Medicare
Medicare is a federal government Health Insurance program for people
- age 65 and older
- under age 65 but with disabilities
- with end-stage renal disease
Medicare Part A - If you are approaching age 65 and are not yet receiving a Social Security benefit or are not enrolled in Medicare Part A, you may apply for Part A and your Social Security benefit at the same time. There is no charge for Part A because you or your spouse paid Medicare payroll taxes while working. If you or your spouse did not pay Medicare taxes, you may be able to buy Part A.
Medicare Part B - You are automatically eligible for Part B if you are eligible for Medicare Part A. If prior to turning age 65 you are already receiving a Social Security benefit you will be automatically enrolled in Part B. If not, you will need to enroll in Part B. The general enrollment runs from January 1 – March 31 of each year. Part B coverage will start on July 1 of the year you enroll. Each year you delay enrolling, the cost will go up by 10%. If you or your spouse are working and are covered under a group medical plan, you may delay enrolling in Part B without penalty. You have eight months in which to enroll in Part B after the group coverage ends, otherwise it will be necessary to wait until the next general enrollment period. Unlike Part A when you enroll in Part B, you will be subject to a monthly premium.
Medicare now has three parts. Part A is coverage for hospitalization. Part B is for non-hospital related care. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 added a prescription drug benefit, Part D. Effective in 2006, a standard prescription drug benefit will be available to Medicare beneficiaries through private plans. An interim prescription drug program called the Medicare Prescription Drug Discount card will go into effect on July 1, 2004, and will end on December 31, 2005.
Medicare Supplement plans are private insurance policies designed to provide supplement payment for the copayments and deductibles applicable to the Original Medicare benefit schedule. Medicare supplement plans are only available if you are covered under Parts A & B of the Original Medicare Plan. Part A of Original Medicare pays for…
- Inpatient hospital care
- Skilled nursing facility care (limited to 100 days)
- Hospice care
- Some home health care
Part B pays for…
- Doctors' services
- Outpatient hospital care
- Some other medical services not covered by Part A, like home health care and durable medical equipment
- Medically necessary covered services and supplies
Medicare Supplement benefit designs are federally regulated. All of the benefit designs for Part B, A-F+, are pre-determined by the federal government. All of the plans respond in the same way to Part A by paying 100% of charges for hospital services. They differ in how they pay for other medical services. Each of the plans pays for the Medicare Part B $100 deductible at 100%. Plan D adds an At-Home Recovery Benefit, Plan E offers a Preventive Care benefit, while Plan F pays for any Part B charges in excess of Medicare eligible amounts. Plan F+ is the same as Plan F, but subjects all expenses to a calendar year deductible of $1,790. New for 2006, Plans K and L. Plans K and L introduce coinsurance into the reimbursement amount. Plan K pays Hospital Care expenses at 50% with an out-of-pocket maximum of $4,000. Plan K pays at the rate of 75% with a $2,000 out-of-pocket maximum.
For a quotation or to apply for individual medical coverage, please visit the page "Contact Us".