PART A – Hospital Benefit• There is no premium for Part A.• It covers Room & Board.• The deductible is $1132 per Benefit Period.• The Benefit Period is 60 days.• For days 61 – 90 the cost is $283 per day.• For days 91 – 150 the cost is $566 per day.• All cost for each day beyond 150 days.Skilled Nursing Facility• Up to $141.50 a day for the 21st -100th day each benefit period.
PART B – Doctors• Monthly premium Part B is $115.40• Annual deductible is $162• Covers Doctor’s services, outpatient care etc.• Medicare pays 80% of Medicare’s approved amount.• Beneficiary pays 20% of Medicares approved amount.• Approval for Medically Necessary care only.• No Foreign Travel Coverage.
PART D – Prescription Drug Plan• Part D must be obtained through a private carrier.• The National Average premium is $32.00• Most plans have an Annual Deductible of $310.• The RX limit is $2840, then Coverage Gap• The Out-Of-Pocket limit is $4550• Catastrophic Coverage $2.50 (gen.) and $6.30 (brand)
PART D – Prescription Drug PlanThe basic plan – all Part D plans are required by law to offer benefits equal to orbetter than the following: 2011 Basic Benefits You PayDeductible $310 100% of first $310 25% of the next $2530Initial Coverage Limit $2,840 ($632.50)Coverage Gap* $3,607.50 100% of next $3,607.50Annual Out-Of-Pocket $4,450**Catastrophic Coverage Medicare and Plan 95% 5%**** CMS and drug companies to provide a 50% discount on covered brand name drugs while in the coverage gap or ‘Donut Hole’** Annual Out-Of-Pocket Amount does not include monthly premiums.*** Member pays the greater of $2.50 for generic/preferred drugs and $6.30 for all other drugs, or 5% percent coinsurance.
Are you eligible?• Enrolled in Medicare Part A and Part B through age ordisability?• Permanent resident in service area?• Do you have End Stage Renal Disease (ESRD)?
PART C – Medicare Advantage• Obtained through Private Insurance Carrier.• “Pay As You Go”• $0 - $60 monthly premium.• In most cases includes Part D Prescription Coverage.• Humana or Coventry for Kansas City Metro.• Can change plan at AEP – Oct. 15th – Dec. 7th 2011.
Medicare Supplements - Medigap• Obtained through Private Insurance Carrier• “All You Can Eat”• Guaranteed Issue for turning age 65• You pay a Monthly Premium• Typically more expensive than Advantage Plans• Plans types from A through N.• Must have a separate Prescription Drug Plan
Medicare Supplements - Medigap• Pays the Part A Deductable, some pay Part B also.• Pays the 20% Part B remainder.• Only pays if Medicare Approves.• Always go with an A rated company.• No Networks for services.• Can be used by anyone who accepts Medicare.• World wide coverage for emergency and urgent care.
What happens now?• Call Paul at 816-898-6969 for a consultation and thebest advice on which products to consider.• Email Paul with any questions email@example.com• Complete an application and you will receive your IDcard in about two weeks.