Medicare

1. Medicare Understanding your options PART B PART A PART C PART D MEDICARE SUPPLMENT

2. Agenda • The ABC’s of Medicare Insurance • Who pays for what? • Plan Types • Plan Comparisons & • YOUR OPTIONS

3. The Parts of Medicare • Part A - covers hospital and inpatient services. • Part B - is the part of Medicare that covers doctor’s office and outpatient services • Part C - an optional part of Medicare that is also known as Medicare Advantage (still part of Medicare, coverage is provided through the private insurance carrier combining part A,B & D) • Part D is the prescription drugs part of Medicare • Medigap – Also called Medicare Supplements are standardized plans can help you pay some of the costs not covered by Original Medicare

4. What Medicare Covers • Part A – Hospital Insurance helps cover* • Inpatient Hospital Care • Skilled Nursing Facility care • Home health care • Hospice care • Part B – Medical Insurance helps cover* • Doctor’s visits • Outpatient medical services • Clinical lab tests • Durable Medical Equipment • Preventive services

5. Paying for Part A • What does Part A cost? • Most people get Part A premium free • If you or your spouse paid FICA taxes at least 10 years • If you paid FICA less than 10 years • You can pay a premium to get Part A

6. Paying for Part B Premiums are typically deducted directly from your Social Security

7. Who pays for what • In Original Medicare you pay. • Yearly deductible of $147 in 2013 and • 20% coinsurance for most services. • What you need to consider is paying for the 20%

8. Medicare Insurance Options Medicare Supplement Insurance • Medicare Supplement Insurance Policies • Sold by private companies • Fill the gaps in Original Medicare • Deductibles, coinsurance, copayments • Standardized plans • All plans with same letter • Have same coverage • Only the costs are different • To join a private Medigap plan, you pay a monthly fee to an insurance company in addition to the premium you pay to the government for Medicare Part B.

9. Standardized Supplment Plans • * Plan F also has a high deductible options, some companies may offer this option. • ** Plans K & L pay 100% of covered services for the rest of the calendar year after you meet your • out-of-pocket yearly limit. • *** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some • office visits and up to a $50copayment for emergency room visits that don't result in an inpatient admission.

10. Part CCombining Parts A&B • Health plan options approved by Medicare • Another way to get Medicare coverage • Still part of the Medicare program • Run by private companies • Medicare pays the insurance carrier a premium • You continue paying for your Part B • May have to use network doctors or hospitals • May include additional benefits, Vision & Dental • Types of plans available may vary HMOs PPOs & Special Needs

11. Part D • Available for all people with Medicare • Provided through • Medicare Prescription Drug Plans • Medicare Advantage Plans

12. How Part D Works • It’s optional (however you may have a penalty for joining late) • You can choose a plan and join • Plans have formularies • Lists of covered drugs • Must include range of drugs in each category • You pay the plan a monthly premium • You pay deductibles and copayments

13. For Comparison

14. Things to keep in mind Plans must offer at minimum, coverage equal to or greater than Original Medicare. You have resources – we are here to help