Making Medicare Choices
Making Sense Of Medicare
No one cares more than you do about
your health, the kind and quality of care you want to receive and the
resulting impact on your financial resources. Access to quality,
affordable health care is high on most Americans' list of
concerns about the future. Your Medicare decisions may affect
not only your own health care experiences but also the ease with
which your family members or other caregivers can help provide for
your health needs later in your life.
| For More Information |
Visit the government's official Medicare Web site, www.medicare.gov, for help in comparing, assessing and understanding Medicare benefits.
| You can also call: |
| Medicare |
(800) 633-4227 |
| Social Security Administration |
(800) 772-1213 |
| Department of Veteran's Affairs |
(800) 827-1000 |
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A general understanding of the federal Medicare
Program and modifications which expand Medicare benefits is helpful
when you are considering your Medicare options.
You can choose different ways to get your
Medicare coverage. Because your options vary in coverage, costs,
quality and even availability, you will want to carefully consider
your own health-care requirements, your financial resources and
other personal factors as you review this material.
Taking
the time to learn about Medicare and evaluate options now
— before you are required to make decisions — is important.
Use this article as a guide to making Medicare choices.
Original Medicare
Often referred to as “Original Medicare,”
the traditional delivery program for Medicare benefits offers
fee-for-service coverage and allows significant latitude in your
choice of health care providers and facilities. When covered by
Original Medicare, you are free to go to any physician (including
specialists), hospitals or other health-care providers that accept
Medicare anywhere in the country at any time. However, Original
Medicare does not cover all medical services. When you incur medical
expenses Medicare pays its share of the Medicare-approved
amount for each service and you pay your share — known as
cost-sharing (deductibles, co-payments and coinsurance fees).
Original Medicare is comprised of two separate parts,
Part A Hospital Insurance and Part B Medical Insurance, each with different
coverages, rules and cost structures. Original Medicare is managed by the
federal government and the benefits are the same for all Medicare beneficiaries
nationwide.
Medicare Part A And Part B
Medicare Part A Hospital Insurance
- Provides coverage to help you pay for inpatient care
in hospitals and skilled nursing facilities (does not
include custodial or long-term care services). Part A
also helps cover some home health-care and hospice
services and inpatient prescription drugs. For specific
coverage details visit
www.medicare.gov or call Medicare at
(800) 633-4227.
- Coverage is premium-free for
most eligible individuals.
- Generally, you are automatically enrolled on your
65th birthday.
Medicare Part B Medical Insurance
- Provides coverage to help you pay for
physician's services, outpatient care and other Medicare-approved
medical expenses not covered by Part A. For specific
coverage details visit
www.medicare.gov or call Medicare at
(800) 633-4227.
- Coverage is voluntary and
premiums are generally deducted from your Social
Security check.
- Premium is set by the federal
government and can change from year to year. The
standard monthly premium in 2010 is $110.50; however,
individuals with higher incomes may pay more. For
2010, individuals will pay a higher monthly premium if
their 2008 federal income tax return had modified
adjusted gross income of $85,000 or more ($170,000 if
married).
- Unlike Medicare Part A where
you are automatically enrolled on your 65th birthday,
you must enroll in Part B coverage. You
will receive a
government-solicited offer before your 65th birthday,
which is your Initial Enrollment Period. Your Initial
Enrollment Period is a 7-month period that begins 3
months before the month you turn age 65, includes the
month you turn age 65, and ends 3 months after the
month you turn age 65. In order for your Part B
coverage to begin when you turn 65, you must enroll
during the 3 months prior to the month you turn age
65.
- If you wait to enroll until your Part B
Initial Enrollment Period is over (3 months after
the month you turn 65), your start date will be
delayed and you may have to pay more for your
Medicare Part B premium. A late enrollment penalty
increases the premium 10 percent for each 12-month
period for which you could have had Part B but did
not enroll and this penalty would apply as long as
you have Medicare Part B.
- If you miss your Initial
Enrollment Period, you may enroll from January 1
through March 31 each year. Part B coverage begins
July 1 if you enroll during this General Enrollment
Period.
- There is a Special Enrollment Period if you delay
Part B enrollment because you or your spouse has
group health coverage through an employer- or
union-sponsored health plan. No late enrollment
penalty is applicable.
- If you do not enroll in Medicare Part B when you first
become eligible, contact the Social Security Administration office
to enroll. If you get benefits from the Railroad Retirement Board,
visit www.rrb.gov.
Topics covered in this section are:
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Updated Thursday, February 11, 2010
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