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.

Medicare Drug Plans- Rx Help is Here! – Medicare Redlands CA, Yucaipa CA

Medicare Drug Plans- Rx Help is Here!

 

Medicare Part D Prescription Drug Plans

Medicare Parts A and B do not include prescription drug coverage. On January 1, 2006, Medicare launched an outpatient prescription drug benefit to all Medicare beneficiaries. The new benefit, called Part D of the Medicare Program, is designed to lower the cost of prescription drugs for most senior and disabled Medicare beneficiaries.

People on Medicare, Part A or B, who would like to receive prescription drug (rx) coverage under Part D have to enroll in a private insurance policy that offers Part D coverage and is approved by Medicare. These plans are called Medicare Prescription Drug Plans (PDPs).

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Signing up for a Medicare Prescription Drug Plans (PDP)

Medicare Prescription Drug Plans (PDPs) will offer prescription drug benefits. Drug plans will vary in what prescription drugs are covered, how much you have to pay, and which pharmacies you can use. Like any other insurance, if you join you will pay a monthly premium and pay a share of the cost of your prescriptions. PDP Prescription Drug Coverage

Available in Two Ways- Integrated and Stand-Alone

Medicare Part D is available in one of two ways- either as an integrated part of a health plan, or as separate, stand-alone drug coverage. In many cases, we find that enrolling in a health plan that includes Part D drug coverage provides a better value than purchasing a drug-only plan. However, for some people (those who want to retain medical coverage through a Medicare Supplement plan, for example) a stand-alone PDP is an appropriate choice. Advantages of Prescription Drug Plans Costs of PDP Plans

Selecting the Right PDP Plan

The Medicare Part D drug benefit will present a wide and confusing array of new options to more than 40 million Medicare beneficiaries. Explore this section on Prescription Drug Plans and learn How The Litchfield Agency Helps Seniors

Choosing a Medicare Plan: How Juanita Decided

Medicare offers a lot of choices. Does Original Medicare Parts A and B provide the coverage you need? What options are available to help with expenses like deductibles and prescription drug coverage? It might be helpful to make a list of your most important coverage needs before you research or enroll in a plan. Then you can compare those needs with what’s available in your area. In this post, you’ll meet Juanita1and learn why a combination of plans met her specific needs.

About Juanita

Juanita will be 65 in three months. This means her Medicare Initial Enrollment Period has just started. When she turns 65, she plans to retire. This will give her the freedom to spend a lot of time out-of-state visiting her children and grandchildren in California. Juanita is in good health, although she takes one drug to keep her bones strong and another to keep her cholesterol levels in check. Juanita has a comfortable pension, but she wants to leave a financial legacy to her family.

Juanita’s Medicare Wish List

  • Flexibility to visit doctors and hospitals when she’s out of state visiting her family
  • Help paying for her prescription drugs
  • Significant help paying for extra out-of-pocket costs if they’re large

Juanita’s Choices – A Combination of Plans

Juanita actually chose three different Medicare plans to meet her specific needs: Original Medicare (Part A and Part B), a standalone Part D prescription drug plan. Rounding out her choices was a Medicare supplement insurance plan.

Original Medicare, consisting of Part A and Part B, provides the medical and hospital coverage Juanita wanted. Part A is generally thought of as “hospital insurance.” It pays for hospital stays and follow-up care in a skilled nursing facility, as well as some home health care services and hospice care. Part B helps pay Juanita’s doctor bills, including doctor office visits, most preventive care and many lab tests and screenings. A standalone  Medicare Part D prescription drug plan helps Juanita pay for prescription drugs. Her  Medicare supplement insurance (Medigap) plan will help pay out-of-pocket expenses the other plans won’t cover.

Why was this combination of plans a good choice for Juanita?

  • Original Medicare gave her access to doctors and hospitals throughout the United States
  • A standalone Part D prescription drug plan offered discounted prices on the drugs she takes
  • A Medicare supplement insurance plan provided help with her Medicare Part A and B deductibles and coinsurance

Cost Sharing

The premiums Juanita will pay include a monthly Part B premium, a monthly Medicare Part D prescription drug plan premium and a monthly Medicare supplement insurance premium.

Her Medicare supplement insurance plan will help pay for most of the out-of-pocket expenses not covered by Original Medicare Parts A and B. Juanita pays for her drug plan cost sharing and any costs not covered by her Medicare supplement insurance plan. Remember: this is just an example. For plans outside of Original Medicare Parts A and B, costs can vary from plan to plan. Contact the plan you’re interested in to see what your costs might be.

Make an Informed Decision

Juanita did her homework and got what she needed with a combination of Medicare plan options. It’s a good idea to understand all the parts to Medicare and research specific plan types and combinations. That way, when it’s time to make your plan selection, you can make an informed, confident choice.

1 Fictional character created to show a specific set of Medicare needs and coverage options.

–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 us today at (888) 891-5557 and we will find the right plan for you.

Serving Redlands, Banning, Yucaipa and the Inland Empire.

All About Medicare Part D – What you Should Know to Get Coverage

In general, prescription drug coverage isn’t included in Original Medicare. To get this coverage, many people enroll in a Medicare Part D plan. There are two main ways to get Medicare prescription drug coverage: a standalone Medicare Part D plan or a Medicare Advantage (Part C) plan with a prescription drug benefit. Which option might be right for you?

Am I eligible?

To be eligible for Part D prescription drug coverage through Medicare, you must first be enrolled in  Original Medicare (Medicare Parts A and B) and paying your Medicare Part B premium. You can enroll in a Part D prescription drug plan during your Initial Enrollment Period (IEP) when you first become eligible for Medicare or during the Medicare Annual Enrollment Period (AEP), which is October 15 – December 7th. If you dropped your Medicare Advantage plan to go back to Original Medicare, you can enroll in a Part D prescription drug plan from January 1 to February 14 each year. Some people may qualify for a Special Enrollment Period that doesn’t fall during one of these other enrollment periods.

What’s the difference between coverage types?

Medicare Part D prescription drug coverage is not automatic. You must enroll in a plan if you want coverage. If Original Medicare meets your other coverage needs and you just need extra help paying for your prescriptions, you can purchase a standalone Medicare Part D prescription drug plan (PDP). Another way to get Part D prescription drug coverage is to purchase a Medicare Advantage (Medicare Part C) plan that offers a prescription drug benefit. Not all Medicare Advantage plans offer this benefit, and coverage can vary widely from plan to plan.

How do I get the most value for my health care coverage needs?

It’s important to consider your health needs when thinking about the prescription drug benefit that might be right for you. Keeping your Original Medicare coverage and purchasing a separate prescription drug plan may be a good option. If your health care coverage needs include a wider range of benefits plus help paying for prescriptions, however, a Medicare Advantage plan with prescription drug benefits may offer greater value. Medicare Advantage plans include hospital and medical benefits, but many also include additional benefits like vision, hearing, dental and wellness care. Which plan you choose depends on your individual coverage needs.

 

What will my plan costs be?
Prices for Part D prescription drug coverage in both Medicare Advantage plans and standalone plans differ. You should research the plans you’re interested in to find out specific costs to you. All plans have similar types of cost sharing, though:

  • Premiums – A premium is the amount you pay each month to be covered by a certain plan. These costs can vary widely from company to company.
  • Deductible – The deductible is the set amount you have to pay out of your own pocket before the plan begins to cover a portion of the costs.
  • Copayment – Your copayment is the amount you pay at the time of service for your prescription drug order. For example you might pay $10 or $15 each time you pick up your prescriptions at the pharmacy.
  • Coinsurance – Defined in percentages, coinsurance indicates the split in health costs between you and your insurance company. For example, you pay 20% of the bill and your plan pays 80%.

What happens if I delay signing up for Part D coverage or my coverage lapses?

If you don’t sign up for Medicare Part D coverage as soon as you are eligible, you may pay a penalty on your premium, unless you qualify for an exception. This penalty is set by Medicare. For each month you delay, you may pay an additional 1% (of the average premium) per month. You will pay that penalty for as long as you’re enrolled in Medicare Part D. If you had prescription drug coverage from another source, such as an employer or union, remember that your coverage may lapse or end when you become eligible for Medicare. If you are without coverage for more than 63 days, you may also have to pay a penalty.

–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. We will find the right plan for you. Call us today at (888) 891-5557
Serving Redlands, Banning, Yucaipa and the Inland Empire.