Turning 65? Call Trish at 203-799-2327 with your Medicare questions.
MEDICARE PART A
Most people are automatically enrolled at age 65
• Covers inpatient hospital care
• Skilled Nursing facility following hospital stay
• No premium, but deductibles range from a lump sum to a daily rate for in hospital stay or extended care facility
• Covers some home health care for up to 100 days – 20% cost share by patient for durable medical equipment
• Deductibles and co-insurance are paid by the insured.
• In 2020, deductible = $1,364
MEDICARE PART B
Most people enroll at age 65 unless they are still on group insurance i.e. employer’s plan. Failure to enroll when eligible and not covered by other “creditable coverage” may result in a penalty.
After annual deductible of $197, pays 80% of medical and other services such as:
• Doctors’ and practitioners i.e. chiropractors, psychologists, physical therapists, etc.
• Clinical laboratory services
• Outpatient hospital services
• Home health care services
• Health screenings and yearly “wellness” visit
Monthly base premium = $145 but could be higher depending on income
MEDICARE PART C - MEDICARE ADVANTAGE
Helps to cover a large portion of the deductibles, coinsurance fees and prescriptions not paid under Medicare A or B.
Functions very much like “traditional health insurance” with small copays and sometimes modest deductibles. Premiums are generally very low –sometimes $0.
MEDICARE PART D - PRESCRIPTION DRUG COVERAGE
A Medicare prescription drug plan can help you manage the expenses associated with your medications. Different types of prescription drug plans are offered by different insurers so premiums and deductibles for prescriptions will vary.
Federal regulations require that all Medicare recipients have a prescription drug plan. Failure to enroll within 60 days of turning 65 or not having “creditable” drug coverage (usually group plan through employer) will result in a penalty being assessed that is permanent and deducted from social security check each month.