Medicare health care is broken down into several different types:
Part-A is an original Medicare, which is for hospital services. It is obtained after 40 quarters of work records. The hospital services have a deductible co-pay of $1340. There are other co-pays that go along with this. Original Medicare pays 80% of costs incurred and you are responsible for the 20% that it is not covered.
The maximum out-of-pocket is $6700 and the other part that is missing is a drug plan-part D.
Part B has a monthly premium of $134.90 in the year 2019. This can go up based on what Congress pays out on the cost of living on an annualized basis. The 80% - 20 % rule still applies to this benefit. So, if you do not want to pay the 20% co-pays to cover that cost, you buy a supplement, which is an additional plan that pays for the 20%.
Also, for part –B, an average of $125 for a supplement plus average of $30 for a drug plan. The total premium in the range of $300 a month goes to any Doctor or hospital associated with Medicare in America. The cost of the supplement goes up anywhere from 4 to 8% per year.
If you do not sign up for a drug plan “part D”, you will be penalized for every month not signed up. If you are not signed up, the average penalty will be about $.30 per month, which is added to your monthly fee you pay for part B.
Supplement and Drug Plans
When you have a supplement you do have to buy a drug plan. Drug plans can range from $15 a month to $80 a month, based on the drugs you take and what the co-pays you’re willing to pay. So, your monthly cost is $134.90
There are several other plans available. The monthly premium cost is based on how much of the deductible you will pay out of your pocket. The premiums vary from company to company. However, the coverage is standard for all of them. Be a wise shopper and talk to a licensed agent.
The next part of this plan healthcare is what they call part C of the Medicare code and which are the advantage plans.
Some of the major companies (the third party contract companies) associated with Medicare looks after all of our health needs. This association of business started in 2005 and has turned out to be a very good benefit for all who chose to go that way.
More About the Plans
These plans cover part A, part B, and your drug plans. There is no additional premium per month for that program. The money is taken out of your social security for part B is passed on to these firms to take care of your needs.
However, there are some differences between these two types of plans.
These are HMOs, POS, PPOs, PFF’s and each one is different with different rules. The one thing which is common is that there is a network of doctors and hospitals and drug pharmacies that are attached to these programs. These plans are usually in major metropolitan areas where the third party companies can build efficient networks of services. In outlying areas such as Payson, Pinetop and other smaller towns these are very few because of the problem with networks that have to be built.
More About the Third Party Companies
The ground rules are these companies have got to provide services as good as or better than original Medicare. Therefore, it is important that you sit with a knowledgeable agent who has experience and who is looking for your best interest to discuss each of these plans.
When you talk to an agent such as no cost is involved, we obtain commissions from these companies to serve you. Our industry is so highly regulated that we have restrictions on how we can educate you, contact you, follow-up on the phone or in writing.
Inquire About the Agent
We are required to participate in continuing education by the government and insurance companies annually, we also have to purchase errors and omissions insurance. CMS can come out and secret shop to see if we're in violation. The penalties are very high, you are well protected. When you meet with an agent make sure that they have a business card. Ask if they have a license with them, how long they’ve been in the business. We do not represent Medicare if somebody says they do there in violation.