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Baby Boomers

October 3, 2017 by helpinsureus

Are you a Baby Boomer?  It’s a fact that from now until the year 2030 10,000 people per day will turn 65. Lucky you! When that happens you will be eligible for MEDICARE.

The government’s book on Medicare is in excess of 100 pagesAnd it’s boring.  Below is my condensed version, more like a Reader’s Digest article.

By the way, if you have not already registered for Medicare now is the time to do so ONLINE at this link:  https://secure.ssa.gov/iClaim/rib

The Devil’s in the Details of Medicare

Let’s take a quick look to make sure you understand exactly what Medicare covers and what you will be responsible to pay.

Medicare PART A is primarily a HOSPITAL plan that – after the small deductible – covers 100% of expenses for in-patient care for your first 60 days. After 60 days you begin to help out with expenses. (see below). If you qualify, you are not charged a premium for PART A.

Medicare PART B covers outpatient benefits such as preventive care visits, certain doctor visits, and lab services. PART B is purchased from an insurance agent who represents private insurance companies. Premiums run from $28/month to over $200/month.

Expenses you will pay under Part A:

  • There is an annual deductible that you must pay before hospital admission – $1,316 for 2017.
  • If your hospital stay is longer than 60 days
    • For days 61-90 you pay $329/day
    • For days 91-150 you pay $659/day
  • Medicare pays nothing beyond that
  • Skilled Nursing Facility
    • Medicare will pay for the first 20 days that you are in a Skilled Nursing Facility
    • For days 21-100 you pay $164.50 per day
    • Medicare will not pay after day 100 in a skilled nursing facility
  • You pay for the first 3 pints of blood – Medicare pays after that
  • If you want a private hospital room YOU PAY

Expenses you will pay under Part B, also called MediGap or Medicare Supplement: (outpatient services)

  • There are 10 different plans available under PART B
  • Some plans have office copays and some do not
  • There is an annual deductible for PART B – $183 for 2017
  • Medically necessary doctor visits are covered. You either pay 20% or you have a copay in your plan
  • You pay for the first 3 pints of blood and Medicare pays 80% after the deductible
  • Durable Medical Equipment – Part B pays 80% after the deductible
  • Part B pays 100% for Lab Services and Home Health Care
  • Other medical expenses – Part B pays 80% and you pay 20% after deductible
  • You pay all expenses above Medicare approved rates – however, some plans pay the expenses above Medicare-approved rates
  • Alternative medicine – you pay all
  • Most dental care and hearing aids – you will pay
  • Custodial care – you pay (help with bathing, toileting, dressing, etc.)
  • You will pay for cancelled or missed appointments; copies of x-rays, etc.

MediGap Plans Pay What Medicare Doesn’t

Most beneficiary’s (that’s what those on Medicare are called) find it prudent to get a Medicare Supplement plan – also called MediGap – to reduce the risk of possible major expenses not covered by Medicare. REMEMBER, Medicare does not pay 100% of your medical bills. It only pays up to 80%. That’s why you need a MediGap plan. Imagine a $100,000 hospital bill where you end up owing $20,000 because you do not have a MediGap plan. MediGap plans can be as little as $28/mo. or as high as $200.

If you would like to get a MediGap QUOTE just let me know. The quote I send you will show all that Medicare pays and all that the MediGap plan pays as well as the premium.

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