Whether you are new to Medicare or have had it for many years it is important to realize the importance of having a Supplement or Advantage plan as well. Listed below you will find a basic overview of some of the expenses you will have if you have basic Medicare only.
If you have worked and paid taxes in the US for 40 quarters (10 years) in your lifetime you will be eligible for Part A with no monthly premium. You should be automatically enrolled when you turn 65.
The Medicare Part A deductible for 2012 is $1156.00 per benefit period*. You will also pay $289.00 per day for stays of 61-90 days. A good insurance plan will cover all or most of this cost.
If you make $85,000 per year or less or up to $170,000 for a married couple your Part B premium will be $99.90 per month in 2012. For those above these income levels a higher premium will apply based upon your income. You should refer to the Medicare And You Handbook to determine your monthly premium.
The Medicare Part B deductible for 2012 is $140.00 per year. After this deductible is met, you are responsible for 20% of all medial costs. This applies to all outpatient services including but not limited to Doctor visits, x-rays, MRI, lab tests, durable medical care and outpatient rehabilitation. There is no limit on your cost sharing. For Example: If you have $100,000 dollars in bills you will pay $20,000.00 as co-insurance.
Having an insurance plan with your Medicare will keep your costs down and protect you from catastrophic medical expenses. The type of plan you choose should be determined by your specific needs. Each plan has a different level of coverage. You will save money by choosing the correct plan
If you travel frequently or require frequent medical care then a Medicare Supplement plan may suit your needs. When you purchase a Medigap plan a separate Part D plan for prescription drug coverage will need to be purchased separately as Medigap plans provide health coverage only. There are many varieties of these plans. Visit our Medicare Supplement page for details.
Benefits: The most comprehensive nationwide coverage, no referrals needed and no network limitations. Many plans have no deductibles or co-pays.
Cost: These plans can have high monthly premiums. Medicare supplement plans are the most expensive option but may be the best choice for some. You should check pricing in your area to determine if this is a good option. Visit our Get A Medicare Quote section for details.
This insurance is provided by private insurance companies with a contract from Medicare. The insurance companies receive subsidies from the Federal Government keeping your costs lower. Most plans have very low or even $0 monthly premiums in many cases. These plans are offered in several varieties including HMO, PPO and PFFS. You can visit our Medicare Advantage page for more details.
Benefits: Many of these plans offer additional benefits that are not provided by original Medicare such as dental, vision, hearing and health club memberships. Most plans also include prescription drug (Part D) coverage.
Cost: Very affordable! Most plans will have a very low or $0 monthly premium. You will have modest co-pays for medical services. You should check for availability in your county for details. Visit our Get A Quote section for pricing in your area.
*Benefit Period—The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you go into a hospital or skilled nursing facility. The benefit period ends when you haven’t received any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a skilled nursing facility after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods.