How Medicare Works For Seniors 65+ and Pre-65 (California) - The David Fluker Health Insurance Agency - Gilroy, California

For complete information concerning Medicare, visit the Medicare site at Medicare.gov

Medicare 2008 Changes
The following changes have been made to your Medicare benefits effective January 1, 2008.

You now will be responsible to pay:

-Part A deductible increased to $1.024(per benefit period)
-Part A Hospital coinsurance for days 61-90 increased to $256 per day
-Lifetime Reserve coinsurance for days 91-150 increased to $512 per day
-Skilled Nursing Facility coinsurance for days 21-100 increased to $128.00 per day
-Part B annual deductible $135

How Medicare Works
Medicare has two parts:
1. Part A (Hospital Insurance)
2. Part B (Medical Insurance)

Part A helps pay for:
-Inpatient Hospital Care,
-Some Skilled Nursing Care,
-Hospice Care, and
-Some Home Health Care.

How to Get Part A
Most people get Medicare Part A automatically when they turn age 65. They do not have to pay a monthly premium for Part A because they or a spouse paid Medicare taxes while working.
If you are your spouse did not pay Medicare Taxes while working, you may still be able to buy Part A but you may have to pay for it.

Part B helps pay for:
-Doctors' Services,
-Outpatient Hospital Care, and
-Some other medical services that Part A does not cover (like some home health care).

Part B helps pay for these covered services and supplies when they are medically necessary.
You pay the Medicare Part B premium of $96.40 per month in 2008. Rates can change every year. Also, this rate may be higher if you did not choose Part B when you first became eligible at age 65. In this case, the cost of Part B will go up 10% for each 12-month period that you could have had Part B but did not sign up for it (except in special cases). You will have to pay this extra amount for the rest of your life.

How to Get Part B
You are automatically eligible for Part B if:
-You are eligible for premium-free Part A,
-You are a US citizen or permanent resident age 65 or older

If you choose to take Part B, Medicare takes the monthly premium out of your Social Security, Railroad Retirement, or Civil Service Retirement payment. If you don't receive any of these benefits, you will get a bill for the Part B premium every 3 months.
If you did not choose Part B when you were first eligible, you can sign up during 2 enrollment periods:
1. The General Enrollment Period (Jan 1 - Mar 1 each year and starts July 1 of that year)
2. The Special Enrollment Period (within 8 months of termination of group or union health plan)

What Is A Medigap Policy?

A Medigap policy (Medicare Supplement) is a health insurance policy sold by private insurance companies to fill the "gaps" in Original Medicare Plan Coverage. There are 10 standardized Medigap plans called "A" through "J". Each plan A-J offers a different set of standardized benefits. Plan A offers the least benefits and Plan J offers the most benefits. Click here to see a chart of Medigap Standardized Plan Benefits

When you buy a Medigap Policy, you pay a premium to the insurance company. As long as you pay the premium, a policy purchased after 1990 is automatically renewed each year.

Why Do I Need A Medigap Policy?

If you are on the Original Medicare Plan, a Medigap Policy may help you:
-Lower your out-of-pocket costs.
-Get more health insurance coverage.

You may want to buy a Medigap Policy because Medicare does not pay for all of your health care. There are "gaps" or costs that you must pay in the Original Medicare Plan. Click here to see a chart of gaps in Medicare