I don’t know about you, but as I approached retirement and researched what I needed to do to collect Medicare, I became increasingly apprehensive about the process. First of all, I needed to educate myself about what Medicare was, the different parts of Medicare, supplemental insurances, and available prescription plans. Luckily, a friend recommended someone to me who was able to painlessly walk me through the application process. Find out more at the end of this article.
So, what is Medicare? Medicare is the federal health-insurance program created in 1965 for people ages 65 and over, regardless of income, medical history, or health status. The program was expanded in 1972 to cover certain people under age 65 who have a long-term disability. Today, Medicare plays a key role in providing health and financial security to 60 million older people and younger people with disabilities. The program helps to pay for many medical-care services including hospitalizations, physician visits, prescription drugs, preventive services, skilled-nursing facility and home health care, and hospice care. In 2017, Medicare spending accounted for 15 percent of total federal spending and 20 percent of total national health spending.
Most people aged 65 and over are entitled to Medicare Part A if they, or their spouse, are eligible for Social Security payments, and these individuals do not have to pay a premium for Part A if they paid payroll taxes for 10 or more years. People under age 65 who receive Social Security Disability Insurance payments generally become eligible for Medicare after a two-year waiting period, while those diagnosed with end-stage renal disease and amyotrophic lateral sclerosis (ALS) become eligible for Medicare with no waiting period.
There are four parts of Medicare: Part A, Part B, Part C, and Part D:
• Part A covers inpatient hospital stays, skilled-nursing facility stays, some home health visits, and hospice care.
• Part B covers physician visits, outpatient services, preventive services, and some home health visits. Many Part B benefits are subject to a deductible ($185 in 2019) and, typically, coinsurance of 20 percent. No coinsurance or deductible is charged for an annual wellness visit for preventive services such as mammography or prostate-cancer screenings.
• Part C refers to the Medicare Advantage program, through which beneficiaries can enroll in a private health plan, such as a health-maintenance organization (HMO) or preferred-provider organization (PPO), and receive all Medicare-covered Part A and Part B benefits (and, typically, also Part D benefits).
• Part D covers outpatient prescription drugs through private plans that contract with Medicare, including stand-alone prescription-drug plans and Medicare Advantage plans with prescription drug coverage.
Medicare provides protection against the costs of many health-care services, but traditional Medicare has relatively high deductibles and cost-sharing requirements and places no limit on out-of-pocket spending for services covered under Parts A and B. And, traditional Medicare does not pay for some services that are important for older people and people with disabilities, including long-term services and supports, dental services, eyeglasses, and hearing aids. Most beneficiaries covered under traditional Medicare have some type of supplemental coverage that helps to cover costs.
As the population ages, keeping Medicare financially secure is a concern. While Medicare spending has slowed down, the Medicare prescription-drug programs are a growing concern. Policy makers are looking at a number of changes to Medicare, including restructuring its benefits and cost-sharing, raising the Medicare-eligibility age, and allowing people under age 65 to buy-in to Medicare. As changes are considered, it will be important to evaluate the potential effects of these changes on health-care and Medicare spending, as well as access to quality care, affordable coverage, and out-of-pocket health-care costs.
On Thursday, September 14, 2023, St. Therese will host a lecture on Medicare and Medicare Supplements presented by Patricia Ostroske, a licensed agent at Medicare Assurance. Patricia will be available for questions and consultations one hour prior to the lecture, from 12:00pm-1:00pm, followed by the lecture from 1:00pm-2:00pm. You are welcome to come early if you would like to speak with her personally at 12:00pm, or if you prefer, only attend the lecture from 1:00pm-2:00pm.
Since a light lunch will be served at 1:00pm, we are asking those who are interested to please RSVP to the Parish Secretary at 586-254-4433 or to Marilyn Cito, the Parish Nurse, at 586-254-4433 Ext.320 or via email at Marilync@stol.church.
References:
• https://www.kff.org/medicare/issue-brief/an-overview-of-medicare, Feb 13, 2019
• https://www.ssa.gov/pubs/EN-05-10043.pdf
• https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare