Market Overview

Medicare 2011


Medicare is a national health insurance program for people 65 years and older, a few younger people who qualify can also receive Medicare benefits.  People with kidney failure or long term disabilities are eligible to receive Medicare.  Medicare has four components: hospital insurance - Part A, medical insurance - Part B, Medicare advantage plans - Part C, prescription drug coverage - Part D. 

To receive Medicare you must be a citizen or permanent resident of the U.S. at least for five years.  People getting Social Security when they turn 65 do not have to apply they will automatically be enrolled for both Part A and Part B, the Medicare card will be mailed three months before their 65th birthday.

If you do not receive Social Security or Railroad Retirement benefits when you turn 65 you have seven months in which to enroll.  People should enroll three months before they turn 65 by contacting the SSA.  If you do not enroll within the seven month period starting three months before turning 65 you will have to wait until the next enrollment period which is January 1 to March 31 of each year, Part B will not start until July. 

Medicare Part A covers inpatient hospital benefits, home health care, hospice care and skilled nursing facility care.  Part A does not require the patient to pay a premium for this coverage.  Part A helps pay for meals, semi-private rooms, regular nursing services, rehabilitation services, drugs, medical supplies and x rays.  The 2011 Part A cost sharing deductible is $1,132 per benefit period and $283 per day for days 61-90 of an inpatient stay.

Medicare Part B covers medical professional services, artificial prosthesis, injectibles, outpatient hospital services, outpatient mental healthcare, ambulance transportation, flu, pneumonia & hepatitis B vaccines.  Medicare recipients are responsible for paying the annual Part B deductible.  After paying the deductible  Medicare pays for 80% of Medicare approved charges.  The patient is responsible for paying the remaining 20% Medicare coinsurance.  The monthly premium for Part B for 2011 is $115.40 per month it will drop to $99.90 in 2012, higher income individuals may pay more.  Many patients with Medicare supplement this coverage with a secondary Medigap insurance.

Medicare Part C includes Medicare Advantage Plans.  The plans must be approved by Medicare and are managed by private companies.

Medicare Part D must also be approved by Medicare as well.  It is the prescription drug coverage offered by private insurance companies to aid with the costs of drugs.  Part D is a voluntary benefit but if it is chosen it includes a monthly premium as well as a share of the cost of the prescriptions. 

It is important to keep a record of your doctor visits and the processing of your bills as well as never giving your Medicare number to people you do not know.  A word to the wise be wary of duplicate payments for the same services and of people that claim they can get Medicare to pay for a service that is not covered.

The preceding article is from one of our external contributors. It does not represent the opinion of Benzinga and has not been edited.


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