Medicare Basics

Feb 6, 2007

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  1. midwestbroker
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    midwestbroker Guru

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    There has been some requests for basic Medicare info, so here are the bare bone facts to it:

    Eligible Age 65 or after 24 months of disability

    Part A is at no cost as long as you have worked 40 quarters (or 10 years). Part B is elected and is $93.50 per month for 2007 (may cost more if annual income is above $80,000).

    What it covers –

    Part A – Hospitalization
    For each benefit period:
    Days 1-60 – Initial deductible of $992
    Days 61-90 - $248 per day
    Days 91-150 - $496 per day (these are the lifetime reserve days, can only be used once)

    Skilled Nursing
    Must have at least a 3 day hospital stay
    Days 1-20 - $0 per day
    Days 21-100 - $124 per day

    Part B – Medical (Doctors, ER Room visits, tests, etc)
    Annual Deductible of $131
    80% / 20% Co-Insurance

    Part C – Medicare Advantage Plans
    Vary by state / region

    Part D – Prescription Drug Coverage
    The Coverage Gap will start at $2400 in total drug cost in 2007
    The Coverage Gap ends at $3850 total out of pocket
    After the Gap, the member will pay $2.15 for generic or $5.35 for all other / or 5% co-insurance
    2 ways to get this – Stand Alone (only drug coverage)
    MAPD – Medicare Advantage Plan with Prescription Drug Coverage Included

    Enrollment Periods:

    November 15th – December 31st is the AEP (Annual Election Period)
    This is when Medicare Beneficiaries can make changes to their plans. They are allowed 1 change.

    January 1st – March 31st is the OEP (Open Enrollment Period)
    Medicare Beneficiaries who have a Part D plan can elect a Medicare Advantage Plan with prescription drug coverage included. They cannot change their stand alone drug plan to another stand alone drug plan.

    There is more to it, but here is a start to understanding it. Hope this helps!
     
  2. honestagent
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    honestagent Guru

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    This was so nice of you to post. Tx.
     
  3. midwestbroker
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    midwestbroker Guru

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    No problem.

    Anyone else have any info to toss in the post have at it!
     
  4. GreenSky
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    Thanks for posting this information.

    Rick
     
  5. somarco
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    somarco That Medicare Guy

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    Is that 25 months on SSDI or 24 months from the date of the award?
     
  6. GreenSky
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    GreenSky Guru

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    Why are you responding to a 4 year old post?

    Rick
     
  7. somarco
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    somarco That Medicare Guy

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    I thought this post was lonely and needed to feel wanted again.

    Also, I seem to recall a more recent post that said the 24 months started from the day of the award. Since I can't find that post it was easier to hide my question in an old post, but now you found me.
     
  8. taterpeeler
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    taterpeeler Guru

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    what is medicare supplement thingies?
     
  9. tins
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    Plans to supplement what medicare doesn't cover. Like a dental plan. Or food insurance. That kind of stuff.

    :nah:
     
  10. somarco
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    somarco That Medicare Guy

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    I thought Centrum Senior was a Medicare supplement
     
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