2015 Medicare Enrollment:  Call: (888) 815-3313

"A Senior Resource Center for Medicare Information"

Medicare Basics

Medicare Basics (4)

Sunday, Oct 27 2013

Medicare 2013 costs at a glance

2013 Costs at a Glance
Part B premium Most people pay $104.90 each month.
Part B deductible $147 per year
Part A premium Most people don't pay a monthly premium for Part A. If you buy Part A, you'll pay up to $441 each month.
Part A hospital inpatient deductible

 You pay: 

  • Days 1-60: $1,184 for each benefit period
  • Days 61-90: $296 coinsurance per day of each benefit period
  • Days 91 and beyond: $592 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs

 

Note: You will pay a higher premium if you file an individual income tax return and your annual modified adjusted gross income is more than $85,000, or if you file a joint income tax return and your annual modified adjusted gross income is more than $170,000. For more information, visit www.medicare.gov.

 

Since Medicare doesn't cover every type of medical care, and you'll have to pay deductibles and coinsurance, you may want to buy a Medicare supplemental insurance (Medigap) policy.

 

  2012 2013
Medicare monthly premium amounts    
Part A (hospital insurance) premium    
Individuals with 40 or more quarters of Medicare-covered employment
$0 $0
Individuals with less than 40 quarters of Medicare-covered employment who are not otherwise eligible for premium-free hospital insurance
Up to $451 Up to $441
Part B (medical insurance) premium per month (standard) $99.90 $104.90
Original Medicare plan deductible and coinsurance amounts    
Part A (hospital insurance)    
Deductible per benefit period
$1,156 $1,184
Coinsurance per day for 61st to 90th day of each benefit period
$289 $296
Coinsurance per day for 91st to 150th day for each lifetime reserve day (total of 60 lifetime reserve days--nonrenewable)
$578 $592
Skilled nursing facility coinsurance per day for 21st to 100th day of each benefit period
$144.50 $148
Part B (medical insurance) annual deductible    
Individual pays 20 percent of the Medicare-approved amount for services after deductible is met
$140 $147

 

Tuesday, Mar 26 2013

You are able to enroll in or change your Medicare plan during one or more of the following enrollment periods:

Tuesday, Mar 26 2013
  • General Information
  • Medicare enrollment is automatic for some of us
  • Some of us have to contact the Social Security Administration (SSA)
  • When can you add or drop forms of Medicare coverage?

General Information. Yes, believe it or not, the Social Security Administration is responsible for enrolling eligible individuals in the Medicare program. As a matter of fact, the SSA takes care of the following Medicare items:

  • Sign up for Medicare Part A and Part B
  • Ask for a replacement Medicare card
  • Change your address
  • Apply for Extra Help with Medicare Prescription Drug costs if you have limited income and resources
  • Ask questions about Medicare Part A and Part B eligibility and enrollment
  • Ask Medicare premium questions
  • Report a death


Medicare enrollment is automatic for some of us. In fact, anyone who is receiving a Social Security  or Railroad Retirement Board (RRB) check is automatically enrolled in Medicare Part A and Part B. Part A is Hospital Insurance; Part B is Medical Insurance. However, if you are not planning on drawing a Social Security retirement check when you turn 65, you must contact Social Security to enroll in Medicare.

In most cases, if you're already getting benefits from Social Security or RRB, you will automatically get Part A and Part B starting on the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the previous month.

If you're under 65 and disabled, you automatically get Part A and Part B after you get disabiity benefits from Social Security or certain disability benefits from the RRB for 24 months.

You will get your red, white, and blue Medicare Health Insurance ID card in the mail about 3 months before your 65th birthday or your 25th month of disability. If you don't want Part B, following the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.

NOTE: If you live in Puerto Rico and you get benefits from Social Security or RRB, you will automatically get Part A. If you want Part B, you will need to sign up for it. Contact your local Social Security office or RRB for more information.

NOTE: If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease), you automatically get Part A and Part B the month your disability benefits begin.

NOTE: If you have Part A and TRICARE (coverage for active duty military or retirees and their families), you must have Part B to keep your TRICARE coverage.

Oh yes, there is another important criterion: you must be a U.S. citizen or a legal resident of this country for five years or longer to be eligible for Medicare.


Some of us have to contact the Social Security Administration (SSA). If you’re coming up on 65 and are not currently receiving Social Security benefits (regardless of whether you plan to enroll in Social Securty Retirement benefits now or at a later date; remember, full retirement benefits are no longer available at age 65 for people born in 1938 or later), SSDI, or benefits from the Railroad Retirement Board, you can still apply for Medicare coverage. As a matter of fact, Part A (Hospital Insurance) is free if you have worked for at least 40 calendar quarters. You can visit your local Social Security Administration office or call (800) 772-1213, TTY users should call 1-800-325-0778 or go to www.ssa.gov to enroll in Medicare.

CAUTION: If you or your spouse (or a family member if you're disabled) is still working and you have coverage through an employer (including the Federal Employee Health Benefits Program) or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare. It may be to your advantage to delay Part B enrollment. If you want Medicare Part A and Medicare Part B, then you should sign your Medicare card and keep it in your wallet. If you don’t want Part B, you put an "X" in the refusal box on the back of the Medicare card form, and send the form to the address shown right below where your signature goes. About four weeks later, you will get a new Medicare card indicating that you only have Part A coverage.


When can you add or drop forms of Medicare coverage? Medicare has enrollment periods that allow you to do this.

The Initial Enrollment Period (IEP) is seven (7) months long. It starts three months before the month in which you turn 65 and ends three months after that month. You can enroll in any type of Medicare coverage within this seven-month window – Part A, Part B, Part C (Medicare Advantage Plan), and Part D (prescription drug coverage). If you don’t sign up for some of this coverage during the initial enrollment period, it may cost you more to add it later.

The Medigap Open Enrollment Period is a six (6) month period which starts the first month you are both age 65 and enrolled in Part B. This period gives you a guaranteed right to buy any Medigap (Medicare Supplement) policy sold in your state.  Once this period starts, it cannot be delayed or repeated.

The Annual Coordinated Election Period (AEP) runs from October 15 to December 7 each year. You can join, switch, or drop a Medicare Advantage (Part C) plan or Prescription Drug (Part D) plan.


The Medicare Advantage Annual Disenrollment Period (MADP) runs from January 1 to February 15 each year. If you are covered by a Medicare Advantage Plan, whether or not it includes prescription drug coverage, this is the time you can return to Original Medicare. You will then have the opportunity to enroll in a stand-alone Part D Prescription Drug plan. Lastly, you can apply for a Medigap policy, but you may not be guaranteed coverage (refer to Medigap Open Enrollment Period and Special Enrollment Periods for exceptions).

The General Enrollment Period is for people who did not sign up for Part A and/or Part B when they were first eligible. It runs from January 1 to March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.

Special Enrollment Period. There are several situations that may occur to place you in a Special Enrollment Period. The most common is for people who didn't sign up for Part B when they were first eligible because they were covered under a group health plan based on current employment. You may also qualify for a SEP if you're a volunteer serving in a foreign country.



 

Citation: 2013 Medicare & You Booklet

Tuesday, Mar 26 2013

At any age, health care is a priority. When you retire, however, you will probably focus more on health care than ever before. Staying healthy is your goal, and this can mean more visits to the doctor for preventive tests and routine checkups. There's also a chance that your health will decline as you grow older, increasing your need for costly prescription drugs or medical treatments. That's why having health insurance is extremely important.

Medicare and You 2014

 

Coverage & costs change yearly Medicare health plans

Read more

Preventive Services

Medicare pays for many preventive services to keep you

Read more

Guide to Who Pays First

If you have Medicare and other health coverage, each type

Read more

Prescription Drug Coverage

To join a Medicare Prescription Drug Plan, you must have

Read more

Medicare Basics

A Guide for Families and Friends of People with Medicare

Read more

Medicare Benefits

The 2010 Affordable Care Act makes many improvements to

Read more

Get connected with Medicare.org

Medicare Reference Materials