Co-Pays and Deductibles

What does Medicare Part B Cost?
People that are already paying $96.40 a month for Medicare Part B in 2009 will continue to do so in 2010, but people that become eligible for Medicare on or after January 1, 2010 will pay at least $110.50 per month. Premiums will be adjusted upward if their income is more than $85,000 a year.  See Medicare Part B Premium Costs in 2010 for more information.

When Should I Sign up for Medicare Part B?
Medicare starts at age 65 whether you are retiring or not. If you work for a small employer, less than 20 employees, then you should take out Part B when you turn 65 or you will accrue a permanent penalty of 10% of the Part B premium for every year that you don't have this coverage. If you are retired then your coverage through a retiree plan becomes secondary to Medicare so you should have both parts A and B. Medicare is not available on a family basis so the community spouse cannot join when a beneficiary becomes eligible. There is no requirement that your insurer notify you when their coverage becomes secondary. Even though you are paying for full coverage, you might owe the deductible and 80% of the cost of covered services if you don't have Medicare after age 65. You have eight months to sign up for Medicare after losing creditable coverage from a company that has 20 or more employees. You will have to wait until the next Open Enrollment period, that starts every year in January, to enroll if you are enrolling late and coverage will not start until July of that year. People on COBRA after age 65 should get Medicare within eight months of losing group coverage as COBRA is not considered group coverage.

Medicare's Preventive Services
Medicare's Preventive Services contains information about how preventive services are paid for in Medicare. There are also links to a number of booklets that cover specific aspects of care for men and women. Some exams are covered with no Part B deductible. An annual exam with your doctor is not covered unless he codes it as a follow-up if you are being treated for a chronic disease or are a high risk for diseases like cancer.
 

Medicare Parts A and B have been around since the beginning of Medicare in the 1960s. Part A covers hospital visits, skilled nursing facilities and some home health care. Part B covers doctor visits, outpatient visits and durable medical equipment. Together, Parts A and B are referred to as "traditional" fee-for-service (FFS) Medicare, or sometimes as "Original Medicare." It is estimated that FFS Medicare only covers about 50 percent of the health care costs incurred by beneficiaries. That is why some people who choose FFS Medicare also obtain a Medicare Supplemental plan. This type of health insurance is also known as Medigap coverage. Medigap plans do just that-cover the "gaps" that FFS Medicare does not cover. However, Medigap plans can be extremely costly. As a result, many seniors are attracted to the broader coverage and more predictable costs of Medicare Part C, commonly called Medicare Advantage.

Extra Benefits
Medicare Advantage plans may offer extra benefits such as vision and hearing coverage, annual physicals and worldwide emergency coverage and many also include coverage for medications. These plans help with your coordination of care across the provider spectrum.

Explains Scott R. Kelly, chief government programs officer, Health Net, Inc., "With the wide array of Medicare options, you have the ability to customize your coverage to really meet your needs." He offers another alphabetical aid, saying, "In reviewing your options, the most important factors are often the 4 Cs-Cost, Customer Service, Convenience and Coverage."

Part D is prescription drug coverage, which started in early 2006 and has turned out to be more popular than expected. Both Part D and Medicare Advantage plans are offered through private health care companies, either as separate options or together in one plan. Some of the plans do not have premiums while others do have monthly fees. Those plans can vary depending on where you live and the services covered.

Dates To Keep In Mind
In addition to the Medicare alphabet, there are some numbers you should keep in mind as well. You are eligible to join Medicare on the first day of the month in which you turn 65.

Once you are on Medicare, you can change your Medicare Advantage or prescription drug plan each year during the Annual Election Period, which runs from November 15 to December 31. During this period, you can pick any plan that is offered in your area. Most beneficiaries can choose between dozens of plans. For more information, please go to www.medicare.gov or call us at (800) 547-1567.

Many seniors are attracted to the broader coverage of Medicare Part C, called Medicare Advantage.

Medicare Secondary Payer
Federal law requires most companies that provide group insurance to make Medicare the secondary payer. Here are two locations to get detailed information about this:
Medicare.gov-Second Payer and You
42 C.F.R. PART 411—Exclusions From Medicare...