![]() ![]() Every Part D plan has its own list (i.e., a “formulary”) of covered medications. While MA plans often offer prescription drug coverage, insurers also sell federally standardized Medicare Part D plans as a standalone product to those with Medicare Part A and/or Part B. In other words, comparing prices and services offered from different vendors may be the best way to find a plan that works for you. This is due to unique provider networks, premiums, copays, coinsurance, and out-of-pocket spending limits. Although these plans come with standardized minimum coverage, the amount of additional protection offered can differ drastically from one person to the next. ![]() MA plans are offered by private companies approved by the federal government. Sometimes called “Medicare Part C,” Medicare Advantage (MA) plans are often viewed as an all-in-one alternative to Original Medicare. The premiums vary, according to the Medicare recipient’s income level, but the standard monthly premium amount is $144., and the current yearly deductible is $198. Part B does come with some costs, however, which are adjusted annually. Part B covers physicians’ fees, outpatient hospital care, certain home health services, durable medical equipment, and other offerings not covered by Medicare Part A. ![]() Knowing the limitations of Part A, some people look for other choices when it comes to managing the costs of extended care. During days 21-100, a $176 daily coinsurance payment may be required of you. ![]() Under the current Part A rules, you would pay $0 for days 1-20 of care in a skilled nursing facility (SNF). Many pre-retirees are frequently warned that Medicare will only cover a maximum of 100 days of nursing home care (provided certain conditions are met). One thing to keep in mind is that, while very few beneficiaries must pay Part A premiums out of pocket, annually adjusted standard deductibles still apply. In general, Part A covers inpatient hospital care, skilled nursing facility costs, hospice, lab tests, surgery, and some home health care services. Counselors provide in-person and telephone assistance.Whether your 65 th birthday is on the horizon or decades away, understanding the different parts of Medicare is critical, as this government-sponsored program may play a role in your future health care decisions. The Maryland SHIP program provides trained staff and volunteer counselors in all 24 counties. The Senior Health Insurance Assistance Program (SHIP) helps you to understand your health insurance benefits, bills and rights. Is there someone that I can meet with to help me sort through the Medicare D options? The answer is Yes. The webpage will post the information or you can contact your local Social Security Office. The extra help is dependent on your income and savings. The Social Security Administration (SSA) and Medicare are working together to give you this extra help. What if I can't afford the cost of the Medicare D plan? If you have limited income and assets, you may qualify for extra help with the costs of your prescription drugs. When does my Part D coverage begin? Your Medicare Part D coverage will begin on January 1 and will continue for the entire year. Type in the names of your drugs and, with the click of a button, find the plans that match your drug list. So, Medicare has set up a Medicare Plans and Formularies web page to help find a match for the best health and prescription drug plans based on the medications you are taking and your zip code. However, finding the right plan for you may depend on the medications you are taking. It allows you to search for available plans in your area. Medicare operates a web page called Medicare Plan Finder. How do I pick a Medicare D plan that is right for me? If you are currently enrolled in a Medicare Advantage Program, you will have from January 1 to February 15, 2011 to sign up for a stand-alone Part D plan if you drop out of your Advantage plan and return to original Medicare during this time period. If you do not enroll/switch by December 31, 2010, you may not be eligible to do so until the next Annual Election Period, which will be October 15 through December 7, 2011. The 2010 Annual Election Period began on November 15 and ends on December 31, 2010. The Annual Election Period for Medicare D is the time of year in which you can join, drop, or switch Part D plans. Each plan can vary in cost and drugs covered. To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Even if you don’t take a lot of prescriptions now, you should still consider joining a Medicare drug plan. Medicare offers prescription drug coverage to everyone with Medicare. ![]()
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