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Medicare is administered by the Centers for Medicare and Medicaid Services. Since there are no Medicare offices available to answer questions in a face to face interview, Medicare provides the following three methods to obtain information: from the website (www.medicare.gov), by contacting a Medicare representative at 1-800-Medicare (1-800-633-4227), or by visiting an insurance counselor at your state health insurance and assistance program (SHIP). The Medicare website is certainly the fastest, and for many, the best way to access Medicare information. Medicare consists of four parts. Part A. Hospital Insurance. Helps pay for hospital services, skilled nursing services (up to 100 days), some limited home health services and hospice care. Part B. Supplemental Medical Insurance. Helps pay for doctor fees, outpatient hospital care and durable medical equipment. Part B is voluntary and has a premium of $78.20 per month (2005). Part C. Medicare Advantage. Medicare managed care plans that cover everything that traditional Medicare covers and most plans cover additional services. Part C is voluntary and fees may include the Part B premium or more, depending on the services. Part D. Prescription Drug Coverage. Beginning January 2006, beneficiaries will have the option to enroll in the Medicare Prescription Drug Plan. Part D is voluntary and includes a monthly premium expected to be $35 per month. Deductibles Part A. $912 for Hospital for first 60 days (2005). Part B. First $100 per calendar year. Part C. (You do not need to buy a Medigap policy if you in a Medicare Advantage plan.) Part D. First $250 for drug costs. Co-Payments Part A. $228 per day for hospital days 61-90 and $456 for days 91-150 (2005). Part A. $114 per day for skilled nursing days 21-100 (2005). Part B. 20% of Medicare approved charges. Part D. 25% for drug costs from $250-$2,250 ("Donut Hole" from $2,250 to $5,100 no drug coverage). Part D. 5% for drug costs above $5,100. Medicare Supplemental Insurance Plans (Medigap) The ten NAIC-Approved Plans from A-J Every state is different (check with the department of insurance). Premiums vary widely, check strength of company. Open Enrollment Requirement. NAIC Medicare Model for Medicare Supplement Insurance-there is an open enrollment for the first six month period when a beneficiary (age 65 and older) enrolls in Medicare Part B. Medicare Does Not Usually Cover Dental care. Eyeglasses and hearing aids. Health services received outside of the United States. Long-term care services. Medicaid Health insurance for the poor. Income and asset limits. Administered by states (federal and state funded). Covers long-term nursing home care.
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