What is the Real Cost of Medicare Plan Insurance?
Contrary to popular assumption, Medicare coverage is not free.
Recipients of social security are automatically enrolled in part A of Medicare at the age of 65.
The monthly premium payment for those who have contributed to Medicare either employed or self-employed for 10 years or more are $0.
Medicare Part A is the mandatory basic program of hospital health insurance under social security. Although better than none, it barely covers basic hospitalization stays and related inpatient services. There is a $1,100 deductible per illness, which is payable when admitted as a hospital inpatient.
Here is a partial list of covered facilities and services:
None of the following expenses are covered under Medicare Part A:
Medicare plans B through D are optional, but again, they are not free.
Part B is designed to pay up to 80% of covered services for doctor bills. The premiums are determined by the government and depend on a variety of factors. The Part B deductible is $155. The monthly premium payments, which are approximately $100, are deducted from social security checks but counted as part of your income.
However, a large percentage of doctors will not accept Medicare patients. In addition, you are almost forced to purchase additional coverage through government approved health insurance agencies such as Medicaid and Medigap to subsidize or cover doctor related services not covered under plan B. In almost all instances, you will have deductibles that you would need to pay out of pocket before the insurance kicks in.
Part C, also known as Medicare Advantage, is a supplementary plan designed to increase benefits of the basic coverage under parts A and B. You must already be covered under parts A and B to be eligible. This plan is only available from Medicare approved private health insurance companies
Part D is another plan provided by private insurance companies that are approved by Medicare. The purpose is to provide prescription drug coverage that is not covered under other Medicare plans. However, there is a large out of pocket percentage and limit of $2,250
If you are nearing the age where you will be eligible to receive social security and subsequent Medicare benefits, carefully research your options including private sector insurance before enrolling in any of the optional Medicare plans.
As mentioned before, Medicare is not a freebie. If you were to take up and pay for all the optional plans, it could meet or exceed any private sector health insurance premium and in some cases still leave you short of full coverage.
For those of you who are covered under plan A and do not pay a monthly premium - you have already paid for it while working where it was taken out of your paycheck.
For more information about social security and Medicare plans, visit these free government websites:
www.medicare.gov/
www.socialsecurity.gov/pubs/10043.html
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