10-12-2022 PTL - Flipbook - Page 22
22 A Special Advertising Section of Baltimore Sun Media Group | Wednesday, October 12, 2022
MEDICARE
Medicare and you
Understanding Parts A, B and
D, Medigap and Medicare
Advantage
By Margit B. Weisgal, Contributing Writer
Y
ou are about to reach the magic age of 65, which means you can enroll in
Medicare, the federal health insurance program for people 65 and older. As you
near your birthday, you enter into the seven-month Initial Enrollment Period: three
months before your 65th birthday, the month of your birthday and the three months
after it. During that period, there are no restrictions, your acceptance is guaranteed,
and all pre-existing conditions are covered immediately. You will also be able to select
participation in the different parts of Medicare and are eligible for additional coverage,
called a Medigap policy. You can enroll in a Medigap policy when you turn 65 and have
enrolled in Medicare Part B. For this, the Open Enrollment Period lasts for six months.
To get started, visit Medicare.gov (www.
medicare.gov). You can set up an account and
elect to receive a Medicare & You handbook
electronically (it resembles one of the old
phone books), as well as your electronic claims
statements, called Medicare Summary Notices
(eMSNs). The handbook, available in a variety
of formats, includes a summary of Medicare
benefits, rights, and protections; lists of available health and drug plans; and answers to
frequently asked questions about Medicare.
Formats include five languages, large print,
Braille, versions for Kindle and other electronic
readers, and an audio version.
Medicare’s website is pretty comprehensive. You can find everything you need there.
It’s worth browsing around. You’ll often find
recommendations that are beneficial.
some home health care. Most people do not
pay for this.
• Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services,
diagnostic tests, outpatient care, medical supplies, and preventive services. Most people
pay for this. In 2022, the cost is $170.10 each
month. There is also a deductible, currently
$233, which you pay once each year. After the
annual deductible is met, Medicare will pay
80%, and you pay the remainder for covered
services. Once you enroll in Part B, you can
also select a Medicare Supplement Insurance
Policy, also called a Medigap policy, that could
pay for some of the costs for which you are
responsible.
You can choose to sign up for Part A and
Part B and enroll in a Medicare Supplement
policy, or you can get a Medicare Advantage
Policy, called Part C, which includes Parts A
and B and, often, Part D. Part D is a private
drug plan that covers your medications.
From the home page, you’ll immediately
see “Welcome to Medicare” and a button to
“Get Started with Medicare. Scroll down, and
you can create an account, find plans, find
providers (who accept Medicare) and get help.
If paying for Medicare is a problem, there’s a
button for savings programs.
At the top, you’ll see Basics. Choose “Get
started with Medicare” or “Talk to someone.”
Then you have “Health & Drug Plans” and
“Providers & Services.”
Here’s a breakdown of what Medicare pro• Medicare Part D (prescription drug coverage)
vides. It all starts with Original Medicare, also
Helps cover the cost of prescription drugs
known as Part A and Part B.
(including many recommended shots or vaccines). You choose a plan and pay for it. There
• Medicare Part A (Hospital Insurance)
is usually a deductible, and the copay varies
Part A covers inpatient hospital stays, care
depending on which tier the drug is in. This is
in a skilled nursing facility, hospice care, and
your responsibility.
Medigap Policies
Medigap, also called Medicare Supplement
Insurance, helps fill “coverage gaps” in Original
Medicare and is sold by private companies.
Original Medicare (Parts A and B) pays for
much, but not all, of the cost for covered
health care services and supplies. A Medicare
Supplement Insurance (Medigap) policy can
help pay some of the remaining health care
costs, like copayments, coinsurance and
deductibles. And you can only buy a Medigap
policy if you have Parts A and B. Medicare
Advantage plans are not the same as Medigap
policies.
Ron Jacobson, president of Medi-Health,
Inc. (www.medi-health.net), is a broker who
specializes in, and is knowledgeable about,
health insurance for people on Medicare. He
helps his clients, for whom there is no fee since
he is paid by the insurance companies, to
figure out which policy makes the most sense
based on their particular needs.
“Medigap policies are regulated so each
Medicare Supplement Plan, identified by
letters, is the same as another company’s
Medicare Supplement Plan,” says Jacobson.
“However, they may add more benefits, such as
health club memberships, discounts for dental,
hearing, or vision, and more. If you turned 65
Medicare,
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