2018 Medicare Conditions and Modifications

Medicare is available to persons over the age of 65 who are US citizens or legal residents. In addition, either you or your spouse must have worked 10 years (40 quarters). Some people under the age of 65 may also qualify for Medicare insurance if they have certain disabilities and comply with the guidelines. Medicare Parts A & B is provided by the government.

Part A:

Many people do not pay for Part A, which covers hospital inpatient care, nursing care, home-based care, and hospice stays, because if you’ve worked, you’ve paid into the system. There is a deductible of about $ 1,316.00 and co-insurance after 60 days.

part B

This is a health insurance that covers the visits of doctors and other health care providers, outpatient care, home health care, permanent medical equipment and some preventative services rather than hospital care. The premium is about $ 134.00 and the deductible is $ 183.00. Part B is designed so that the government will pay for about 80% of the medical costs.

Part C

This is called Medicare Advantage, which combines parts A and B and provides additional benefits that can be covered by prescription drugs (Part D) and dental or visual coverings. You can be zero premium (you still have to pay the Medicare rewards) or have an extra reward based on the benefits.

Part D:

Private insurance companies cover the Medicare Prescription Drug Plan and costs about $ 15.00 to $ 100.00 per month. They each have a list of approved medications.

Medicare options and supplements:

Because Medicare does not cover all healthcare costs, these guidelines known as Medigap cover some or all of the costs not included in Parts A and B. However, these plans do not cover medication and have additional premiums for Medicare Part A & B.

Many people choose a combination of these to get the most comprehensive coverage they can. For example:

  • Medicare Supplement Plan with Medicare Part A & B and Part D (to cover prescription drugs)
  • Medicare Advantage Plan (Part C) with Medicare Part A & B, and most Part C plans include Part D (to cover prescription drugs)

Other Medicare facts:

You can’t have both: a Medicare supplement and a Medicare Advantage plan.  Get one here https://www.medicareadvantageplans2019.org

You can change your Part C or Part D plan each year during the annual registration period, which ran for 2018 from October 15 to December 7, 2017.

Some individuals qualifying for Medicaid (another government program) may qualify for the QMB (Qualified Medicare Beneficiary) status only. That is, they receive Medicare rewards and co-pays, such as deductibles, coinsurance, or co-pay. However, this status does not cover other healthcare costs. Medicare-approved providers are not allowed to pay QMB status people, but Medicaid can cover these costs.

Also note that if Medicare declines a fee as a covered service, the supplemental insurance will also decline. An example is a person who has a ambulance transport to a doctor’s office. Balance is the responsibility of the patient or the patient may respond with medical records that provide medical need for transportation.