ABCs of Medicare

Turning 65?  Getting ready to retire?  If so there are critical decisions you will have to make about your health coverage.  Failing to do so with in certain timelines could result in both penalties and gaps in coverage.  Click read more to see an overview of the different parts of Medicare that we can help you with.

 

MEDICARE PART A

Hospital Services

  • Days 1-60 $1340 deductible
  • Days 61-90 $335 per day
  • Days 91 and to 150 (60 lifetime reserve days) $670 per day

Skilled Nursing Facility

(must be in the hospital as an inpatient 3 or more days)

  • Days 1-20 $0 per day
  • Days 21-100 $167.50 per day
  • Days 101 and beyond you pay all costs

MEDICARE PART B

MEDICAL SERVICES

Part B Deductible $183 yearly

After your deductible is met, you generally pay 20% of the Medicare approved amount for most doctor services, outpatient therapy and durable medical equipment. You will also pay for most doctor services while you are a hospital inpatient.

MEDICARE PART C

MEDICARE ADVANTAGE PLANS

Medicare Advantage Plans are offered by private insurance companies approved by Medicare. If you join a Medicare Advantage Plan you are still part of the Medicare program. However your Part A and Part B benefits are provided by the Medicare Advantage Plan rather than Original Medicare.

These plans are required to cover all services approved by Medicare. Most Medicare Advantage Plans offer services in addition to Original Medicare and may also include Part D prescription drug coverage. Most Advantage Plans will be HMO’s or PPO’s.

MEDICARE PART D

PRESCRIPTION DRUGS

Medicare Part D plans are prescription drug plans offered by private insurance companies approved by Medicare. Each plan has its own list of covered drugs called a formulary. Within the formulary there are different drug tiers. The cost of your drug will depend on the tier it falls under. Typically the lower the tier the lower the cost.

Medicare Part D has a standard deductible of $405 in 2018. Some plans offer a lower deductible while others have no deductible at all. Part D Plans may also have discounts when using certain preferred pharmacies or mail order services. You can enroll in Part D coverage by purchasing a stand alone Prescription Drug Plan or by enrolling in one of the various Medicare Part C options (Advantage Plans) available in your service area.