Posts Tagged ‘premiums’

More Medicare Information to think about.

Monday, April 1st, 2013

More Medicare Information to think about.

So, we know that at age 65 you can enroll in Medicare, but do you have to? It is not a question we ever thought anyone would ask, however we recently read an advice column in the newspaper where a reader asked just that.

Well, do you have to take Medicare? The answer is no, but it’s not that simple.

First, let’s review again that parts that make up Medicare. Part A (hospital insurance) cover inpatient hospital stays and has already been paid for by the Medicare payroll tax deduction from your paycheck while you were working, so there is no premium or cost for that. Part B (Medical Insurance) does have a premium and covers doctor’s visits, lab tests and most other expenses not covered by Part A. The 2013 monthly premium for Medicare Part B is currently $104.90 (for most people, higher income enrollees may pay more, see www.medicare.gov for more information).

Part A and Part B are the two main components of Medicare. Part C is the Medicare Advantage program, where you select a Medicare HMO (this could be an entire post in itself, visit www.medicare.gov for your info). Part D is your prescription drug coverage.

Okay, back to the question at hand- do you have to enroll in Medicare? If you are receiving Social Security, you will be sent a Medicare Enrollment Package before your 65th birthday. You will be automatically enrolled in both A and B, unless when you receive your packet you contact Medicare to turn down Part B, they give you this option since Part B will cost you a monthly premium. They assume you’ll want Part A since you’ve technically already paid for it through the payroll tax. But before you turn down Part B you should review your current insurance coverage.

In the advice column referenced in the beginning of the post, the writer of the question was asking because they have a insurance through their former employer. However, you should not assume that your employers coverage does not change when you become Medicare eligible or that the company might prefer you switch to Medicare. Often the plan that covered you under your employer will end when you become Medicare eligible but they can offer you a supplemental plan. Because, the other thing to remember about Medicare is that you’ll have a 20% copay and a supplemental plan (also called a Medigap plan) can help to cover that.

One more caution if you chose to turn down Medicare Part B, should you later decide you want it, you can still apply, but you’ll have to wait until the next enrollment period and you’ll face a 10% penalty each month once you enroll.

You don’t have to take Medicare, but you probably should.

Visit wwww.medicare.gov for more info.

Medicare Myths

Wednesday, December 22nd, 2010

According to a study done by Prudential in 2009 37% of people think that Medicare will cover their long-term care costs. This is false. Medicare does not pay for long-term care. Medicare is also not free, there is a monthly premium associated with Medicare Part B.

Here are the facts about Medicare.  Medicare is for people 65 years of age or older (or people with disabilities). Medicare Part A (also known as hospital insurance) covers hospital stays, short-term skilled nursing care, hospice and home care services. Medicare Part A does not have a premium (if you or your spouse have paid Medicare taxes).

Medicare Part B (also known as Medical Insurance) does have a premium that is paid monthly. Part B covers doctor’s services, outpatient care, home care services and some preventive services.

Back to long-term care, what Medicare does cover, under Part A is Skilled Nursing Facility care on a short term basis. There are several guidelines for that coverage that you should also be aware of. After a 3 day minimum hospital stay, you are eligible under Medicare Part A for a short-term stay in a Skilled Nursing Facility, for rehab and nursing services. The goal is to get the individual strong enough to return home.

What Medicare Part A covers is up to 100 days of this skilled care at a nursing facility. You may not need the entire 100 days. The staff at the nursing facility will estimate the amount of time needed to rehabilitate the patient based on Medicare guidelines for Physical, Occupational and Speech Therapies, as well as, medical interventions given by nursing staff. It is also important to note that there is a benefit period associated with your 100 days of Skilled Nursing Care. This means that if you use your 100 days, you will not be eligible for another 100 days (even if you have another 3 day hospital stay) for 60 days. During those 60 days you must not have received any Skilled Nursing services. So, keep this in mind when planning your discharge from the Skilled Nursing Facility. Another thing to keep in mind is that after 20 days in the Skilled Nursing Facility you are responsible for a 20% co-pay per day. The co-pay is based on the per day rate approved by Medicare. If you have a supplemental or Medi-Gap policy, this may cover your co-pay, call your insurance plan to verify this. It is very important when being admitted to a Skilled Nursing Facility to provide all of your insurance information, including you supplemental coverage.

In closing, Medicare covers many inpatient and outpatient services through Part A & Part B, but they do not cover long term care, also referred to at custodial care. It is important to know what Medicare covers when thinking of your short term and long term health needs.

For more information visit:

 www.medicare.gov Рto view the 2011 Medicare and You Handbook,

or call 1-800-633-4227 to request a Handbook.

http://www.medicare.gov/publications/pubs/pdf/10153.pdf – for a handbook on Medicare Coverage of Skilled Nursing Facilities