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Medicare

Medicare. Four Parts of Medicare:. Medicare Part A – Hospital Insurance Medicare Part B – Medical Insurance Medicare Part C – Medicare Advantage Plans Medicare Part D – Prescription Drug Coverage. Who Can Get Medicare?. 65 & older -or- Receiving Social Security disability

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Medicare

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  1. Medicare

  2. Four Parts of Medicare: Medicare Part A – Hospital Insurance Medicare Part B – Medical Insurance Medicare Part C – Medicare Advantage Plans Medicare Part D – Prescription Drug Coverage

  3. Who Can Get Medicare? 65 & older -or- Receiving Social Security disability benefits at least 24 months -or- Permanent kidney failure -or- Amyotrophic Lateral Sclerosis (ALS)

  4. When Can I Sign Up for Medicare? • Medicare Enrollment Periods: • Initial - at age 65 • Special - if still working • General - January-March

  5. Full Retirement Age Year of Birth Full Retirement Age 1937 or earlier 65 1938 65 & 2 months 1939 65 & 4 months 1940 65 & 6 months 1941 65 & 8 months 1942 65 & 10 months 1943 – 1954 66 1955 66 & 2 months 1956 66 & 4 months 1957 66 & 6 months 1958 66 & 8 months 1959 66 & 10 months 1960 or later 67

  6. Medicare Coverage • Part A Hospital Insurance • Covers most inpatient hospital expenses. 2008 Deductible $1,024 • Part B Supplementary Medical Insurance • Covers 80% doctor bills & other outpatient medical expenses after 1st$135 in approved charges. 2008 Monthly Premium $96.40 Part D Medicare Prescription Drug Plan • Covers a major portion of prescription drug costs for Medicarebeneficiaries. 2008 average Monthly Premium $27.93

  7. Part B Medically-Necessary Services • Ambulatory Surgical Services • Clinical Laboratory Services • Emergency Room Services • Outpatient Hospital Services • Diagnostic Tests (x-rays, MRI, CT scan) 7

  8. PREVENTIVE SERVICES “Welcome to Medicare” Physical Exam Bone Mass Measurement Cardiovascular Screenings Colorectal Cancer Screenings Diabetes Screening Diabetes Self-Management Training Annual Flu Shot Mammograms Prostate Cancer Screenings Smoking Cessation Counseling

  9. ASSIGNMENT An agreement between you and your doctor that he/she will accept as payment the amount Medicare approves for the service provided.

  10. LIMITING CHARGE The highest amount you can be charged for a Part B-covered service is the “limiting charge”. The limiting charge is 115% over the Medicare-approved amount. It applies to only certain services and does not apply to some supplies and durable medical equipment.

  11. NON-STANDARD PART B PREMIUMS If Your Yearly Income is: You pay: Individual Tax Return Joint Tax Return $82,000 or below $164,000 or below $ 96.40 $82,001 - $102,000 $164,001 - $204,000 $122.20 $102,000 - $153,000 $204,001 - $306,000 $160.90 $153001, - $205,000 $306,001 - $410,000 $199.70 Above $205,000 Above $410,000 $238.40

  12. NON-COVERED SERVICES • Acupuncture • Chiropractic services with one exception • Cosmetic Surgery • Routine Eye Exams • Routine foot care • Hearing aids • Long –term care • Routine physical examinations

  13. How Will the Prescription Drug Plan Affect You? • You will pay the first $275 (called an “annual deductible”). • Medicare will pay 75% of costs between $275 and $2,510 in drug spending. You pay only 25% of these costs. • Example: $2510 - $275 = $2235. $2235 x 75% = $1676.25. • You will pay 100% of the drug costs between $2,510 and $5726.25. Part D pays nothing. (Donut hole). • Medicare will pay about 95% of the costs above $5726.25. You pay between $2 and $5 per prescription.

  14. Extra Help Could Further Reduce Medicare Prescription Drug Costs Extra help is available for low income beneficiaries to pay for part of the Medicare Part D monthly premiums, annual deductibles and prescription co-payments. The extra help could be worth more than $3,600 per year. Go online to www.socialsecurity.govto apply for extra help.

  15. Income and Resource Limits - Subsidy INCOME: Individual – below $15,600 a year ($1300 per month) Couple – below $21,000 a year ($1750 per month) RESOURCES: Individual – no more $11,990 Couple – no more than $23,970

  16. Advantages of Qualifying for Medicare Part D Subsidy? • No monthly premium (limited to several plans) • No yearly deductible • No donut hole • Can enroll in Part D anytime you qualify

  17. For More Medicare Information 1-800-MEDICARE (1-800-633-4227) TTY 1-877-486-2048 www.medicare.gov

  18. Social Security’s Online Services • Retirement & Disability Applications • Apply for Extra Help • Retirement/Survivors/Disability Planner • Request a Statement • Change of Address • Medicare Card Replacements • Request a Benefit Verification Letter • Start or Change Direct Deposit

  19. Social Security Cost-of-Living Adjustments Effective Date Amount June 1975 8% June 1976 6.4% June 1977 5.9% June 1978 6.5% June 1979 9.9% June 1980 14.3% June 1981 11.2% June 1982 7.4% Dec 1983 3.5% Dec 1984 3.5% Dec 1985 3.1% Dec 1986 1.3% Dec 1987 4.2% Dec 1988 4% Dec 1989 4.7% Dec 1990 5.4% Dec 1991 3.7% Effective Date Amount Dec 1992 3% Dec 1993 2.6% Dec 1994 2.8% Dec 1995 2.6% Dec 1996 2.9% Dec 1997 2.1% Dec 1998 1.3% Dec 1999 2.5% Dec 2000 3.5% Dec 2001 2.6% Dec 2002 1.4% Dec 2003 2.1% Dec 2004 2.7% Dec 2005 4.1% Dec 2006 3.3% Dec 2007 2.3%

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