Which Medicare Benefit Is Right For You?

Several years ago I became involved with Medicare as a result of my husband’s disability and I had to learn which Medicare benefit and hopefully a Medigap plan were right for us. I spent many hours at http://medicare.gov to make the best decision for his healthcare and how much this was going to cost.

Medicare Became Law in 1965

Back in 1945 President Harry Truman requested Congress establish a national health insurance plan.  It took two decades of debates with Congress and finally in 1965 President Lyndon Johnson signed Medicare and Medicaid into law.   Ex-president Truman was the first person to enroll in Medicare and at that time Part B premiums were only $3 per month.

Summary of Medicare Benefits Parts A, B, C, D and Medigap

Part A

Part A is hospital insurance.  Generally it has no cost and covers inpatient and skilled care at nursing facilities, access to most hospitals, home healthcare and Hospice.

Part B

Part B coverage pays for medically necessary services, doctor visits, physical therapy, and additional home health care.  Medicare pays 80% of the approved charges and you are responsible for the other 20%.  There is a monthly premium and in 2009 it is $96.40 per month for most people.

Part C

Part C is the combination of Part A and Part B and called Medicare Advantage   Some companies offer Part D. The difference is that Part C is run by private insurance companies and must offer the same benefits of Original Medicare Parts A and B. Some plans have additional premiums.

Part D

Part D is stand-alone prescription drug coverage insurance. There is a premium associated with all plans for the drug coverage. Te plans vary and cover different drugs.  This is a complicated plan, not very good, but at least it is something to cover prescriptions.

Medigap

Medigap plans are from private insurers and cover those gaps in Part A and B .  There are 12 plans, with different features and different costs from insurers, but must provide for:

• Coinsurance for days 61-90 ($267 per day) and days 91-150 ($534 per day) in hospital
• Payment in full for 365 additional hospital days
• 20% coinsurance for physician and other Part B services

You’ve Got Important Decisions To Make About Your Medicare Benefits

If you’re already enrolled, eligible or even close to eligibility take the time to find out which Medicare benefit will work best for you by visiting http://medicare.gov.  It’s really worth your time and effort to make an informed decision about your healthcare and associated costs.