So, the Medicare Enrollment Period is near. If you’re new to Medicare, pay attention, because this is information you should know.
Last (week/time) we went over Medicare’s Part A. If you missed it, please go back and read, because it will make today’s post easier to understand. Whereas Medicare Part A covers beneficiaries during medically necessary hospital and nursing facility care, Medicare Part B was created for times like your routine doctor’s office visit.
The same 10 years, of social security contributions for eligibility that apply to Part A also apply to Part B. But, the bad news is you will probably have to pay a monthly premium for it.
Unless you are still working and covered by your employers health plan, you need to elect coverage with Medicare and start paying any applicable premium before you turn 65. "You better be there, or be square," because if you're late, for his date, you're not going to skate…. In fact, you may have to pay a late enrollment penalty. That is unless you have comparable coverage through your employer. So, knowing when to sign up is important!
Again, for those not already collecting social security, you must enroll to begin receiving coverage. To make it easy we are providing the following chart:
So what does Part B Cover?
Basically, Part B is for physician services. Or generally, anything that doesn't include a hospital admission is going to fall under "Part B". Part B also has a separate deductible and co insurance from Part A hospital services.
Right now, if you have Medicare only, you would have to pay the first $147 of physician services, doctor visits, chiropractor, specialists, outpatient hospitalization (i.e. this means you went in for a procedure but could go home afterwards without actually being admitted), and 20% of the Medicare allowable charge. So even though you paid for Medicare through your social security contributions, you will probably still have some health care expenses. Unless you qualify for social security assistance, full Medicaid etc. and you are new to Medicare, you are most likely going to have to fork over $104.00 or more per month for your Part B Premium.
But that’s not the bad news. To be fully covered many people new to Medicare acquire additional coverage to cover the gaps in Medicare (Part A or hospital co-insurance $1,184 per admission, Physician or Part B deductible $147 annually and 20% of Medicare allowable charge).
One solution is to go out and purchase what's called a Medigap Policy, (For obvious reasons. Get it? It covers the gaps in Medicare). Generally, with this type of coverage you have the "freedom" to go directly to specialists without a referral from another doctor or the health plan. But they do add a significant expense in the form of a plan premium.
Plans are standardized so each insurance company offers the same exact benefits by plan letter. The variables to consider are premiums charged and the how they implement administrative services, you know, things like customer service.
Medicare Part C
In our next post on the A-B-Cs of Medicare, we’ll talk about Medicare Part C
, commonly referred to as Medicare Advantage.