Medicare
Medicare Plans
What are the important dates for Medicare Enrollment?
Listed below are the most important dates when it comes to "Medicare and You" for 2008.
October - Prepare and Compare:
- Prepare: Watch your mail for the "Medicare and You" handbook and for information about plans in your area. Gather all of the information you’ll need to make a decision. If you are currently enrolled in a plan, the plan will send you important information about your coverage, benefits, and costs next year. Be sure to review this material. Call us with your questions.
- Compare: Complete your Medicare Enrollment Review. In mid-October, review and compare plans based on cost, coverage, and customer service by visiting www.medicare.gov on the web. We can assist you through this process.
- Or, call 1- 800 - MEDICARE or 1-800-633-4227.
- TTY users should call 1-877-486-2048
- November 15 - Enrollment Begins Decide: November 15 is the first day you can change your Medicare health or prescription drug coverage for next year. This is the one chance this year most people with Medicare have to make a change in their health and prescription drug plans. Enroll as early as possible-the earlier the better-to avoid any issues at the pharmacy counter in January.
- December 31 - Enrollment Ends: In most cases, December 31 is the last day you can change your Medicare coverage for next year.
- January 1 - Coverage Begins: Your new coverage begins if you switched to a new plan. If you stay with the same plan, January 1 is the date that any changes to coverage, benefits, or costs for the New Year will begin.
What are Medicare Premiums for 2008?
- Part A: (Hospital Insurance) Premium Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment. The Part A premium is$233.00 for people having 30-39 quarters of Medicare-covered employment. The Part A premium is $423.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.
- Part B: (Medical Insurance) Premium $96.40 per month for individuals earning less than $82,000 per year or married couples filing a joint tax return earning less than $164,000 per year
What are Medicare Deductible and Coinsurance Amounts for 2008?
Listed below are the Medicare Deductibles and Coinsurance amounts for 2008 broken into their appropriate categories:
- Part A
This pays for inpatient hospital, skilled nursing facility, and some home health care. For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2008 = $1,024) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days. - Each benefit period
You pay a total of $1,024 for a hospital stay of 1-60 days. $256 per day for days 61-90 of a hospital stay. $512 per day for days 91-150 of a hospital stay (Lifetime Reserve Days). All costs for each day beyond 150 days. - Skilled Nursing Facility Coinsurance
$128.00 per day for days 21 through 100 each benefit period. - Part B
Covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment $135.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $135.00 deductible.) - Original Medicare Plan
A fee-for-service plan that is managed by the Federal Government. You can go to any doctor or supplier that is enrolled and accepts Medicare and is accepting new patients, or to any hospital or other facility. The Original Medicare Plan has two parts: Part A (hospital) and Part B (medical). You will be in the Original Medicare Plan unless you choose to join a Medicare Advantage Plan (like an HMO or PPO). Most people get their coverage through the Original Medicare Plan. -
Medicare Advantage Plans
Medicare Advantage plans are health plan options that are approved by Medicare and run by private companies. They are part of the Medicare program, and sometimes called "Part C." Some of these plans include prescription drug coverage. Medicare Advantage Plans include:- Medicare Preferred Provider Organization (PPO) Plans you pay less if you use doctors, hospitals, and providers that belong to the PPO plan network.
- Medicare Health Maintenance Organization (HMO) Plans in most HMOs, you can only go to doctors, specialists, or hospitals on the plan’s list except in an emergency or certain other urgent situations.
- Medicare Private Fee-for-Service (PFFS) Plans you may go to any Medicare-approved doctor or hospital that accepts the plan’s payment.
- Medicare Special Needs Plans Provides more focused and specialized health care for specific groups of people, such as those who have both Medicare and Medicaid, who reside in a nursing home, or have certain chronic medical conditions.
- Medicare Medical Savings Account (MSA) Plans a two-part plan that has an HMO or PPO with a high deductible, and a Medical Savings Account.
- Other Medicare plans
there are some types of Medicare plans that provide health care coverage that aren’t part of Medicare Advantage, but are still part of the Medicare Program.- Medicare Cost Plans A type of HMO that is available in certain areas of the country. In a Medicare Cost Plan, if you get services outside of the plan’s network without a referral, your Medicare-covered services will be paid for under the Original Medicare Plan (your Cost Plan pays for emergency services, or urgently needed services).
- Demonstrations/Pilot Programs Demonstrations are special projects that test improvements in Medicare coverage, payment, and quality of care. Pilot programs are designed to reduce health risks, improve quality of life, and provide savings for people with Medicare with one or more chronic illness.
- PACE (Programs of All-inclusive Care for the Elderly) A joint Medicare and Medicaid program that combines medical, social and long-term care services for frail elderly people who live in and get health care in the community.
- Other Coverage
- Medicare Prescription Drug Coverage (Part D) Medicare prescription drug plans (Part D) are run by insurance companies and other private companies approved by Medicare.
- Medigap (Medicare Supplement Insurance) Policies Health insurance sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage.
What are Medicare Part B 2008 monthly premiums for higher wage earners?
Most people will pay the standard monthly Part B premium of $96.40 in 2008. Some people will pay a higher premium based on their modified adjusted gross income. Your monthly premium will be higher if you file an individual tax return and your annual income is more than $82,000, or if you are married (file a joint tax return) and your annual income is more than $164,000. If you meet these criteria, Social Security will use the income reported two years ago on your IRS income tax return to determine your premium (if unavailable, SSA will use income from three years ago). For example, the income reported on your 2006 tax return will be used to determine your monthly Part B premium in 2008. If your income has decreased since 2006, you can ask that the income from a more recent tax year be used to determine your premium, but you must meet certain criteria. At the end of each year, Social Security will send you a letter if your Part B premium will increase based on the level of your income and to tell you what you can do if you disagree. For more information about Part B premiums based on income, call Social Security at 1-800-772-1213. TTY users should call1-800-325-0778. The chart below shows the Part B monthly premium amounts based on income. These amounts change each year. There may be a late-enrollment penalty.
| You Pay | Single(yearly income) | Married(yearly income) | Married File Separate(yearly income) |
| $96.40 | $82,000 or less | $164,000 or less | $82,000 or less |
| $122.20 | $82,001-$102,000 | $164,001-$204,000 | N/A |
| $160.90 | $102,001-$153,000 | $204,001-$306,000 | N/A |
| $199.70 | $153,001-$205,000 | $306,001-$410,000 | $82,001-$123,000 |
| $238.40 | Above $205,000 | Above $410,000 | Above $123,000 |
When do Medicare Premiums and Coinsurance rates change and how will I know what they are?
New Medicare premium and coinsurance rates come out each fall and become effective in January. If you get Social Security premiums or Railroad Retirement benefits, new rates are sent to you each year with your December cost of living adjustment notice. You can get new Medicare rates each fall on this website or by calling 1-800-MEDICARE (1-800-633-4227).
What are my Medicare healthcare coverage choices?
Choosing the right Medicare coverage can be a confusing and overwhelming task. Below are listed four groups of Medicare healthcare coverage that should be considered when evaluating your Medicare healthcare needs:
Please contact your JC Lewis agent. We’ll be glad to help with all your Medicare Supplement questions. There is no cost for our services.