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A Quick Guide To Medicare Plans

Photo from the Medicare website

Medicare is the United States government’s health program for seniors 65 years and older. Established by President Lyndon Johnson in 1965, the first Medicare card was issued to President Harry Truman. By 2014, over 49 million Americans receive Medicare coverage and the company has paid out $597 billion in benefits, according to the Kaiser Family Foundation.

Medicare choices can be confusing, so here’s a simplified summary of the available coverage plans.

Medicare Part A is hospital insurance, covering inpatient care in hospitals. This includes semi-private room expenses, meals and supplies. There is no monthly premium necessary if a person qualifies for Medicare and has paid Social Security taxes for at least 10 years. Part A has a yearly deductible, and if this is met, 60 days of hospitalization are 100% covered by the plan. After 60 days, Medicare sets the costs a patient must pay.

Medicare Part B is medical insurance that pays for doctors’ fees, hospital outpatient care and home health care. Annual premiums depend on a person’s annual income. Once the yearly deductible is met, Part B pays 80% of Medicare-approved amount for services covered, while the patient pays for the remaining 20%. Medicare pays 100% of preventive services.

Medicare Part C refers to Medicare Advantage Plans. This alternative to the original Medicare is offered by private insurance companies, covering the same services as Part A and Part B, plus prescription drugs and other services such as vision or hearing. The cost of this plan depends on the insurance company, as do costs.

Medicare Part D is Prescription Drug Plans. There are multiple Part D plans available, varying in cost and medications. Premiums for these plans likewise depend on the provider, but coverage is similar.

Supplemental Insurance or Medigap Insurance covers the costs not taken up by Part and Part B. This refers to medical service copays or excess hospitalization. This Supplemental Insurance is offered by private companies and prices vary depending on location and provider.

“Open Enrollment” for Medicare is on October 15 to December 7 – the time period when patients can change their Medicare health coverage and Prescription Drug Plans, all of which will take effect on January 1.


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