Medicare ExplainedA Brief Presentation bySTEPHEN BRUINGTONFor more information visit www.medicare.gov, or call 1.800.MEDIC...
ObjectiveWhat I’m here to talk about: Medicare The Low Income Subsidy (LIS) Program MA/MAPD, PDP, and Medigap Policies...
ObjectiveWhat I’m NOT here to talk about: Specific Plans Insurance Companies President Obama, or any other member of Co...
What is Medicare?Medicare is a Health Insurance Program for people: age 65 or older. under age 65 with certain disabilit...
What is Medicare?Medicare has Two Parts (“Original Medicare”): Part A (Hospital Insurance)• Most people don’t have to pay...
Original Medicare“Original Medicare” consists of Parts A and B: Run by the federal government. Provides your Part A and/...
Part A (Hospital Insurance)Helps Pay For: Inpatient hospital care. Critical access hospitals. Skilled Nursing Facility(...
Part A (Hospital Insurance)Cost (for coverage): Most people get Part A automatically when they turn65. They don’t have to...
Part B (Medical Insurance)Helps Pay For: Outpatient hospital care. Doctor’s services. Home healthcare. Preventive serv...
Part B (Medical Insurance)Cost (for coverage): Most beneficiaries (who were enrolled in Part Bduring or prior to 2009) wi...
What is Medicare? (continued)Medicare has Two Other Parts: Part C (Medicare Advantage, aka. “MA or MAPD”)• MA/MAPD plans ...
Healthcare TerminologyMedicare and InsuranceCompanies use terms like: Premium Deductible Co-pay Co-insurance Cost-sha...
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Medicare Explained

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This is a brief overview of Medicare I put together back in 2010. It's not intended to be comprehensive, and I don't think I finished it, but it's enough to give you a general idea.

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Medicare Explained

  1. 1. Medicare ExplainedA Brief Presentation bySTEPHEN BRUINGTONFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).
  2. 2. ObjectiveWhat I’m here to talk about: Medicare The Low Income Subsidy (LIS) Program MA/MAPD, PDP, and Medigap Policies Commonly Used Healthcare TerminologyMedicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  3. 3. ObjectiveWhat I’m NOT here to talk about: Specific Plans Insurance Companies President Obama, or any other member of Congress. Healthcare ReformMedicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  4. 4. What is Medicare?Medicare is a Health Insurance Program for people: age 65 or older. under age 65 with certain disabilities. of all ages with End-Stage-Renal-Disease (ESRD).Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  5. 5. What is Medicare?Medicare has Two Parts (“Original Medicare”): Part A (Hospital Insurance)• Most people don’t have to pay a premium for Part A. Part B (Medical Insurance)• Most people pay monthly for Part B.• By default, the monthly Part B premium is deducted from yourSocial Security benefit check.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  6. 6. Original Medicare“Original Medicare” consists of Parts A and B: Run by the federal government. Provides your Part A and/or Part B coverage. You can…• go to any doctor that accepts Medicare.• join a Medicare Prescription Drug Plan to add drugcoverage.• buy a Medigap (Medicare Supplement Insurance) policy(sold by private insurance companies) to help fill the gaps inParty A and Part B.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  7. 7. Part A (Hospital Insurance)Helps Pay For: Inpatient hospital care. Critical access hospitals. Skilled Nursing Facility(SNF). Hospice care. Home healthcare.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  8. 8. Part A (Hospital Insurance)Cost (for coverage): Most people get Part A automatically when they turn65. They don’t have to pay a premium because they, ora spouse paid Medicare taxes while they were working. If you don’t automatically get premium-free Part A, youmay be able to buy if:• You (or your spouse) aren’t entitled to Social Securitybecause you didn’t work or didn’t pay enough Medicaretaxes while you worked and you are age 65 or older, or• You are disabled, but no longer get premium-free Part Abecause you returned to work.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  9. 9. Part B (Medical Insurance)Helps Pay For: Outpatient hospital care. Doctor’s services. Home healthcare. Preventive services.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  10. 10. Part B (Medical Insurance)Cost (for coverage): Most beneficiaries (who were enrolled in Part Bduring or prior to 2009) will continue to pay thesame $96.40 Part B premium in 2010. For all others, the standard Medicare Part Bmonthly premium will be $110.50 in 2010.• The cost of Part B may go up 10% for each 12-monthperiod that you could have had Part B but did not sign up forit, except in special cases. You will have to pay this extra10% as long as you have Medicare Part B.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  11. 11. What is Medicare? (continued)Medicare has Two Other Parts: Part C (Medicare Advantage, aka. “MA or MAPD”)• MA/MAPD plans are offered by private insurancecompanies. Part D (Prescription Drug Plan, aka. “PDP”)• PDP are also offered by private insurance companies.Medicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
  12. 12. Healthcare TerminologyMedicare and InsuranceCompanies use terms like: Premium Deductible Co-pay Co-insurance Cost-sharing Out Of Pocket Limit (OOP) In / Out of NetworkMedicare ExplainedFor more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).A Brief Presentation by STEPHEN BRUINGTON
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