Medicare is a Health Insurance Program for:
Medicare has Four Parts:
Covering generally hospitalization, skilled nursing facility services, some home health and hospice – is available to most beneficiaries premium-free beginning at their 65th birthday or when they have been receiving Social Security disability benefits for 24 months. Those beneficiaries who are not entitled to premium-free Part A, because their employment was not covered by Social Security or Railroad Retirement, can pay a premium up to $443.00 per month (depending on how many quarters of Social Security coverage the individual has) to enroll, but they must have Part B to do so. A time-limited penalty is imposed on those enrolling in Part A after their first opportunity to do so. Part A is necessary, but not sufficient, to enroll in Part C (private managed care plans) and sufficient to enroll in Part D (private prescription drug plans). General enrollment for Part A is available January through March of each year, with benefits starting July 1 of that year.
Covering physicians’ services, outpatient therapies, durable medical equipment, long-term home health services and other outpatient services – is voluntary and available to beneficiaries at the same time they are eligible for Part A. The monthly premium, $94.60 per month in 2010, is generally deducted from a beneficiary’s Social Security or Railroad Retirement check. A one-time limited penalty is imposed for late enrollment. Part B is necessary for Part A enrollment for those not entitled to premium-free Part A, is necessary but not sufficient for Part C enrollment, and is sufficient to enroll in Part D. The general enrollment period is the same as for Part A.
Medicare Advantage Plans are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:
When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, generally there are extra benefits and lower copayments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.
If you join a Medicare Advantage Plan, your Medigap policy won’t work. This means it won’t pay any deductibles, copayments, or other cost-sharing under your Medicare Health Plan. Therefore, you may want to drop your Medigap policy if you join a Medicare Advantage Plan. However, you have a legal right to keep the Medigap policy.
There are several companies to choose from if you would like to enroll in Medicare Part C, also know as Medicare Advantage Plans. Not all carriers offer products in all counties though, so you need to find the plan that best suits your needs in your particular county of the state.
Part D, provided
mostly through private plans offering only prescription drug coverage - is
voluntary and available at the same time a beneficiary is first entitled to
Parts A and B. Part D was offered for the first time January 1, 2006,
with enrollment running from November 15, 2005 through May 15, 2006. The Part D enrollment period continues to be November 15th to December 31st of each year. Beneficiaries can also make further changes to their Part D drug plans during the Open Enrollment Period (OEP) that runs from January 1st through March 31 of each year. During this OEP you cannot add or drop drug coverage, but if you have Part D drug coveage on January 1st, you can change Part D carriers and plan designs during this OEP. Your new choice for Part D will be effective on April 1st. 2010.
Currently, general enrollment will follow that of Part C. A beneficiary must have
either Part A or Part B to enroll in Part D. Otherwise coverable Part D drugs
that are covered under Part A or Part B will not be covered under Part D,
regardless of whether the beneficiary has Part A or Part B coverage. A non-time-limited
late enrollment penalty is determined by application of two formulas and assessing
as penalty the one that yields the highest amount.
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The Medicare and Medicaid programs were signed into law on July 30, 1965. President Lyndon B. Johnson is pictured at the signing ceremony in Independence, Missouri at the Truman Library. Former President Truman is seated beside him. You can enlarge the picture by clicking on the smaller picture above. President Johnson held the ceremony there to honor President Truman’s leadership on health insurance, which he first proposed in 1945.
The most significant legislative change to Medicare—called the Medicare Modernization Act or MMA --was signed into law by another President from Texas, George W. Bush, on December 8, 2003. You can read his speech at the signing ceremony and see pictures of the event at the White House web site. This historic legislation adds an outpatient prescription drug benefit to Medicare and makes many other important changes.
Click here to read and download the official government handbook on Medicare, called Medicare & You 2010