Dissecting Medicare

A closer look at the various Medicare plans

 
No Author Published: October 11, 2011    Comment on this article Leave a comment

Medicare is a federally administered system of health insurance available to people age 65 and older and people of any age with certain disabilities or permanent kidney failure.

photo - Larry Hatley, 65, of Muskogee reviews Medicare drug and health plan information during a senior summit the state insurance department hosted on Monday in Tulsa. PHOTO PROVIDED <strong></strong>
Larry Hatley, 65, of Muskogee reviews Medicare drug and health plan information during a senior summit the state insurance department hosted on Monday in Tulsa. PHOTO PROVIDED

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Medicare Part A: Covers care at hospitals that accept Medicare and is available to beneficiaries for no monthly premium, provided they've worked and paid FICA taxes for at least 10 years. The Part A deductible — or out-of-pocket cost owed before an insurer will pay expenses — is $1,132 per benefit period, which starts when you enter the hospital. The benefit period resets when you've been out of the hospital 60 days.

Medicare Part B: Covers medical care with doctors and other health care professionals who accept Medicare; the monthly premium is deducted from beneficiaries' Social Security checks. Seniors new to Medicare generally pay $115.40, but most pay only $96.40 because there've been no cost-of-living increases for Social Security recipients for several years. The current Part B annual deductible is $162.

Part A & B are referred to as Original Medicare. Beneficiaries generally are responsible for 20 percent of their medical costs unless they choose to buy supplemental private insurance policies (Medigap) to cover deductibles, co-pays and coinsurance. There are 10 standardized supplemental plans, each with varying benefits. The most popular is Plan F that, depending on a beneficiary's age, gender and ZIP code, carries a $80 to $177 monthly premium with no deductibles. Depending on their health issues and the possibility of denied coverage, beneficiaries can change supplemental insurance policies whenever they want.

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