Medicare Part A (Hospital Insurance)

Medicare Part A helps pay for care in hospitals as an inpatient, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care. Information about your coverage under Medicare Part A can be found in the Medicare Coverage database.

If you aren’t sure if you have Part A, look on your red, white, and blue Medicare card. If you have Part A, “HOSPITAL (PART A)” is printed on your card.

How Can I Enroll In Traditional Medicare?

If you already receive Social Security Benefits, you will automatically be enrolled in Medicare Part A and Part B the month you turn 65. Three months prior to your birth date you should be receiving your Medicare card in the mail.

If you do not receive Social Security Benefits, you will not be automatically enrolled. You need to apply at the beginning of your seven-month initial enrollment period (90 days prior to your 65th birthday) to make sure your coverage start date will not be delayed. At this time you have also the option to apply for Social Security Benefits.

Do I Have To Pay For Traditional Medicare?

If you or your spouse paid Medicare taxes while you worked you do not have to pay a monthly payment called a premium for Part A. If you or your spouse did not pay Medicare taxes or you did not work, and you are age 65 or older, you still may be able to buy Part A when:

• You (or your spouse) aren’t entitled to Social Security because you didn’t work or didn’t pay enough Medicare taxes while you worked and you are age 65 or older, or
• You are disabled but no longer get premium-free Part A because you returned to work.

If you have limited income and resources, your state may help you pay for Part A and/or Part B.

For more information you can visit www.socialsecurity.gov or call your Social Security office.
It might be a good idea to think about additional coverage by comparing Medicare Supplemental insurance quotes and Medicare Advantage plan quotes to your Medicare Part B premium in order to find the health care coverage that best suits your needs and your budget. Also, adding a Medicare prescription drug plan may help you with high costs for medications in the future.

Medicare Part B (Medical Insurance)

Medicare Part B helps pay for doctors’ visits, outpatient hospital care, and some other medical services that Part A doesn’t cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Information about your coverage under Medicare Part B can be found in the Medicare Coverage database.

To find out about the 2010 rates for Part B, click here.

How Do I Enroll In Medicare Part B?

If you already receive Social Security Benefits, you will automatically be enrolled in Medicare Part A and B the month you turn 65. Three months prior to your birth date you should be receiving your Medicare card in the mail.

If you don’t receive Social Security Benefits you need to apply at the beginning of your seven-month initial enrollment period (90 days prior to your 65th birthday) to make sure your coverage start date will not be delayed. Please call or visit your Social Security office to sign up. At this time you have also the option to apply for Social Security Benefits.

What Is The Late Enrollment Penalty For Part B?

If you don’t sign up for Medicare Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it. Usually, you don’t pay a late enrollment penalty if you sign up for Part B during a special enrollment period.

Do I have To Enroll in Part B?

Enrolling in Part B is your choice. However, you will automatically be enrolled in Plan B if you qualify for traditional Medicare, and have to opt out if you don’t want it.

How Do I Opt-Out Of Part B Coverage?

If you want to opt out of Part B coverage, you will need to follow the instructions with your Medicare card.

Do I Have To Pay For Traditional Medicare?

If you or your spouse paid Medicare taxes while you worked you do not have to pay a monthly payment called a premium for Part A.

If you or your spouse did not pay Medicare taxes or you did not work, and you are age 65 or older, you still may be able to buy Part B when:

• You (or your spouse) aren’t entitled to Social Security because you didn’t work or didn’t pay enough Medicare taxes while you worked and you are age 65 or older, or
• You are disabled but no longer get premium-free Part A because you returned to work.

If you have limited income and resources, your state may help you pay for Part A and/or Part B.

It might be a good idea to think about additional coverage by comparing Medicare Supplemental insurance quotes and Medicare Advantage plan quotes to your Medicare Part B premium in order to find the health care coverage that best suits your needs and your budget. Also, adding a Medicare prescription drug plan may help you with high costs for medications in the future.

Medicare Supplement Plans

What Are Medicare Supplement Plans?

Traditional Medicare (Part A and B) does not provide 100% coverage for medical expenses such as deductibles, co-payments, and co-insurance. Therefore Medicare Supplement Plans were designed to help pay the costs that Medicare does not cover. Medicare Supplement Plans are also referred to as Medigap.

Medicare Supplement Plans add additional health care insurance coverage provided by private insurance companies to cover the gaps in the traditional Medicare Plan. Medigap policies are regulated by Federal and State Laws in order to protect you as a consumer. Medigap policies have to be clearly labeled as Medicare Supplement Insurance, and the policies are standardized for each State.

Medicare pays the private insurance company a set amount of money for each person who enrolls in their plan. The insurance company then pays the medical bills for the enrollee. The enrollee is responsible for co-payments as described in each plan’s summary of benefits.

Am I Eligible For A Medicare Supplement Plan?

Medicare Supplement Plans only work in conjunction with Traditional Medicare.

Typically, you must have Medicare Part A and Part B in order to be eligible for a Supplement Plan.

Your application will be accepted if you are 65 or older and apply within six (6) months of your initial enrollment in Plan B of Medicare. Under certain circumstances pre-existing conditions might be waived.

As Medicare Supplement Plans only cover one person per policy you and your spouse must each buy separate policies.

Medicare Supplement Plans (Medigap) A through L And The New Plans M And N

Medicare Supplement Plans A through J

Plans A through J have more benefits, higher premiums, and lower out-of-pocket expenses. Basic benefits include Medicare Part A and B co-payment or co-insurance, and three pints of blood. Extra benefits may include Skilled Nursing Facility co-insurance, Medicare Part A and B deductibles, Medicare Part B excess charges, foreign travel emergency services, at-home recovery, preventive care, and some may still cover prescription drugs.

Attention: The benefits in any Medicare Supplement Plan A through L are the same for any insurance company, but the rate insurance companies charge for their plans may vary. When selecting a Medicare Supplement Plan, carefully compare each plan and compare different insurer quotes.

Medicare Supplement Plans K through L

Medicare Supplement Plans K through L have lower premiums and higher out-of-pocket expenses. Basic benefits include Medicare Part A hospital benefits, Medical Part A and B co-insurance or co-pay, blood, and hospice care. Extra benefits include Skilled Nursing Facility co-insurance and Medicare Part A deductibles.

Attention: When selecting a Medigap plan, carefully compare each plan and compare different insurer quotes. Make sure you have adequate coverage that meets your needs, but you don’t want to pay more as the benefits of each plan are the same for every insurance company.

What Is New In 2010 For Medicare Supplement Plans?

Starting June 1, 2010, the types of Medigap Plans that you can buy will change:

There will be two new Medicare Supplemental Plans offered: Plans M and N. The Plans E, H, I, and J will no longer be available to buy.

If you already have bought Plan E, H, I, or J before June 1, 2010, you can keep that plan.

Contact your plan provider for more information.

If you shop for a new plan, be aware that insurance companies may charge different premiums for exactly the same Medicare Supplement plan coverage. Before you enroll in a Medigap policy, be sure to compare policies from different providers, e.g. compare Plan A from one company with Plan A from another company.

Do I Have Medicare Part D Prescription Drug Coverage With A Medicare Supplement Plan?

If you have a Medicare Part D Prescription Drug Plan and a Medicare Supplement Plan that covers drugs, you need to tell your Medicare supplement insurance provider to remove the drug coverage from your policy.

You cannot have both Medicare Part D and Medicare Supplement plan drug coverage at the same time.

Attention: At times, Medicare Part D coverage is more beneficial than the Medicare Supplement plan drug coverage, so compare both carefully.

Can I switch to a different Medicare Supplement Plan (Medigap)?

In most cases, you won’t have a right under Federal law to switch Medicare Supplement plans, unless you are within your 6-month Medigap open enrollment period or are eligible under a specific circumstance for guaranteed issue rights.

But, if your state has more generous requirements, or the provider is willing to sell you a Medicare Supplement Plan, make sure you compare benefits and premiums before switching. If you bought your Medicare Supplement plan before 1992, it may offer coverage that isn’t available in a newer Medigap policy. On the other hand, older Medigap plans might not be guaranteed renewable and might have bigger premium increases than newer standardized Medicare Supplemental plans currently being sold.

If you decide to switch, don’t cancel your current plan until you have decided to keep the new one. On the application for the new plan, you will have to promise that you will cancel your first Medicare Supplement Plan. You have 30 days to decide if you want to keep the new plan. This is called your ‘free look’ period. The 30-day free look period starts when you get your new Medicare Supplement Plan. You will need to pay both premiums for a month.

Can I keep my current Medicare Supplemental Insurance or switch to a different Medigap policy if I move out-of-state?

You can keep your current Medicare Supplemental Insurance Plan (Medigap policy) regardless of where you live as long as you are still in Original Medicare.

How Do I Cancel My Medicare Supplement Plan (Medigap Policy)?

If you decide to drop your entire Medicare Supplement Plan policy, you need to be careful about the timing. For example, you may want a completely different Medigap policy (not just your old one without the prescription drug coverage), or you might decide to switch to a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drugs.

You can join a Medicare Advantage Plan between November 15 through December 31 each year.

If you drop your entire Medicare Supplement Plan (Medigap policy) and the prescription drug coverage wasn’t creditable or you go more than 63 days before your new Medicare coverage begins, you will have to pay a late enrollment penalty.

Does Medicare Supplemental Work With A Medicare Advantage Plan?

No, you have to select one or the other. If you enroll in a Medicare Advantage Plan, your Medicare Supplement Plan coverage will not work.

You should (although legally you don’t have to) cancel your Supplemental policy if you choose to join a Medicare Advantage Plan.

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