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Frequently
Asked Questions About Medicare
This Page will deal with the questions that most people have about
medicare and the other services that we provide.
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 Medicare & You is a valuable resource for anyone seeking answers about Medicare. |
Q:
What
are the changes coming to Medigap in 2010? A: Two common terms to refer to Medicare Supplement Insurance are Medigap Insurance or Medigap. The gaps in Original Medicare are filled by Medigap or Medicare Supplements. Medicare Advantage is not the same thing as a Medicare Supplement and the two should not be confused. Medigap plans will be affected by the changes taking place in June of 2010 so you should learn about these changes now. The National Association of Insurance Commissioners suggested the new changes to Medicare Supplement Insurance. Consumers will be protected by these new changes. Duplicate coverage will be eliminated and additional coverage will be offered. In the early 1990's the existing plans were created and had become stale. Some of the benefits in the old plans could not even be collected. Many people felt it was high time for changes. There will be new pricing available by all companies with these new plans. This means that companies that are not selling supplements now will likely begin to sell them in addition to the companies already selling them. This should create more competition and lower prices for premiums. These changes should help most consumers enrolling in Medicare for the first time. People with chronic or serious health problems may have to stay on their current plans, though this may not be the case. The new changes include: *Plans E, H, I and J will be eliminated *The lower cost Plan M and Plan N will be released and co-pays will be included in these newer plans *The Home Care benefit will be removed from plan G and the 80% coverage will be increased to 100% coverage *Plans A and Plans C and F must be sold by all insurers offering Plan A *A hospice benefit will be included in all new plans being released Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010
*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$1900] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$1900]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible.
Q: What is Medicare? A: Medicare is a federal government program that helps older folks and some disabled people pay their medical bills and prescription drug costs. The program is divided into three parts: Part A, Part B, and Part D. Part A Is called hospital insurance and covers most hospital stay costs, as well as some follow-up costs. Part B Medical insurance, pays some doctor and outpatient medical care costs. Part D Covers some prescription drug costs Q: Who is eligible for Medicare Part D coverage? A: Anyone entitled to Medicare Part A (whether actually enrolled or not) or who is currently enrolled in Medicare Part B may join Medicare Part D to get help paying prescription drug costs. Enrollment is voluntary except for people who also receive benefits from Medicaid (Medi-Cal in California). If you qualify for Medicaid, the government automatically enrolls you in a Medicare Part D plan through which you will receive your prescription drug coverage. Q: How much of my bill will Medicare Part B pay? A: When all of your medical bills are added up, you will see that Medicare pays, on average, only about half the total. There are three major reasons why it pays so little. First, Medicare does not cover a number of major medical expenses, such as routine physical examinations, medications, glasses, hearing aids, dentures, and a number of other costly medical services. Second, Medicare pays only a portion of what it decides is the proper amount -- called the approved charges -- for medical services. When Medicare decides that a particular service is covered, it determines the approved charges for it. Part B medical insurance then usually pays only 80% of those approved charges; you are responsible for the remaining 20%. Note, however, that there are now several types of treatments and medical providers for which Medicare Part B pays 100% of the approved charges rather than the usual 80%. These categories of care include home health care, clinical laboratory services, and flu and pneumonia vaccines. Finally, the approved amount may seem reasonable to Medicare, but it is often considerably less than what doctors actually charge. If your doctor or other medical provider does not accept assignment of the Medicare charges, you are personally responsible for the difference. Have any questions you'd like to see
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