Turning 65 today is good news and bad news. The bad news: is you’re getting up there. But 65 in this day and age is the new 45. The good news is: you are now eligible for Medicare. What a relief! So congratulations, you are about to join over 47 million people on Medicare today. Although we have heard the word ‘Medicare’ time and time again, no one really knows what it provides.
To start, it provides Medical and Hospital coverage. We turned to Joseph Battaglia to educate us on Medicare. Joseph is the President of Senior Services of North America. He assists thousands of Medicare Beneficiaries across the country with their health insurance options. Joseph is a featured speaker on this topic with many associations and holds seminars to educate retirees and seniors as well as insurance agents. He is highly regarded in the insurance industry for his expertise in the senior marketplace and has mapped out Medicare for our LATF readers.
“In today’s world, it is not unusual to be living on limited income and with the spiraling costs of healthcare, protecting your health is a major concern. Inadequate health insurance could be disastrous both financially and emotionally,” said Joseph Battaglia, President of Senior Services of North America.
Joseph helped to navigate us through the different parts of Medicare, which he refers to as A, B, C and D.
WHAT IS “PART A” & HOW MUCH DOES IT COST?
Part A covers your hospitals, hospice and skilled nursing facilities. If you have worked 10 years, there is no premium for Part A. However, that does not mean there are no costs when you go into the hospital. For example currently if you are in the hospital from 1-60 days there is a $1216 deductible which increases as your stay increases.
WHAT IS “PART B” & HOW MUCH DOES IT COST:
Part B covers medically necessary doctors’ services, out-patient care, home health services, durable medical equipment as well as other preventive services. The premium for this coverage depends on your income. The standard monthly premium amount is $104.90. Now that you have paid the premium, that does not mean there are no other costs involved. For example, there is a one-time annual deductible of $147 and a 20% co-insurance for all costs after the annual deductible. Considering the high costs of medical procedures, the 20% co-insurance can be costly.
So now you are probably wondering, “How do I cap my medical and hospital costs and also include a prescription drug plan?”
Coming to the healthcare rescue is “PART C” and “PART D,” as well as a Medicare Supplement Plan.
“PART C” ALSO KNOWN AS “MEDICARE ADVANTAGE PLANS”
A Medicare Advantage Plan is in addition to your Original Medicare Part A & B and there are plans that even include “Part D” Prescription Drug Coverage. This wrap-around coverage enhances your Medicare coverage and eliminates or reduces many of your out-of-pocket expenses. With Medicare Advantage Plans, you may pay a monthly premium and small co-payments when you utilize the plan services. There are different plan types such as HMO’s or PPO’s depending on where you live. These plans are offered by private insurance companies that have a contract with Medicare and are affordable. Millions of seniors take advantage of these plans yearly.
WHAT IS “PART D”?
“Part D” is Prescription Drug Coverage. If you enroll in a Medicare Advantage Plan, most include a “Part D” Plan. If you do not enroll in a Medicare Advantage Plan and choose to stay on only Original Medicare, then you may enroll in a “Part D” Prescription Drug Plan. Each plan can vary in costs and coverage.
Now that you know the A, B, C’s of Medicare. What exactly is a Medicare Supplement Plan?
Medicare Supplement Plans are also health insurance options offered by private insurance carriers that provide comprehensive coverage to supplement Medicare. These plans vary in costs depending on the plan that is chosen. Typically a person chooses this type of plan when they prefer to pay a higher monthly premium and eliminate or reduce co-payments. So, if a higher monthly premium is not a concern to you, this may be a good option to give you piece of mind. With this type of coverage, you will need to get a stand-alone Part D plan for your prescriptions.
This is a basic summary on the parts of Medicare and the coverage for each. Like millions of Medicare beneficiaries, you may be looking for additional coverage that Medicare does not cover. Reviewing your “Medicare and You” Handbook will give you more detailed information.
You may also seek out help from a professional, licensed health insurance agent. There may be Medicare Advantage Plans in your area with a zero monthly or low cost premium. Whether you are turning 65 and new to Medicare or already have a Medicare Advantage Plan, it is wise to review your coverage annually to ensure that it is the most suitable, comprehensive and affordable plan for you. Knowing your options can save you hundreds or even thousands of dollars each year on your healthcare expenses. When looking at your options, it is important to make sure that your doctors, hospitals and prescriptions are covered by a plan you have interest in. Make a list of your doctors, hospitals and prescription drugs and compare it to the plans available to find the most comprehensive, suitable and affordable plan to best cover your needs.
Did you know…..
OCTOBER 15th THRU DECEMBER 7th IS KNOWN AS THE ANNUAL ENROLLMENT PERIOD (AEP). THIS IS THE TIME OF YEAR THAT YOU SHOULD REVIEW AND COMPARE YOUR PRESENT COVERAGE TO THE NEW OPTIONS THAT MAY BE AVAILABLE EACH YEAR AND MAKE ANY CHANGES TO YOUR PRESENT PLAN. ALL CHANGES HAVE TO BE MADE DURING THIS PERIOD AND ARE EFFECTIVE FOR JANUARY 1st.