|
| |
MEDICARE |
|
|
Medicare is the national health
insurance to which all social security recipients who are either over 65 or
permanently disabled are entitled. Railroad retirees and individuals suffering
from end stage renal disease are also eligible.
Medicare is insurance and is not a welfare program, it should not be confused
with Medicaid.
|
|
Medicare has two components: Part A and Part B.
Part A covers inpatient hospital care, hospice care, skilled inpatient care in a
skilled nursing home and home health. There are annual deductibles for Part A.
Part B covers doctors' services and some other items. Beneficiaries pay a
deductible and a premium for Part B and that amount is automatically deducted
from their social security.
Many eligible beneficiaries are choosing to receive their health care through an
HMO rather than traditional Medicare. Many HMOs offer services not available
through traditional Medicare, such as prescriptions. It is important to have a
clear understanding of traditional Medicare and Medicare HMOs before you make
the decision to go with an HMO.
Many individuals who are in traditional Medicare pay for Medicare supplementary
insurance to cover the deductibles.
You are eligible to enroll in the Medicare Prescription Drug Program (Medicare
Part D) if you are entitled to Medicare benefits under Part A, or are enrolled
in Medicare Part B and live in the service area of a Part D plan. Prescription
drug benefits begin in January 2006.
You will not be automatically enrolled in Medicare Part D and you will be
penalized if you do not enroll, unless you already have “creditable” drug
coverage. If you have prescription drug coverage now as part of your current
health insurance plan, the insurer must provide you with a letter indicating
whether the coverage you currently have meets the definition of “creditable”
coverage.
The penalty for failing to enroll in Medicare Part D when you are first
eligible, is 1% of the plan premium per month, for each month that you fail to
enroll. Therefore, if you do not have creditable coverage and are unsure whether
to enroll, if you can afford the estimated $37.00 per month premium, you may
want to go ahead and enroll to avoid the penalty.
For more detailed information
contact:
Center for Medicare Advocacy, Inc.
P.O. Box 350
Willimantic, CT 06226
http://www.medicareadvocacy.org |
|
