By: McKenzie Duffy

Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities, permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease).

The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term-care.

My goal is to take the complicated details and deliver to you the basis because even if this doesn’t relate to you now it one day will.

Medicare/Medicaid picanmaurestter.blogspot.comInformation: Social Security Adm.

Your Medicare Coverage Choices at a Glance There are two main w ay s to get your Medicare c ove ra ge : Original Medicare o r a Medicare Advantage Plan. Use these steps to help you decide which w ay to get your coverage.

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Step 1: Decide how you want to get your coverage

or

ORIGINAL M EDICARE M EDIC ARE ADV ANTAG E PLAN (like an H M O or PP O )

Part A H o sp ita l In su ra n c e

Part B Medical In su ra n c e

Combines Part A, Part B , a n d u su a l ly Part D

Step 2: Decide if you need to add drug coverage

Part D P re sc r ip t ion Drug Coverage

Part D P re sc r ip t ion Drug Coverage (if not already in c lu d e d)

Step 3: Decide if you need to ad d supplemental coverage

Medigap (Medicare S u p p lem en t In su ra n c e) policy

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If you join a Medicare A d v a nta ge Plan, you d on ’t need and c a n ’t be sold a M ed igap policy.

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Co-pays apply80/20 plan after deductible

Deductibles, co-pays and maximum out of pocket apply

10 standard plans with a variety of benefits

ALSO

CALLED

PART-C

Medicare Publication: A Quick Look at Medicare

$$$$What you Pay

C What You Pay:• Part B Premium

(unless you qualify for Medicaid, Extra Help, or Medicare Saving Programs)

• Additional co-pays arranged by the plan.

• Advantage Plans are not guaranteed an 80/20 payment on the allowed amount.

What you Pay:Hospital

$1,132- 1 to 60 days$283/day - 61 to 90$566/day - 91 to 150After 150 days – All costs

Skilled Nursing Facility 21 to 100 - $141.50/dayafter 100 days – All costs

Home Health Care no cost for services

Hospice 5% of Medicare approved amount for inpatient respite care$5/prescription

What you Pay:Medical and Other Services:

$162 deductible/yr 20% of approved amount 45% outpatient mental health

Home Health Care:no cost for services20% of approved amount for durable medical equipment

Outpatient Hospital Services:20% of approved amount if Medicare onlyif Medicare Advantage Plan, out of pocket cost will be determined based on the plan enrolled in

SLCO Training slide update 06 2011

Medigap

The Importance of Knowing

• In the future when it comes to insurance procrastination is not advised. There are deadlines and penalties if you don’t get Medicare timely. For more information know that Salt Lake County Aging Services has the (Senior Health Insurance) SHIP program where Medicare Specialists can help answer all your questions.

McKenzie DuffySalt Lake County Aging ServicesMedicare Specialistmduffy@slco.org801-468-2481Fax (801) 468-2852