Once you reach age 65 you probably will have Medicare -- basic health insurance for older Americans. Medicare is a federal health insurance program for people age 65 and older and certain disabled individuals. Medicare is the first payer of health care costs for most older people and for many disabled people. The U.S. Government Official Web Site for people with Medicare, http://www.medicare.gov
offers a wealth of information on benefits, plans, eligibility and other tools.
Medicare Premiums for 2010:
Part A: (Hospital Insurance) Premium
Part B: (Medical Insurance) Premium
Most beneficiaries will continue to pay the same $96.40 premium amount in 2010. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2010. This is because of a combination of the absence of a Social Security COLA (Cost of Living Adjustment) and the “hold harmless provision” which does not allow Social Security checks to decrease because of an increase in the Part B premium.
For all others, the standard Medicare Part B monthly premium will be $110.50 in 2010, which is a 15% increase over the 2009 premium. The Medicare Part B premium is increasing in 2010 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $110.50 per month. In addition, those who will be new to Medicare in 2010 or those who are not yet collecting Social Security will be subject to the $110.50 Part B premium amount.
Medicare Deductible and Coinsurance Amounts for 2010:
Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2010 = $1,100) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
For each benefit period you pay:
Skilled Nursing Facility Coinsurance (only after a 3-day minimum inpatient hospital stay for a related illness or injury)
Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)
Open Enrollment Period for Medicare Advantage Plans
Medicare Advantage Plans are health plan options that are part of the Medicare program. These Medicare plans are offered by private insurance companies and pay for the same health care services as Original Medicare. But they might also pay for additional services that aren't covered by Original Medicare and have other program rules and restrictions.
You can join or switch Medicare Advantage Plans from January 1st to March 31, each year, but you cannot add or drop Medicare prescription drug coverage during this time. For example, if you are currently enrolled in a Medicare Advantage Plan with prescription drug coverage, you can switch to Original Medicare, but you'd also have to join a Medicare Prescription Drug Plan.
Some plans cover prescription drugs. In some Medicare Advantage plans (like a Health Maintenance Organization), you may only be able to see certain doctors or go to certain hospitals to get covered services. Be sure to read all of the information provided by the plan before you sign any documents! There are a number of different Medicare Advantage Plan types - HMO's, PPO's, Private Fee for Service Plans and Special Needs Plans - that provide different levels of service and various network options. Knowing whether or not your doctor participates in the plan is important to the selection of the right plan for you.
To compare Medicare Advantage Plans and Medicare Prescription Drug Plans that are available in your area, visit medicare.gov or call Medicare at 1-800-633-4227- or - call your Local Health Insurance Information, Counseling and Assistance Program (HIICAP) at 1-800-701-0501. Once you have decided on a plan, contact the plan to find out more information and to obtain enrollment information. Once you enroll, the plan will let you know when your new coverage begins.
Medicare Beneficiaries Who Were Misled Into Choosing Wrong Advantage Plan Can Switch
Complaints about improper and aggressive marketing of Medicare Advantage plans have grown steadily in New York State. Insurance agents who sell these products to Medicare beneficiaries often have used aggressive and misleading sales pitches that fail to explain how their plans work. Some beneficiaries have felt deceived when they are signed up for a plan that is inappropriate for their health needs. Seniors who believe they have been subjected to illegal sales practices should contact the New York State Insurance Department (212-480-6400; toll-free at 800-342-3736).
