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Medicare Essential 102

Medicare Essential 102

In addition to 101, there are other things to essential for you regarding your Medicare. These are as follows:

  • You can choose to sign up for traditional Medicare — Parts A, B and D, and a supplemental medigap policy. Or you can go an alternative route by signing up for Medicare Advantage, which offers comprehensive coverage through private insurance companies. Technically Part C, Medicare Advantage has a monthly cost, in addition to the Part B premium, that varies depending on which plan you choose. With Medicare Advantage, you don’t need to sign up for Part D or buy a medigap policy. Like traditional Medicare, you’ll also be subject to co-payments, deductibles and other out-of-pocket costs, although the total costs tend to be lower than for traditional Medicare. In many cases, Advantage policies charge lower premiums but have higher cost-sharing. Your choice of providers may be more limited with Medicare Advantage than with traditional Medicare.
  • Beneficiaries of traditional Medicare will likely want to sign up for a medigap supplemental insurance plan offered by private insurance companies to help cover deductibles, co-payments and other gaps. You can switch medigap plans at any time, but you could be charged more or denied coverage based on your health if you choose or change plans more than six months after you first signed up for Part B. Medigap policies are identified by letters A through N. Each policy that goes by the same letter must offer the same basic benefits, and usually the only difference between same-letter policies is the cost. Plan F is the most popular policy because of its comprehensive coverage; it has a wide range of prices, from an annual $934 to $5,590 for a male, check the policy to clarify if there are changes in fees.
  • If you choose traditional Medicare and your income is above a certain threshold, you’ll pay more for Parts B and D. Premiums for both parts can come with a surcharge when your adjusted gross income (plus tax-exempt interest) is more than $85,000 if you are single or $170,000 if married filing jointly. In 2013, high incomers pay from $146.90 to $335.70 per month per person, depending on their income level, for Part B coverage. They also pay extra for Part D coverage, ranging from $11.60 to $66.40 per month, on top of their regular premiums.
  • One cost for Medicare is decreasing — the dreaded Part D “doughnut hole.” That is the period during which you must pay out of pocket for your drugs. For 2013, the coverage gap begins when a beneficiary’s total drug costs reach $2,970. Catastrophic coverage, with the government picking up most costs, begins when a patient’s out-of-pocket costs reach $4,750. Because of the health care law, the amount a beneficiary pays while in the doughnut hole is gradually shrinking, so that by 2020, beneficiaries will pay just 25% of the costs of their generic and brand-name drugs while in the coverage gap. For 2013, the discount on brand-name drugs in the coverage gap will rise to 52.5%, from 50% in 2012, and the federal subsidy for generics will rise to 21%, from 14%.
  • Besides shrinking the costs that beneficiaries will pay for prescription drugs in the Part D doughnut hole, health care reform also increased the number of free preventive services available to Medicare beneficiaries. You get an annual free “wellness” visit to develop or update a personalized prevention plan. Beneficiaries also get a free cardiovascular screening every five years, annual mammograms, annual flu shots, and screenings for cervical, prostate and colorectal cancers.

Make use of your Medicare and before applying any Health Insurance, make sure you know what it is really about.

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