What is Medicare?

Medicare is a federally funded health insurance program for people age 65 and older, people under 65 with certain disabilities, and people of all ages with end stage renal disease.

Medicare does not cover Long Term Care. It also will not cover routine eye exams and glasses, dental coverage except under certain medical conditions, and hearing loss.

Medicare

If you are looking at this web site, you are probably looking for more information about Medicare, how it works, what it covers, what are your options. Many of you, if you are approaching your 65th birthday, have been getting lots of information in the mail from a variety of sources and the more you get, the more confusing it all is. We are a local company whose job it is to help you sort through all of the information and to help you get started.

Let’s start with Medicare:

Medicare is a federally funded health insurance program for people age 65 and older, people under 65 with certain disabilities, and people of all ages with end stage renal disease.


Part A is for your hospital coverage. You paid payroll taxes for this part, but it only covers room and board. You will also have a deductible that you will pay when you are admitted of $1216 in 2014. Any procedures, doctors seen, or tests are covered under Part B.

Part B is the medical part of your coverage. There is a small deductible currently $147 in 2014,and then Medicare will pay, on average, 80% of the Medicare allowable amount. You are responsible for the remaining 20%. You will pay a monthly premium for Part B currently, $104/mo in 2014. There is no maximum for what this 20% can add up to, so many people want to carry additional coverage.

Part D is the prescription drug plan, which you need to obtain when you become eligible, or there will be a penalty assessed. This penalty is 1% of the average drug plan cost per month or approx. $4/year. This will be added to the premium monthly, if and when, you decide to pick up a plan in the future. This penalty is for the rest of the time you have Part D.

Part C is a Medicare Advantage Plan, which can include Part D. These are very different from Medigap policies. Medicare pays companies a fixed amount every month for your health care, and you pay the set co-payments. In this instance, you are still on Medicare, but they are paying through a third party, so you do not use your Medicare Card. Many of these plans have value added benefits, like membership to a health club, and some vision and dental. The plans have to cover everything that Medicare covers. Many of the current plans have networks that you need to stay within, but their costs are generally lower than a Medigap or Supplement policy.