (Medigap Insurance) in order to make sure deductibles, co-insurance and co-pays are covered.  You can click the link if you would like to Compare Medicare supplement insurance instantly online.


Bill Loughead
SummitMedigap.com
We make Medicare seem easy
1-888-40-Summit (888-407-8664)
info@summitmedigap.com

 

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