Medicare- The Basics-

Welcome back! I hope this blog is providing helpful information for people living with cancer. In this post, I want to start a new discussion focusing on the basics of Medicare. The Medicare open enrollment period for 2021 starts October 15, 2020. This is a great opportunity for you to review your current Medicare policy and make changes.

The U.S. Centers for Medicare & Medicaid Services offers great online resources regarding Medicare:

Official Medicare website: www.Medicare.gov

Phone number: 1-800-MEDICARE or (800) 633-4227

Medicare costs: https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance

Find your state’s Medicare Savings Programs (MSPs): https://www.medicare.gov/Contacts/#resources/msps

You can find local Medicare assistance at your State Health Insurance Assistance Programs (SHIPs): https://www.shiptacenter.org/

Medicare Vocabulary:

• Medicare A (or part A) (Hospital Insurance): Health insurance plan that pay for a portion of the bill, after you pay your deductible, for inpatient hospital visits, skilled nursing care, home health care, and hospice care. Surgery that requires an overnight stay is typically covered by Medicare A.
• Medicare B (or part B) (Medical Insurance): Health insurance plan that pays for a portion of the bill for doctor’s visits, lab tests, ambulance services, some medical equipment. Same day surgery that does not require an overnight stay as well as radiation treatments are typically covered by Medicare B. IV Chemotherapy (administered into a vein) given at your doctor’s office is usually covered by Medicare B.
• Medicare C (or Medicare Advantage Plans): Health insurance plans offered by private insurance companies that contract with Medicare to provide Part A & Part B coverage. Some Medicare C plans include Part D (but not all). Some also cover vision and dental services. Read the details carefully before selecting a plan.
• Medicare D (or part D) (Prescription Drug Insurance): You can search prescription medication coverage in each plans formulary. However, some chemotherapy drugs may not be included. When this is the case, talk with your health care team about patient assistance programs through specific pharmaceutical companies.
• Medigap: Health insurance plans available from private insurance companies that help to pay some of the costs that Medicare does not pay (ie: Part A deductible, co-pays & co-insurance). As on Jan 1, 2020, new Medigap plans sold to Medicare recipients aren’t allowed to cover the Part B deductible. You pay an additional monthly premium for Medigap plans, and you must have Medicare A & B to be eligible. Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). You do not need a Medigap plan if you have Medicaid.

Take a look at additional information in my blog: Health Insurance Marketplace, part 3: Insurance Vocabulary

A word of caution… There are a ton of scams from people trying to use your Medicare ID number to submit false claims and commit Medicare fraud. Do not give out your number over the phone to anyone, unless you called them directly to schedule a healthcare service.

Next, we will take a closer look at Medicare Savings Programs and Low Income Subsidy.

I hope this information is helpful.  If you would like to continue this conversation, please click on the Subscribe button at the top of the Blog page. I would love to hear your comments as well as resources that have worked for you. Please share this information with your family and friends.

Keeping you in my prayers,

Jackie

For introductory information and to understand the mission of this blog, please see the Introduction: Introduction | Living with cancer take my hand