Confused About Medicare Part II

Continuing the conversation on Confused About Medicare, I wanted to answer the question, what does Medicare part B cover? These are services, in or out of the hospital and outpatient hospital treatment, such as physicians services. In and out patient medical and surgical services and supplies, physical and speech therapy, diagnostic test, durable medical equipment. Home health care Medicare approved services. Your Medicare guide book goes into more detailed information on these services.

In most cases Medicare is responsible to pay for 80% of these services and you are left to cover the remainder of the cost of these expenses. There is also a $183 deductible which must be met before Medicare kicks in.

Medicare does not cover dental or vision, unless you have cataract surgery, then there is some coverage for eyeglasses. At this point people start asking ” what kind of insurance can help me pay for my medical expenses”?

Since basic Medicare only covers about 80 percent of most medical bills, the majority of people will want to use either a Medicare Supplement or a Medicare Advantage plan.  You need to enroll in one within six months of enrolling in Part B.  If you do that, you cannot be denied coverage or charged higher premiums because of a preexisting medical condition  no matter how sick you are.  This is a one-time opportunity.  If you are not happy with the plan you initially selected, in most cases you can change it each year during the open enrollment period. (Your choices may be limited if you have end-stage renal failure). If you sign up for Part B when you turn 65, but you do not get a supplemental policy within six months because you are still working and have employer provided insurance, you lose the federal protection against being charged higher premiums because of a preexisting medical condition.

Just talking about the Medicare supplement, that type of insurance should cover the remaining 20% that Medicare doesn’t cover. I won’t talk about the Medicare Advantage plan now because it may become to confusing talking about both, it’s better to keep it simple and only talk supplement for now. There are many insurance companies that sell supplements and because our government has standardized  the plans from each different company, they all cover the same thing, the only difference is the price.

I’ve worked with these type of plans for about the last 18 years and even then I still have to stay on top of the information daily , so I can retain as much as possible. I don’t know how anyone, who is not an agent, is supposed to make sense of all the information they receive during the Annual enrollment Period. Most of my clients call me wanting to know what they’re supposed to do, and most of the time it’s to throw all that stuff away because all that information doesn’t pertain to them because they already are set with their coverage.

If you’re confused on what to do when you get all this information, and you don’t have an agent you can personally  call me at my office or mobile phone and I would be happy to help you understand this better on a one on one basis.

–Dave Obregon | 888-355-1599 

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