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Turning 65 and Need Help with Medicare?

Medicare is health insurance for people age 65 or older, under 65 with disabilities and people of any age with End-Stage Renal Disease.  Medicare alone was never intended to pay for all medical expenses including coinsurance, co-pays and deductibles.  A Medigap policy is health insurance sold by private insurance companies to fill the gaps in Original Medicare coverage.  Medicare Supplement insurance can help you pay your medical expenses not paid for by Original Medicare.

Overview of Medicare Coverage

There have been many changes to Medicare since it was created in 1965.  With these changes it is difficult to keep up with what is covered, enrollment dates and who is covered.  Alabama Medicare wants to help you understand Medicare and the options available to you.
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SAMPLE MEDIGAP (MEDICARE SUPPLEMENT INSURANCE) RATES | Print |

The rates shown below are sample monthly rates current as of 5/23/2011. Actual premiums may vary. These rates also assume you can pass medical underwriting, if required. In this example, rates for smokers are higher.

The cost of your Medigap policy may also depend on whether the insurance company does any of the following:

  • Offer discounts
    • male/female
    • smoker/non-smoker
    • married/single
    • discounts for paying annually
    • discounts for paying your premiums using electronic funds transfer
    • discounts for multiple policies with the same company
  • Uses medical underwriting, or applies a different premium when you don't have a guaranteed issue right, or aren't in a Medigap Open Enrollment period.
  • Sells Medicare SELECT policies that may require you to use certain providers.
  • Offers a "high-deductible option" for Medigap Plan F. If you buy Medigap Plan F with a high-deductible option, you must pay the first $2,000 (in 2011) of deductibles, copayments, and coinsurance not paid by Medicare before the Medigap policy pays anything.

 

Sample Monthly Medigap Rates

 

 

 

 

 

 

 

 

 

 

Sample Monthly Medigap Rates Male
 
Medicare & You 2011 | Print |

The Medicare & You 2011 is the Official U.S. government Medicare Handbook with important information about the following:

What's new
Medicare costs
What Medicare covers
Health and prescription drug plans
Your Medicare rights

What you need to know in 2011:

  • Pay less for Preventive Services
  • Durable Medical Equipment Suppliers
  • New Yearly Wellness Exam
  • New Dates to Change Plans
  • Help in the Prescription Drug Coverage Gap
  • Fighting Medicare Fraud
  • Ways to Manage your Health Information Online
  • What you pay for Medicare

Download the Medicare & You 2011 guide now.

Medicare and You 2011 Guide
 
Medicare Premiums | Print |

Medicare 2011 Premiums & Cost Sharing

Medicare Premiums for 2011

 

Part A (Hospital Insurance) Premium

  • Most people do not pay a monthly Part A premium because they or a spouse has 40 or more calendar quarters of Medicare-covered employment.
  • If you aren't eligible for premium-free Part A, you may be able to buy Part A if you meet one of these conditions:
    • You're 65 or older
    • You're entitled to (or enrolling in) Part B
    • You meet the citizenship or residency requirements; OR
    • You're under 65, disabled, and your premium-free Part A coverage ended because your returned to work.
  • The Part A premium is $248.00 per month for people having 30-39 calendar quarters of Medicare-covered employment (down from $254.00 in 2010)
  • The Part A premium is $450.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment (down from $461.00 in 2010).

NOTE: If you pay a late enrollment penalty, these amounts will be higher.

CAUTION: In most cases, if you choose to buy Part A, you must also have Part B and pay a monthly premium for both. If you have limited income and resources, your state may help you pay for Part A and or Part B.
Read more...
 
Medigap | Print |

Medigap (Medicare Supplement) Plans (A through N)

 

What is Medigap (Medicare Supplement)?

First, a clarification is in order. The terms "Medigap" and "Medicare Supplement" are used interchangeably. Both terms mean exactly the same thing. Because Medicare coverage has limitations, many people purchase supplemental insurance policies that are specifically designed to cover some of the gaps in the Original Medicare program. This supplemental insurance is provided by private health insurance companies, not the government, although it is typically called Medigap. In general, you will not need a Medigap policy if your Medicare coverage is through a Medicare Advantage plan or if you are covered by Medicaid. Specific income and resource requirements for Medicaid eligibility are determined by individual states. In either case, your Medicare Advantage plan or Medicaid generally fills the gaps in Medicare coverage. Additionally, you must have Medicare Part A and Part B to purchase a Medigap policy.
Read more...
 
Coverage Choices | Print |

There are two main ways to get your Medicare coverage:

  • Original Medicare (Parts A and B), or
  • Medicare Advantage Plan (Part C)

 

TIP: You will automatically be placed in the Original Medicare program unless you enroll in a Medicare Advantage plan.

After you decide which method to obtain your basic Medicare benefits from, you need to decide if you need to add Prescription Drug coverage. Currently, most Medicare Advantage plans automatically include prescription drug coverage. However, this practice may be changing in future years as a result of the Affordable Care Act (ACA) of 2010. Currently, Medicare pays Medicare Advantage companies over $1,000 more per person per year than Original Medicare. These additional payments are paid for in part by increased premiums by all Medicare beneficiaries -- including the 77% of seniors not enrolled in a Medicare Advantage plan. The new law will be gradually eliminating these overpayments to Medicare Advantage insurance companies.

If you have selected a Medicare Advantage plan to obtain your Medicare benefits, you don't need and can't be sold a Medigap policy.

If you have selected Original Medicare, you need to decide if you should add supplemental coverage (Medigap or Medicare Supplement Insurance policy).

There are advantages and disadvantages to each coverage choice. Click here to see a chart showing the difference between a Medicare Advantage and a Medicare Supplement plan.

 

 

Citation: Medicare & You, cms.gov
 
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