Medicare Q & A
By Jamie Smith
Special to The Pilot
Confused about Medicare? Here are some answers to frequently asked questions about Medicare from a Seniors' Health Insurance Information Program (SHIIP) counselor.
Q. What are the -differences in Medicare Parts A, B, C and D?
A. Medicare Part A covers inpatient hospital stays and inpatient skilled nursing stays, hospice and home health services.
Medicare Part B covers outpatient and professional charges.
Medicare Part C is a Medicare Advantage Plan.
Medicare Part D is prescription drug coverage.
Q. How do I become eligible for Medicare?
A. You are eligible for Medicare if you are age 65 or older and if you paid into the system for enough quarters while working. You are also eligible if you are under 65 and are disabled and have been drawing a Social Security check for 24 months.
Q. What is the cost for Medicare Parts A and B?
A. Medicare Part A is generally free if you have paid in enough quarters while you were working. Medicare Part B costs for 2013 are $104.90 if you are single and make $85,000 or less on your 2011 income tax return. If filing jointly, that figure is $170,000 or less. The higher your income is, the higher your Part B premium will be.
Q. What is a Medicare Advantage Plan?
A. Medicare Advantage is an insurance plan that -combines Medicare Part A, Medicare Part B, and -usually Medicare Part D into one plan. Hospital charges, drug costs and physician charges are covered with a co-pay amount that you pay the doctor, hospital or -pharmacy. However, some Medicare Advantage plans will pay 100 percent once you have reached the plan's maximum out-of-pocket limit.
Q. What are some questions I should consider before I enroll in a Medicare Advantage Plan?
A. You should ask the following:
* Are my doctors and hospital in the network?
* Are there co-pays and, if so, how much are they?
* Does the plan have drug coverage?
* Where is the Medicare Advantage Plan available?
* How will the plan work when I am away from home?
Q. Can I change my Medicare Advantage plan other than during the open enrollment period that lasts from Oct. 15 through Dec. 7 of each year?
A. You can leave a Medicare Advantage plan and switch to Original Medicare between Jan. 1 and Feb. 14. If you switch to Original Medicare during this period, you will also have until Feb. 14 to join a Medicare Prescription Drug Plan to add drug coverage. The -coverage will begin the first day of the month after the plan gets the enrollment form.
During this period, a person cannot do the following:
* Switch from Original Medicare to a Medicare Advantage Plan;
* Switch from one Medicare Advantage Plan to -another;
* Switch from one Medicare Prescription Drug Plan to another.
For more information, call (800) Medicare or visit www.medicare.gov.
Jamie Smith is director of Navigation and Donor Relations for the Foundation of FirstHealth, and a SHIIP counselor trained to provide education to Medicare -b-eneficiaries and caregivers about Medicare, Medicare supplements, Medicare Advantage, Medicare Part D and long-term care insurance.
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