Medicare 101
What is Medicare?
Medicare is health insurance for people who are 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD)(which is permanent kidney failure requiring dialysis or a kidney transplant. It is run by the federal government, provides parts A & B.
There are 2 parts to Medicare
Part A: Is known as “Hospital Insurance”
- there is usually no monthly premium for part A coverage for the beneficiary of their spouse paid Medicare taxes while working. If you are NOT eligible for Medicare Part A, you can “buy into it”.
- helps to cover inpatient care in hospitals, skilled-nursing facility, hospice, home healthcare, and blood
- you are automatically enrolled in Medicare part A when you turn 65, and your card is sent 3 months before your 65th birthday.
Part B: Is known at “doctor insurance”
- there is a premium for part B, the premium is based on income, and comes out of the Social Security check AUTOMATICALLY. 2009 rate for most people was $96.40 per month.
- helps to cover doctors visits, ambulance services, ambulatory surgical centers, diabetic supplies, doctor services, durable medical equipment, ER services, eye exams for people with diabetes, glaucoma tests, physical therapy, preventative services (mammograms, flu shots, bone mass measurement).
- What is NOT covered by Medicare:
- acupuncture, chiropractic services, cosmetic surgery, custodial care, dental and dentures, eye exams, eye glasses, hearing aids, hearing tests, any type of long-term care, physical exams (except the 1st “welcome to Medicare physical”), prescription drugs, syringes or insulin (will be covered under part D), travel outside the United States.
- Medicare had deductibles and co-insurance
- Medicare Part A deductible – $1,132 Hospital
- Days 1-60 = $1100 Deductable
- Days 61-90 = $275 Per Day
- Days 91-150 = $ 550 Per Day
- Medicare Part B deductible- $165 Office Visits
- PLUS a 20% co-insurance on most other services and the doctor CAN balance bill.
