Monday, November 11, 2013

8 Critical Definitions of Medicare Related Terms



Which Medicare Parts Do You Need?  Learn What Each Type Includes

Premium -  The amount you pay for coverage. This is commonly paid monthly, but may have other payment structures including quarterly or annually.

Deductible - The total amount that you must pay for medical expenses before Medicare kicks in. 

CoCo-pay/Co-insurance - Any portion you pay for each medical service or prescription.

Part A - Pays for in-patient care at hospitals and skilled nursing facilities, hospice, and some home health care services. You do not pay a premium for this coverage if you paid Medicare taxes while employed. There is, however, a deductible for hospital stays. 

Part B - Pays for doctors' services, lab tests, x-rays, mental health care and other medically necessary services.  The monthly premium for this coverage in 2014 it will be $104.90.  There is an annual deductible of $147 as of 2014.
If you or your spouse have employee-sponsored health care you may prefer to delay signing up for Part B.   When coverage ends from your employer ends, and you desire to be covered under Part B, you will need to sign up immediately.  Otherwise you may be subject to penalties and have a waiting period before coverage begins.

Part C - Alternatively, you may prefer Medicare Advantage.  Medicare has approved plans from private insurers which include services covered in Parts A and B as well as prescription drug benefits.  Some also include hearing, vision and dental.

Part D - Pays for the prescription drugs other than those taken in a hospital.  You won't need this portion if you are using Medicare Advantage, only if you are using Part A & B. Generally there will be an annual deductible, and co-pays.

Medigap - Pays deductibles, co-pays, and other costs associated with Part A & B, not C. You may already be receiving some type of coverage from your employer or union.

1 comment:

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