Medicare is divided
into two separate parts: Part A and Part B. If you are eligible
for Social Security, you automatically qualify for Part A. Part
B is voluntary, and costs $96.40 per month, which will be deducted
from your Social Security check. Part A covers approved hospital
expenses. Part B is medical insurance for doctor and surgeon
fees, lab tests, and other outpatient treatment.
Medicare does not pay for all of your
health care expenses.
It has no provision for long-term custodial care. It will only
pay for skilled nursing or rehabilitative care after a hospital
stay of at least 3 days, you must enter the facility within
30 days after leaving the hospital, and benefits will only be
paid for 100 days. Fact: Medicare nationally covers less than
2% of nursing home expenses. (See Long-term
Care) Under Part A, you pay a $1024 deductible
for the first 60 days of each hospital admission. For the next
30 days in the hospital you pay for a coinsurance amount of
$256 per day. After the first 90 days you pay $512 per day.
Days 91-150 are known as your “lifetime reserve days”,
and once theses are used you pay all costs. Under Part B you
pay the first $135 of all Medicare approved expenses each calendar
year. After that, Medicare generally pays 80% and you pay the
remaining 20%.
Medicare Supplements can be quite confusing.
We are given a choice of ten separate options (plans A thru
J), and then there are the Advantage Plans which include PPO’s,
Fee for Service Plans, and HMOs. At Golden Gates Agency we feel
that Advantage Plans severely limit one’s options, and
should only be considered under certain special circumstances.
(See HMO vs. PPO) Plans A
thru J are federally regulated. They must offer identical benefits
plan for plan. Once you have decided which plan is right for
you, your only considerations need to be the quality of the
company providing the insurance (i.e.: financial strength, claims
paying record, customer satisfaction) and cost of premium.
Plans A thru E do not provide for the 20% that you pay under
Medicare Part B. Doctor’s fees, medical tests, and outpatient
procedures are more costly than ever. A surgeon’s fee
alone may amount to hundreds of thousands of dollars. Are you
willing to assume even 20% of that type of risk?
Plans F and J seem to be the most
logical options available. They pay 100% of Medicare Part A
hospital deductible and 100% of the coinsurance. You pay nothing.
Plan F and J also cover 100% of your covered hospital expenses
after your lifetime reserve days are used up, adding 365 days
to your lifetime maximum. They also the Part A blood deductible,
and 100% of the Medicare skilled nursing coinsurance. Plan F
and J also pay 100% of the Medicare Part B deductible, coinsurance,
and blood deductible. Again, you pay nothing. You have complete
freedom to choose your own doctors and hospitals, and no waiting
period for preexisting conditions. There is no lifetime limit
for Medicare Part B medical expenses, and this policy is guaranteed
renewable for life. Plan J also offers at home recovery services
and preventative medical care. Plan F is available with a high
deductible option, which in turn saves a substantial amount
on the policy premium.
The Golden Gates Agency has partnered
with a premier insurance company, offering fast, accurate claims
service, and extremely competitive rates. Our senior companion
services membership provides you and you family discounts on
all prescriptions, dental expenses, vision care, chiropractic,
and hearing aids
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