 | Prescription Drug Coverage: $30 Per Month |
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 | Outpatient Care Coverage: $99-$317 Per Month |
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 | Inpatient Care Coverage: $248-$451 Per Month |
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| Medicare is a public health insurance plan with some private options that helps pay for health care for seniors or the disabled. Although some are opting out, most doctors and hospitals nationwide accept Medicare, which is funded through mandatory payroll deductions. Employees or their spouses who paid into the Medicare system for a minimum period are eligible for Medicare when they turn 65 or have a qualifying disability. Those who did not pay into the system or who did so for less than the minimum amount of time may sign up for Medicare but will pay higher premiums.(Note: Although the name is similar, Medicaid is a separate assistance program to help low-income individuals and families pay medical bills; Medicaid is not an insurance plan and is not the same as Medicare. For low-income seniors, a combination of Medicare and Medicaid may cover most health care needs. However, doctors and private hospitals or medical facilities which accept Medicare may not accept Medicaid.) | | |
| Typical costs: | - Medicare Part A is a government-run program covering inpatient hospital care. Monthly premiums are free for seniors or their spouses who paid into Medicare as an employee for 40 or more quarters (10 years in three-month increments). For those with fewer than 40 quarters, the 2012 Medicare Part A monthly premium is $248 -$451,or $2,976 -$5,412 annually.
- Medicare Part B is a government-run program covering outpatient/doctor care. It's possible to be covered by Part A, Part B or both. Part B monthly premiums are based on income. For 2012, the standard premium for Medicare Part B is $99.90 a month ($1,198 a year), but it can cost $139.90 -$319.70 a month ($1,679 -$3,837 a year) if total annual income is more than $85,000 for a single person or $170,000 for a married couple.
- Medicare Part A and Part B pay a portion of typical health care costs, but not the total amounts. Therefore, private insurance companies offer Medicare Supplemental policies (also called Medigap plans) that fill some or all of the "gap" between what Medicare Part A and Part B cover and the actual cost of health care, creating more comprehensive coverage than just traditional Medicare alone. Premiums for Medigap plans might cost anywhere from $700 -$2,500 or more a year, depending on the insurance company, what's included under the plan and local rates. Search the Medicare plan finder tool by zip code for Medigap plan availability and pricing in a specific area.
- Medicare Advantage (Part C) plans allow seniors the choice of receiving Medicare benefits through a private insurance plan, usually a HMO or a PPO. Medicare Advantage plans are required to provide at least as much coverage as original Medicare (Part A and Part B) and may offer expanded benefits such as dental or vision coverage, but they can also have different rules, coverage restrictions and costs. The individual pays the government's Medicare Part B premium plus the Part C premium from the private insurance company. The average Medicare Advantage Part C premium for 2012 is $30 a month, or $360 a year, according to Medicare.gov. However, premiums can range from $0 to $1,500 or more a year depending on the company, coverage provided and location. Search the Medicare plan tool by zip code for Medicare Advantage availability and pricing in a specific area.
- Until relatively recently, Medicare did not cover the cost of prescription drugs. This coverage is now available through Medicare Part D Prescription Drug plans that are regulated by the government but designed, operated and sold by private insurance companies. Part D coverage can be purchased in addition to signing up for Medicare Part A and/or B, or as part of a private Medicare Advantage (Part C) policy. A wide variety of Part D plans are offered, with a large range of premium costs and coverage options. In 2012, premiums for Medicare Part D Prescription Drug Plans average $30 a month or $360 a year, according to Medicare.gov.
What should be included: | - A packet with coverage information, a Medicare card and a questionnaire is automatically mailed to individuals three months before their 65th birthday. Medicare.gov charts the different parts of Medicare and the two main choices for receiving Medicare.
- Traditional Medicare doesn't cover everything. For example, dental care, hearing aids or health care received outside the United States are not included. Medigap/Medicare Supplement or Medicare Advantage/Part C policies may cover some of these services, depending on the terms of the policy. The Centers for Medicare and Medicaid lists what is and isn't covered by Medicare.
Discounts: | - The Medicare Rights Center lists government programs such as Medicaid or Veterans benefits that might also help with seniors' health care costs.
Shopping for medicare: | - The typical enrollment period for Medicare is the month of the person's 65th birthday, as well as three months before and three months after that month. The annual open enrollment period for making changes is Oct. 15 to Dec. 7.
- Medicare.gov explains who is eligible for Medicare and provides a confidential Medicare eligibility tool.
- Various plans are offered in different parts of the country. Medicare.gov provides a Medicare Plan Finder Tool and a Medigap policy tool; both search by zip code or by an individual's Medicare information (name, Medicare number, etc.).
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Article updated February 2012 |
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