Medicare News

Turning 65 or going on Medicare for the first time can be an overwhelming experience in one’s life. Coupled with that, most make an attempt, sometimes futile, to understand the complex world of Medicare and Medicare insurance. This article is to serve as a primer of the “parts” of Medicare, of which there are currently four, and what they do.

Part A

Part A is the part of Medicare that everyone gets from paying into the social security system during their working life (as long as they meet the minimum work amount requirements). The primary thing that it covers as inpatient hospital care, and you will sometimes here it referred to as the “hospital” part of Medicare. However, it does also cover skilled nursing facility care, home health care and hospice facility care.

Part B

Medicare Part B is optional – most people who have employer coverage that works with Medicare coverage do not necessarily need Part B until or unless their employer coverage ends. Medicare Part B has a monthly premium associated with it, that is typically paid out of one’s social security check.

Part B covers “services” primarily, and it is sometimes called the “doctor’s office” part of Medicare. Some of the primary things that it covers include doctor’s services, diagnostic tests, outpatient services and physical therapy and some preventive-type screenings.… Read more

If you are about to turn 65, you have probably been studying up on how Medicare works and the various plans it offers. Because some of the plans are similar, the differences between them are often blurred, leaving potential beneficiaries confused about what plan is right for them.

Medicare Part C, known as a Medicare Advantage Plan, is one of the four basic parts of the Medicare system. It allows users of the original Medicare Parts A and B to get coverage from a government approved private insurance company of their choice. Medicare Advantage Plans include plans like Health Maintenance Organization Plans (HMO) and Preferred Provider Organization Plans (PPO). The biggest weakness the original Medicare plans have is that they do not cover the cost of prescription drugs. If you want additional coverage, you have a few options.

Medicare Part D is available to anyone with original Medicare (Parts A and B), and can help cover the costs of prescription drugs. You must get this coverage through a private insurance company approved by Medicare. If you have a Medigap policy, the same as supplemental Medicare insurance, it may already cover the costs of drugs. But if it does not, you are allowed to get a Medicare Prescription Drug Plan as part of Medicare Part D, but must alert your insurance company if you do so.… Read more

If you are eligible for Medicare, you might want to look into Medicare Advantage programs as well. Formerly known as Medicare +Choice, Medicare Advantage is the private insurance option of Medicare. It offers participants the choice of using a private insurance plan instead of Medicare itself. Since Medicare’s for-fee services and restrictions can be significant, particularly in the case of prescriptions, providing people with this option allows many people to get better health insurance coverage with more benefits and lower out-of-pocket costs. And, because the cost of these plans is determined by competition among providers, you can often find an inexpensive plan that covers your needs, becoming an excellent alternative to Medicare itself.

Medicare Advantage (also known as Medicare Part C) allows you to sign up for a HMO or PPO plan…or Fee For Service (FFS) or a Medical Savings Account (MSA)…whatever fits your needs best. Or not. You are not forced to use a private insurer if you feel that Medicare’s coverage is adequate for your needs.

In the past, a Medicare Advantage plan also included the opportunity for much better prescription coverage. However, with the passage of the Medicare Part D prescription plan instituted in 2006, Medicare recipients now must sign up for a private prescription plan, even if they do not sign up for anything else but basic Medicare.… Read more

Medicare is not 100 percent coverage of all your medical care. There are “gaps” in the coverage that Medicare supplemental insurance plans are designed to fill. That’s why supplemental Medicare insurance is also called “Medigap” insurance.

Basic Medicare coverage – what the insurance folks call original Medicare – provides coverage of most medically necessary hospital bills and doctor’s fees for participating providers, up to about 80 percent. And therein lies the first big gap: the 20 percent you have to pay.

Medicare also does not cover vision, dental and hearing care. There is no coverage for routine checkups. Nor are outpatient prescription drugs covered. You also won’t find long-term care included. Now Medicare is beginning to look more like a sieve than a safety net.

This isn’t to say that Medicare coverage can’t be a financial lifesaver. It can. But the things Medicare doesn’t cover can add up pretty quickly if illness strikes.

But let’s talk about what Medicare does before going too far into what it doesn’t do. First, who’s eligible? That’s easy. You are eligible for Medicare if you are:

? 65 years old or better and eligible to receive Social Security

? Disabled

? Receiving dialysis or awaiting a transplant for permanent kidney failure (end-stage renal disease, ESRD)

Original Medicare consists of a Part A and a Part B.… Read more

Medicare is notorious for creating gaps in coverage that make it hard to accept when you get a bill for your money out-of-pocket. Not knowing what your premiums or deductibles are could get you into trouble with not knowing what is going on in an important game. You can walk in the door of multiple companies and get different quotes for Medigap policies from each and every one of woh.

When researching Medicare supplement insurance you want to make sure it is a fair comparison and compare very similar policies. If you are desperate to get help as soon as possible you should look in to your local state office as the Medicare supplement insurance policies will vary greatly from one area to another.

As of June 1, 2010, the types of Medigap Plans that you buy changed: 1. Plans M and N are going to be the newest kids on the block and should be treated with care.

2. Plans E, H, I, and J are no longer available to buy on the open market. If you already have or you buy Plan E, H, I, or J before June 1, 2010, you can keep that plan, just look around for something new that could benefit you.… Read more

There are several different parts of Medicare to learn about when you use it as your health insurance. If you take the time to learn about the differences, you will be educated enough to make the best decision on which plan to choose. One of the parts of Medicare is called Medicare Part B.

Premiums Associated with Part B

Almost everyone who has Part B coverage must pay the premium price for it. It is possible to qualify in your state for help to pay the premiums and/or deductibles. If you don’t qualify for the state help, the premium is normally deducted from a person’s Social Security, Civil Service Retirement, or their Railroad Retirement check. You also have the options of paying the premium every quarter, through Medicare Easy Pay, or by using the electronic payment option. As of January, 2007, Medicare Part B premiums are based on a person’s income level.

So What Exactly is Medicare Part B?

Part B is simply a health insurance program overseen by the government that is available to those who meet eligibility requirements. This insurance covers doctors appointments, outpatient services, physical or occupational therapy, certain home health care, and a few other services Medicare Part A doesn’t cover.… Read more

If you or someone you know is about to go on Medicare, you should know that you’ll be able to choose how you receive your Medicare benefits including your prescription drug coverage. This brief article will explain some of the more popular options as well as give you specific phone numbers to call with you Medicare questions. Medicare health insurance is currently for people who are age 65 or older, under age 65 with certain disabilities, and at any age living with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant.

While Medicare covers a lot of different health care services and supplies, it does not cover all of the costs associated with your health care. There are “gaps” associated with Medicare that require the beneficiary to pay out of their pocket. These Medicare costs include coinsurance, copayments and deductibles. Depending on the Medicare health plan you choose, you’ll have varying degrees of costs.

Medicare Health Plan Options

Original Medicare is managed by the Federal Government and provides Part A and Part B health coverage. Original Medicare pays for many of the health care services and costs associated with normal services and supplies. Original Medicare does not pay for all of your health care costs.… Read more

Some Medicare Advantage Plans have gotten a bad rap lately, but that may have been because of the overzealous marketing efforts of a few people, rather than the actual plans. All Medicare Advantage plans must be approved by the Center for Medicare and Medicaid (CMS). They must provide services that are equal to, or better than, services provided by the traditional Medicare Part A and Part B. Of course, the point of these plans is to provide services that will provide advantages over Part A and Part B!

What is the Problem With Medicare Advantage?

The recent flak over Medicare Advantage Plans is over the type of plan called PFFS (Private Fee For Service). These plans allowed access to “any doc”, or the enrolled person’s choice of Medicare care. The problem there was that the doctor or other medical provider had to accept and bill to the plan. Since some of the plans were very new, medical providers like doctors, hospitals, and therapists did not have the plans yet. This caused problems because the enrolled people needed to file the bill with the insurance companies instead of having the medical provider do it. Indeed, this did cause problems for many Medicare recipients.… Read more

To say that Medicare is a labyrinth of legal jargon that’s beyond the comprehension of the average American is an understatement. When it comes to Medicare and a Texas Medicare supplement, what you don’t know can definitely hurt you. In fact, many people simply don’t have the right information to make educated decisions – something that could come to haunt them down the road. Here are some common myths about Medicare, and some facts about finding a Medicare supplement in Texas.

Myth #1: Medicare automatically covers me after I retire.

Retirement and Medicare are unrelated. Unless you receive Medicare for a disability, you must be 65 years old in order to be eligible for Medicare benefits.

Myth #2: The government will automatically enroll me in Medicare.

You won’t necessarily receive automatic enrollment; rather, it depends upon your work history. If you’ve worked 40 quarters in the United States, you’ll be automatically enrolled in Medicare Part A. If you started receiving Social Security benefits when you were 62, you’ll automatically be enrolled in Part B, but have the option of declining the coverage if you’re covered by, for example, a group health plan.

If you haven’t worked 40 quarters, you have to enroll in Medicare through your local Social Security office.… Read more

A Medigap policy is a supplemental health insurance plan offered by private insurance carriers to fill the “gaps” in Original Medicare Plan coverage. Insurance carriers selling Medigap plans must follow all Federal laws as well as state laws that protect people with Medicare. All Medigap policies must clearly be identified as “Medicare Supplement Insurance”on the front of the policy. The Original Medicare Plan pays for many healthcare services and medical supplies, however it will not cover all your healthcare expenses. There are a number of costs you have to pay, such as co-payments, co-insurance, and your deductibles. These charges are usually called “gaps” in your Medicare coverage.

All new Medigap policies sold must be one of twelve standardized insurance plans, A through L. This is true for all states except Wisconsin, Massachusetts, and Minnesota. The actual benefits in any Medigap Plan A through Plan L are required to be exactly the same for every insurance company. For example, the features and benefits in one insurance carrier’s Medigap Plan C are exactly the same as every other insurance carrier’s Medigap Plan C. However, the premiums for a Medigap policy can be quite different, and are determined by the insurance carrier. The twelve plans include two additional plans, K and L which were added in 2005.… Read more