Understanding the ABC of Medicare

Understanding the ABC of Medicare

While most of the seniors I help with the purchase of a Medicare Supplement or Advantage Policy are well educated, everyone makes a comment about being totally confused by their choices. A large part of the problem is the language of Medicare. Once you understand the basics, you realize that it is not so complex. Medicare is a federal health insurance program that pays most, but not all, of the medical expenses of people over 65. It also covers people under 65 with certain disabilities.

These are the four parts:

• Part A helps cover hospital care in a hospital, skilled nursing facility, palliative care and home care. If you or your spouse paid Medicare taxes while working, you will not pay anything for Part A.

• Part B helps cover medical services, outpatient hospital care and some preventive services. For people new to Medicare in 2011, the average Part B premium is $ 115 per month. This value is higher for singles who earn more than $ 85,000 or couples who earn more than $170,000.

• Part C is the Medicare Advantage Plans (also known as Medicare Health Plans). These plans are another way to receive your Medicare benefits and are sold by private insurance companies approved by Medicare. They combine the benefits of A, B and often D. To qualify for the Medicare Advantage Plan, you must be enrolled in A and B.

• Part D is Medicare prescription drug coverage. As of this year 2011, people with high incomes will pay a surcharge for this coverage. If you are not currently taking prescription medications, you may be tempted not to buy a plan. However, if you stop buying a drug plan when you are first eligible, you will have to pay a higher premium if you decide to buy it later. Financial assistance is available through government programs for low-income people.

Most people buy a Medicare supplement and a drug plan or a Medicare benefit plan that includes drug coverage. The Medicare Government Manual and you are designed to help you make this decision. If you already know that you want a Medicare Supplement (also known as Medigap Policy), the government manual “Choosing a Medigap Policy” will help you decide which policy is your best option. The government website, helps Medicare beneficiaries choose Medicare Advantage and drug plans with an online review based on their zip code and prescription drugs. North Carolina residents can call the Senior Health Insurance Information Program (SHIIP) at 1-800-443-9350 when they have questions about their health insurance care plans. While you can spend days doing the research yourself and buy without assistance, an insurance broker with a Medicare Supplement License can do the research for you.