I read a "letter to the editor" in my local news paper and its content made me realize that many of the recipients of Social Security and Medicare do not understand them. Let's see if we can do a "Cliff Notes" version for medicare that would help get folks on the right track.
Part- A - Hospital Inpatient. MANDATORY WHEN YOU REACH AGE 65.
Part "A" has no premium.
Part B - IS OPTIONAL: It is Hospital Outpatient, doctor’s visits, ambulance, laboratory, emergency Room.
Part "B" does have a premium and it is automatically deducted from your Social Security Check each month.
Part C - is somewhat of a Hybrid of "A" "B" and "D" and is an alternative to regular Medicare.
CAUTION: Be sure you give "Due Diligence" to this option before doing this because it is a lot like an HMO or PPO. When you join Medicare Part “C” you are Opting for a MEDICARE ADVANTAGE PLAN.
This means you have a Primary Care Medical Doctor. This doctor refers you to specialists and manages all your medical needs. You will not be able to visit any doctor of your choice and you stay within the group you are assigned. You can go out of the group BUT then you are responsible for up to 100% of the tab.
Part D - Prescription Drug
Part "D" Does have variable premiums depending on the plan selected.
For beneficiaries, the plan covers 75% of prescription costs above $250 per year. The recipient has to pay an initial deductible of $250, then one quarter of the costs from $250 to $2250. From $2250 to $5100 per year, the beneficiary pays for ALL of those costs out of pocket, and any costs above $5100 are completely covered by Part D insurance. This ensures beneficiaries who need to have expensive treatments will be covered for any extreme costs.
The insurance works to reduce the amount of your out of pocket costs in agreement with the other medical care provided by Medicare's other parts. NOTE: This program has a feature refered to as the "Donut Hole". My assessment is its more like a "Black Hole" and VERY costly. The best layman's description I found was on Wikipedia. This link should help explain what I mean. http://en.wikipedia.org/wiki/Medicare_Part_D#Costs_to_beneficiaries
REMEMBER:
THE PART D PLANS ARE NOT PROVIDED DIRECTLY BY THE GOVERNMENT; AS A RESULT, THE TYPES OF DRUGS COVERED CAN VARY. Variable premiums are available depending on the plan coverage you select.
FILLING THE MEDICARE “GAP”
Medicare also does not always pay all of the charges made. Many procedures have a Medicare deductible or maximum. This is where the senior has to consider an alternate source to pick up these charges.
It is commonly called "GAP INSURANCE" and is provided by a number of carriers and does have a premium as well. You can choose from a variety of plans from A through F. Each has different features. Be sure you assess your needs carefully before choosing.
The good news here is that the Federal Government has made all providers of these type of plans carry the same components. What is important is what each component provides based on your medical needs.
