Many seniors find that it is like climbing a flight of stairs finding the right Medicare Supplement.
Hopefully the information that we have posted will help you make the right decision for your particular situation.
What is Medicare?
Medicare is a Health Insurance Program for:
People 65 years of age and older.
Some people with disabilities under age 65.
People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Effective January 1, 2009, your Medicare Part B monthly premium will be the same as 2008 at $96.40. This is the premium that is automatically deducted from your monthly Social Security check.
It is likely to change every January.
The Medicare Part B annual deductible is $135 for 2009.
The Medicare Part A (Hospital Insurance)
deductibles and coinsurance amounts for 2009 are:
- $1,068 for the first 60 days of a hospital stay (per benefit period);
- $267 per day for days 61-90 of a hospitalization (per benefit period);
- $534 for each lifetime reserve day; and
- $128 per day for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period.
Medicare has Two Parts:
Part A (Hospital Insurance)
Most people do not have to pay for Part A.
Medicare Part A is "Hospital Insurance." It helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice.
Medicare Part A is financed primarily through federal payroll taxes (FICA taxes) paid into Social Security by employers and employees. The FICA tax is 7.65 percent. Of this, 1.45 percent goes to the Medicare Part A Trust Fund. The rest of Part A is paid for by people who must purchase it.
Medicare Part A Covered Services and Costs
| Covered Services -- |
What You Pay -- |
Hospital Stays:
Semiprivate room, meals, general nursing and other hospital services and supplies (but not private duty nursing, a television or telephone in your room, or a private room unless medically necessary). |
For each benefit period you pay:
- A total of $1,068 for a hospital stay of 1-60 days.
- $267 per day for days 61-90 of a hospital stay.
- $534 per day for days 91-150 of a hospital stay.
- All costs for each day beyond 150 days. |
Skilled Nursing Facility (SNF) Care:
Semiprivate room, meals, skilled nursing and rehabilitative services, and other services and supplies. |
For each benefit period you pay:
- Nothing for the first 20 days.
- Up to $133.50 per day for days 21-100.
- All costs beyond the 100th day in the benefit period. |
Home Health Care:
Intermittent skilled nursing care, physical therapy, occupational therapy, speech language pathology services, home health aide services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers) and supplies, and other services. |
You pay:
- Nothing for home health care services.
- 20 percent of approved amount for durable medical equipment (such as a wheelchair, hospital beds, oxygen, and walkers). |
Hospice Care:
Pain and symptom relief, and supportive services for the care of a terminal illness.
Home care is provided. Also covers necessary inpatient care and a variety of services otherwise not covered by Medicare. |
You pay:
Limited costs for outpatient drugs and inpatient respite care (care given to a hospice patient so that the usual caregiver can rest). |
Blood:
From a hospital or skilled nursing facility during a covered stay. |
You pay:
For the first three pints. |
Chart source: The Centers for Medicare & Medicaid Services.
You have 60 lifetime reserve days that may only be used once. For each reserve day, Medicare pays all covered costs except for a daily coinsurance.
You must meet certain conditions in order for Medicare to cover these services.
Benefit Period: Starts the day you go to a hospital or skilled nursing facility and ends when you haven't received hospital inpatient or skilled nursing facility care for 60 consecutive days.
For More Information About Medicare Part A Coverage:
Part B (Medical Insurance)
Most people pay monthly for Part B.
Medicare Part B is "Medical Insurance." It helps pay for medical services -- physician, ambulance, outpatient therapy and other professional services.
Medicare Part B is financed by general revenues and beneficiary premiums. Currently, general revenues pay for approximately 75 percent of the cost of Part B and the monthly premiums pay for the other 25 percent.
Medicare Part B Covered Services and Costs
| Covered Services -- |
What You Pay -- |
Medical Expenses:
Doctors' services, inpatient and outpatient medical and surgical services and supplies, physical, occupational and speech therapy, diagnostic tests, and durable medical equipment (DME). |
You Pay:
- $135 deductible (pay once per year). Note: This is an increase from previous years.
- 20 percent of approved amount after the deductible, except in the outpatient setting.
- 50 percent for most outpatient mental health.
- 20 percent for all outpatient physical, occupational and speech-language services. |
Clinical Laboratory Service:
Blood tests, urinalysis, and more. |
You Pay:
Nothing for services. |
Home Health Care:
Intermittent skilled care, home health aide services, durable medical equipment (DME) and supplies, and other services. |
You pay:
- Nothing for services.
- 20 percent of approved amount for durable medical equipment (DME). |
Outpatient Hospital Services:
Services for the diagnosis or treatment of an illness or injury. |
You pay:
A coinsurance or fixed co payment amount which may vary according to service. |
Blood:
As an outpatient, or as part of a Part B covered service. |
You pay:
For the first three pints plus 20 percent of approved amount for additional pints (after the deductible). |
Note: Actual amounts you must pay for coinsurance are higher if the doctor does not accept assignment. Call your Medicare carrier if you have questions about your Medicare Part B coverage.
Part B also helps pay for:
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X-rays
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Emergency care
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Speech language pathology services
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Limited chiropractic services
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Artificial limbs and eyes
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Medical supplies: items such as ostomy bags, surgical dressings, splints, and casts
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Arm, leg, back and neck braces
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Kidney dialysis and kidney transplants
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Breast prostheses following a mastectomy
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Under limited circumstances, heart, lung and liver transplants in a Medicare approved facility
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The services of practitioners such as clinical psychologists, clinical social workers, and nurse practitioners
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Preventive services
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Very limited outpatient drugs
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One pair of eyeglasses after cataract surgery with an intraocular lens
Senior Care of Texas can assist you with finding the right Medicare Supplement that fills the gap for you
To request more information please CLICK HERE
