Changes In Medigap Might Cost Seniors More

Congress is heatedly debating alterations to   Medicare  Supplemental Insurance Plans that may soon mean more out-of-pocket costs for  health  care.

 Medicare  is the government  health  insurance program for those 65 or older as well as younger disabled people.  Medicare  has never covered all of their  health  care needs, though.  Medicare  beneficiaries have out-of-pocket costs for both doctor and hospital treatments. To reduce these out-of-pocket costs, many  Medicare  beneficiaries add a Medigap Plan. Medigap or  Medicare  Supplement Insurance doesn’t replace  Medicare . It picks up some of the medical bills that  Medicare  doesn’t cover.

Some experts on  health  care policy say that such coverage generates an increased demand for  health  care by reducing the amount  Medicare  beneficiaries have to cover for treatment. That increase in the demand for  Medicare  services can also be abused when providers bill for additional and unnecessary medical care. It’s normal for beneficiaries to want as much  health  care as they can afford with the expanded coverage of Medigap Plans, but the government hasn’t funded  Medicare  to keep up with the demand.

One response has been to propose that  Medicare  Supplement Insurance plans be blocked from filling all of the gaps in  Medicare . To drive up out-of-pocket costs for beneficiaries, adding $530 per year to existing out-of-pocket costs is also under consideration. But, are beneficiaries the only ones on a spending spree?

Hospitals have been known to bill for services after a  Medicare  beneficiary’s death. Fraudulent billing for services can also take a high toll on government coffers. Is it reasonable to expect  Medicare  beneficiaries to blow the whistle when doctors recommend tests that increase the burden of governmental funding?

A recent study by the Kaiser Family Foundation showed that increasing out-of-pocket expenses for  Medicare  Supplement Insurance could save  Medicare  $1.5 billion to $4.6 billion per year. It has also been suggested that higher out-of-pocket costs would reduce the demand for health care and in turn, lower Medigap premiums because of reduced expenses for insurance companies. Is it really necessary to take health care away from seniors and people with disabilities?

There is extensive debate over what the government can’t afford, but some of the reasons for the shortfall may be surprising. According to David Cay Johnston who reported on the tax system for the New York Times, the trend for U.S. companies to drastically reduce their tax bills by incorporating in Bermuda has been growing. Johnston, who won a Pulitzer Prize for his coverage of our tax system, points out that our laws don’t prevent this. He reported on a New Jersey industrial manufacturer that incorporated in Bermuda for $27,000 and could avoid at least $40 million in U.S. corporate income taxes. The company didn’t even need to maintain a Bermuda office. A mail drop there was sufficient to save them $40 million or more.

How Can  Medicare  Beneficiaries Protect Their  Health  If Access To Medical Care Becomes More Expensive?

While our policymakers are still debating over what to do with Medigap Plans, you can take measures to reduce your out-of-pocket costs for health care.

The more you work to improve your  health , the less you’ll have to spend on medical intervention regardless of  Medicare  politics. Exercise plays a major role in keeping the body fit and improving a lot of health problems. It also helps to keep your brain functioning at peak levels.

How you fuel your body is even more important than staying active. For starters, fruits and vegetables fight cancer, high blood pressure, and help you to maintain a healthy weight. Avoiding preventable disease does more than cut your cost for health care. It also makes it easier to navigate between  Medicare  Supplement Insurance Plans. Outside of open enrollment, it’s difficult or impossible to clear medical underwriting standards to buy a supplement if your medical history is problematic.

No matter how you look at it, investing in ways to protect your health is a money saver. Perhaps that’s why some  Medicare  Supplement Plans offer discounts on  health  club memberships and online access to  tips  to stay healthy.

Excellent Medicare Benefits Available

Excellent  Medicare  benefits are available. However, if you are a  Medicare  beneficiaries you must become well informed to get the benefits you are entitled to and that can save you money.

Original  Medicare  is the federal  health  insurance program for almost all Americans age 65 and older and for many adults with permanent disabilities. You are eligible for  Medicare  if you are a US citizen and eligible to receive Social Security; or you are under 65, permanently disabled and have received Social Security disability insurance payments for at least two years; or you have a permanent kidney failure or need a kidney transplant; or you have Lou Gehrig’s disease.

You have options of not paying the deductible and coinsurance that are part of Original  Medicare  by joining a  Medicare  Advantage Plan (MAP). For example, the deductible for inpatient hospital care under Original  Medicare  per each benefit period is $1068 for days 1-60; then $267 per day for days 61-90; and $543 for days 91-150. For doctor visits, it is a 20% coinsurance. Until March 31st, of each year called the Open Enrollment Period (January 1st through March 31st), you can enroll in a MAP and leave from Original  Medicare . While you cannot add to or drop the part D Prescription Plan(PD), if you are willing to choose a doctor from the MAP, you can save a ton of money on your health care.

The IEP (Initial Enrollment Period) is still available for those who are just turning 65 and thus are aging in. If you have dual eligibility, that is, if you are entitled to  Medicare  part A and part B and are eligible for some form of Medicaid benefit, you are under the SEP (Special Election Period) which allows beneficiaries to make an enrollment change outside the regular enrollment periods. You can change from one  Medicare  Advantage-Prescription Drug Plan to another or from Original  Medicare  and a Prescription Drug Plan to a  Medicare  Advantage-Prescription Drug Plan anytime during the course of the year.

If you are in an Employer-sponsored plans and are considering joining a  Medicare  private plan, you should talk to your employer or former employer to be sure you won’t lose valuable retiree  health  benefits if you sign up with a private plan. Many employers offer retiree  health  coverage as a supplement to traditional  Medicare . Some also offer coverage through  Medicare  HMO and other private options.

Some private plans also offer a SNP designed to address identified needs of a targeted population for three verifiable chronic conditions: hypertension, high cholesterol, and diabetes. If you have at least one of these conditions, you are eligible to enroll in this plan during the SEP.

Medicare Supplement Insurance, Get the Facts

The  Medicare  Insurance policy provides cover for most of the medical expenses incurred by the insured. But there are many shortcomings of the policy. To overcome these shortcomings  Medicare  Supplement Insurance was created. The  Medicare  Supplement Insurance policy is sold by private insurance companies. The  Medicare  Supplement Insurance policy is also called Medigap Policy. You can avail a medigap policy only if you are insured under the  Medicare  policy part A and B. You take up a  Medicare  policy and avail for a medigap policy to take care of your  health  care costs that are not covered in the  Medicare  policy. So a combo of both the policies can take care of most of your health care costs. The Medigap insurance policy has twelve plans. They are named A through L and each offers some basic and few extra covers. As said these policies are sold by private insurance companies, but the features of the policy are same regardless of the company. Each company can decide what policies it wants to sell.

There is one more policy apart from the twelve plans that comes under Medigap policy. It is called  Medicare  SELECT. The reason for having this policy is that it is cheaper than the other twelve policies. But there is a downside of this policy as well. You can avail services from a limited number of physicians and hospitals only. There is one more thing that you need to know before buying a Medigap policy; you cannot buy a Medigap policy if you already have  Medicare  Advantage Plan. Buying a Medigap policy while already having a  Medicare  Advantage is illegal.

There are twelve plans under Medigap policy. Out of these twelve E, H, I, and J are terminated from June 1, 2010. There is also addition of two more plans. They are M and N. People insured under the terminated plans will have their policies renewed without any changes in the coverage. The  Medicare  Insurance Policy covers 80 percent of the  health  care costs incurred by the insured. To cover the rest 20 percent Medigap Plans were formulated. The twelve plans cover all the voids left uncovered by the  Medicare  Policy. A single glance on the plans will reveal that all the plans offer more or less the same cover what differs is the amount of cover offered by each. For instance plan K covers half of – hospital expenses, first three pints of blood annually and  Medicare  part B coinsurance. Plan L also provides cover for the same costs but it covers 75 percent of the costs. All the plans provide extended insurance cover for a year after the  Medicare  policy expires. Cost borne by you while at a skilled nursing home is covered by the plans. Plans C through J cover a part of the expense borne by you to pay the emergency treatment fee outside the country. In case you require skilled assistance at home for recovery then Plans D, G, I, and J cover a part of the fee charged by the service providers.

Just Qualifying for Medicare Benefits? Some Things to Consider

When you finally qualify for  Medicare  benefits you can breathe a sigh of relief. Original  Medicare  as it stands currently is arguably the best  health  insurance plan available. Granted there are some gaps in the coverage. There are deductibles and co-insurances and co-pays that you will be responsible to pay. The good news is that these gaps are very well defined and very simple to cover with any of the 10 standardized  Medicare  Supplement Plans currently available.

You finally have a chance to set yourself up in a situation where you can totally predict your medical costs for the year. No surprises, no medical bills. Yet this time for a lot of folks is filled with stress. Piles and piles of mail, hundreds of emails and phone calls. This from agents and brokers looking for your business.

Then you have the people you actually know. Your brother-in-law who retired last year telling you what he did and why you should do the same thing. Your neighbor who can’t tell you enough how happy she is with her  Medicare  Advantage Plan.

The bottom line is that this is your open enrollment period and you only get one! One open enrollment period in your entire life. You have very special rights during this time. You have what are called Guaranteed Issue Rights. This means that during this time you can not be denied coverage for any plan that you choose. It does not matter what your past medical history is. You do not have to answer any health questions at all. Just pick the plan that is right for you and apply. These rights last until 6 months after your 65th birthday or your Part B effective date. Even if you are in great heath now, we know that unfortunately may not always be true. It would be tragic to not get the facts, make a choice that you regret and then not be able to rectify the situation because you can’t qualify health-wise.

So please, find an Independent Broker. One who specializes in  Medicare . It should be their one focus. Ask the questions to determine if they have your best interests at heart. To the best of your ability make sure that the information that they are providing is up to date and accurate. Do not accept a partial understanding of your options. A competent broker will make sure that you comprehend the choices and the impact each option will have on your pocket-book and your health care. In other words demand the service that you deserve.

Please don’t just throw your hands up and say it’s too much, too confusing. Don’t do what your best friend, neighbor or your brother-in law did. Your circumstances are unique to you. Seek the help you need from a licensed professional. It is far too important. Believe me the decisions that you make during your  Medicare  Open Enrollment Period will have lasting impact.

How to Understand Part D Medicare

Making sense of Part D Medicare can be frustrating, but in this article, I will attempt to make it simple by answering some frequently asked questions about Medicare Part D.

First, what is Medicare Part D? When I was first learning about Medicare, the way I would remember Part D, is that Part D stands for “Drugs” (or more properly, prescription drugs). Part D is the part of Medicare that provides coverage for prescription medication.

1. Who is Eligible for Medicare Part D?

In order to get prescription drug coverage under Medicare, you must be eligible for Medicare Part A (hospital coverage) and enrolled in Part B (outpatient coverage). Most people are eligible for Medicare when they turn 65, or if they have been disabled for 24 months (receiving social security disability benefits).

When you become eligible for Medicare, you will also be eligible for Part D Medicare.

2. Is Part D Coverage Automatic?

No, you must enroll in Part D in order to receive the benefits. Some people choose to skip enrollment, because they are not taking many, or any prescription drugs. This however may be a mistake. If you do not enroll in Part D (an approved Medicare Drug Plan) when you are first eligible, you will be charged a penalty for every month you were not enrolled (1% per month in 2009-2010).

3. How Do I Enroll and Get Medicare Prescription Plans?

As of the writing of this article, Medicare Prescription Plans provided through private insurance companies, approved by Medicare. If you want prescription drug coverage, you must apply through an approved insurance company. You can think of it like getting a little insurance policy that only pays for your prescription medications (at least part of them anyway).

Some Medicare prescription drug plans work alone (they are called stand-alone prescription drug plans). Other drug plans are combined with a medical plan. Most often, these combined plans are HMO’s or PPO’s, combined which include prescription drug plans.

4. Are All Medicare Part D Plans the Same?

No, most Medicare Part D Plans do have some differences. One of the most obvious differences is the price. Just as you can “shop” for a better price for auto insurance or life insurance, you can also shop for a better price for your Medicare Plan D.

There is another important factor that you should think about though and that is what is called the “formulary.” A formulary is a list of approved drugs, along with a “tier” system that tells you how much the drugs will cost.

For example, the Super Duper Drug Plan (fictional) from Company ABC (also fictional), might charge $5.00 for tier one drugs (generics) and 60% for tier three drugs (slightly expensive name brands).

Every prescription drug plan has a different formulary, which is why one size rarely, if ever fits everybody (no matter what a movie star on a commercial might say about a particular company)!

5. What is this Donut Hole I Hear So Much About?

The donut hole, A.K.A. coverage gap is a bit complicated, but lets see if we can make it easy.

Imagine that there are three water tanks. The first two tanks have a watermark and the last tank has no mark.

In 2009, the watermark for the first tank was $2,700. Both you and your insurance company pour in your part of the water (dollars) until you reach the watermark together. After you reach the watermark, you move on to the second tank by yourself, without your insurance company to help you (the notorious donut hole).

In 2009, the watermark for the donut hole tank was $4,350. After you have spent a total of $4,350 out of your own pocket for the year, you will move on to the third tank.

At the third tank, your insurance company does most of the heavy lifting. You only put in a few dollars (like a $6 co-pay for your medications) and your insurance company puts in the rest with no limits.

6. What If I Cannot Afford My Prescription Drugs?

If you cannot afford to pay for your drug coverage, or your prescription drug coverage, you may be eligible for “extra help” to pay for what you need. To find out if you qualify for extra help, you can call your local social security office, Medicare (1-800-MEDICARE), or contact me at (we can help you find out if you qualify).

The Growth of Medicare Test Sites

The new chief of  Medicare , Donald Berwick, has maintained a low profile after finding himself ensconced in controversy following his appointment to the position. But he has been quite busy trying to create up to 300  Medicare  Test Sites as a new way of providing care to patients.

Berwick was named to the role while Congress was in recess, and since then the former professor from Harvard has put a great deal of effort into launching the  Medicare  Test Sites.

Lobbyists from the health care industry are trying to influence how it will be determined which physician groups and which hospitals will be included in the new program. Several northeast states are pushing to have its doctor groups be designated “accountable care organizations” which will entitle them to funding under the new program.

The director was given a mandate to spend $10 billion over the next tens years to determine the best ways to improve care offered in  Medicare  while driving down costs.

The government is working to fundamentally change the way it pays doctors and hospitals in the  Medicare  program, and the Test Sites, which launch by 2012, are the first step in the program. The hope is that in the next 10 years, these sites will help save $1.3 billion (though this is small compared to the total half-trillion dollar annual budget.) Advocates for health care have been fighting to have this number increased in the near-term.

But  Medicare  officials and advocates still expect that the center will help the government begin to phase out wasteful “fee-for-service”  health  insurance and increase the use of “global payments.”

With global payments, physicians will receive flat fees for managing a large number of patients, with financial incentives built in based on patient health and lowering the number of days patients stay in the hospital.

In some states, private insurance companies like Blue Cross and Blue Shield have started increasing global payments for diabetes care, high-blood pressure, and cardiovascular disease. State politicians charged with controlling health care costs, have been working on the decision of whether they should adopt new ideas like global payments.

“Among the lessons of Massachusetts is that you can’t sustain coverage reform without taking big steps on affordability,” said Andrew Dreyfus, chief executive of Blue Cross and Blue Shield of Massachusetts. “No one understands that better than Don.”

Berwick, who has been well admired by other health insurance policy experts, has several hurdles he will need to face while trying to implement his agenda in Washington. Republicans, specifically, have been upset that they were unable to use his confirmation to put up a fight about the new health insurance law.

Without the support of some Republican senators, Unless he can win over some GOP senators, who voted uniformly against the health care law, Berwick won’t be able to win a 60-vote confirmation in the Senate and will be forced to leave office when his recess appointment expires at the end of 2011.

Consumers interested in saving money through  Medicare  test sites would do well to search for multiple  Medicare  quotes online sooner rather than later.

Deciphering Medicare Eligibility

Questions arise all the time about  Medicare . Eligibility, cost and coverage are the three topics of conversation that are talked about the most. Eligibility is a topic all in its own. Most people are under the assumption that the only requirements to qualify for  Medicare  benefit is that they have turned sixty-five. That however is not the case. This article will help layout guidelines on eligibility so that it is easy to determine if you fall under the guidelines to qualify for the  Medicare  benefits and Medigap supplement insurance.

The first group of people we will look into is the group of adults that are sixty-five and older. Sixty-five is a qualifying age however there are other requirements that must be met to receive  Medicare  aid from our government. It is a must that you are a United States citizen or legal resident. You must also have proof that you have lived within the United States for at least five years. It is also important to note that you receive  Medicare  from working at least ten years in  Medicare  covered employment.

If you find you meet all three of these guidelines it is most likely that just prior to your sixty-fifth birthday you will receive a  Medicare  card and packet in the mail. This will detail what  Medicare  is, what it offers to you and how you start using it for your  health  care needs. You are automatically given both  Medicare  part A and  Medicare  part B. Part B can be declined as it is optional and does require a monthly premium.

If you are under sixty-five you can also qualify for  Medicare  benefits under certain circumstances. One is if you have End Stage Renal Disease. Kidney disease does allow you to qualify for  Medicare  benefits if you are under sixty-five. Another reason qualifications for  Medicare  are considered under sixty-five is if Social Security Disability Income has been received for twenty-four months.

 Medicare  is not the perfect coverage. It will not cover all of your medical expenses. This is why it is so important when you finally do qualify for coverage that you look into different Medigap supplemental insurance plans.  Medicare  does not cover prescriptions and does require you pay premiums and co-pays. Additional coverage through the supplemental insurance will help to fill in gaps left by  Medicare  coverage.

There are multiple items that  Medicare  part A and part B do not cover. Below is a sample list of items that are not covered and that additional coverage should be sought out if they are important for your well being both financial and health.

Acupuncture is a type of alternative medicine is not covered. Acupuncture is a treatment that works through the insertion of thin needles strategically placed throughout the body to help cure ailments.

Dental care is an incredibly important part of the aging process and is not part of  Medicare . It is advisable if your dental history has been anything less than stellar that you seek out additional insurance to fill the gap left by  Medicare .

Chiropractic care is also something that many older people rely on that is not covered. Often time’s doctors of chiropractics will offer discounted rates to seniors. This is something to think about however when seeking out gap insurance if your doctor is not one that does.

Obviously the list of covered versus not covered is detailed in great lengths through handbooks, websites and pamphlets. Supplemental insurance providers are a great source of knowledge as they can review your past history with you and based on the pattern that has developed guide you into the right combination of plans. This way you are not purchasing additional coverage that is not ever going to be utilized.

Things You Need To Know About Medicare Part C and Medicare Part D

 Medicare  Part C is a combination of the  Medicare  Part A and Part B options, which are categories of the  Medicare  program.  Medicare  approved private insurance companies offer Part C, a lower cost option as opposed to the original  Medicare  plan and offer additional benefits, also covering Part D or prescription drug coverage to a certain extent. In brief, anyone who joins Part C will have complete access to Part A and Part B.

 Medicare  Part C has its own network, so all the doctors and specialists that you can consult have to be a part of the  Medicare  plan. Under Part C, there is a primary doctor that refers the beneficiary to medical experts and specialists. One cannot consult doctors of his/her own choice; the beneficiary has to be within the group of medical experts assigned to the plan to avail  Medicare  services. If one chooses to consult out of this group, the treatment or visit may prove more expensive. Under Part C one co-pays for each doctor’s visit.

Part C could also be referred to as the  Medicare  Advantage Plans. Different insurance companies develop different kinds of Part C plans. Some may include Part D or Prescription Drugs as well. There are a number of Part C plans, and most of them include PPO, MSA, PFFS, HMO and  Medicare  special needs.

 Medicare  Preferred Provider Organisation (PPO)

In a PPO, one has the freedom to choose his/her own medical providers (doctors and specialists) out of the network. The beneficiary might have to pay out of network charges but has the freedom to see medical experts without referral.

 Medicare  Medical Savings Account (MSA)

Under this plan, one can either use the High Deductible Plan, which will not provide coverage until the mentioned amount of deductible is met. The other is that,  Medicare  provides a savings account that it manages, to its beneficiary, which has a certain sum of money deposited into it exclusively for the purpose of  health  care costs.

 Medicare  Private Fee For Service (PFFS)

Here the beneficiary can see any doctor or specialist of choice without referral only if they concur with the terms, conditions and fees of the PFFS.

 Medicare   Health  Maintenance Organisations (HMO)

Each beneficiary has an HMO network and can choose hospital(s) and medical providers from that network alone. One might require a referral from his/her primary care physician in order to see a specialist.

 Medicare  Special Needs

This plan is usually for persons with special health needs and chronic illnesses. A special plan must include Part A, B and D too.

Most Part C plans should have Part D or prescription drug coverage, but if one already has a separate Part D plan then, s/he cannot buy a Part C plan with drug coverage. An individual will need to buy a Part C plan with no drug coverage.

 Medicare  Part D

Anyone who is eligible for  Medicare  Part A (Hospital Insurance) and  Medicare  Part B (Medical Insurance) is automatically eligible for  Medicare  Part D (Prescription Drugs). This means anyone who has Part D coverage gets the insurance company to pay for a section of his/her prescription medicines, regardless of the cost factor. A beneficiary who is outside the US territory and is in prison, will no longer be eligible to this section of  Medicare .

Who Qualifies For Medicare Coverage?

 Medicare  is a program funded from the U.S. Government to deliver medical insurance protection to retired people and those with disability. The majority of U.S. citizens and those residents who are more than 65 years of age should have insurance coverage. Should you be at or over the age of 65, you may be eligible for  Medicare  presuming that you fall under one of the types outlined down below:

* You’re a dependent child of someone who paid out  Medicare   health  insurance taxes when employed by the government.

* While working for the federal government, you or your wife or husband paid in to the  Medicare  insurance system.

* You are qualified to apply for or are receiving benefits for railroad retirement.

* You’re qualified to apply for or are receiving Social Security benefits.

Unless you come under one of the examples outlined above, you might still receive  Medicare  part A insurance if you pay a monthly premium. Nevertheless, to become eligible, you need to sign-up for the hospital insurance coverage at the time of enrollment. To ensure you obtain insurance coverage as it’s needed, you really should submit an application for benefits many months ahead of your 65th birthday.

For those that are less than sixty five, you can also get free of charge  Medicare  hospital insurance if any of the following scenarios pertains to you:

* You worked for a time in a federal position which is categorized under  Medicare  insurance coverage.

* You receive railroad benefits or perhaps you meet the criteria to get them.

* You are a sufferer of full kidney failure or receive dialysis maintenance and/or you had a renal system transplant.

* You’re the kid of someone who previously worked for the federal government and paid  Medicare  taxes or perhaps you are a widow(er) over 50 years old or you are disabled by social security.

* You previously worked in a federal job and paid  Medicare  taxes and/or you qualified for the Social Security disability program.

* You suffer from Lou Gehrig’s condition.

* You meet particular criteria and have railroad retirement board authorized disability pension plan.

* You’ve gotten social security benefits (or are eligible) for more than two calendar years (24 months).

This is the basic summary of which individuals are qualified for  Medicare  insurance coverage. To learn more, you’ll be able to talk to  Medicare  by calling them toll-free or by going to the local social security government office.

Medicare – What’s it All About?

 Medicare  is a government regulated healthcare program for those 65 and older. You’ll probably be on it, so it’s important to understand how it works.

In this article I summarize the different parts and coverages that come under the  Medicare  program.

 Medicare  is a program with different parts. Only the first – Part A – is free if you contributed enough FICA over the years. The other parts each cost an amount depending on your income and choices of ‘supplemental coverage’ they offer.

Let’s take a look at what each part is about.  Medicare  is divided into components:

Part A – hospital insurance

Part B – medical insurance (this is optional)

Part C – additional insurance coverage

Part D – offers voluntary prescription drug coverage offered via private vendors

Part A is called hospital insurance. It covers most costs of your stay in the hospital as well as some follow-up costs after being in the hospital. It also pays some outpatient medical services, including medically necessary equipment and supplies, home health care, and physical therapy. Under most circumstances (if you’ve paid enough FICA taxes), you don’t have to pay a premium for Part A.

Part B is medical insurance. It’s optional. If you elect it, the monthly premium is deducted from your Social Security check automatically. It provides for certain out-of-hospital treatments and is intended to help pay doctor’s bills for treatment in or out of the hospital. It also covers many other medical expenses you incur when you’re not in the hospital, such as the costs of necessary medical equipment and tests.

 Medicare  Part B has spawned additional insurance coverages to supplement what it and part A don’t cover. The first is the ‘Original  Medicare  Plan’. Here, you pay your Part B monthly premium and then pay for additional services as you use them. With this plan you might also choose to buy  Medicare  Supplement Insurance, or “Medigap” insurance. The term Medigap implies that these insurance policies will cover the gaps in  Medicare  payments. Medigap doesn’t fill all the gaps, but it helps. More types of coverages are relegated to part C.

Part C:  Medicare  Managed Care and Private Fee-for-Service plans are offered by private insurance companies. Managed care plans generally fall into two main varieties:

1) health maintenance organizations (HMOs) and

2) preferred provider organizations (PPOs).

HMOs are generally less expensive than PPOs but usually more restrictive in their services and choice of doctors.

With these latter two plans in Part C, you must still continue to pay your Part B premiums, and you may also have to pay an additional premium to the insurance company as well as any related deductible or co-insurance payments. However, the services you receive may be more comprehensive than those offered through the Original  Medicare  Plan.

 Medicare  Part D requires you to join a Medical Drug Plan (MDP) in either of two categories of such plans:

1. You can join one of the  Medicare  Prescription Drug Plans (called PDPs). These plans add drug coverage to either of your Original  Medicare  Plan, some  Medicare  Cost Plans, some  Medicare  Private Fee-for-Service (PFFS) plans, and  Medicare  Medical Savings Account (MSA) plans. Or

2. Join a Medical Advantage Plan – like a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO) or some other Medical health plan that includes prescription drug coverage.

Through these plans, you get all your  Medicare  coverage of Part A and Part B including prescription drugs (Part D). These Plans are called ‘MA-PDs’

In either category you’ll usually pay a separate monthly premium for the drug coverage in addition to your Part B premium.

After joining a specific MDP, the plan mails you membership materials including a card to use when you get your prescriptions filled. When you use the card, you may have to pay a copayment, coinsurance, or a deductible amount depending on your plan

What to consider when comparing which MDP to choose:

Look for the Coverage, Cost and Convenience to you from each plan. These will be different.

Coverage – check if the type of prescription you want comes under that plan.

Cost – see what costs and payment schedule that plan offers you.

Convenience – make sure the plan’s pharmacies include the ones you want to use.

You can switch your plan each your from November 15 to December 31.

Be sure to apply for  Medicare  coverage three months before your 65th birthday so you can start it when you turn 65.

If you’re on Medicaid, they’ll automatically enroll you in a MDP if you don’t join yourself. Under Medicaid, in most cases, you’ll pay from nothing to about $5.60 out-of-pocket for each covered drug. alicevbheatherta alicevbheatherta aliceananabinar aliceananabinar katherinehjjudith katherinehjjudith Agustus stable Edu