Medicare Advantage Plans and Details

Medicare is the federal health insurance program for people age 65 and older, certain young people with disabilities, and people with terminal kidney ailment (permanent kidney failure that needs dialysis or transplantation, sometimes called DRT). If either you or your partner has worked for full time for a period of 10 years or more throughout your life, you are likely to qualify to receive Medicare Part A free of charge.

Part A covers hospital stays for hospitalized patients, specialized nursing facility assistance, palliative care and some home health care. What is covered by Medicare is dependent on federal and state laws, national insurance decisions made by Medicare about whether something is insured, and local coverage decisions made by companies in each state that process Medicare claims. These companies decide if something is clinically necessary and should be addressed in your area.

Medicare Part B is available at a monthly rate set annually by Congress ($121.80 in 2016 for an income of $ 85,000 or less for an individual). Part B insures some medical services, medical supplies, outpatient care, and preventive services. Certain seniors are also qualified to receive part of the free medical insurance (Part B), depending on income and asset levels.

For more information, ask about the Qualified Medicare Beneficiary (QMB), the Medicare Low Income Special Beneficiary (SLMB), and the individual programs qualified by your county social services office. Keep in mind that in most instances, if you do not enroll for Part B when you are first eligible, you are going to pay a late registration penalty while you have Part B.

Your monthly Part B premium may increase by 10% for each full 12-month period Part B may have had, but has not registered. In addition, you may have to wait until the General Application Period (January 1 through March 31) to enroll in Part B, and coverage will begin July 1 of the same year. Generally, you do not pay a late registration fee if you satisfy certain conditions that permit you to enroll in Part B during a special registration period.

 

Medicare Part C i.e. Medicare Advantage Plans is a type of Medicare health plan offered by a private insurance company that has a contract with Medicare to meet all of your Part A & Part B benefits. The best Medicare Advantage plans include Preferred Provider Organizations (PPO), Health Maintenance Organizations (HMO), Special Needs Plans (SNP), Private Payments for Services Plans (PFFS), and Medical Savings Account Policies. If you are registered in a Medicare Advantage plan, most Medicare services are insured by the policy and are not covered by Original Medicare. Many Medicare Advantage policies include prescription drug coverage.