Medicare and Its Components
Basic summary of medicare and its benefits.
Medicare is going to be changing under the new health laws. It is important to keep up with these changes. To further complicate things, Congress has introduced bills to alter the changes under Obama health. Right now, this is where we are:
Medicare A: covers hospitalization including some nursing home care such as rehab, this is a free benefit if you have enough Social Security quarters. Some individuals wind up paying for this.
Medicare B: covers doctor visits and out of hospital care – you have to pay for this – you can refuse this coverage, but it is usually cost effective to take. If you refuse this benefit when first offered, you will pay a penalty if you elect it later on. Most people are paying $96.40 monthly for this benefit. Even if you select C, you still need to pay for B.
Medicare C: This is the Senior Advantage programs that include HMOs or PPOs – you elect these and will have to pay for this. Most Senior Advantage Plans include A,B,C, and D at this time. You do not need to sign up for Medicare C.
Medicare D: This is drug coverage which you have to elect. It is about $30 a month if you buy it separately. This is usually a good deal, but you don’t have to buy it.
When you turn 65, you have a seven month window to sign up for benefits. If you fail to do this, then you must sign up during the annual enrollment period of January 1 – March 31 each year. It will cost you more if you don’t sign up during the initial enrollment period. If you have you insurance through an employer, say the federal government, you will have to sign up during the company’s open enrollment period. Beware that disability and certain medical diseases will allow you to sign up for these benefits before 65, and some folks can be eligible at 62 if they retire early.
If you have or sign up for a Senior Advantage Plan you do not need and cannot be sold a Medicare Gap Plan. A Medicare Gap Plan will cover some of the gaps in your A, B, and D coverage. It will cover only the gaps listed in the plan. If you buy a Senior Advantage Plan and have Medigap coverage, the Medigap coverage will not pay for any of your expenses. Medicare will not pay twice for the same care. You cannot have both types of coverage.
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