New Medicare Guides Provide Latest Information

babyboomersIt’s a new year, and that often means a few changes in Medicare. Changes may include new covered services, adjustments to out-of-pocket costs and more.

Medicare Made Clear offers two educational guides that may help you get up to speed on Medicare for 2013. Both are available to download free.

This is a comprehensive introduction to Medicare. It begins with a simple explanation of ten key facts for understanding the program. It goes on to talk about enrollment and the two ways you can get Medicare—through Original Medicare run by the federal government or through a private Medicare Advantage plan.

Once you’re through the basics, the Show Me Guide explains the parts of Medicare, what each covers and your cost-sharing responsibilities. Examples, colorful graphics and clear answers to common questions help make the information come to life. There’s even a decision road map to help you think through your Medicare needs and find a plan that works for you. The guide ends with a list of resources and a Medicare glossary.

This guide may help give you a solid foundation for understanding Medicare and your choices. It’s a great reference to keep in your Medicare file.

Some people like to get right to the point. They don’t need to know the details right away. They would rather get an overview and have the choice to go deeper. If you are one of these people, then the Getting Started With Medicare guide may be for you.

This guide covers the basics about Parts A, B, C and D as well as supplement insurance—one page for each. It provides a list of questions that may help you understand your coverage needs and make a confident choice. Then it gives you a worksheet to help you find and compare the plans you are interested in side by side.

Getting Started With Medicare is a hands-on tool. It walks you through the steps you can take to help find the plan that’s right for you.

–This information was provided by Medicare Made Clear

GeorgeLitchfield.com– If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com and we will give you a quote and help you keep money in your pocket.

What Will Medicare Cost in 2013?

Medicare Costs 2013Medicare shares costs with you in four ways:

  • Premium—a fixed fee that you pay each month
  • Deductible—an amount you must pay out-of-pocket before your plan will begin paying some of your costs
  • Copayment (copay)—a fixed amount you pay each time you use a service, fill a prescription or buy a product
  • Coinsurance—a percentage of the cost for a service or product

Here’s a run-down of these costs for Parts A and B in 2013.

What You’ll Pay for Part A

Medicare Part A is hospital insurance. Coverage generally includes:

  • A semi-private room
  • Meals
  • General nursing care
  • Drugs
  • Other hospital services and supplies

Part A is premium free for most people. You will pay a premium only if you or your spouse did not work and pay taxes for at least ten years. The 2013 Part A premium is $441 per month.

Part A charges a deductible for each benefit period. A benefit period begins the day you go into a hospital or skilled nursing facility. It ends when you have been out for 60 days in a row. You may have more than one hospital stay during a benefit period. Medicare does not limit the number of benefit periods that it will cover. The 2013 Part A deductible is $1,184 per benefit period.

In addition, you are responsible for some copayments and coinsurance for inpatient stays. The table below shows your portion of the costs.

Covered Inpatient Care Your Cost
Hospital days 1-60 $0 (after deductible)
Hospital days 61-90 $296 per day
Hospital days 91+

(“lifetime reserve” days)

$592 per day (maximum of 60)
Skilled nursing facility days 1-20 $0 (after deductible)
Skilled nursing facility days 21-100 $148 per day
Skilled nursing facility days 101+ 100% of costs

It’s important to know that you must be admitted to the hospital by doctor’s order. If you are there only for observation, Part A will not cover the cost. Always ask whether you have been admitted as an inpatient. In addition, you must be in the hospital as an inpatient for at least three days to qualify for follow-up care in a skilled nursing facility. The day of your discharge does not count.

Some other Part A covered services and your related costs include:

  • Mental health services in the hospital: 20% of Medicare-approved amount
  • Home health care: $0 (after deductible)
  • Durable medical equipment used at home (wheel chairs, walkers, etc.): 20% of Medicare-approved amount
  • Hospice care: $0 (no deductible)
  • Outpatient prescriptions for pain and symptom management during hospice: $5 per prescription
  • Caregiver respite care during hospice: 5% of Medicare-approved amount

Finally, Part A does not cover doctor services in the hospital—Part B does.

What You’ll Pay for Part B

Medicare Part B is medical insurance. It covers doctor visits and outpatient care.

You must pay a premium for Part B. Find your tax filing status and your income to see what you’ll pay in 2013.

If you file an individual tax return and your income is: If you file a joint tax return and your income is: Your Part B premium is:
$85,000 or less $170,000 or less $104.90 per month
$85,001 to $107,000 $170,001 to $214,000 $146.90 per month
$107,001 to $160,000 $214,001 to $320,000 $209.80 per month
$160,001 to $214,000 $320,001 to $428,000 $272.70 per month
Over $214,000 Over $428,000 $335.70 per month

In addition to the monthly premium, your Part B costs include an annual deductible of $147. You are also responsible for some copayments and coinsurance, including:

  • 20% of the Medicare-approved amount for doctor services, outpatient therapy and durable medical equipment
  • 20% of the Medicare-approved amount for most doctor services you receive while in the hospital
  • $0 for Medicare-approved clinical laboratory services (after deductible)
  • $0 for home health care services (after deductible)
  • 20% of the Medicare-approved amount for doctor visits to diagnose a mental health condition and to monitor or change prescriptions
  • 35% of the Medicare-approved amount for outpatient mental health treatment

There may be additional costs that Part B may help with. You can contact your State Health Insurance Assistance Program for answers to your questions.

Help Paying for What’s Not Covered

Out-of-pocket costs for a serious illness can mount up quickly.

You can add a Medicare supplement insurance plan (Medigap) to Original Medicare to help pay some out-of-pocket costs. Many beneficiaries choose to add a prescription drug plan (Part D) as well. Original Medicare does not include prescription drug coverage.

You may want to look into Medicare Advantage plans (Part C) in your area. These plans combine the coverage of Part A and Part B. Most also include prescription drugs (Part D) and extra benefits like vision, dental and hearing care—all in one plan.

–This information was provided by Medicare Made Clear

GeorgeLitchfield.com– If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com and we will give you a quote and help you keep money in your pocket.

What’s the Difference Between Medicare Advantage HMO and PPO Plans?

Medicare Advantage (Medicare Part C) plans offer you a different way to get your Original Medicare Parts A and B benefits. They’re offered by private companies approved by Medicare, and can be set up in different ways.

Let’s look at two types of Medicare Advantage plans: Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans.

HMOs and PPOs: How They’re Alike

Both HMO and PPO Medicare Advantage plans offer one-stop shopping for all of your health care. As does any Medicare Advantage plan, they combine hospital care with doctors’ visits in a single plan. Many plans offer prescription drug coverage, too. They may also have dental, vision and hearing care, fitness and wellness programs, and other health care benefits not included in Original Medicare.

Both HMOs and PPOs are coordinated care Medicare Advantage plans. The care is called “coordinated” because the plans are created around a network of doctors and hospitals working together to provide your care. When a plan sets up a “network,” it signs agreements with health care providers to see plan members for less than their usual cost.  Each coordinated care plan sets up its own network. You may have to choose specific doctors and hospitals. This is different from Original Medicare, which allows you to visit any doctor or hospital that accepts payment from Medicare.

HMOs and PPOs: How They’re Different

HMOs: With an HMO Medicare Advantage plan, you may need to see only doctors in the network in order for your plan to pay for it. If you go outside the networkThe group of health care providers, such as hospitals, doctors and pharmacies, that agrees to provide care to the members of a Medicare Advantage coordinated care plan or Medicare Part D prescription drug plan. These providers are called “network providers” and “network pharmacies.” for care, you may have to pay the full cost for that health care. So if you have a doctor that you want to keep seeing, it’s important to make sure that doctor is “in-network” for any HMO you’re considering.  Note: This network rule doesn’t apply to emergency care, urgent care or out-of-area renal dialysis.

HMO members also often have to choose a primary care physician (PCP) in the network to coordinate their care. Your PCP provides you general medical care. You may also need a referral from your PCP to see an in-network specialist.

PPOs: Unlike an HMO, with a PPO Medicare Advantage plan, you may not need to choose a PCP. And you probably don’t need to go through a PCP in order to see a specialist.

With most PPOs, you can see doctors outside the network The group of health care providers, such as hospitals, doctors and pharmacies, that agrees to provide care to the members of a Medicare Advantage coordinated care plan or Medicare Part D prescription drug plan. These providers are called “network providers” and “network pharmacies.”without having to pay the entire cost yourself. However, you’ll usually pay a larger share of the cost of your care at a non-network health care provider. For example, the plan may pay 90% of the cost for care received in-network, but only 60% of the cost for the same care provided out-of-network. With some PPOs you may need to pay the non-network doctor directly, and then file a claim for partial reimbursement (payback).

 

–This information was provided by Medicare Made Clear

http://www.turning65-newtomedicare.com – Turning 65 ? Looking for reliable Medicare Insurance? or Looking to get better rates. The Litchfield Insurance Agency assists the Beaver Medical Group in Redlands. Whether it be Medicare, Health, Life. Call 888-891-5557 and we will find the right plan for you. Serving Redlands, Banning, Yucaipa and the Inland Empire.

Medicare Part A: The Ins and Outs of Hospital Coverage

Hospitalizations are often followed by a barrage of bills and statements. Only the initiated can hope to understand them. This is when energy is needed for recuperation, recovery and care-giving. You don’t want to spend it figuring out what’s covered and what’s not. So here’s a little primer on Medicare Part Ato help you prepare ahead of time.

 Part A covers hospital care, but…

Did you know that you can spend the night in the hospital and not be an inpatient?

It’s true. This is important because it can affect how much you may pay out-of-pocket for your hospital care. It can also affect whether Medicare will pay for any skilled nursing care you may need afterward.

You are an inpatient only after you are admitted to the hospital by doctor’s orders. If you are in the hospital for observation, for example, you may or may not be admitted.

You must be in the hospital at least three days to qualify for covered follow-up care in a skilled nursing facility. Your last day in the hospital is the day before you leave. The day you go home doesn’t count.

When you are in the hospital, it’s important to ask whether you have been admitted.

Part A charges a deductible, and…

The Part A deductible, $1,156 in 2012, is charged per benefit period. A benefit period begins the day you go into a hospital or skilled nursing facility. It ends when you have been out for 60 days in a row.

You may be in the hospital more than once during one benefit period. For example, you may leave the hospital and then be re-admitted. If you’re re-admitted within 60 days, then it’s the same benefit period. In this case, your coverage continues. If you are re-admitted after 60 days, it’s a new benefit period. You will be charged another deductible. There is no limit on the number of benefit periods that Medicare will cover.

Part A fully covers 60 hospital days, then…

After the deductible, you pay $0 for up to 60 days of hospital care during one benefit period. If you are in the hospital for more than 60 days, then you will start to be charged a copay.

You must pay a copay for hospital days 61 through 90 during one benefit period. In 2012, the copay is $289 per day.

Starting with day 91 in the hospital, you can begin to draw on your “lifetime reserve days.” Lifetime reserve days are like a “bank” of extra hospital days covered by Medicare. You have 60 extra covered days in your “account” that you can use over your entire life. You must pay a copay for the lifetime reserve days you use. The copay is $578 per day in 2012.

Here’s one final note about coverage. Most doctor services are covered by Medicare Part B, even when you’re in the hospital.

Part A is premium-free, if…

Most people qualify for premium-free Part A benefits. You qualify if you or your spouse paid into Social Security for at least ten years while working. If you don’t qualify, you will have to pay a premium. In 2012, you will pay up to $451 a month. If you don’t sign up for Part A when you are first eligible, you may be charged a penalty.

–This information is provided by Medicare Made Clear

http://turning65-newtomedicare.com – Are you a senior age 65+ looking for Medicare Supplemental Insurance? Call 909-790-7748. We will explain your options and find the right plan for you.

 

What Will You Pay for Medicare Part A and Part B in 2012?

What will be your out-of-pocket costs in 2012 for Medicare Part A and Part B? Read this blog post to find out more.

 

Medicare provides many benefits, but it isn’t free. You will have out-of-pocket costs, and it’s a good idea to learn what they are to help you avoid unwelcome surprises.

Your Share of Medicare Part A Costs

Medicare Part A covers care received in a hospital or skilled nursing facility. It is premium free for most people. However, you do pay a deductible for each benefit period. In 2012, the deductible is $1,156.00.

After the deductible, Part A pays 100% of covered costs for the first 60 hospital days, and the first 20 skilled nursing facility days, of each benefit period. Multiple hospitalizations may be included in the same benefit period, if they are for the same health problem.

A benefit period begins the day you go into a hospital or skilled nursing facility. The benefit period ends when you haven’t received any inpatient hospital care (or skilled care in a skilled nursing facility) for 60 days in a row.

The table shows your out-of-pocket costs for different services covered under Medicare Part A.

What Will You Pay for Medicare Part A and Part B in 2012?

Your Share of Medicare Part B Costs

Medicare Part B covers doctor visits and outpatient care. You will pay a monthly premium for Part B that is based on your income. In 2012, Part B premiums range from $99.90 to $319.70 a month. The low end rose by $3.50 over the 2011 amount, but most people will see it returned through an increase in their Social Security benefit.

Find your tax filing status and your income in the table to see how much your 2012 premium is.

What Will You Pay for Medicare Part A and Part B in 2012?

In addition to the monthly Part B premium, you will pay an annual deductible of $140 for Part B services in 2012. Some other costs you are responsible for include:

  • 20% of the Medicare-approved amount for doctor services, outpatient therapy and durable medical equipment
  • 20% of the Medicare-approved amount for most doctor services you receive while in the hospital
  • 40% of the Medicare-approved amount for outpatient mental health care
  • Copays or coinsurance amounts for other covered services
  • A coinsurance for most outpatient hospital services

Help Paying for What Medicare Doesn’t

Out-of-pocket costs for a serious illness can mount up quickly. If you have Original Medicare Parts A and B, you can choose to add a Medicare supplement insurance plan (Medigap) to help pay some of these costs. Also, it’s important to know that Original Medicare does not include prescription drug coverage. Many beneficiaries choose to add a prescription drug plan (Part D) to help with the cost of medications.

–This information was provided by Medicare Made Clear

For more answers to your question about the different Medicare upplemental plans call us at (909)790-7748 or 888-891-5557. Visit our website for videos and blogs post with related articles www.Turning65-NewtoMedicare.com