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This is a brief overview of Medicare I put together back in 2010. It's not intended to be comprehensive, and I don't think I finished it, but it's enough to give you a general idea.
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Medicare Explained
A Brief Presentation by
STEPHEN BRUINGTON
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
ObjectiveWhat I’m here to talk about:
Medicare The Low Income Subsidy (LIS) Program MA/MAPD, PDP, and Medigap Policies Commonly Used Healthcare Terminology
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
ObjectiveWhat I’m NOT here to talk about:
Specific Plans Insurance Companies President Obama, or any other member of Congress. Healthcare Reform
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
What is Medicare?Medicare is a Health Insurance Program for people:
age 65 or older. under age 65 with certain disabilities. of all ages with End-Stage-Renal-Disease (ESRD).
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
What is Medicare?Medicare has Two Parts (“Original Medicare”):
Part A (Hospital Insurance)• Most people don’t have to pay a premium for Part A.
Part B (Medical Insurance)• Most people pay monthly for Part B.
• By default, the monthly Part B premium is deducted from your Social Security benefit check.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
Original Medicare“Original Medicare” consists of Parts A and B:
Run by the federal government. Provides your Part A and/or Part B coverage. You can…
• go to any doctor that accepts Medicare.• join a Medicare Prescription Drug Plan to add drug
coverage.• buy a Medigap (Medicare Supplement Insurance) policy
(sold by private insurance companies) to help fill the gaps in Party A and Part B.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
Part A (Hospital Insurance)Helps Pay For:
Inpatient hospital care. Critical access hospitals. Skilled Nursing Facility
(SNF). Hospice care. Home healthcare.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
Part A (Hospital Insurance)Cost (for coverage):
Most people get Part A automatically when they turn 65. They don’t have to pay a premium because they, or a spouse paid Medicare taxes while they were working.
If you don’t automatically get premium-free Part A, you may be able to buy if: • You (or your spouse) aren’t entitled to Social Security
because you didn’t work or didn’t pay enough Medicare taxes while you worked and you are age 65 or older, or
• You are disabled, but no longer get premium-free Part A because you returned to work.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
Part B (Medical Insurance)Helps Pay For:
Outpatient hospital care. Doctor’s services. Home healthcare. Preventive services.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
Part B (Medical Insurance)Cost (for coverage):
Most beneficiaries (who were enrolled in Part B during or prior to 2009) will continue to pay the same $96.40 Part B premium in 2010.
For all others, the standard Medicare Part B monthly premium will be $110.50 in 2010.• The cost of Part B may go up 10% for each 12-month
period that you could have had Part B but did not sign up for it, except in special cases. You will have to pay this extra 10% as long as you have Medicare Part B.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
What is Medicare? (continued)
Medicare has Two Other Parts:
Part C (Medicare Advantage, aka. “MA or MAPD”)• MA/MAPD plans are offered by private insurance
companies. Part D (Prescription Drug Plan, aka. “PDP”)
• PDP are also offered by private insurance companies.
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON
Healthcare TerminologyMedicare and InsuranceCompanies use terms like:
Premium Deductible Co-pay Co-insurance Cost-sharing Out Of Pocket Limit (OOP) In / Out of Network
Medicare Explained
For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
A Brief Presentation by STEPHEN BRUINGTON