Medicare Summary:
Medicare is a government-run health insurance program for people who are 65 or older, people with certain disabilities, and people with End-Stage Renal Disease. It has four parts:
- Part A, which covers Inpatient Hospital stays, Inpatient Skilled nursing Facility Stays, Hospice Care, Blood and
home health services (medically necessary part-time or intermittently skilled nursing care, physical therapy,
occupational therapy, intermittent home health services(medically necessary) and more).
*See Medicare &You Handbook (in Resource Section)
- Part B, which covers doctor visits, durable medical equipment, preventive services and outpatient hospital services
- Part C, Medicare Advantage is Original Medicare plus additional benefits administered by heath insurance
companies
- Part D, which covers prescription drugs
You will automatically be signed up for Original Medicare (Parts A and B):
- if your are already getting Social Security or Railroad Retirement Board Benefits when you turn 65
- if you have a disability and you are under 65 and have been receiving Social Security disability benefits Or
Railroad board benefits for 24 months
- if you have ALS (Lou Gehrig's disease)
If you are not automatically enrolled in Medicare:
- You can sign up during your INITIAL ENROLLMENT PERIOD (3 months before the month you turn 65 and 3
months after the month you turn 65)
- If you have End-Stage Renal Disease
Cost of Medicare:
- Part A is usually free for most recipients (those that paid Medicare taxes (or their spouses) while working for a
certain period of time. You can buy it if you don't qualify for it. You will have to pay a penalty if you sign up
late and are eligible to sign up,
- Part B usually has a premium that is deducted form your Social Security check. If you are not receiving a Social
Security check and have Part B then Medicare will bill you. If you do not have other Qualified Coverage and
sign up late for Part B, you will have to pay a penalty.
- Part C requires that you have Parts A and B and you pay the Part B premium to be eligible. Some Part C plans
have a premium and some do not.
- Part D plans usually have a premium when they are purchased separately. If you have a Part C plan, Part D is
usually included in those plans.
- If you're on a limited income, you might be able to get help paying for your Medicare costs through programs such as Medicaid and LIS (Low Income Subsidy).
What is not Covered:
- Most Dental Care
- Eye exams for glasses or contacts
- Dentures or dental implants
- Long Term care
- Short Term Recovery Care
- Cosmetic Surgery
- Hearing Aids and exams to fit them
- And More (contact Medicare for full list)
Tips:
1. For inpatient hospital stays make sure your are officially admitted to the hospital with a doctor order and not as
observatory status (Outpatient Observatory). If you are listed as receiving observatory services then this can affect
how much you pay during your stay in the hospital and for additional service you receive once you leave the
hospital.
2. Make sure you insurance plan at work is considered qualified coverage when you turn 65 so you won't be
penalized for not taking Part B until you retire.
3. If you are still working after 65 and have retiree health coverage, Medicaid or group health coverage make sure to
find out how your coverage works with Medicare.
4. Check with Medicare or Insurance company ahead of time to see what the costs (deductibles, co-payments or
coinsurance) will be before you receive services so you will not be unpleasantly surprised.
For more information feel free to give us a call at 610-660-7801 or fill out the form below.
Medicare is a government-run health insurance program for people who are 65 or older, people with certain disabilities, and people with End-Stage Renal Disease. It has four parts:
- Part A, which covers Inpatient Hospital stays, Inpatient Skilled nursing Facility Stays, Hospice Care, Blood and
home health services (medically necessary part-time or intermittently skilled nursing care, physical therapy,
occupational therapy, intermittent home health services(medically necessary) and more).
*See Medicare &You Handbook (in Resource Section)
- Part B, which covers doctor visits, durable medical equipment, preventive services and outpatient hospital services
- Part C, Medicare Advantage is Original Medicare plus additional benefits administered by heath insurance
companies
- Part D, which covers prescription drugs
You will automatically be signed up for Original Medicare (Parts A and B):
- if your are already getting Social Security or Railroad Retirement Board Benefits when you turn 65
- if you have a disability and you are under 65 and have been receiving Social Security disability benefits Or
Railroad board benefits for 24 months
- if you have ALS (Lou Gehrig's disease)
If you are not automatically enrolled in Medicare:
- You can sign up during your INITIAL ENROLLMENT PERIOD (3 months before the month you turn 65 and 3
months after the month you turn 65)
- If you have End-Stage Renal Disease
Cost of Medicare:
- Part A is usually free for most recipients (those that paid Medicare taxes (or their spouses) while working for a
certain period of time. You can buy it if you don't qualify for it. You will have to pay a penalty if you sign up
late and are eligible to sign up,
- Part B usually has a premium that is deducted form your Social Security check. If you are not receiving a Social
Security check and have Part B then Medicare will bill you. If you do not have other Qualified Coverage and
sign up late for Part B, you will have to pay a penalty.
- Part C requires that you have Parts A and B and you pay the Part B premium to be eligible. Some Part C plans
have a premium and some do not.
- Part D plans usually have a premium when they are purchased separately. If you have a Part C plan, Part D is
usually included in those plans.
- If you're on a limited income, you might be able to get help paying for your Medicare costs through programs such as Medicaid and LIS (Low Income Subsidy).
What is not Covered:
- Most Dental Care
- Eye exams for glasses or contacts
- Dentures or dental implants
- Long Term care
- Short Term Recovery Care
- Cosmetic Surgery
- Hearing Aids and exams to fit them
- And More (contact Medicare for full list)
Tips:
1. For inpatient hospital stays make sure your are officially admitted to the hospital with a doctor order and not as
observatory status (Outpatient Observatory). If you are listed as receiving observatory services then this can affect
how much you pay during your stay in the hospital and for additional service you receive once you leave the
hospital.
2. Make sure you insurance plan at work is considered qualified coverage when you turn 65 so you won't be
penalized for not taking Part B until you retire.
3. If you are still working after 65 and have retiree health coverage, Medicaid or group health coverage make sure to
find out how your coverage works with Medicare.
4. Check with Medicare or Insurance company ahead of time to see what the costs (deductibles, co-payments or
coinsurance) will be before you receive services so you will not be unpleasantly surprised.
For more information feel free to give us a call at 610-660-7801 or fill out the form below.
Before completing the form please read the following disclaimer:
According to Medicare rules, we need your permission to contact you to discuss your Medicare plan options. The person who will be discussing plan options with you is with or contracted by a Medicare health plan or prescription drug plan that is NOT the Federal Government, and they may be compensated based on your enrollment in a plan. Discussing Medicare plans options does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan. |
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(We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options regarding Medicare, Medicare Advantage, Medicare Supplement plans and Prescription Drug plans.)