Posts Tagged ‘medicare part b’
Sunday, July 17th, 2011
Medicare Part B covers medically-necessary services and numerous preventive services that are not covered by Medicare Part A. If you enroll in Part B, Medicare will pay 80% of the “reasonable charge” for covered services after you’ve met the deductible for that year. You’re responsible for paying the other 20% (co-insurance).
Medicare has a defined “reasonable charge” for services that might be less than what the doctor charges. In that case, you’ll be responsible for paying 20% plus the difference between the actual cost of service and Medicare’s reimbursement. Some doctors may accept assignment, meaning they’ll only charge Medicare’s “reasonable charge” for services, forcing you to pay the 20% co- insurance.
You are responsible for paying the Part B premium every month. The standard premium is $96.40. You may have to pay a higher premium depending on your income if you file single on your tax return and your modified adjusted gross income (MAGI) is higher than $85,000. For married filing jointly, the MAGI limit is $170,000. Individuals and couples who exceed the minimum income limits could pay as much as $308.30 a month.
If you get Social Security or Retired Railroad Board (RRB) benefits, you’ll automatically receive Part B on the first day of the month you turn 65. Your Medicare card will come in the mail 3 months before your 65th birthday. If you are under 65, you will receive Part B after you’ve received disability benefits from Social Security or RRB for 2 years. Your Medicare card will come in the mail on the 25th month of your disability.
Though you are automatically enrolled in Part B under the previously mentioned circumstances, you don’t have to keep it. If you don’t want Part B, your card will come with instructions on cancelling it. Follow those instructions and send the card back. If you keep the card, you will pay Medicare part B premiums. Premiums are automatically deducted from your Social Security or RRB benefits.
If you would like to receive Part B, but you are not receiving Social Security or RRB benefits, you can sign up during the initial enrollment period which starts 3 months before the month you turn 65 and ends 3 months after you turn 65. You can also sign up for Part B during the usual enrollment period from January 1 to March 31 every year and your coverage will start on July 1 of that year. Note, if you missed the signup during your initial enrollment period, you could face a 10% increase in your monthly premium.
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Tuesday, May 3rd, 2011
Medicare Part B, after a small annual deductible, pays 80% toward your outpatient medical treatment. While most diseases and medical conditions are covered by Medicare Part B, internal cancer is a condition which seems to cause people the most concern when thinking about future medical costs. After all, radiation, surgery and chemotherapy for cancer can be particularly expensive, even when you are only paying 20% of the price of treatment. Medigap plans are one way in which individuals can supplement their coverage under original Medicare and lower their financial risks.
Pre-existing cancer should not cause undue financial worry for people entering Medicare for the first time. When you first enroll in Medicare Part B, you are given an open enrollment period during which you can get any medigap plan you wish without health underwriting. Your plan can become effective the same day as your Part B, or at any time within 6 months afterward. Since the insurance carrier cannot turn you down for any health reason during this enrollment period, it is one of the best times to enroll in a medicare supplement
Medicare supplements are standardized by our federal government so that you as a consumer can more easily compare prices between carriers without having to worry that benefits differ. Medicare supplements are categorized into plans A - N, and each one fills in various gaps in your original A & B benefits. Plan A, which covers the least amount of gaps, still offers coverage for the other 20% of Part B medical expenses that you would normally owe. This means your coverage for normal forms of cancer treatment like chemotherap and radiation are quite good under any medigap plan. Choosing which one suits you the best is a matter of assessing how much you are able to pay for a supplement and whether you are willing to share in any of the deductible or co-insurance cost-sharing in order to lower your monthly premiums.
It should be noted that consumers also have private Medicare health plans available to them called Medicare Advantage, or Part C. With most of these plans, the premium you pay for the coverage is considerably less than the cost of a supplement, but you will pay copays and co-insurance for various types of medical services as you go along. Many of these plans have higher cost-sharing for cancer treatments — sometimes as much as 20%. Although the plans do have an out-of-pocket-maximum to protect you from spending past a certain amount annually, a serious illness like cancer can often cause you to reach this limit. You should carefully evaluate whether you can afford this higher financial exposure before you consider an Advantage plan.
Assessing how your medicare supplemental coverage provides benefits for cancer treatment is a routine but wise precaution. While there is no crystal ball that we can look into to know our medical future, we know that cancer is common and also costly. Your personal tolerance for medical financial risk as well as how much you can willingly spend for coverage will guide you in choosing supplemental insurance. Consulting a professional insurance broker who can explain benefits for each type of coverage will also save you time and effort in finding a plan, as well as ensuring that plan is most suitable one for your lifestyle habits, monthly budget and individual needs.
Want to find out more about Medicare Part A & B Benefits, then visit Danielle Kunkle’s site on how to choose the best medicare supplement for your needs.
Tags: health, health insurance, medicare, medicare cancer coverage, medicare insurance, medicare outpatient coverage, medicare part a, medicare part b
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Wednesday, April 21st, 2010
Medicare became the law of the United States in 1965 under the presidency of Lyndon Johnson. It originated as an amendment to the Social Security Act. The first part of the coverage consisted of two sections, Parts A and B. Hospital stays and associated costs were paid under Part A while Part B paid for medical expenses originating from outpatient care. Although 45 million people were enrolled in the program in 2008, the growth by the year 2030 will be dramatic, rising to 78 million under current projections.
Funding for the program is provided by FICA, which stands for Federal Insurance Contributions Act and SECA, the Self-Employment Contributions Act. Employees and employers together pay taxes of 2.9 percent into the program, split evenly. Self-employed individuals pay the entire amount.
Eligibility for the original Part A and B of this program is offered to any U. S. Citizen age 65 or older. The premium costs are waived if the worker has paid into FICA for ten years. Part A coverage is the portion available for hospital expenses. The inpatient hospital costs such as physician and nursing care, medicines and medical procedures and tests are all covered. There is a deductible cost that must be paid out-of-pocket. Part A also covers convalescent care in a skilled nursing facility. Again, deductibles and co-payments apply.
Medical costs are covered under Part B. This part of program coverage is optional, but there will be a penalty applied if you don’t enroll. Outpatient costs of all types are paid under Part B. These costs can be anything from seeing a physician to medical equipment to prosthetic equipment. Medications that are administered by a physician are covered.
Part C provisions allows for individuals to receive benefits from Part A and Part B through private insurance plans. Under the 2003 Prescription Drug, Improvement and Modernization Act, prescription medications were added to the list of benefits. Monthly premiums for Part C coverage is in addition to the Part A and B premiums. Extra fees for benefits not covered under the original act may apply.
Part D is the latest addition to the program. It was enacted into law in 2006. This portion of benefits law provides payment for prescription drug plans. It also allows for combining benefits from Part C for better coverage. This part requires additional payments for out-of-pocket expenses and monthly premiums.
Part A premiums are waived for most people. Those enrolled in Part B paid just under $100 monthly in 2009. Payment for Part B premiums is automatically collected from the Social Security check each month. The amounts for Part C and Part D premiums depend upon the insurance program and coverage level of the individual plan. Some Type C plans provide for rebate of a portion of the Part B premium paid by enrollees.
An extensive system of reviews and checks are in place to prevent misuse of the Medicare benefits system. There continues to be complaints of fraud and waste in the program, mostly directed at the doctors and hospitals who receive reimbursement for covered services provided. With the passage of the the U. S. Health care reform legislation, it is expected that there will be significant changes in the provisions of the law.
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Tags: health insurance, medicare d, medicare part b, medicare part d coverage, medicare part d plans
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Saturday, July 4th, 2009
by Matthew Wilder
When the Medicare program was passed in 1965 it had two parts to it. There was what we’ll call “Part A”: hospital insurance coverage. And then there was “Part B”: medical insurance coverage. Late a “Part C” and a “Part D” were added to cover further health concerns.
Medicare insurance Part A is insurance covering hospital stays at least 72 hours long, depending on time of admission and release. Furthermore, it pays for nursing home stays on the condition that the stay is related to a covered hospital stay, and that both the nursing supervision and nursing both require skilled personnel. Medicare insurance Part A part is paid for by the beneficiary’s (and their employer’s) periodic payroll tax deductions during his or her working career.
Part B is an optional benefit of Medicare. Pat B includes many medical services and medical providers not covered by Part A. This means that lab tests, visits to the doctor, particular outpatient procedures, flu vaccinations and more are covered by Part B of Medicare insurance.
Part A is completely free, however, Part B requires a monthly premium. When you are notified that you can have Medicare insurance just before you turn 65, you must choose whether or not you would like Part B coverage. You must pay $88.50 for Part B premiums as of 2006.
Part C Medicare insurance gave Medicare members the option to receive medical care through private insurance plans in beginning in 1997. The private plans replaced Part A/B Medicare insurance coverage. In 2003, the private plan changed and they were called Medicare Advantage (MA) Medicare insurance plans.
On January 1, 2006, Part D Medicare insurance was activated. Those already eligible for Parts A and B were therefore already eligible to participate in the new Part D prescription drug plan. The Medicare insurance benefit of Part D allowed members to subscribe to one of many private insurance prescription drug plans.
Part D Medicare insurance allowed members to pay less for their prescriptions. Like Part B, Part D Medicare insurance required the member to pay a monthly premium. Unfortunately, each of the private insurance prescription drug plans had varying restrictions and caused a great deal of confusion among those trying to choose a plan.
Some government agencies predict that the Medicare insurance program may run out of money around 2018. It seems that workers are retiring and using Medicare insurance faster than current workers are paying into the Medicare insurance bank account.
In 2005, the Medicare insurance program provided coverage to an estimated 42.5 million persons. The “Baby Boom” generation, once fully retired and enrolled in Medicare insurance, is expected to swell the ranks of the Medicare insurance members to approximately 77 million persons around the year 2031.
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