Health care coverage in the US is becoming a growing concern, not only for the working class but also for those close to retirement and who have retired. If you’re 65 or older and searching for a suitable health insurance plan, then chances are that you might have come across Medicare. Medicare is basically a federal health insurance program primarily designed for people above 65, and people who are young but disabled, or those who are suffering from end stage renal diseases.
Though you may be eligible for the program, it is important to understand that it is not free. Therefore, you must have a good understanding of the basics of the Medicare program before you sign up for it to avoid making bad choices that can be expensive.
Medicare—What Does it Cover?
The Medicare program can be divided into 4 parts. Knowing what these parts cover is extremely important to select the right coverage and avoid duplicating coverage from other health insurance plans, if you have any.
Part A— This part of the program covers hospital care, home healthcare, skilled nursing and hospice. The premium amount for part A coverage is determined on the basis of your Social Security work history/credits. For example, if you have at least ten years of Social Security work history, then Part A of Medicare will be free of cost. Otherwise, it may cost you up to 413 US dollars, monthly.
Part B—It covers preventive care, doctors visit, outpatient care and some home healthcare. This part of the program helps you pay for doctor services and other services like rehab therapies and lab tests.
Part C— Also referred to as Medicare Advantage, this part substitutes for the benefits provided under parts A, B and D. It is offered by a private company that contracts with Medicare. Premiums may range from 0 dollars to over $100 per month.
Part D— It covers prescription drugs, and also insulin supplies and vaccines.
Medicare—Associated Costs
Medicare, just like other types of health insurance programs, has a variety of deductibles, premiums and even co-pays that policy buyers must pay for coverage.
Premiums—As mentioned above, premiums on part A are determined on Social Security work credits. However, part B requires a premium of about 121.80 US dollars on a monthly basis, while Part D requires premiums of about $15 to $50/ month. Please note that you may be required to pay a higher premium on part B and D if your adjusted gross income on recent tax return is over $85,000 (if you are single) and $170,000 if you are married.
Deductibles— Part A includes deductibles for hospital stays which is approximately $1,288 while on Part B and D deductibles are liable on annual basis before coverage kicks-in. In 2016, deductibles for Part B were $166 and Part D around $360. Please note here that Part D coverage is designed uniquely which means that depending on the drugs and their cost, you may move through different coverage phases such as you may have to pay for annual deductibles out of your own pocket and co-pay until the cost of the drugs reaches a certain amount.
Co-pays—If you have a Medicare plan of part A and B, then you pay 20% of the Medicare approved amount, while in Part A, after you meet the deductibles, you then pay nothing more up to sixty days in the hospital. However, after 60 days, you may require daily co-pays
To understand Medicare better and to make sure that you select the right plan, call JS Benefits Group on 877-355-6070. Allow our team to help you make the best choice.
