How Medicare Part A, B, and D Work

On this page you will find links and tips on Medicare Parts A, B and D.

Medicare doesn't cover everything it's important to do your research and know what's covered and what's not as well as any deductible and co-pays.

 

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Order Your Booklet

How to Order Your 2015 Medicare Booklet

 

Medicare and You Book 2015

 

 

 

 

 

 

 

 

If you don't have the "Medicare and You 2015" you can order either print or digital download by CLICKING HERE.

Medicare Part B

A List of Common Procedures Part B Covers

Click Here for a List of Some Common Procedures Medicare Part B Covers.

How to Put Medicare To Work

Go to |Medicare Part A | Medicare Part B | Medicare Part D


Put Medicare to workIf you’re already getting Social Security benefits, you’ll automatically get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) starting the first day of the month you turn 65.

If your 65th birthday is on the first day of the month, Part A and Part B will start the first day of the prior month. Medicare will mail you a Medicare card and general information before the date you become eligible.

In most cases, you usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working.


Medicare Part B

Medicare part bHowever, Medicare Part B is a voluntary program that will normally require you to pay a monthly premium.

(Currently $104.90 per month in 2014; will be the same in 2015)

If you don’t want to keep Part B, you must follow the directions when you get your Medicare card to let Medicare know you don’t want it.

Otherwise, keep your card and you’ll be charged the Part B premium.

If you aren’t receiving Social Security benefits by age 65, and you want to enroll in Medicare, you should contact Social Security and sign up during your Initial Enrollment Period.

In most cases, this is the seven month period that starts three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

 

Go to |Medicare Part A | Medicare Part B | Medicare Part D

 

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Important:

In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare coverage.

If you’re covered under a group health plan based on your, or your spouse’s current employment, you should contact your employer benefits administrator to see if it might be best to postpone Part B enrollment until you or your spouse retires.

This decision will depend on how your insurance works with Medicare. Once your employment ends, you’ll have an eight-month Special Enrollment Period in which to sign up for Part B. You won’t have to pay a penalty if you sign up during this period.

Note:

These eligibility rules are general and apply to people who are nearing their 65th birthday. Visit www.medicare.gov to learn about eligibility rules for other situations.

 

Go to |Medicare Part A | Medicare Part B | Medicare Part D

 

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Medicare Part A: The Hospital

What Does Part A Cover and How Does It Work?

  • Medicare Part A: Covers your stay in a medical facility such as a hospital or rehabilitation center but only as an inpatient — not an outpatient. You are only an inpatient if you are officially admitted as a patient to the facility. Always ask what your status is so you can submit the proper claim.
  • Medicare Part A is paid for in part from all those years it was taken out of your paycheck. The only out of pocket pay for Part A is for those items not covered by Medicare. (See below)

    • Medicare Part A helps pay for Inpatient care in hospitals, skilled nursing facility care, Hospice care, and home health care.

    • Medicare Part A pays for semi-private rooms, meals, and general nursing care, and drugs as part of your inpatient treatment.

    • Medicare Part A also includes care you receive in acute care hospitals, critical access hospitals, inpatient care as part of a qualifying clinical research study, and mental health care.
  • Medicare Part A DOES NOT PAY FOR:
    • Private duty nursing, a television or phone in your room (if there is a separate rate charged for those items), or personal care items such as razors for example.

    • Medicare will not pay for a private room unless it is required for medical reasons.

      Go to |Medicare Part A | Medicare Part B | Medicare Part D

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Medicare Part B: Your Doctor

What Does Part B Cover and How Does It Work?

 

Medicare part b your doctorMedicare Part B is an option of Medicare that pays your doctor.

There is a monthly fee deducted from your Social Security Payment each month (currently $104.90 per month in 2014; will be the same in 2015) to cover Medicare Part B.

(There is also an additional charge for Medicare Part D: Prescription Drug Plans based on the plan you select that best fits your needs).

  • IMPORTANT: Things you need to know about Medicare Part B:
    • Medicare Part B has a deductible of $147 in 2014 that must be paid, out of pocket by you, before Medicare begins paying any benefits.

    • After your deductible is paid then you are responsible to pay the 20% Medicare Part B does not cover and any copayments that might apply.

    • The monthly premium for Medicare Part B is $104.90 per month deducted from your Social Security Payment.  (If you make over $85,000 you will pay $146.90 monthly).

    • Unlike the Patient Protection and Affordable Care Act (Obamacare) there is no cap on out of pocket expenses each year with Medicare.

      If you have a serious disease, then that 20% that Medicare does not pay might be thousands and could put you in bankruptcy.

      Please consider a supplemental medical insurance plan to cover those costs that Part A and Part B do not cover.

Medicare Part B covers the doctor’s services you receive while in the hospital.

Part B also covers visits to your doctor’s office, some preventative care and will pay for services that are approved under Part B of Medicare.

 

Click Here for a List of Some Common Procedures Medicare Part B Covers.

Go to |Medicare Part A | Medicare Part B | Medicare Part D

 

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Medicare and You 2015

 

Medicare and You Book 2015

You should have received the book on the left in your mailbox.

It's a complete explanation of how Medicare works and all the changes that will be taking place in 2015.

We have documented the major changes on this page and our Medicare Part A and Part B Page as well as Medicare Part D also.

If you don't have the "Medicare and You 2015" you can order or download it by CLICKING HERE.

 

Click Here for a List of Some Common Procedures Medicare Part B Covers.

Go to |Medicare Part A | Medicare Part B | Medicare Part D

 

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Photo credits:
Some Images courtesy of StockImages at FreeDigitalPhotos.net
Some images courtesy of Nattavut at FreeDigitalPhotos.net
 

 

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