subject: Make Sure You Understand Your Medicare Coverage [print this page] Make Sure You Understand Your Medicare Coverage
A recent Wall Street Journal article, "Dodging a Medicare Mishap," warns Medicare beneficiaries and their families to take special care when it comes to outpatient and prescription drug coverage. The main reason is that the rules are more complicated than most people realize. What makes matters worse is that things are expected to be even worse next year.
"As unfortunate as this may be, sometimes seniors leave important decisions to chance," says Alan Weinstock, insurance broker at http://www.MedicareSupplementPlans.com, "especially when it comes to complex programs such as Medicare."
Medicare Beneficiaries and Their Families Leave Medicare to Chance
Sometimes people who are accustomed to having employer benefits and, therefore, don't realize their responsibility in transitioning to Medicare, believe that because Medicare is a Federal program they will be contacted by the government and guided on what to do. Nothing could be further from the truth.
Waiting for someone else to inform you about Medicare Parts A through D and to help you decide what is right for you can place you or your family members in a precarious situation. There are specific guidelines with regard to enrollment obligations and deadlines.
What Medicare Beneficiaries and Their Families Need to Know
First, there are four parts to Medicare: Parts A, B, C and D. Medicare Part A covers hospitalization and inpatient care. It is generally free for people who are age 65 or older if they (or their spouse) have worked for at least 10 years. Part B covers doctor's visits and outpatient treatment. The cost of Medicare Part B depends on your annual income.
For most current Medicare beneficiaries already on the plan and with annual earnings under $85,000 the monthly rate is $96.40. For those who are new to Medicare in 2010, the new higher rate is $110.50 per month. However, for those whose earnings exceed $85,000 per year for individuals and $170,000 per year for couples, the cost of Medicare Part B is higher. Check with Medicare to find out your cost.
Many Medicare beneficiaries, who sign up for Medicare Parts A and B, also chose to sign up for Medicare Part D, the prescription drug coverage plan. They may also choose to add a Medicare supplement insurance or Medigap plan as well.
It's important to note that Medicare Part D coverage is tied to the area where the beneficiary lives. So if you move or are temporarily staying outside your coverage area, make sure your Part D plan understands you are not moving permanently or you may be dis-enrolled.
Finally, Medicare Part C is an alternative to Medicare Parts A, B and D. It is Medicare Advantage which is an all-inclusive package that covers supplemental expenses and prescription drugs, but only if Medicare beneficiaries are treated by providers within a specified network.
Here are two additional rules to keep in mind regarding Medicare coverage. If you don't sign up for Medicare at age 65, special-enrollment-rules may apply. Know how they will affect you. And if you choose a Medicare Advantage plan, your opportunity to switch plans later on are more limited.
Starting in 2011, the annual enrollment period shrinks to Jan. 1 through Feb. 14 instead of until March 31. And now instead of being able to switch to a different Medicare Advantage plan, you will be limited to dis-enrolling from your Medicare Advantage plan altogether and enrolling in traditional Medicare instead.
It's important to understand how Medicare coverage affects your or your loved ones to ensure that you don't miss out on important coverage. For more information on Medicare coverage, check with your Senior Health Insurance Program, a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers.
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