What is Medicare?
Medicare is a federal health insurance program for people 65 years or older and people who are under 65 with certain disabilities and/or diseases.

Who is eligible for Medicare?
You are eligible for Medicare if you are a U.S. citizen or have been a permanent legal resident for five continuous years, and: you are 65 years or older and eligible to receive Social Security; or you are under 65, permanently disabled, and have received Social Security disability insurance payments for at least two years; or you get continuing dialysis for permanent kidney failure or need a kidney transplant

What should you be doing now?

As you are getting closer to becoming eligible to receive Medicare, there are a number of things to consider in determining the type of coverage and plan you will need. If you are currently working and getting ready to retire, find out from your employer what your retirement coverage options are and the costs and benefits associated with each. If you will not be receiving coverage from your employer and have a spouse that will be working, determine if you can obtain coverage from their insurance plan. To continue your planning and make your search easier, we have included some general questions you should ask yourself to find the right coverage for you. Begin with these questions:

Do you want coverage for certain benefits, like prescription drugs or routine physical exams?

Determine the benefits that are of the most importance to you. Original Medicare alone does not cover prescription drugs, dental services, or all costs associated with physical exams. Some health plans (like Medicare Advantage plans) offer additional coverage for these services. You will need to determine specifically which type of plan will include the best benefits to fit your health care needs.

How important is doctor and hospital choice to you?

Most HMO (Health Maintenance Organization) plans require you to choose a physician within their network and to get a referral each time you need to go to a specialist. Many PPO (Preferred Provider Organizations) plans and Medicare Supplement plans allow you to see the doctor of your choice. Costs may be higher if you go outside an insurer's network.

What are your monthly health care costs?

Consider your current spending on health care along with your anticipated future spending. Remember that you will be required to pay your Medicare Part B premium each month. Your Part B premium is based on your income. Most people will pay the 2009 standard monthly Part B premium of $96.40 (you must meet an annual deductible of $135.00). However, some people will pay a higher premium based on their modified adjusted gross income. Your monthly premium will be higher if you file an individual tax return and your annual income is more than $85,000, or if you are married (file a joint tax return) and your annual income is more than $170,000. These amounts change each year.

Determining the cost and coverage that you need up front will help you be more prepared when it comes time for you to make a decision.

There are 4 different parts to Medicare 
 
Part A – Hospital Insurance 
 
 Part B – Medical Insurance 
 
 Part C – Medicare Advantage 
 
 Part D – Prescription Drug Coverage 

Medicare Part A

Hospital Insurance
Medicare Part A pays for the services that hospitals provide, such as the room, nursing services, and supplies for an inpatient stay. In some cases, Part A may pay for a stay in a skilled nursing facility, as well as home health and hospice care. Fortunately, most people do not have to pay a monthly premium for Part A coverage. It is funded by a portion of the Social Security tax you and your employers have already paid.

Part A, however, will not cover all your hospital costs. There is a deductible of $1,068 per benefit period for 2009. You must pay your entire deductible before Medicare Part A will cover any hospital expenses. In addition, if you are hospitalized for an extended period, you will also have to pay a daily coinsurance fee. This is $267 per day for days 61 – 90, and it rises to $534 a day for your 91st day through 150th day.

These costs can build up. If you are hospitalized for 60 days, you’ll only be responsible for your Part A deductible. But if you are hospitalized for 100 days, you’ll pay almost $13,350.

Medicare Part B

Medical Insurance
Medicare Part B pays for the services that doctors provide, in the hospital or in their offices. It also pays for outpatient hospital services, long-lasting medical equipment like wheelchairs and walkers, and other medical services and supplies. Part B is optional. If you decide to enroll in Medicare Part B, you may also apply for a supplemental plan of your choice without answering health questions.

Part B works like most health insurance plans. You pay a monthly premium which is based on your income, that you can even have deducted from your Social Security check. For 2009, you must meet an annual deductible of $135.00. After that, Medicare generally pays 80% of the charges it approves. You typically are responsible for paying the remaining 20% or applicable co-payment, plus any charges that are higher than Medicare’s approved amounts if the provider does not accept Medicare assignment.

Medicare Supplement or “Medi-Gap” plans pay for many health care services and supplies, but original Medicare plans do not cover all. These costs are called “gaps” in Medicare coverage. A Medicare Supplement or “Medi-Gap” policy is designed to help cover these gaps. You pay a monthly premium for this additional coverage.

Medicare Part C

Medicare Advantage
Certain private insurance companies offer Medicare Advantage plans, also referred to as Medicare Part C. Medicare Advantage plans have a contract with Medicare that allows them to administer your Medicare benefits (Part A and Part B), so you have one source for your health care coverage. These plans may also provide enhanced benefits that go beyond those required by Medicare. To help you save more on the cost of your coverage, certain Medicare Advantage plans use provider networks (health maintenance organizations and preferred provider organizations) to reduce your share of the cost for covered services.

Medicare Part D

Prescription Drug
Anyone who is entitled to Medicare Part A or enrolled in Part B will be able to enroll in Medicare Prescription Drug coverage. Here’s how it works: The Centers for Medicare and Medicaid Services (CMS) have chosen a variety of private companies to offer Medicare Prescription Drug Plans (PDPs). Premiums and benefits may vary, based on your geographic region and on the company. However, average premiums are about $38 per month. This premium may be lower for those with limited income and resources. When Medicare designed its standard prescription drug benefit, it focused on providing solid coverage to the majority of people with Medicare. PDPs may offer Medicare’s standard benefit or plans with enhanced benefits.abc

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Art Cambridge financial servicing Springfield metro and Southwest Missouri. Life Insurance, Long Term Care Insurance, Health Care Insurance, Parents Needs Planning, Estate Planning, Cash For Life Planning, Fixed Rate Annuities, Equity Indexed Annuities, Single Premium Immediate Annuities SPIA , Medicare Medicaid Planning, Medicare Parts A,B,C,D choices.