Medicare Basics
Establising a strong, fundamental foundation of Medicare knowledge will help you to make informed decisions about your health coverage. Medicare has 4 primary components:
- Medicare Part A - Hospital
- Medicare Part B -Medical Insurance
- Medicare Part C - Medicare Advantage
- Medicare Part D - Prescription Drug Beneftis
Medicare Part A: Hospital Insurance
Medicare Part A pays for the services that hospitals provide, such as the room, nursing services, and supplies for an inpatient stay. In some cases, Part A may pay for a stay in a skilled nursing facility, as well as home health and hospice care. Fortunately, most people do not have to pay a monthly premium for Part A coverage. It is funded by a portion of the Social Security tax you and your employers have already paid.
Part A, however, will not cover all your hospital costs. There is a deductible of $1,068 per benefit period for 2009. You must pay your entire deductible before Medicare Part A will cover any hospital expenses. In addition, if you are hospitalized for an extended period, you will also have to pay a daily coinsurance fee. This is $267 per day for days 61 – 90, and it rises to $534 a day for your 91st day through 150th day.
These costs can build up. If you are hospitalized for 60 days, you’ll only be responsible for your Part A deductible. But if you are hospitalized for 100 days, you’ll pay almost $13,350.
Medicare Part B: Medical Insurance
Medicare Part B pays for the services that doctors provide, in the hospital or in their offices. It also pays for outpatient hospital services, long-lasting medical equipment like wheelchairs and walkers, and other medical services and supplies. Part B is optional. If you decide to enroll in Medicare Part B, you may also apply for a supplemental plan of your choice without answering health questions.
Part B works like most health insurance plans. You pay a monthly premium which is based on your income, that you can even have deducted from your Social Security check. For 2009, you must meet an annual deductible of $135.00. After that, Medicare generally pays 80% of the charges it approves. You typically are responsible for paying the remaining 20% or applicable co-payment, plus any charges that are higher than Medicare’s approved amounts if the provider does not accept Medicare assignment.
Medicare Supplement or “Medi-Gap” plans pay for many health care services and supplies, but original Medicare plans do not cover all. These costs are called “gaps” in Medicare coverage. A Medicare Supplement or “Medi-Gap” policy is designed to help cover these gaps. You pay a monthly premium for this additional coverage. |