AS Americans live longer than ever, Medicare is probably the most popular of all health insurance programs. Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).
The original Medicare has two parts: Part A - hospital insurance- which in most cases were paid by most people through their payroll taxes when they were working and Part B- medical insurance-which is paid monthly by the insured.
Part A helps cover your inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Depending on your income level, Part A could either be free or you need to pay a monthly premium if your income is higher than the threshold set.
Medicare Part B helps cover your doctors’ services and outpatient hospital care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.
A Medicare eligible individual can also elect to participate in a Medicare Advantage Plan, Part C and Medicare prescription drug coverage, Part D.
You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in the Original Medicare Plan. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall.
Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program, and sometimes called "Part C." When you join a Medicare Advantage Plan, you are still in Medicare. As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have the Original Medicare Plan, or you belong to a Medicare Advantage Plan (like an HMO or PPO).
Medicare Prescription Drug Plans are offered by insurance companies and other private companies approved by Medicare.
Today’s Medicare is about choices among different programs. Whether you end up enrolling in the original Medicare administered by the federal government or elect to go to a Medicare Advantage Plan such as Scan Health, Blue Shield 65 Plus, among others, you have to ensure that the administration of your insurance policy best fits your medical needs.
Orientations and seminars are often held free for seniors prior to the enrollment season in November. You could check your local community centers for any announcements.
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Evangeline can be reached at her marketing location at the Ground Floor of Eagle Rock Plaza (in front of Jollibee), 2700 Colorado Blvd., Los Angeles, CA 90041 or at her business address at 655 N. Central Ave., 17th Flr., Glendale, CA 91203, phone number (323) 356-3803 or (323) 254-6787.
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The purpose of this article is to provide information of general interest to our clients and prospective clients. The information provided is general in nature and should not be considered complete information on any product or concept described.
( Published October 31, 2009 in Asian Journal Los Angeles p. C5 )
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